Multicenter Phase I Trial of the Mitogen-Activated Protein Kinase 1/2 Inhibitor BAY 86-9766 in Patients with Advanced Cancer

• Published in: Clinical cancer research 2013-03, Vol.19 (5), p.1232-1243
• Main Authors: WEEKES, Colin D, VON HOFF, Daniel D, MA, Wen W, SHEEDY, Beth, IVERSON, Cory, MINER, Jeffrey N, ZANCONG SHEN, YEH, Li-Tain, DUBOWY, Ronald L, JEFFERS, Michael, RAJAGOPALAN, Prabhu, CLENDENINN, Neil J, ADJEI, Alex A, LEFFINGWELL, Diane P, ECKHARDT, S. Gail, GORE, Lia, LEWIS, Karl D, WEISS, Glen J, RAMANATHAN, Ramesh K, DY, Grace K
• Format: Article
• Language: English
• Subjects: Administration, Oral; Adult; Aged; Aged, 80 and over; Antineoplastic agents; Biological and medical sciences; Cohort Studies; Diphenylamine - analogs & derivatives; Diphenylamine - pharmacokinetics; Diphenylamine - therapeutic use; Female; Follow-Up Studies; Humans; Male; Maximum Tolerated Dose; Medical sciences; Middle Aged; Mitogen-Activated Protein Kinase 1 - antagonists & inhibitors; Mitogen-Activated Protein Kinase 1 - metabolism; Neoplasm Staging; Neoplasms - drug therapy; Neoplasms - pathology; Pharmacology. Drug treatments; Prognosis; Protein Kinase Inhibitors - pharmacokinetics; Protein Kinase Inhibitors - therapeutic use; Sulfonamides - pharmacokinetics; Sulfonamides - therapeutic use; Tissue Distribution; Young Adult
• ISSN: 1078-0432; 1557-3265
• DOI: 10.1158/1078-0432.CCR-12-3529

To evaluate the safety, pharmacokinetics, and pharmacodynamics of BAY 86-9766, a selective, potent, orally available, small-molecule allosteric inhibitor of mitogen-activated protein kinase 1/2 in patients with advanced solid tumors. BAY 86-9766 was administered orally daily in 28-day courses, with doses escalated to establish the maximum-tolerated dose (MTD). An expanded cohort was evaluated at the MTD. Pharmacokinetic and pharmacodynamic parameters were assessed, with extracellular signal-regulated kinase (ERK) phosphorylation evaluated in paired biopsies from a subset of the expanded MTD cohort. Tumor specimens were evaluated for mutations in select genes. Sixty-nine patients were enrolled, including 20 patients at the MTD. The MTD was 100 mg given once-daily or in two divided doses. BAY 86-9766 was well-tolerated. The most common treatment-related toxicities were acneiform rash and gastrointestinal toxicity. BAY 86-9766 was well-absorbed after oral administration (plasma half-life ~12 hours), and displayed dose proportional pharmacokinetics throughout the tested dose range. Continuous daily dosing resulted in moderate accumulation at most dose levels. BAY 86-9766 suppressed ERK phosphorylation in biopsied tissue and tetradecanoylphorbol acetate-stimulated peripheral blood leukocytes. Of 53 evaluable patients, one patient with colorectal cancer achieved a partial response and 11 patients had stable disease for 4 or more courses. An ocular melanoma specimen harbored a GNAQ-activating mutation and exhibited reduced ERK phosphorylation in response to therapy. This phase I study showed that BAY 86-9766 was well-tolerated, with good oral absorption, dose proportional pharmacokinetics, target inhibition at the MTD, and some evidence of clinical benefit across a range of tumor types.