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Authors | Y. Kuboki, N. Matsubara, H. Bando, K. Shitara, K. Yoh, T. Kojima, I. Ohno, H. Takahashi, K. Harano, S. Kondo, H. Hirai, C. Morizane, T. Doi | ||||||||||||
Title | First-in-human (FIH) study of TAS-120, a highly selective covalent oral fibroblast growth factor receptor (FGFR) inhibitor, in patients (pts) with advanced solid tumors | ||||||||||||
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URL | https://www.annalsofoncology.org/article/S0923-7534(20)37792-9/fulltext | ||||||||||||
Abstract Text | Background: Dysregulation of the FGF/FGFR signaling pathway has been associated with many developmental disorders and varieties of cancers. TAS-120 is an oral, highly selective covalent FGFR inhibitor with potent antitumor activity in vitro and in vivo models with FGFR pathway aberration. Methods: This FIH study consists of dose escalation phase (DE) and expansion phase (EX). The objectives of this study are to determine the maximum tolerated dose (MTD)/recommended dose (RD) and to investigate the safety, pharmacokinetics, pharmacodynamics, and efficacy. In DE, the first three cohorts were evaluated by a single patient then a 3 + 3 design is used which is currently ongoing. Pts with FGFR abnormalities can be enrolled to EX during the evaluation of DE with dose lower than maximum administered dose under evaluation. TAS-120 was administered orally three times weekly (Monday-Wednesday-Friday) in a 21day cycle. Results: As of 3 Apr 2017, 36 pts (34% FGFR with genetic abnormalities) were enrolled (DE; 26 pts, EX; 10 pts). Tumor types enrolled were bladder cancer (n = 8), colorectal cancer (n = 7), biliary tract cancer (n = 4), gastric, esophageal and pancreas cancer (n = 3 each), and others (n = 8). Pts were treated in 8 dose cohorts of 8 -160 mg. MTD has not been reached. The most common drug-related AEs (all AEs ≥10%) were hyperphosphatemia (79%), and anorexia (12%). Grade ≥3 hyperphosphatemia has never been observed. Hyperphosphatemia was managed with dose interruption or reduction in addition of phosphate binders. Drug-related SAE has not occurred. TAS-120 exposure increased with dosage. Mean Cmax and AUC0-48 at 160 mg were 1,192 ng/mL and 9,972 ng*h/mL, respectively, with a mean Tmax of 2.67 hrs and apparent T1/2 of 6.06 hrs. Two pts showed the clinical response, one of them was gastric cancer with FGFR2 amplification at 80 mg, and the other was esophageal cancer (FGFR status is under evaluation) at 120 mg. Moreover, two biliary tract cancer with FGFR2 fusion at 56 mg, and one bladder cancer at 36 mg (FGFR status is unknown) had stable disease > 24 weeks. Conclusions: TAS-120 was well-tolerated, and the safety profile was confirmed up to 120 mg. The ongoing DE and EX are still under evaluation and RD will be determined. |
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Therapy Name | Drugs | Efficacy Evidence | Clinical Trials |
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Gene | Variant | Impact | Protein Effect | Variant Description | Associated with drug Resistance |
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Molecular Profile | Indication/Tumor Type | Response Type | Therapy Name | Approval Status | Evidence Type | Efficacy Evidence | References |
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FGFR2 amp | stomach cancer | predicted - sensitive | Futibatinib | Case Reports/Case Series | Actionable | In a Phase I trial, Lytgobi (futibatinib) treatment resulted in clinical response in a gastric cancer patient harboring FGFR2 amplification (Ann Oncol 2017, Vol 28, Suppl 5, Abstract # 372PD). | detail... |
FGFR2 fusion | biliary tract cancer | predicted - sensitive | Futibatinib | Case Reports/Case Series | Actionable | In a Phase I trial, Lytgobi (futibatinib) treatment resulted in stable disease over 24 weeks in two biliary tract cancer patients harboring FGFR2 fusions (Ann Oncol 2017, Vol 28, Suppl 5, Abstract # 372PD). | detail... |