ENDOLUNG trial. A phase 1/2 study of the Akt/mTOR inhibitor and autophagy inducer Ibrilatazar (ABTL0812) in combination with paclitaxel/carboplatin in patients with advanced/recurrent endometrial cancer
Leary, Alexandra (Institut Gustave Roussy (Villejuif, França))
Estévez-García, Purificación (Hospital Universitario Virgen del Rocío (Sevilla, Andalusia))
Sabatier, Renaud (Institut Paoli-Calmettes (Marsella, França))
Ray-Coquard, Isabelle (Centre Léon Bérard (França))
Romeo, Margarita (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Barretina-Ginesta, Maria-Pilar (Institut Català d'Oncologia)
Gil-Martin, Marta (Hospital Universitari de Bellvitge)
Garralda, Elena (Vall d'Hebron Institut d'Oncologia)
Bosch-Barrera, J. (Institut Català d'Oncologia)
Morán, Teresa (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Martin-Martorell, Paloma (INCLIVA-Hospital Clínico Universitario (València, País Valencià))
Nadal, Ernest (Hospital Universitari de Bellvitge)
Gascón, Pere (Hospital Clínic i Provincial de Barcelona)
Rodon Ahnert, Jordi (The University of Texas M. D. Anderson Cancer Center (Houston, Estats Units d'Amèrica))
Lizcano de Vega, José Miguel (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Muñoz-Guardiola, Pau (Ability Pharmaceuticals (Cerdanyola del Vallès, Catalunya))
Fierro-Durán, Gemma (Ability Pharmaceuticals (Cerdanyola del Vallès, Catalunya))
Pedrós-Gámez, Oriol (Ability Pharmaceuticals (Cerdanyola del Vallès, Catalunya))
Pérez-Montoyo, Hector (Ability Pharmaceuticals (Cerdanyola del Vallès, Catalunya))
Yeste-Velasco, Marc (Ability Pharmaceuticals (Cerdanyola del Vallès, Catalunya))
Cortal, Marc (Ability Pharmaceuticals (Cerdanyola del Vallès, Catalunya))
Perez Campos, Antonio (Ability Pharmaceuticals (Cerdanyola del Vallès, Catalunya))
Alfón, José (Ability Pharmaceuticals (Cerdanyola del Vallès, Catalunya))
Domenech, Carles (Ability Pharmaceuticals (Cerdanyola del Vallès, Catalunya))
Pérez-Fidalgo, Alejandro (INCLIVA-Hospital Clínico Universitario (valència, País Valencià))
Oaknin, Ana (Vall d'Hebron Institut d'Oncologia)
Universitat Autònoma de Barcelona

Data:	2024
Resum:	Background: Carboplatin and paclitaxel (CP) have been the standard of care for advanced/recurrent endometrial cancer (EC) for many years. However, this chemotherapy combination shows limited efficacy and recurrences often occur in less than 12 months. ABTL0812 is a novel drug that selectively kill cancer cells by cytotoxic autophagy and has shown anticancer efficacy in preclinical models of EC in combination with CP. Methods: ENDOLUNG was an open-label, phase 1/2 clinical trial designed to determine the safety and efficacy of Ibrilatazar (ABTL0812) with CP in patients with advanced/recurrent EC and non-irradiable stage III and IV squamous non-small cell lung cancer (sq-NSCLC). The phase 1 part consisted of a 3 + 3 de-escalation design followed by an expansion cohort with 12 patients. The primary endpoint was safety. ABTL0812 starting dose was 1300 mg tid combined with carboplatin at area under the curve (AUC) 5 and paclitaxel at 175 mg/m both administered every 21 days for up to 8 cycles. The phase 2 part included a total of 51 patients. The primary endpoint was overall response rate (ORR) and the secondary endpoints included duration of response (DOR), progression-free survival (PFS) and overall survival (OS). Results: During the phase 1 only one dose limiting toxicity (DLT), a grade 4 neutropenia, was observed in 1 out of 6 patients, thus no de-escalation was applied. One additional DLT, a grade 3 febrile neutropenia, was observed in the expansion cohort, thus the recommended phase 2 dose (RP2D) for ABTL0812 was established at 1300 mg tid. Most frequent hematological adverse events (AE) of the combination were neutropenia (52. 9%), anemia (37. 3%) and thrombocytopenia (19. 6%). Nausea (66. 7%), asthenia (66. 7%), diarrhea (54. 9%) and vomiting (54. 9%) were the most frequent non-hematological adverse events (AEs). The combination of ABTL0812 plus CP showed an ORR of 65. 8% (13. 2% complete response and 52. 6% partial response) with a median DOR of 7. 4 months (95% CI: 6. 3-10. 8 months). Median PFS was 9. 8 months (95% CI: 6. 6-10. 6) and median OS 23. 6 months (95% CI 6. 4-ND). Pharmacokinetic parameters were compatible with target engagement observed in preclinical studies, and blood pharmacodynamic biomarkers indicated sustained target regulation during, at least, 28 days after starting the treatment. Conclusions: This study suggests that the combination of ABTL0812 with CP is safe and feasible with an encouraging activity in patients with advanced/recurrent EC. Our data warrant further confirmation in prospective randomized trials. Trial registration: EU Clinical Trial Register, EudraCT number 2016-001352-21 and National Clinical Trials Number, NCT03366480. Registration on 19 September 2016.
Ajuts:	Instituto de Salud Carlos III PI18/00442 Ministerio de Economía y Competitividad PI15/00339
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Autophagy ; Chemotherapy ; Endometrial cancer ; Phase 1/2 ; Safety profile
Publicat a:	BMC Cancer, Vol. 24 Núm. 1 (december 2024) , p. 876, ISSN 1471-2407

Article original: https://ddd.uab.cat/record/311669?ln=ca
Erratum: https://ddd.uab.cat/record/311641?ln=ca
DOI: 10.1186/s12885-024-12501-5
PMID: 39039449

14 p, 2.2 MB

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