title: Phase I/II multicenter study to assess the safety, tolerability, pharmacokinetics and pharmacodynamics of AZD4877 in patients with refractory acute myeloid leukemia.
abstract: Eg5 (kinesin spindle protein) is a microtubule motor protein, essential for centrosome separation during mitosis. This Phase I/II, open-label, multicenter, two-part study investigated AZD4877, a potent Eg5 inhibitor, in patients with acute myeloid leukemia. Primary objectives were to determine the maximum tolerated dose (MTD) (part A), assess efficacy (part B) and determine the pharmacokinetic profile (parts A and B). Secondary objectives included assessment of safety and tolerability. AZD4877 was administered at a range of doses (2, 4, 7, 10, 13, 16 and 18 mg/day) as a 1-hour intravenous infusion on three consecutive days of a continuous 2-week schedule. The MTD in part A was defined as 16 mg/day based on dose-limiting stomatitis at 16 and 18 mg/day, hyperbilirubinemia at 16 mg/day and palmar-plantar erythrodysesthesia syndrome at 18 mg/day. Systemic exposure to AZD4877 generally increased with increasing dose whereas half-life was not dose dependent. No evaluable patients experienced a complete remission (CR) or CR with incomplete blood count recovery (CRi), demonstrating no evidence of AZD4877 efficacy in this population. Evidence of monoasters in all but the 4 mg/day dose group provided proof of mechanism for AZD4877. This study was terminated due to lack of efficacy. (ClinicalTrials.gov identifier NCT00486265).
authors.affiliation: University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Box 428, Houston, TX 77030-1402, USA. hkantarj@mdanderson.org
authors.forename: H M
authors.initials: HM
authors.lastname: Kantarjian
authors.forename: S
authors.initials: S
authors.lastname: Padmanabhan
authors.forename: W
authors.initials: W
authors.lastname: Stock
authors.forename: M S
authors.initials: MS
authors.lastname: Tallman
authors.forename: G A
authors.initials: GA
authors.lastname: Curt
authors.forename: J
authors.initials: J
authors.lastname: Li
authors.forename: A
authors.initials: A
authors.lastname: Osmukhina
authors.forename: K
authors.initials: K
authors.lastname: Wu
authors.forename: D
authors.initials: D
authors.lastname: Huszar
authors.forename: G
authors.initials: G
authors.lastname: Borthukar
authors.forename: S
authors.initials: S
authors.lastname: Faderl
authors.forename: G
authors.initials: G
authors.lastname: Garcia-Manero
authors.forename: T
authors.initials: T
authors.lastname: Kadia
authors.forename: K
authors.initials: K
authors.lastname: Sankhala
authors.forename: O
authors.initials: O
authors.lastname: Odenike
authors.forename: J K
authors.initials: JK
authors.lastname: Altman
authors.forename: M
authors.initials: M
authors.lastname: Minden
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050256:Antimitotic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D001549:Benzamides / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D005260:Female; D006801:Humans; D016547:Kinesins / Q000037:antagonists & inhibitors*; D015470:Leukemia, Myeloid, Acute / Q000097:blood / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011744:Pyrimidinones / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D055815:Young Adult
chemical_list: D050256:Antimitotic Agents; D001549:Benzamides; C470243:KIF11 protein, human; C568512:N-(3-aminopropyl)-N-(1-(5-benzyl-3-methyl-4-oxo-(1,2)thiazolo(5,4-d)pyrimidin-6-yl)-2-methylpropyl)-4-methylbenzamide; D011744:Pyrimidinones; D016547:Kinesins