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Clin Cancer Res. 2016 Apr 15;22(8):1932-9. doi: 10.1158/1078-0432.CCR-15-1665. Epub 2015 Nov 24.

First-in-Human Phase I Study of GSK2126458, an Oral Pan-Class I Phosphatidylinositol-3-Kinase Inhibitor, in Patients with Advanced Solid Tumor Malignancies.

Author information

1
University of California, San Francisco, California. pmunster@medicine.ucsf.edu.
2
University of California, San Francisco, California.
3
MD Anderson Cancer Center, Houston, Texas.
4
The Netherlands Cancer Institute, Amsterdam, the Netherlands.
5
Fred Hutchinson Cancer Research Center, Seattle, Washington.
6
Cancer Center University Utrecht, the Netherlands.
7
Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah.
8
UNC Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina.
9
GlaxoSmithKline, Research Triangle Park, North Carolina.
10
GlaxoSmithKline, Collegeville, Pennsylvania.

Abstract

PURPOSE:

GSK2126458 (GSK458) is a potent inhibitor of PI3K (α, β, γ, and δ), with preclinical studies demonstrating broad antitumor activity. We performed a first-in-human phase I study in patients with advanced solid tumors.

MATERIALS AND METHODS:

Patients received oral GSK458 once or twice daily in a dose-escalation design to define the maximum tolerated dose (MTD). Expansion cohorts evaluated pharmacodynamics, pharmacokinetics, and clinical activity in histologically and molecularly defined cohorts.

RESULTS:

One hundred and seventy patients received doses ranging from 0.1 to 3 mg once or twice daily. Dose-limiting toxicities (grade 3 diarrhea,n= 4; fatigue and rash,n= 1) occurred in 5 patients (n= 3 at 3 mg/day). The MTD was 2.5 mg/day (MTD with twice daily dosing undefined). The most common grade ≥3 treatment-related adverse events included diarrhea (8%) and skin rash (5%). Pharmacokinetic analyses demonstrated increased duration of drug exposure above target level with twice daily dosing. Fasting insulin and glucose levels increased with dose and exposure of GSK458. Durable objective responses (ORs) were observed across multiple tumor types (sarcoma, kidney, breast, endometrial, oropharyngeal, and bladder cancer). Responses were not associated withPIK3CAmutations (OR rate: 5% wild-type vs. 6% mutant).

CONCLUSIONS:

Although the MTD of GSK458 was 2.5 mg once daily, twice-daily dosing may increase duration of target inhibition. Fasting insulin and glucose levels served as pharmacodynamic markers of drug exposure. Select patients achieved durable responses; however,PIK3CAmutations were neither necessary nor predictive of response. Combination treatment strategies and novel biomarkers may be needed to optimally target PI3K.

PMID:
26603258
DOI:
10.1158/1078-0432.CCR-15-1665
[Indexed for MEDLINE]
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