title: Phase I study of the angiogenesis inhibitor BIBF 1120 in patients with advanced solid tumors.
abstract: OBJECTIVE
  BIBF 1120 is an oral, potent angiokinase inhibitor targeting receptors of the vascular endothelial growth factors, platelet-derived growth factors, and fibroblast growth factors. This phase I, accelerated titration study assessed the maximum tolerated dose, safety, pharmacokinetics, and pharmacodynamic effects of BIBF 1120.
  
  
  METHODS
  Sixty-one patients with advanced cancers received BIBF 1120 in successive cohorts. Twenty-five received 50 to 450 mg once daily and 36 received 150 to 300 mg twice daily in 4-week treatment courses interspersed by 1 week of washout. Dynamic contrast-enhanced magnetic resonance imaging assessed antiangiogenic effect in 42 patients.
  
  
  RESULTS
  Most frequent BIBF 1120-related adverse events were mostly mild to moderate (Common Toxicity Criteria grade 1-2) nausea (68.9%), vomiting (45.9%), and diarrhea (44.3%). The majority of dose-limiting adverse events of Common Toxicity Criteria grade 3 or 4 were reversible liver enzyme elevations. The maximum tolerated dose was 250 mg of BIBF 1120 for once and twice daily dosing. BIBF 1120 was absorbed moderately fast (t(max) = 1-3 hours at steady state), with no deviation from dose linearity and no decrease of exposure over time. The gMean terminal half-life was from 13 to 19 hours. One complete and two partial responses occurred in patients with renal cell cancer (n = 2) and colorectal cancer (n = 1). Dynamic contrast-enhanced magnetic resonance imaging showed a significant reduction in tumor blood flow in 55% of evaluable patients.
  
  
  CONCLUSIONS
  BIBF 1120 dosed continuously displayed a favorable safety and pharmacokinetics profile, and first efficacy signals were observed. Twice daily dosing permitted increased drug exposure without additional toxicity. Two hundred milligrams BIBF 1120 twice daily is the recommended dose for phase II monotherapy studies.
authors.affiliation: Tumour Biology Center and Department of Radiology, Section MR-Development, Albert-Ludwigs-Universität Freiburg, Freiburg, Germany. mross@tumorbio.uni-freiburg.de
authors.forename: Klaus
authors.initials: K
authors.lastname: Mross
authors.forename: Martin
authors.initials: M
authors.lastname: Stefanic
authors.forename: Daniela
authors.initials: D
authors.lastname: Gmehling
authors.forename: Annette
authors.initials: A
authors.lastname: Frost
authors.forename: Franziska
authors.initials: F
authors.lastname: Baas
authors.forename: Clemens
authors.initials: C
authors.lastname: Unger
authors.forename: Ralph
authors.initials: R
authors.lastname: Strecker
authors.forename: Jürgen
authors.initials: J
authors.lastname: Henning
authors.forename: Birgit
authors.initials: B
authors.lastname: Gaschler-Markefski
authors.forename: Peter
authors.initials: P
authors.lastname: Stopfer
authors.forename: Lothar
authors.initials: L
authors.lastname: de Rossi
authors.forename: Rolf
authors.initials: R
authors.lastname: Kaiser
mesh_terms: D000328:Adult; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007211:Indoles / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D020714:Maximum Tolerated Dose; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*
chemical_list: D020533:Angiogenesis Inhibitors; D000970:Antineoplastic Agents; D007211:Indoles; C530716:nintedanib