title: Safety, tolerability, and pharmacokinetics of amuvatinib from three phase 1 clinical studies in healthy volunteers.
abstract: OBJECTIVE
  Amuvatinib is a multi-targeted tyrosine kinase inhibitor with activity that also disrupts DNA damage repair through suppression of homologous recombination protein Rad51. Amuvatinib dry-powder capsules (DPC) showed evidence of activity in early Phase 1 cancer studies but low systemic exposure. The purposes of the studies were to investigate the cause of low exposure, develop, and test an alternative formulation with improved exposure, and establish the dose to be tested in future studies in cancer patients.
  
  
  METHODS
  Three studies were conducted in a total of 58 healthy subjects: a food-effect study using amuvatinib DPC, a single-dose pharmacokinetic study comparing amuvatinib DPC to a new lipid-suspension capsules (LSC), and a multiple-dose pharmacokinetic study using amuvatinib LSC.
  
  
  RESULTS
  A high-fat meal administered with amuvatinib DPC increased the rate and extent of absorption compared to the Fasted state, a 183 and 118% increase in the mean C(max) and AUC(0-∞) of amuvatinib, respectively. The single-dose pharmacokinetics of amuvatinib LSC resulted in an approximately two-third-fold increased exposure (AUC) compared with amuvatinib DPC. The multiple-dose pharmacokinetics of the amuvatinib LSC 300 mg administered every 8 h exhibited improved accumulation compared with the 12-h regimens and achieved presumed therapeutic level safely with no serious or severe adverse events reported. No subject discontinued treatment due to an adverse event.
  
  
  CONCLUSIONS
  Amuvatinib LSC, 300 mg every 8 h, is being studied in cancer patients based on the improved exposure and similar safety profile to amuvatinib DPC. A lipid-based formulation approach may be a useful tool for other low aqueous soluble compounds.
authors.affiliation: Astex Pharmaceuticals, Inc. (formerly SuperGen, Inc.), 4140 Dublin Blvd., Ste. 200, Dublin, CA 94568, USA. Gavin.Choy@astx.com
authors.forename: Gavin
authors.initials: G
authors.lastname: Choy
authors.forename: Rajashree
authors.initials: R
authors.lastname: Joshi-Hangal
authors.forename: Aram
authors.initials: A
authors.lastname: Oganesian
authors.forename: Gil
authors.initials: G
authors.lastname: Fine
authors.forename: Scott
authors.initials: S
authors.lastname: Rasmussen
authors.forename: Joanne
authors.initials: J
authors.lastname: Collier
authors.forename: James
authors.initials: J
authors.lastname: Kissling
authors.forename: Amarpal
authors.initials: A
authors.lastname: Sahai
authors.forename: Mohammad
authors.initials: M
authors.lastname: Azab
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Redkar
mesh_terms: D000284:Administration, Oral; D000328:Adult; D019540:Area Under Curve; D002214:Capsules; D018592:Cross-Over Studies; D004041:Dietary Fats / Q000008:administration & dosage / Q000494:pharmacology*; D005215:Fasting; D005260:Female; D018565:Food-Drug Interactions; D006261:Headache / Q000139:chemically induced; D006801:Humans; D008297:Male; D008657:Metabolic Clearance Rate; D010879:Piperazines; D011743:Pyrimidines / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics*; D013890:Thiourea; D055815:Young Adult
chemical_list: D002214:Capsules; D004041:Dietary Fats; D010879:Piperazines; D011743:Pyrimidines; D013890:Thiourea; C521047:amuvatinib