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Carneiro BA, Cavalcante L, Mahalingam D, Saeed A, Safran H, Ma WW, Coveler AL, Powell S, Bastos B, Davis E, Sahai V, Mikrut W, Longstreth J, Smith S, Weisskittel T, Li H, Borden BA, Harvey RD, Sahebjam S, Cervantes A, Koukol A, Mazar AP, Steeghs N, Kurzrock R, Giles FJ, Munster P. Phase I Study of Elraglusib (9-ING-41), a Glycogen Synthase Kinase-3β Inhibitor, as Monotherapy or Combined with Chemotherapy in Patients with Advanced Malignancies. Clin Cancer Res 2024; 30:522-531. [PMID: 37982822 DOI: 10.1158/1078-0432.ccr-23-1916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 10/21/2023] [Accepted: 11/16/2023] [Indexed: 11/21/2023]
Abstract
PURPOSE The safety, pharmacokinetics, and efficacy of elraglusib, a glycogen synthase kinase-3β (GSK-3β) small-molecule inhibitor, as monotherapy or combined with chemotherapy, in patients with relapsed or refractory solid tumors or hematologic malignancies was studied. PATIENTS AND METHODS Elraglusib (intravenously twice weekly in 3-week cycles) monotherapy dose escalation was followed by dose escalation with eight chemotherapy regimens (gemcitabine, doxorubicin, lomustine, carboplatin, irinotecan, gemcitabine/nab-paclitaxel, paclitaxel/carboplatin, and pemetrexed/carboplatin) in patients previously exposed to the same chemotherapy. RESULTS Patients received monotherapy (n = 67) or combination therapy (n = 171) elraglusib doses 1 to 15 mg/kg twice weekly. The initial recommended phase II dose (RP2D) of elraglusib was 15 mg/kg twice weekly and was defined, without dose-limiting toxicity observation, due to fluid volumes necessary for drug administration. The RP2D was subsequently reduced to 9.3 mg/kg once weekly to reduce elraglusib-associated central/peripheral vascular access catheter blockages. Other common elraglusib-related adverse events (AE) included transient visual changes and fatigue. Grade ≥3 treatment-emergent AEs occurred in 55.2% and 71.3% of patients on monotherapy and combination therapy, respectively. Part 1 monotherapy (n = 62) and part 2 combination (n = 138) patients were evaluable for response. In part 1, a patient with melanoma had a complete response, and a patient with acute T-cell leukemia/lymphoma had a partial response (PR). In part 2, seven PRs were observed, and the median progression-free survival and overall survival were 2.1 [95% confidence interval (CI), 2-2.6] and 6.9 (95% CI, 5.7-8.4) months, respectively. CONCLUSIONS Elraglusib had a favorable toxicity profile as monotherapy and combined with chemotherapy and was associated with clinical benefit supporting further clinical evaluation in combination with chemotherapy.
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Affiliation(s)
- Benedito A Carneiro
- Legorreta Cancer Center, Brown University and Lifespan Cancer Institute, Providence, Rhode Island
| | | | | | - Anwaar Saeed
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Howard Safran
- Legorreta Cancer Center, Brown University and Lifespan Cancer Institute, Providence, Rhode Island
| | | | | | - Steven Powell
- Sanford Health, University of South Dakota Medical Center, Sioux Falls, South Dakota
| | - Bruno Bastos
- Miami Cancer Institute at Baptist Health, Miami, Florida
| | | | | | | | | | | | | | - Hu Li
- Mayo Clinic Cancer Center, Rochester, Minnesota
| | - Brittany A Borden
- Legorreta Cancer Center, Brown University and Lifespan Cancer Institute, Providence, Rhode Island
| | | | | | - Andrés Cervantes
- Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain
| | | | | | | | | | | | - Pamela Munster
- University of California San Francisco, San Francisco, California
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