Dose-finding study of the checkpoint kinase 1 inhibitor, prexasertib, in Japanese patients with advanced solid tumors

Cancer Sci. 2018 Oct;109(10):3216-3223. doi: 10.1111/cas.13750.

Abstract

Prexasertib is a novel inhibitor of checkpoint kinase 1. The primary objective of this study was to evaluate prexasertib tolerability in Japanese patients with advanced solid tumors. This nonrandomized single-arm open-label phase 1 study of prexasertib consisted of 2 dose levels, 80 mg/m2 and the global-recommended dose based on a US study of 105 mg/m2 , administered intravenously once every 14 days (n = 6 for each dose). Transition to the higher dose proceeded if the frequency of dose-limiting toxicity observed in cycle 1 was <33% at the lower dose. Safety measures, pharmacokinetics and antitumor activity were assessed. A total of 12 patients were treated. Two patients, one in each dose group, experienced dose-limiting toxicities of febrile neutropenia, one grade 4 and the other grade 3; both patients recovered and continued the study treatment. The grade 4 treatment-emergent adverse events related to study treatment were neutropenia (6 patients [50.0%]), leukopenia (4 patients [33.3%]), and 1 instance each (8.3%) of anemia, febrile neutropenia and thrombocytopenia. Neutropenia was generally transient and reversible; 11 patients (91.7%) required granulocyte colony-stimulating factor treatment during the study. There were no discontinuations due to adverse events or deaths. The prexasertib pharmacokinetics displayed dose-independent and time-independent behavior across both dose levels, similar to the profile observed in the US-based phase 1 study. Eight patients had a best overall response of stable disease. These data are consistent with the known safety profile for prexasertib and confirm its tolerability in Japanese patients with advanced solid tumors.

Keywords: Checkpoint kinase 1; Japan; phase I clinical trial; prexasertib; solid tumors.

Publication types

  • Clinical Trial, Phase I

MeSH terms

  • Adult
  • Aged
  • Anemia / chemically induced
  • Anemia / epidemiology
  • Antineoplastic Agents / pharmacokinetics
  • Antineoplastic Agents / therapeutic use*
  • Checkpoint Kinase 1 / antagonists & inhibitors*
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Female
  • Filgrastim / therapeutic use
  • Humans
  • Japan / epidemiology
  • Leukopenia / chemically induced
  • Leukopenia / epidemiology
  • Male
  • Maximum Tolerated Dose
  • Middle Aged
  • Neoplasms / blood
  • Neoplasms / drug therapy*
  • Neutropenia / chemically induced
  • Neutropenia / drug therapy
  • Pyrazines / therapeutic use*
  • Pyrazoles / therapeutic use*
  • Thrombocytopenia / chemically induced
  • Thrombocytopenia / epidemiology
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Pyrazines
  • Pyrazoles
  • prexasertib
  • CHEK1 protein, human
  • Checkpoint Kinase 1
  • Filgrastim

Associated data

  • GENBANK/NCT02514603

Grants and funding