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Phase I/II multicenter study to assess the safety, tolerability, pharmacokinetics and pharmacodynamics of AZD4877 in patients with refractory acute myeloid leukemia

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Summary

Eg5 (kinesin spindle protein) is a microtubule motor protein, essential for centrosome separation during mitosis. This Phase I/II, open-label, multicenter, two-part study investigated AZD4877, a potent Eg5 inhibitor, in patients with acute myeloid leukemia. Primary objectives were to determine the maximum tolerated dose (MTD) (part A), assess efficacy (part B) and determine the pharmacokinetic profile (parts A and B). Secondary objectives included assessment of safety and tolerability. AZD4877 was administered at a range of doses (2, 4, 7, 10, 13, 16 and 18 mg/day) as a 1-hour intravenous infusion on three consecutive days of a continuous 2-week schedule. The MTD in part A was defined as 16 mg/day based on dose-limiting stomatitis at 16 and 18 mg/day, hyperbilirubinemia at 16 mg/day and palmar–plantar erythrodysesthesia syndrome at 18 mg/day. Systemic exposure to AZD4877 generally increased with increasing dose whereas half-life was not dose dependent. No evaluable patients experienced a complete remission (CR) or CR with incomplete blood count recovery (CRi), demonstrating no evidence of AZD4877 efficacy in this population. Evidence of monoasters in all but the 4 mg/day dose group provided proof of mechanism for AZD4877. This study was terminated due to lack of efficacy. (ClinicalTrials.gov identifier NCT00486265).

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Acknowledgments

We are indebted to Linda Hylander-Gans for excellent immunohistochemical analysis of monoasters. We would like to thank Dr Claire Routley, from Mudskipper Bioscience, who provided medical writing assistance funded by AstraZeneca. This study was sponsored by AstraZeneca.

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Author notes

  1. M. S. Tallman

    Present address: Memorial Sloan-Kettering Cancer Center Weill Cornell Medical College, New York, NY, USA

  2. K. Wu

    Present address: Translational and Experimental Medicine, Sanofi-Aventis R&D, Cambridge, MA, USA

Authors and Affiliations

  1. University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Box 428, Houston, TX, 77030–1402, USA

    H. M. Kantarjian, G. Borthukar, S. Faderl, G. Garcia-Manero & T. Kadia

  2. Cancer Therapy and Research Center, San Antonio, TX, USA

    S. Padmanabhan & K. Sankhala

  3. The University of Chicago, Chicago, IL, USA

    W. Stock & O. Odenike

  4. AstraZeneca Pharmaceuticals, Concord Pike, Wilmington, DE, USA

    G. A. Curt, J. Li & A. Osmukhina

  5. Cancer Bioscience, AstraZeneca R&D Boston, Waltham, MA, USA

    D. Huszar

  6. Northwestern University, Chicago, IL, USA

    M. S. Tallman & J. K. Altman

  7. University Health Network Princess Margaret Hospital, Toronto, ON, Canada

    M. Minden

  8. AstraZeneca R&D Boston, Waltham, MA, USA

    K. Wu

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  1. H. M. Kantarjian
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Correspondence to H. M. Kantarjian.

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Kantarjian, H.M., Padmanabhan, S., Stock, W. et al. Phase I/II multicenter study to assess the safety, tolerability, pharmacokinetics and pharmacodynamics of AZD4877 in patients with refractory acute myeloid leukemia. Invest New Drugs 30, 1107–1115 (2012). https://doi.org/10.1007/s10637-011-9660-2

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