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Blood. 2015 Jan 15;125(3):443-8. doi: 10.1182/blood-2014-05-573741. Epub 2014 Nov 13.

Dinaciclib, a novel CDK inhibitor, demonstrates encouraging single-agent activity in patients with relapsed multiple myeloma.

Author information

1
Division of Hematology and.
2
Department of Biostatistics, Mayo Clinic, Rochester, MN;
3
Department of Haematology-Oncology, National University Cancer Institute of Singapore, National University Health System, Singapore;
4
Karmanos Cancer Center, Detroit, MI;
5
Section of Hematology and Bone Marrow Transplant, University of Wisconsin, Madison, WI;
6
Division of Hematology and Oncology, Mayo Clinic, Scottsdale, AZ;
7
Division of Hematology and Oncology, Mayo Clinic, Jacksonville, FL; and.
8
Division of Medical Oncology, Mayo Clinic, Rochester, MN.

Abstract

Dysregulation of cyclin-dependent kinases is a hallmark of myeloma, and specifically, cdk5 inhibition can enhance the activity of proteasome inhibitors in vitro. Dinaciclib is a novel potent small molecule inhibitor of cyclin-dependent kinases (CDK)1, CDK2, CDK5, and CDK9. Patients with relapsed multiple myeloma and ≤5 prior lines of therapy, with measurable disease, were enrolled. Dinaciclib was administered on day 1 of a 21-day cycle at doses of 30 to 50 mg/m(2). Overall, 27 evaluable patients were accrued; the median number of prior therapies was 4. The dose level of 50 mg/m(2) was determined to be the maximally tolerated dose. The overall confirmed partial response rate (PR) was 3 of 27 (11%), including 1 patient at the 30 mg/m(2) dose (1 very good PR [VGPR]) and 2 patients at the 40 mg/m(2) dose (1 VGPR and 1 PR). In addition, 2 patients at the 50 mg/mg(2) dose achieved a minimal response (clinical benefit rate, 19%). Leukopenia, thrombocytopenia, gastrointestinal symptoms, alopecia, and fatigue were the most common adverse events. The current study demonstrates single agent activity of dinaciclib in relapsed myeloma, with 2 patients achieving a deep response (VGPR) and 10 patients obtaining some degree of M protein stabilization or decrease. This trial was registered at www.clinicaltrials.gov as #NCT01096342.

PMID:
25395429
PMCID:
PMC4296007
DOI:
10.1182/blood-2014-05-573741
[Indexed for MEDLINE]
Free PMC Article

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