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Pachynski RK, Iannotti N, Laccetti AL, Carthon BC, Chi KN, Smith MR, Vogelzang NJ, Tu W, Kwan EM, Wyatt AW, Villaluna K, Younginger B, Cesano A. Oral EPI-7386 in patients with metastatic castration-resistant prostate cancer. J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.6_suppl.177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
Abstract
177 Background: EPI-7386 is a next generation aniten, a novel class of compounds designed to inhibit androgen receptor (AR) activity by binding to the N-terminal domain. Preclinical data supports disruption of AR regulated gene transcription even in the presence of resistance mechanisms including ligand-binding domain point mutations and truncated splice variants. Here we report results of the Part 1a first-in-human trial of EPI-7386 in mCRPC (NCT04421222). Methods: This Phase 1, open-label, multicenter, dose escalation (Part 1a) and expansion (Part 1b) trial was designed to evaluate the safety, pharmacokinetics, pharmacodynamics, and antitumor activity of EPI-7386 in mCRPC patients (pts) progressing on standard of care treatment, including next generation antiandrogen(s) and chemotherapy. Originally designed to assess up to 5 doses of EPI-7386 (200, 400, 600, 800, and 1000 mg QD), two additional cohorts were added examining 400 and 600 mg BID due to 600 mg QD showing exposure saturation while demonstrating a favorable safety profile. Results: 31 pts were enrolled in the QD cohorts and 8 in the BID cohorts. Pts had a median of 4 lines of prior therapy for mCRPC: 83% received abiraterone and at least one next generation AR inhibitor, and 58% had at least one line of prior chemotherapy. No DLTs were observed; EPI-7386 was safe and well tolerated at all doses/schedules evaluated. All related adverse events (AEs) were Grade 1 and 2 and consistent with AEs associated with second-generation antiandrogens. For doses above 400 mg QD, exposures were at or above those associated with antitumor activity in animal models. Evidence of antitumor activity (including significant and durable PSA responses and/or decreases in ctDNA, and/or radiographically documented tumor shrinkage) were observed in pts with fewer than 3 lines of treatment for mCRPC, no visceral metastases and no prior chemotherapy (9/31 pts). Conclusions: Part 1a treatment with EPI-7386 monotherapy was safe, well tolerated up to a daily dose of 1200 mg (600 mg BID), achieved target clinical exposures and showed preliminary signals of antitumor activity in heavily-pretreated mCRPC. Part 1b is open with enrollment focused on pre-chemotherapy, post-second generation antiandrogen treated mCRPC pts in one cohort, and treatment-naïve non-mCRPC pts in a window of opportunity proof-of-concept second cohort. Two doses will be evaluated (600 mg BID and QD) based on FDA Project Optimus recommendations. Clinical trial information: NCT04421222 .
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Affiliation(s)
| | - Nicholas Iannotti
- Hematology Oncology Associates of the Treasure Coast, Port St. Lucie, FL
| | | | | | - Kim N. Chi
- BC Cancer, Vancouver Centre, Vancouver, BC, Canada
| | | | | | - Wilson Tu
- Vancouver Prostate Centre, Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Edmond Michael Kwan
- Vancouver Prostate Centre, Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Alexander William Wyatt
- Vancouver Prostate Centre, Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
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Gladstone DJ, Dorian P, Spring M, Panzov V, Mamdani M, Healey JS, Thorpe KE, Aviv R, Boyle K, Blakely J, Cote R, Hall J, Kapral M, Kozlowski N, Laupacis A, O’Donnell M, Sabihuddin K, Sharma M, Shuaib A, Vaid H, Pinter A, Abootalebi S, Chan R, Crann S, Fleming L, Frank C, Hachinski V, Hesser K, Kumar B, Soros P, Wright M, Basile V, Boyle K, Hopyan J, Rajmohan Y, Swartz R, Vaid H, Valencia G, Ween J, Aram H, Barber P, Coutts S, Demchuk A, Fischer K, Hill M, Klein G, Kenney C, Menon B, McClelland M, Russell A, Ryckborst K, Stys P, Smith E, Watson T, Chacko S, Sahlas D, Sancan J, Côté R, Durcan L, Ehrensperger E, Minuk J, Wein T, Wadup L, Asdaghi N, Beckman J, Esplana N, Masigan P, Murphy C, Tang E, Teal P, Villaluna K, Woolfenden A, Yip S, Bussière M, Dowlatshahi D, Sharma M, Stotts G, Robert S, Ford K, Hackam D, Miners L, Mabb T, Spence JD, Buck B, Griffin-Stead T, Jassal R, Siddiqui M, Hache A, Lessard C, Lebel F, Mackey A, Verreault S, Astorga C, Casaubon LK, del Campo M, Jaigobin C, Kalman L, Silver FL, Atkins L, Coles K, Penn A, Sargent R, Walter C, Gable Y, Kadribasic N, Schwindt B, Shuaib A, Kostyrko P, Selchen D, Saposnik G, Christie P, Jin A, Hicklin D, Howse D, Edwards E, Jaspers S, Sher F, Stoger S, Crisp D, Dhanani A, John V, Levitan M, Mehdiratta M, Wong D. Atrial Premature Beats Predict Atrial Fibrillation in Cryptogenic Stroke. Stroke 2015; 46:936-41. [DOI: 10.1161/strokeaha.115.008714] [Citation(s) in RCA: 132] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- David J. Gladstone
- From the Division of Neurology (D.J.G.), Department of Medicine (D.J.G., P.D., M.S., M.M.), and Dalla Lana School of Public Health (K.E.T.), University of Toronto, Toronto, Ontario, Canada; University of Toronto Stroke Program, Toronto, Ontario, Canada (D.J.G.); Division of Neurology, Department of Medicine, and the Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, Toronto, Ontario, Canada (D.J.G.); Heart and Stroke Foundation Canadian Partnership for
| | - Paul Dorian
- From the Division of Neurology (D.J.G.), Department of Medicine (D.J.G., P.D., M.S., M.M.), and Dalla Lana School of Public Health (K.E.T.), University of Toronto, Toronto, Ontario, Canada; University of Toronto Stroke Program, Toronto, Ontario, Canada (D.J.G.); Division of Neurology, Department of Medicine, and the Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, Toronto, Ontario, Canada (D.J.G.); Heart and Stroke Foundation Canadian Partnership for
| | - Melanie Spring
- From the Division of Neurology (D.J.G.), Department of Medicine (D.J.G., P.D., M.S., M.M.), and Dalla Lana School of Public Health (K.E.T.), University of Toronto, Toronto, Ontario, Canada; University of Toronto Stroke Program, Toronto, Ontario, Canada (D.J.G.); Division of Neurology, Department of Medicine, and the Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, Toronto, Ontario, Canada (D.J.G.); Heart and Stroke Foundation Canadian Partnership for
| | - Val Panzov
- From the Division of Neurology (D.J.G.), Department of Medicine (D.J.G., P.D., M.S., M.M.), and Dalla Lana School of Public Health (K.E.T.), University of Toronto, Toronto, Ontario, Canada; University of Toronto Stroke Program, Toronto, Ontario, Canada (D.J.G.); Division of Neurology, Department of Medicine, and the Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, Toronto, Ontario, Canada (D.J.G.); Heart and Stroke Foundation Canadian Partnership for
| | - Muhammad Mamdani
- From the Division of Neurology (D.J.G.), Department of Medicine (D.J.G., P.D., M.S., M.M.), and Dalla Lana School of Public Health (K.E.T.), University of Toronto, Toronto, Ontario, Canada; University of Toronto Stroke Program, Toronto, Ontario, Canada (D.J.G.); Division of Neurology, Department of Medicine, and the Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, Toronto, Ontario, Canada (D.J.G.); Heart and Stroke Foundation Canadian Partnership for
| | - Jeff S. Healey
- From the Division of Neurology (D.J.G.), Department of Medicine (D.J.G., P.D., M.S., M.M.), and Dalla Lana School of Public Health (K.E.T.), University of Toronto, Toronto, Ontario, Canada; University of Toronto Stroke Program, Toronto, Ontario, Canada (D.J.G.); Division of Neurology, Department of Medicine, and the Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, Toronto, Ontario, Canada (D.J.G.); Heart and Stroke Foundation Canadian Partnership for
| | - Kevin E. Thorpe
- From the Division of Neurology (D.J.G.), Department of Medicine (D.J.G., P.D., M.S., M.M.), and Dalla Lana School of Public Health (K.E.T.), University of Toronto, Toronto, Ontario, Canada; University of Toronto Stroke Program, Toronto, Ontario, Canada (D.J.G.); Division of Neurology, Department of Medicine, and the Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, Toronto, Ontario, Canada (D.J.G.); Heart and Stroke Foundation Canadian Partnership for
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - R. Chan
- London Health Sciences Centre; London, Ontario
| | - S. Crann
- London Health Sciences Centre; London, Ontario
| | - L. Fleming
- London Health Sciences Centre; London, Ontario
| | - C. Frank
- London Health Sciences Centre; London, Ontario
| | | | - K. Hesser
- London Health Sciences Centre; London, Ontario
| | - B.S. Kumar
- London Health Sciences Centre; London, Ontario
| | - P. Soros
- London Health Sciences Centre; London, Ontario
| | - M. Wright
- London Health Sciences Centre; London, Ontario
| | - V. Basile
- Sunnybrook Health Sciences Centre; Toronto, Ontario
| | - K. Boyle
- Sunnybrook Health Sciences Centre; Toronto, Ontario
| | - J. Hopyan
- Sunnybrook Health Sciences Centre; Toronto, Ontario
| | - Y. Rajmohan
- Sunnybrook Health Sciences Centre; Toronto, Ontario
| | - R. Swartz
- Sunnybrook Health Sciences Centre; Toronto, Ontario
| | - H. Vaid
- Sunnybrook Health Sciences Centre; Toronto, Ontario
| | - G. Valencia
- Sunnybrook Health Sciences Centre; Toronto, Ontario
| | - J. Ween
- Sunnybrook Health Sciences Centre; Toronto, Ontario
| | - H. Aram
- Foothills Hospital; Calgary, Alberta
| | | | - S. Coutts
- Foothills Hospital; Calgary, Alberta
| | | | | | - M.D. Hill
- Foothills Hospital; Calgary, Alberta
| | - G. Klein
- Foothills Hospital; Calgary, Alberta
| | - C. Kenney
- Foothills Hospital; Calgary, Alberta
| | - B. Menon
- Foothills Hospital; Calgary, Alberta
| | | | | | | | - P. Stys
- Foothills Hospital; Calgary, Alberta
| | | | | | - S. Chacko
- Hamilton Health Sciences Centre; Hamilton, Ontario
| | - D. Sahlas
- Hamilton Health Sciences Centre; Hamilton, Ontario
| | - J. Sancan
- Hamilton Health Sciences Centre; Hamilton, Ontario
| | - R. Côté
- Montreal General Hospital; Montreal, Québec
| | - L. Durcan
- Montreal General Hospital; Montreal, Québec
| | | | - J. Minuk
- Montreal General Hospital; Montreal, Québec
| | - T. Wein
- Montreal General Hospital; Montreal, Québec
| | - L. Wadup
- Montreal General Hospital; Montreal, Québec
| | - N. Asdaghi
- Vancouver Hospital and Health Sciences Centre; Vancouver, British Columbia
| | - J. Beckman
- Vancouver Hospital and Health Sciences Centre; Vancouver, British Columbia
| | - N. Esplana
- Vancouver Hospital and Health Sciences Centre; Vancouver, British Columbia
| | - P. Masigan
- Vancouver Hospital and Health Sciences Centre; Vancouver, British Columbia
| | - C. Murphy
- Vancouver Hospital and Health Sciences Centre; Vancouver, British Columbia
| | - E. Tang
- Vancouver Hospital and Health Sciences Centre; Vancouver, British Columbia
| | - P. Teal
- Vancouver Hospital and Health Sciences Centre; Vancouver, British Columbia
| | - K. Villaluna
- Vancouver Hospital and Health Sciences Centre; Vancouver, British Columbia
| | - A. Woolfenden
- Vancouver Hospital and Health Sciences Centre; Vancouver, British Columbia
| | - S. Yip
- Vancouver Hospital and Health Sciences Centre; Vancouver, British Columbia
| | | | | | - M. Sharma
- The Ottawa Hospital; Ottawa, Ontario
| | - G. Stotts
- The Ottawa Hospital; Ottawa, Ontario
| | - S. Robert
- The Ottawa Hospital; Ottawa, Ontario
| | - K. Ford
- Stroke Prevention & Atherosclerosis Research Centre, Robarts Research Institute; London, Ontario
| | - D. Hackam
- Stroke Prevention & Atherosclerosis Research Centre, Robarts Research Institute; London, Ontario
| | - L. Miners
- Stroke Prevention & Atherosclerosis Research Centre, Robarts Research Institute; London, Ontario
| | - T. Mabb
- Stroke Prevention & Atherosclerosis Research Centre, Robarts Research Institute; London, Ontario
| | - J. D. Spence
- Stroke Prevention & Atherosclerosis Research Centre, Robarts Research Institute; London, Ontario
| | - B. Buck
- Grey Nuns Hospital; Edmonton Alberta
| | | | - R. Jassal
- Grey Nuns Hospital; Edmonton Alberta
| | | | - A. Hache
- Centre Hospitalier Affilié Universitaire de Québec: Hôpital de l’Enfant-Jesus; Québec, Québec
| | - C. Lessard
- Centre Hospitalier Affilié Universitaire de Québec: Hôpital de l’Enfant-Jesus; Québec, Québec
| | - F. Lebel
- Centre Hospitalier Affilié Universitaire de Québec: Hôpital de l’Enfant-Jesus; Québec, Québec
| | - A. Mackey
- Centre Hospitalier Affilié Universitaire de Québec: Hôpital de l’Enfant-Jesus; Québec, Québec
| | - S. Verreault
- Centre Hospitalier Affilié Universitaire de Québec: Hôpital de l’Enfant-Jesus; Québec, Québec
| | - C. Astorga
- University Health Network; Toronto, Ontario
| | | | | | | | - L. Kalman
- University Health Network; Toronto, Ontario
| | - FL Silver
- University Health Network; Toronto, Ontario
| | - L. Atkins
- Vancouver Island Health Authority; Victoria, British Columbia
| | - K. Coles
- Vancouver Island Health Authority; Victoria, British Columbia
| | - A. Penn
- Vancouver Island Health Authority; Victoria, British Columbia
| | - R. Sargent
- Vancouver Island Health Authority; Victoria, British Columbia
| | - C. Walter
- Vancouver Island Health Authority; Victoria, British Columbia
| | - Y. Gable
- Mackenzie Health Sciences Centre; Edmonton, Alberta
| | | | - B. Schwindt
- Mackenzie Health Sciences Centre; Edmonton, Alberta
| | - A. Shuaib
- Mackenzie Health Sciences Centre; Edmonton, Alberta
| | | | - D. Selchen
- St. Michael’s Hospital; Toronto, Ontario
| | | | - P. Christie
- Kingston General Hospital; Kingston, Ontario
| | - A. Jin
- Kingston General Hospital; Kingston, Ontario
| | - D. Hicklin
- Thunder Bay Regional Health Sciences Centre; Thunder Bay, Ontario
| | - D. Howse
- Thunder Bay Regional Health Sciences Centre; Thunder Bay, Ontario
| | - E. Edwards
- Thunder Bay Regional Health Sciences Centre; Thunder Bay, Ontario
| | - S. Jaspers
- Thunder Bay Regional Health Sciences Centre; Thunder Bay, Ontario
| | - F. Sher
- Thunder Bay Regional Health Sciences Centre; Thunder Bay, Ontario
| | - S. Stoger
- Thunder Bay Regional Health Sciences Centre; Thunder Bay, Ontario
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