A phase I trial of the aurora kinase inhibitor, ENMD-2076, in patients with relapsed or refractory acute myeloid leukemia or chronic myelomonocytic leukemia

Invest New Drugs. 2016 Oct;34(5):614-24. doi: 10.1007/s10637-016-0375-2. Epub 2016 Jul 12.

Abstract

ENMD-2076 is a novel, orally-active molecule that inhibits Aurora A kinase, as well as c-Kit, FLT3 and VEGFR2. A phase I study was conducted to determine the maximum tolerated dose (MTD), recommended phase 2 dose (RP2D) and toxicities of ENMD-2076 in patients with acute myeloid leukemia (AML) and chronic myelomonocytic leukemia (CMML). Patients received escalating doses of ENMD-2076 administered orally daily [225 mg (n = 7), 375 mg (n = 6), 325 mg (n = 9), or 275 mg (n = 5)]. Twenty-seven patients were treated (26 AML; 1 CMML-2). The most common non-hematological toxicities of any grade, regardless of association with drug, were fatigue, diarrhea, dysphonia, dyspnea, hypertension, constipation, and abdominal pain. Dose-limiting toxicities (DLTs) consisted of grade 3 fatigue, grade 3 typhilitis, grade 3 syncope and grade 3 QTc prolongation). Of the 16 evaluable patients, one patient achieved a complete remission with incomplete count recovery (CRi), three experienced a morphologic leukemia-free state (MLFS) with a major hematologic improvement in platelets (HI-P), and 5 other patients had a reduction in marrow blast percentage (i.e. 11-65 %). The RP2D in this patient population is 225 mg orally once daily.

Keywords: Acute myeloid leukemia; Aurora kinase inhibitor; Chronic myelomonocytic leukemia; ENMD-2076.

Publication types

  • Clinical Trial, Phase I

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents* / adverse effects
  • Antineoplastic Agents* / pharmacokinetics
  • Antineoplastic Agents* / pharmacology
  • Antineoplastic Agents* / therapeutic use
  • Aurora Kinases / antagonists & inhibitors
  • Drug Resistance, Neoplasm
  • Extracellular Signal-Regulated MAP Kinases / metabolism
  • Female
  • Humans
  • Leukemia, Myeloid, Acute / drug therapy*
  • Leukemia, Myeloid, Acute / metabolism
  • Leukemia, Myelomonocytic, Chronic / drug therapy*
  • Leukemia, Myelomonocytic, Chronic / metabolism
  • Male
  • Maximum Tolerated Dose
  • Middle Aged
  • Protein Kinase Inhibitors* / adverse effects
  • Protein Kinase Inhibitors* / pharmacokinetics
  • Protein Kinase Inhibitors* / pharmacology
  • Protein Kinase Inhibitors* / therapeutic use
  • Proto-Oncogene Proteins c-akt / metabolism
  • Proto-Oncogene Proteins c-kit / antagonists & inhibitors
  • Pyrazoles* / adverse effects
  • Pyrazoles* / pharmacokinetics
  • Pyrazoles* / pharmacology
  • Pyrazoles* / therapeutic use
  • Pyrimidines* / adverse effects
  • Pyrimidines* / pharmacokinetics
  • Pyrimidines* / pharmacology
  • Pyrimidines* / therapeutic use
  • Recurrence
  • Ribosomal Protein S6 Kinases / metabolism
  • STAT5 Transcription Factor / metabolism
  • Treatment Outcome
  • Vascular Endothelial Growth Factor Receptor-2 / antagonists & inhibitors
  • fms-Like Tyrosine Kinase 3 / antagonists & inhibitors

Substances

  • Antineoplastic Agents
  • ENMD 2076
  • Protein Kinase Inhibitors
  • Pyrazoles
  • Pyrimidines
  • STAT5 Transcription Factor
  • FLT3 protein, human
  • KDR protein, human
  • Proto-Oncogene Proteins c-kit
  • Vascular Endothelial Growth Factor Receptor-2
  • fms-Like Tyrosine Kinase 3
  • Aurora Kinases
  • Proto-Oncogene Proteins c-akt
  • Ribosomal Protein S6 Kinases
  • Extracellular Signal-Regulated MAP Kinases