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Phase I clinical and pharmacokinetic study of PM01183 (a tetrahydroisoquinoline, Lurbinectedin) in combination with gemcitabine in patients with advanced solid tumors

  • PHASE I STUDIES
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Summary

Background To determine the recommended dose (RD) of a combination of PM01183 and gemcitabine in patients with advanced solid tumors. Methods Forty-five patients received escalating doses of PM01183/gemcitabine on Days 1 and 8 every 3 weeks (d1,8 q3wk) following a standard 3 + 3 design. Results PM01183 3.5 mg flat dose (FD)/gemcitabine 1000 mg/m2 was the highest dose level tested. Dose-limiting toxicities (DLTs) were mostly hematological and resulted in the expansion of a lower dose level (PM01183 3.5 mg FD/gemcitabine 800 mg/m2); 19 patients at this dose level were evaluable but >30% had DLT and >20% had febrile neutropenia. No DLT was observed in 11 patients treated at PM01183 3.0 mg FD/gemcitabine 800 mg/m2, which was defined as the RD. This regimen was feasible and tolerable with manageable toxicity; mainly grade 3/4 myelosuppression. Non-hematological toxicity comprised fatigue, nausea, vomiting, and transaminases increases. Fifteen (33%) patients received ≥6 cycles with no cumulative hematological toxicity. Pharmacokinetic analysis showed no evidence of drug-drug interaction. Nine of 38 patients had response as per RECIST (complete [3%] and partial [21%]), for an overall response rate (ORR) of 24% (95% Confidence Interval [CI] 12–40%). Eleven patients (29%) had disease stabilization ≥4 months. Responses were durable (median of 8.5 months): overall median progression-free survival (PFS) was 4.2 months (95% CI, 2.7–6.5 months). Conclusions The RD for this combination is PM01183 3.0 mg FD (or 1.6 mg/m2)/gemcitabine 800 mg/m2 d1,8 q3wk. This schedule is well tolerated and has antitumor activity in several advanced solid tumor types.

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Acknowledgements

Support was provided to Martin Forster by the National Institute for Health Research, the University College London Hospitals Biomedical Research Centre, and the Cancer Research UK University College London Experimental Cancer Medicine Centre.

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Author notes

  1. Luis Paz-Ares

    Present address: Chair of the Medical Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain

  2. Samantha Turnbull

    Present address: Clinical Research Fellow and SpR in Medical Oncology, Leeds Immunotherapy Team (LIT) at the Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK

  3. Iker López Calderero

    Present address: Consultant Clinical Oncologist in Can Misses Hospital, Ibiza, Spain

Authors and Affiliations

  1. Hospital Universitario Virgen del Rocío, Seville, Spain

    Luis Paz-Ares, Jesús Corral & Iker López Calderero

  2. University College of London Hospital, London, UK

    Martin Forster & Samantha Turnbull

  3. START Madrid, Centro Integral Oncológico Clara Campal, Hospital Universitario Madrid Sanchinarro, Madrid, Spain

    Valentina Boni, Antonio Cubillo & Emiliano Calvo

  4. Pharma Mar, S.A, Colmenar Viejo, Madrid, Spain

    Sergio Szyldergemajn, Carlos Fernandez Teruel, Mariano Siguero & Patrick Bohan

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Correspondence to Emiliano Calvo.

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Conflict of interest

Emiliano Calvo, Martin Forster, Valentina Boni, Jesús Corral, Samantha Turnbull, Antonio Cubillo, and Iker López Calderero declare that they have no conflict of interest. Luis Paz-Ares reports honoraria from Pharma Mar, S.A. outside the submitted work. Sergio Szyldergemajn, Carlos Fernandez Teruel and Patrick Bohan are employees of Pharma Mar, S.A. Mariano Siguero is an employee and shareholder of Pharma Mar, S.A.

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This work was funded by a grant from Pharma Mar, S.A.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Paz-Ares, L., Forster, M., Boni, V. et al. Phase I clinical and pharmacokinetic study of PM01183 (a tetrahydroisoquinoline, Lurbinectedin) in combination with gemcitabine in patients with advanced solid tumors. Invest New Drugs 35, 198–206 (2017). https://doi.org/10.1007/s10637-016-0410-3

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