title: A phase I trial to determine the safety, pharmacokinetics, and pharmacodynamics of intercalated BMS-690514 with paclitaxel/carboplatin (PC) in advanced or metastatic solid malignancies.
abstract: OBJECTIVE
  A phase I dose escalation study was performed to determine the maximum tolerated dose (MTD) of intercalated dosing of BMS-690514, a reversible oral panHER/VEGF receptor inhibitor, combined with paclitaxel/carboplatin (PC) in advanced solid tumors. Secondary endpoints included safety, pharmacokinetics (PK), exploratory pharmacodynamics (PD), and preliminary efficacy.
  
  
  METHODS
  Patients received fixed doses of P (200 mg/m(2)) and C (AUC 6 mg/mL min) q21 days with intercalated BMS-690514 (Days 4-19) starting at 100 mg/day and increasing by 50 mg/day using a 3 + 3 dose escalation design until the MTD was reached. Twenty additional patients were enrolled in the expansion cohort at the recommended phase II dose (RP2D).
  
  
  RESULTS
  The MTD was reached at 150 mg/day. DLTs included grade 3 thrombosis at 100 mg (1 patient) and grade 3 diarrhea at 150 mg (1 patient) and 200 mg (2 patients). Serious adverse events (AEs) occurring in 20/37 patients included neutropenia (n = 5), diarrhea (n = 4), pulmonary embolism (n = 3), and simultaneous dehydration, acute renal failure, and febrile neutropenia (n = 2). BMS-690514-related AEs included diarrhea (97 %), acneiform rash (60 %), fatigue (43 %), nausea (30 %), and anorexia (30 %). There were no treatment-related deaths. Sequential intermittent administration of PC did not affect the PK of BMS-690514. Of the 32 patients evaluable for efficacy, there were 12 partial responses including five patients with non-small-cell lung cancer and 12 patients with stable disease.
  
  
  CONCLUSIONS
  The MTD of intercalated BMS-609514 combined with PC was 150 mg/day. This approach was tolerable with manageable toxicities and antitumor activity in a variety of solid tumor types.
authors.affiliation: Ottawa Hospital Cancer Centre, 501 Smyth Road, Ottawa, ON K1H 8L6, Canada. lqchow@uw.edu
authors.forename: Laura Q M
authors.initials: LQ
authors.lastname: Chow
authors.forename: Derek I
authors.initials: DI
authors.lastname: Jonker
authors.forename: Grace K
authors.initials: GK
authors.lastname: Dy
authors.forename: Garth
authors.initials: G
authors.lastname: Nicholas
authors.forename: Catherine
authors.initials: C
authors.lastname: Fortin
authors.forename: Daniel
authors.initials: D
authors.lastname: Patricia
authors.forename: Alex A
authors.initials: AA
authors.lastname: Adjei
authors.forename: Chandra P
authors.initials: CP
authors.lastname: Belani
authors.forename: Ashok
authors.initials: A
authors.lastname: Gupta
authors.forename: Jong-Soon
authors.initials: JS
authors.lastname: Park
authors.forename: Steven
authors.initials: S
authors.lastname: Zhang
authors.forename: Eric I
authors.initials: EI
authors.lastname: Sbar
authors.forename: Scott A
authors.initials: SA
authors.lastname: Laurie
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D019540:Area Under Curve; D016190:Carboplatin; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D020714:Maximum Tolerated Dose; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009369:Neoplasms / Q000188:drug therapy* / Q000473:pathology; D017239:Paclitaxel / Q000008:administration & dosage; D010880:Piperidines / Q000008:administration & dosage; D011758:Pyrroles / Q000008:administration & dosage; D016896:Treatment Outcome; D014227:Triazines / Q000008:administration & dosage
chemical_list: C552150:BMS-690514; D010880:Piperidines; D011758:Pyrroles; D014227:Triazines; D016190:Carboplatin; D017239:Paclitaxel