Phase I safety, pharmacokinetic, and pharmacodynamic trial of ZD1839, a selective oral epidermal growth factor receptor tyrosine kinase inhibitor, in patients with five selected solid tumor types - PubMed (original) (raw)
Clinical Trial
. 2002 Nov 1;20(21):4292-302.
doi: 10.1200/JCO.2002.03.100.
D Rischin, M Ranson, H Calvert, E Raymond, D G Kieback, S B Kaye, L Gianni, A Harris, T Bjork, S D Averbuch, A Feyereislova, H Swaisland, F Rojo, J Albanell
Affiliations
- PMID: 12409327
- DOI: 10.1200/JCO.2002.03.100
Clinical Trial
Phase I safety, pharmacokinetic, and pharmacodynamic trial of ZD1839, a selective oral epidermal growth factor receptor tyrosine kinase inhibitor, in patients with five selected solid tumor types
J Baselga et al. J Clin Oncol. 2002.
Abstract
Purpose: To establish the safety and tolerability of ZD1839 (Iressa), a selective epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, and to explore its pharmacokinetic and pharmacodynamic effects in patients with selected solid tumor types.
Patients and methods: This was a phase I dose-escalating trial of oral ZD1839 150 mg/d to a maximum of 1,000 mg/d given once daily for at least 28 days. Patients with either advanced non-small-cell lung, ovarian, head and neck, prostate, or colorectal cancer were recruited.
Results: Eighty-eight patients received ZD1839 (150 to 1,000 mg/d). At 1,000 mg/d, five of 12 patients experienced dose-limiting toxicity (grade 3 diarrhea [four patients] and grade 3 somnolence [one patient]). The most frequent drug-related adverse events (AEs) were acne-like rash (64%) and diarrhea (47%), which were generally mild (grade 1/2) and reversible on cessation of treatment. No change in ZD1839 safety profile was observed with prolonged administration. Pharmacokinetic analysis showed steady-state exposure to ZD1839 in 98% of patients by day 7. Nineteen patients had stable disease and received ZD1839 for >or= 3 months; seven of these patients remained on study drug for >or= 6 months. Serial skin biopsies taken before treatment and at approximately day 28 revealed changes indicative of inhibition of the EGFR signaling pathway.
Conclusion: ZD1839 was generally well tolerated, with manageable and reversible AEs at doses up to 600 mg/d and dose-limiting toxicity observed at 1,000 mg/d. ZD1839 treatment resulted in clinically meaningful disease stabilization across a range of tumor types and doses. Pharmacodynamic changes in skin confirmed inhibition of EGFR signaling, which was predicted from the mode of action of ZD1839.
Comment in
- The multifunctional, multi-institutional, and sometimes even global phase I study: a better life for phase I evaluations or just "living large"?
Tolcher AW, Takimoto CH, Rowinsky EK. Tolcher AW, et al. J Clin Oncol. 2002 Nov 1;20(21):4276-8. doi: 10.1200/JCO.2002.20.21.4276. J Clin Oncol. 2002. PMID: 12409324 No abstract available.
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