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Phase I study of the safety, pharmacokinetics and antitumor activity of famitinib

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Abstract

Purpose

To evaluate the safety, tolerability, pharmacokinetics and antitumor activities of famitinib (famitinib l-malate), a novel oral multitargeting tyrosine kinase inhibitor that acts against vascular endothelial growth factor receptor-2, platelet-derived growth factor receptor, stem cell factor receptor (c-kit), FMS-like tyrosine kinase-3 receptor and protooncogene tyrosine kinase receptor in patients with advanced solid cancer.

Methods

Patients received once daily oral famitinib. Doses were increased from 4 to 8, 13, 20, 27, 24, 25 and eventually 30 mg. Each cycle was defined as 28 days. The pharmacokinetic profile and various biomarkers were evaluated during the first cycle. Antitumor efficacy was evaluated every 8 weeks.

Results

Fifty-four patients were evaluable for safety and efficacy. Dose-limiting toxicities were observed in 2 of 3 patients at 30 mg. The dose-limiting toxicities observed in the first cycle of famitinib treatment included hypertension, hand-foot skin reaction and diarrhea. Grade 3 hypertriglyceridemia/hypercholesterolemia and proteinuria were notable side effects in the subsequent treatment cycles. Other common side effects included bone marrow suppression, oral mucositis, fatigue, pain, elevated transaminase or bilirubin, peripheral sensory disturbance and hypothyroidism, most of which were mild to moderate in severity. Pharmacokinetic studies revealed no significant accumulation of famitinib or its major metabolite, M3. The half-lives of famitinib and M3 were approximately 28.7–33.8 and 41.3–47.7 h, respectively. Food demonstrated a minimal effect on the pharmacokinetics of famitinib. Eight partial responses were determined, including 6 cases of renal cell carcinoma, 1 case of gastrointestinal stromal tumor (GIST) and 1 case of alveolar soft part sarcoma. Fourteen patients demonstrated stable disease with various degrees of tumor shrinkage.

Conclusions

Famitinib is generally well tolerated. Famitinib demonstrates a wide spectrum of antitumor activities, which warrants further study in renal cell carcinoma, GIST, hepatocellular carcinoma and soft tissue sarcoma. The recommended dose for future phase II clinical trials is 25 mg.

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Conflict of interest

This research was sponsored by Jiangsu Hengrui Medicine Co. Ltd. The following author has a financial relationship to the sponsor: Jiang HY was an employee of Jiangsu Hengrui Medicine Co. Ltd.

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Authors and Affiliations

  1. Department of Medical Oncology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China

    Aiping Zhou, Wen Zhang, Chunxiao Chang, Qiong Qin & Jinwan Wang

  2. Center for Drug Metabolism and Pharmacokinetics Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China

    Xiaoyan Chen & Dafang Zhong

  3. Department of Epidemiology and Biostatistics, Nanjing Medical University, Nanjing, China

    Donghua Lou

  4. Department of Clinical Development, Jiangsu Hengrui Medicine Co., Ltd, Lianyungang, China

    Haoyuan Jiang

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  1. Aiping Zhou
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  2. Wen Zhang
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  3. Chunxiao Chang
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  4. Xiaoyan Chen
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  5. Dafang Zhong
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  7. Donghua Lou
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  8. Haoyuan Jiang
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  9. Jinwan Wang
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Correspondence to Jinwan Wang.

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Zhou, A., Zhang, W., Chang, C. et al. Phase I study of the safety, pharmacokinetics and antitumor activity of famitinib. Cancer Chemother Pharmacol 72, 1043–1053 (2013). https://doi.org/10.1007/s00280-013-2282-y

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  • DOI: https://doi.org/10.1007/s00280-013-2282-y

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