TY - JOUR
T1 - Phase i study of oral rigosertib (ON 01910.NA), a dual inhibitor of the PI3K and PLK1 pathways, in adult patients with advanced solid malignancies
AU - Bowles, Daniel W.
AU - Diamond, Jennifer R.
AU - Lam, Elaine T.
AU - Weekes, Colin D.
AU - Astling, David P.
AU - Anderson, Ryan T.
AU - Leong, Stephen
AU - Gore, Lia
AU - Varella-Garcia, Marileila
AU - Vogler, Brian W.
AU - Keysar, Stephen B.
AU - Freas, Elizabeth
AU - Aisner, Dara L.
AU - Ren, Chen
AU - Tan, Aik Chook
AU - Wilhelm, Francois
AU - Maniar, Manoj
AU - Eckhardt, S. Gail
AU - Messersmith, Wells A.
AU - Jimeno, Antonio
PY - 2014
Y1 - 2014
N2 - Purpose: To determine the pharmacokinetics (PK), maximum tolerated dose (MTD), safety, and antitumor activity of an oral formulation of rigosertib, a dual phosphoinositide 3-kinase (PI3K) and polo-like kinase 1 (Plk1) pathway inhibitor, in patients with advanced solid malignancies. Experimental Design: Patients with advanced solid malignancies received rigosertib twice daily continuously in 21-day cycles. Doses were escalated until intolerable grade 2 toxicities, at which point the previous dose level was expanded to define the MTD. All patients were assessed for safety, PK, and response. Urinary PK were performed at the MTD. Archival tumors were assessed for potential molecular biomarkers with multiplex mutation testing. A subset of squamous cell carcinomas (SCC) underwent exome sequencing. Results: Forty-eight patients received a median of 2 cycles of therapy at 5 dose levels. Rigosertib exposure increased with escalating doses. Dose-limiting toxicities were hematuria and dysuria. The most common grade 2 drug-related toxicities involved urothelial irritation. The MTD is 560 mg twice daily. Activity was seen in head and neck SCCs (1 complete response, 1 partial response) and stable disease for 12 weeks was observed in 8 additional patients. Tumors experiencing partial response had PI3K pathway activation, inactivated p53, and unique variants in ROBO3 and FAT1, two genes interacting with the Wnt/b-catenin pathway. Conclusions: The recommended phase II dose of oral rigosertib is 560mgtwice daily given continuously. Urinary toxicity is the dose-limiting and mostcommontoxicity. Alterations in PI3K, p53, and Wnt/b-catenin pathway signaling should be investigated as potential biomarkers of response in future trials.
AB - Purpose: To determine the pharmacokinetics (PK), maximum tolerated dose (MTD), safety, and antitumor activity of an oral formulation of rigosertib, a dual phosphoinositide 3-kinase (PI3K) and polo-like kinase 1 (Plk1) pathway inhibitor, in patients with advanced solid malignancies. Experimental Design: Patients with advanced solid malignancies received rigosertib twice daily continuously in 21-day cycles. Doses were escalated until intolerable grade 2 toxicities, at which point the previous dose level was expanded to define the MTD. All patients were assessed for safety, PK, and response. Urinary PK were performed at the MTD. Archival tumors were assessed for potential molecular biomarkers with multiplex mutation testing. A subset of squamous cell carcinomas (SCC) underwent exome sequencing. Results: Forty-eight patients received a median of 2 cycles of therapy at 5 dose levels. Rigosertib exposure increased with escalating doses. Dose-limiting toxicities were hematuria and dysuria. The most common grade 2 drug-related toxicities involved urothelial irritation. The MTD is 560 mg twice daily. Activity was seen in head and neck SCCs (1 complete response, 1 partial response) and stable disease for 12 weeks was observed in 8 additional patients. Tumors experiencing partial response had PI3K pathway activation, inactivated p53, and unique variants in ROBO3 and FAT1, two genes interacting with the Wnt/b-catenin pathway. Conclusions: The recommended phase II dose of oral rigosertib is 560mgtwice daily given continuously. Urinary toxicity is the dose-limiting and mostcommontoxicity. Alterations in PI3K, p53, and Wnt/b-catenin pathway signaling should be investigated as potential biomarkers of response in future trials.
UR - http://www.scopus.com/inward/record.url?scp=84896499090&partnerID=8YFLogxK
U2 - 10.1158/1078-0432.CCR-13-2506
DO - 10.1158/1078-0432.CCR-13-2506
M3 - Article
C2 - 24493827
AN - SCOPUS:84896499090
VL - 20
SP - 1656
EP - 1665
JO - Clinical Cancer Research
JF - Clinical Cancer Research
SN - 1078-0432
IS - 6
ER -