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Wong AL, Soo RA, Tan DS, Lee SC, Lim JS, Marban PC, Kong LR, Lee YJ, Wang LZ, Thuya WL, Soong R, Yee MQ, Chin TM, Cordero MT, Asuncion BR, Pang B, Pervaiz S, Hirpara JL, Sinha A, Xu WW, Yuasa M, Tsunoda T, Motoyama M, Yamauchi T, Goh BC. Phase I and biomarker study of OPB-51602, a novel signal transducer and activator of transcription (STAT) 3 inhibitor, in patients with refractory solid malignancies. Ann Oncol 2015; 26:998-1005. [PMID: 25609248 DOI: 10.1093/annonc/mdv026] [Citation(s) in RCA: 116] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 01/05/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The aim of this study was to determine the maximum-tolerated dose (MTD), safety, pharmacokinetics, and pharmacodynamics of OPB-51602, an oral, direct signal transduction activator of transcription 3 (STAT3) inhibitor, in patients with refractory solid tumors. PATIENTS AND METHODS Three cohorts were studied: cohort A, a sequential dose escalation of OPB-51602 administered intermittently (days 1-14 every 21 days); cohort B, an expansion cohort evaluating the dose lower than the MTD; cohort C, evaluating continuous daily dosing. RESULTS Fifty-one patients were studied at 2, 4, and 5 mg per day dosing. The MTD was 5 mg; first-cycle dose-limiting toxicities (DLTs) were grade 3 hyponatremia in one patient, and grade 3 dehydration in another. Intermittent dosing of both 2 and 4 mg doses were tolerable, and the recommended phase II dose was 4 mg. Cohort B investigated 4 mg intermittently, whereas cohort C investigated 4 mg continuously. Common toxicities included fatigue, nausea/vomiting, diarrhea, anorexia, and early-onset peripheral neuropathy. Drug-induced pneumonitis occurred in two patients in cohort C. Continuous dosing was associated with a higher incidence of peripheral neuropathy and a lower mean relative dose intensity, compared with intermittent dosing. Steady-state pharmacokinetics was characterized by high oral clearance, mean elimination half-life ranging from 44 to 61 h, and a large terminal-phase volume of distribution. An active metabolite, OPB-51822, accumulated to a greater extent than OPB-51602. Flow cytometry of peripheral blood mononuclear cells demonstrated pSTAT3 (Tyr(705)) inhibition following exposure. Two patients achieved partial responses at 5 mg intermittently and 4 mg continuously; both had epidermal growth factor receptor (EGFR) mutation-positive non-small-cell lung cancer (NSCLC) with prior EGFR tyrosine kinase inhibitor exposure. CONCLUSION OPB-51602 demonstrates promising antitumor activity, particularly in NSCLC. Its long half-life and poorer tolerability of continuous dosing, compared with intermittent dosing, suggest that less frequent dosing should be explored. CLINICALTRIALSGOV IDENTIFIER NCT01184807.
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Affiliation(s)
- A L Wong
- Department of Haematology-Oncology, National University Health System; Haematology Oncology Research Group, National University Cancer Institute of Singapore, National University Health System; Cancer Science Institute
| | - R A Soo
- Department of Haematology-Oncology, National University Health System; Haematology Oncology Research Group, National University Cancer Institute of Singapore, National University Health System; Cancer Science Institute
| | - D S Tan
- Department of Medical Oncology, National Cancer Centre
| | - S C Lee
- Department of Haematology-Oncology, National University Health System; Haematology Oncology Research Group, National University Cancer Institute of Singapore, National University Health System; Cancer Science Institute
| | - J S Lim
- Department of Haematology-Oncology, National University Health System; Haematology Oncology Research Group, National University Cancer Institute of Singapore, National University Health System
| | - P C Marban
- Haematology Oncology Research Group, National University Cancer Institute of Singapore, National University Health System
| | | | | | - L Z Wang
- Cancer Science Institute; Departments of Pharmacology
| | | | | | | | - T M Chin
- Department of Haematology-Oncology, National University Health System; Haematology Oncology Research Group, National University Cancer Institute of Singapore, National University Health System; Cancer Science Institute
| | - M T Cordero
- Haematology Oncology Research Group, National University Cancer Institute of Singapore, National University Health System
| | | | | | - S Pervaiz
- Physiology, Yong Loo Lin School of Medicine
| | | | - A Sinha
- Department of Diagnostic Imaging, National University Health System, Singapore
| | - W W Xu
- Otsuka Beijing Research Institute, Beijing, China
| | - M Yuasa
- Otsuka Pharmaceutical Co., Ltd, Chiyoda-ku
| | - T Tsunoda
- Otsuka Pharmaceutical Co., Ltd, Chiyoda-ku
| | - M Motoyama
- Otsuka Pharmaceutical Co., Ltd, Chiyoda-ku
| | - T Yamauchi
- Fuji Memorial Research Institute, Otsuka Pharmaceutical Co. Ltd, Chiyoda-ku, Japan
| | - B C Goh
- Department of Haematology-Oncology, National University Health System; Haematology Oncology Research Group, National University Cancer Institute of Singapore, National University Health System; Cancer Science Institute; Departments of Pharmacology.
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