TY - JOUR
T1 - Phase I study of procaspase-activating compound-1 (PAC-1) in the treatment of advanced malignancies
AU - Danciu, Oana C.
AU - Holdhoff, Matthias
AU - Peterson, Richard A.
AU - Fischer, James H.
AU - Liu, Li C.
AU - Wang, Heng
AU - Venepalli, Neeta K.
AU - Chowdhery, Rozina
AU - Nicholas, M. Kelly
AU - Russell, Meredith J.
AU - Fan, Timothy M.
AU - Hergenrother, Paul J.
AU - Tarasow, Theodore M.
AU - Dudek, Arkadiusz Z.
N1 - Financial support was provided by Vanquish Oncology. Inc., the University of Illinois Cancer Center, the University of Illinois, the NIH (R01CA120439), and Engdahl Family Foundation.
PJH serves as Chief Scientific Officer and has equity in Vanquish Oncology, Inc. TMT serves as Chief Executive Officer and has equity in Vanquish Oncology, Inc. TMF serves as VP Preclinical Development and has equity in Vanquish Oncology, Inc. AZD reports research funding from Eli Lilly. AZD served as Chief Medical Officer for Vanquish Oncology, Inc. AZD serves as Chief Executive Officer for TTC Oncology, LLC, and Chief Medical Officer for IGF Oncology. All other authors declare no competing interests.
PY - 2023/3/23
Y1 - 2023/3/23
N2 - Background: Procaspase-3 (PC-3) is overexpressed in multiple tumour types and procaspase-activating compound 1 (PAC-1) directly activates PC-3 and induces apoptosis in cancer cells. This report describes the first-in-human, phase I study of PAC-1 assessing maximum tolerated dose, safety, and pharmacokinetics. Methods: Modified-Fibonacci dose-escalation 3 + 3 design was used. PAC-1 was administered orally at 7 dose levels (DL) on days 1–21 of a 28-day cycle. Dose-limiting toxicity (DLT) was assessed during the first two cycles of therapy, and pharmacokinetics analysis was conducted on days 1 and 21 of the first cycle. Neurologic and neurocognitive function (NNCF) tests were performed throughout the study. Results: Forty-eight patients were enrolled with 33 completing ≥2 cycles of therapy and evaluable for DLT. DL 7 (750 mg/day) was established as the recommended phase 2 dose, with grade 1 and 2 neurological adverse events noted, while NNCF testing showed stable neurologic and cognitive evaluations. PAC-1’s t1/2 was 28.5 h after multi-dosing, and systemic drug exposures achieved predicted therapeutic concentrations. PAC-1 clinical activity was observed in patients with neuroendocrine tumour (NET) with 2/5 patients achieving durable partial response. Conclusions: PAC-1 dose at 750 mg/day was recommended for phase 2 studies. Activity of PAC-1 in treatment-refractory NET warrants further investigation. Clinical trial registration: Clinical Trials.gov: NCT02355535.
AB - Background: Procaspase-3 (PC-3) is overexpressed in multiple tumour types and procaspase-activating compound 1 (PAC-1) directly activates PC-3 and induces apoptosis in cancer cells. This report describes the first-in-human, phase I study of PAC-1 assessing maximum tolerated dose, safety, and pharmacokinetics. Methods: Modified-Fibonacci dose-escalation 3 + 3 design was used. PAC-1 was administered orally at 7 dose levels (DL) on days 1–21 of a 28-day cycle. Dose-limiting toxicity (DLT) was assessed during the first two cycles of therapy, and pharmacokinetics analysis was conducted on days 1 and 21 of the first cycle. Neurologic and neurocognitive function (NNCF) tests were performed throughout the study. Results: Forty-eight patients were enrolled with 33 completing ≥2 cycles of therapy and evaluable for DLT. DL 7 (750 mg/day) was established as the recommended phase 2 dose, with grade 1 and 2 neurological adverse events noted, while NNCF testing showed stable neurologic and cognitive evaluations. PAC-1’s t1/2 was 28.5 h after multi-dosing, and systemic drug exposures achieved predicted therapeutic concentrations. PAC-1 clinical activity was observed in patients with neuroendocrine tumour (NET) with 2/5 patients achieving durable partial response. Conclusions: PAC-1 dose at 750 mg/day was recommended for phase 2 studies. Activity of PAC-1 in treatment-refractory NET warrants further investigation. Clinical trial registration: Clinical Trials.gov: NCT02355535.
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U2 - 10.1038/s41416-022-02089-7
DO - 10.1038/s41416-022-02089-7
M3 - Article
C2 - 36470974
AN - SCOPUS:85143291130
SN - 0007-0920
VL - 128
SP - 783
EP - 792
JO - British Journal of Cancer
JF - British Journal of Cancer
IS - 5
ER -