A First-in-Human, Phase I, Dose-Escalation Study of TAK-117, a Selective PI3Kα Isoform Inhibitor, in Patients with Advanced Solid Malignancies.
de Bono, JS
Macarulla Mercadé, T
Jose de Miguel-Luken, M
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<b>Purpose:</b> To evaluate the safety, MTD, pharmacokinetics, pharmacodynamics, and preliminary antitumor activity of TAK-117 (MLN1117/INK1117), an investigational PI3Kα-selective inhibitor, in patients with advanced solid tumors.<b>Experimental Design:</b> Seventy-one patients received oral TAK-117 once daily [100-300 mg (<i>n</i> = 24)] or 3 days per week [Monday-Wednesday-Friday (MWF), 200-1,200 mg (<i>n</i> = 27); Monday-Tuesday-Wednesday (MTuW), 200-900 mg (<i>n</i> = 20)], in 21-day cycles. Dose escalation proceeded via a 3 + 3 design.<b>Results:</b> TAK-117 once-daily dosing was associated with dose-limiting grade ≥3 alanine/aspartate aminotransferase (ALT/AST) elevations, resulting in a narrow range of tolerable doses (100-150 mg once daily). With MWF/MTuW dosing, no dose-limiting ALT/AST elevations occurred until the MTD of 900 mg; total weekly dose was 2.6-fold that of 150 mg once daily. Drug-related grade ≥3 adverse events occurred in 25%/22%/35% (including hyperglycemia in 0%/7%/15%) of once-daily/MWF/MTuW patients. TAK-117 (100-1,200 mg) exhibited moderately fast oral absorption, a generally dose proportional increase in exposure, and plasma half-life of approximately 11 hours. Total weekly exposures with 900 mg MWF/MTuW dosing were approximately 4 times greater than with 150 mg once daily. Skin pS6 expression was suppressed at ≥200 mg. There were 3/1/0 partial responses (once daily/MWF/MTuW) and 5/7/5 patients had stable disease lasting ≥3 months (all <i>PIK3CA</i> mutated).<b>Conclusions:</b> Intermittent dosing of TAK-117 had an acceptable safety profile and enabled higher doses and total weekly exposures versus once-daily dosing. Although the potential for TAK-117 as single-agent therapy appears limited, further evaluation in combination approaches for advanced solid tumors is warranted. <i>Clin Cancer Res; 23(17); 5015-23. ©2017 AACR</i>.
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Protein Kinase Inhibitors
Dose-Response Relationship, Drug
Aged, 80 and over
Class I Phosphatidylinositol 3-Kinases
Prostate Cancer Targeted Therapy Group
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Clinical cancer research : an official journal of the American Association for Cancer Research, 2017, 23 (17), pp. 5015 - 5023