Abstract | PURPOSE: To identify the maximum-tolerated dose (MTD) and to evaluate the antileukemic activity of tosedostat (formerly CHR-2797), an orally bioavailable aminopeptidase inhibitor. PATIENTS AND METHODS: RESULTS: In phase I, 16 patients were treated in four cohorts with tosedostat (60 mg to 180 mg) for 28 days. Three patients reported dose-limiting toxicities: two with reversible thrombocytopenia (> 75% reduction in platelet count) at 180 mg (MTD) and one with a Common Toxicity Criteria (CTC) grade 3 ALT elevation at 130 mg (MAD). In phase II, 41 patients were treated with 130 mg tosedostat. In phases I and II, the most common severe (CTC grades 3 to 5) adverse event was a reduction in the platelet count. Of the 51 AML patients in this study, seven reached complete marrow response (< 5% marrow blasts), with three achieving complete remission, and a further seven patients reaching a partial marrow response (between 5% and 15% marrow blasts). The overall response rate was therefore 27%. All responders were age > 60 years, and 79% had either relapsed or refractory AML. CONCLUSION: This phase I/II study demonstrates that oral once daily dosing with 130 mg tosedostat is well tolerated and has significant antileukemic activity. The favorable risk-benefit profile suggests that further clinical trials are warranted.
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Authors | Bob Löwenberg, Gareth Morgan, Gert J Ossenkoppele, Alan K Burnett, Pierre Zachée, Ulrich Dührsen, Daan Dierickx, Carsten Müller-Tidow, Pieter Sonneveld, Utz Krug, Elisabeth Bone, Nicolas Flores, Alison F Richardson, Leon Hooftman, Chris Jenkins, Sonja Zweegman, Faith Davies |
Journal | Journal of clinical oncology : official journal of the American Society of Clinical Oncology
(J Clin Oncol)
Vol. 28
Issue 28
Pg. 4333-8
(Oct 01 2010)
ISSN: 1527-7755 [Electronic] United States |
PMID | 20733120
(Publication Type: Clinical Trial, Phase I, Clinical Trial, Phase II, Journal Article)
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Chemical References |
- Hydroxamic Acids
- Aminopeptidases
- tosedostat
- Glycine
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Aminopeptidases
(antagonists & inhibitors)
- Female
- Glycine
(administration & dosage, adverse effects, analogs & derivatives, therapeutic use)
- Humans
- Hydroxamic Acids
(administration & dosage, adverse effects, therapeutic use)
- Leukemia, Myeloid, Acute
(drug therapy)
- Male
- Maximum Tolerated Dose
- Middle Aged
- Myelodysplastic Syndromes
(drug therapy)
- Treatment Outcome
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