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weimeiandy鐵蟲 (正式寫手)
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求助給位專家翻譯一下如下臨床醫(yī)學(xué)專業(yè)英語 已有1人參與
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Context The study continues to evaluate safety, PK, activity and pharmacodynamics of GDC-0919 at a continuous dosing schedule (BID 28/28) to enable greater flexibility in future dosing regimens. GDC-0919 also is being evaluated in a Phase Ib study in combination with atezolizumab (PD-L1 inhibitor) in patients with recurrent or advanced solid tumors. Design Per the abstract, this open-label, single center, Phase Ia study with a 3+3 design assesses safety, pharmacokinetics (PK), pharmacodynamics (PD), and preliminary anti-tumor activity of GDC-0919 in patients (pts) with recurrent/advanced solid tumors. GDC-0919 is administered at doses 50–800mg BID on a 21 days on/7 days off schedule, for up to 12 months. PK parameters and PD markers (plasma Kyn: Trp ratio) were evaluated after single and multiple doses. Tumor assessments are performed every 2 cycles (RECIST v1.1 and immune related response criteria [irRC]). Results The data showed an acceptable safety profile, disease stabilization and preliminary evidence of peripheral pharmacodynamic modulation. GDC-0919 was well tolerated up to 800 mg BID (twice daily) on a 21/28 day cycle. Thirty seven percent of patients available for tumor assessments (7/17) achieved stable disease. The MTD was not reached. Single and multiple dose exposure from 50 to 800 mg of GDC-0919 increased in approximately dose-proportional manner, and higher doses of GDC-0919 modulated plasma Kynurenine in a manner consistent with the half-life of GDC-0919. Per the abstract, as of March 26, 2015, 19 pts were treated and 3 remained active (16 pts discontinued treatment due to progressive disease). Pts received a median of 3 cycles (range 1–11) of GDC-0919 and remained 77 days on treatment (range 13–289 days). Preliminary PK results up to 600mg BID suggest that GDC-0919 is rapidly absorbed and demonstrates dose proportional increases in exposure, with a half-life supportive of BID dosing. Best RECIST responses among 16 pts with on-treatment tumor assessments were 7 (44%) stable disease (SD, lasting ≥4 cycles in 4 pts) and 9 (56%) progressive disease. irRC and PD marker data are pending. Most Common Adverse Events The most common adverse events related to GDC-0919 were lower grade and included pruritus or itching (37%), fatigue, (26%) and decreased appetite (21%). Per the abstract, one DLT of Grade 4 lower gastrointestinal hemorrhage was reported at 800mg in 69 yo male w/mRCC with extensive GI serosal metastasis (the only Grade ≥3 AE assessed as related to GDC-0919). Adverse events (AEs) regardless of causality and reported in ≥4 pts were fatigue (9 pts, 47%), cough, decreased appetite, and nausea (8 pts, 42% each), pruritis (7 pts, 37%), vomiting (6 pts, 32%), increased AST (5 pts, 26%), and hypokalemia and dyspnea (4 pts, 21% each). Grade ≥3 AEs regardless of causality occurred in 11 pts (58%), and those in ≥2 pts were neoplasm progression (3 pts, 16%) and increased AST (2 pts, 10.5%). Grade 3 AST elevations coincided with progression of liver metastases (2 pts, 10%) and were reported as unrelated; a 3rd pt with Grade 2 AST/ALT elevations at Cycle 2 Day 1 was assessed as related to GDC-0919. No AEs led to treatment discontinuation. Conclusion Per the abstract, GDC-0919 has been well tolerated up to 800mg BID on 21 days on/7 days off. PK was linear and dose-proportional. Prolonged SD was reported in 4 patients. Updated results will be presented. |
鐵蟲 (正式寫手)
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【項目背景與意義】 本研究將繼續(xù)評價GDC-0919的安全性、藥代動力學(xué)、在連續(xù)給藥時間表活性和藥效學(xué)的(每日兩次28 / 28),加大未來給藥方案服藥劑量的靈活性。同時,也評價GDC-0919在臨床Ib期聯(lián)合atezolizumab(PD-L1抑制劑)治療復(fù)發(fā)性或晚期實體腫瘤進行研究。 【試驗設(shè)計】 據(jù)摘要,臨床Ia期研究實驗采用非盲、單中心、3 + 3設(shè)計,評價GDC-0919藥物安全性、藥代動力學(xué)(PK)、藥效學(xué)(PD)和該藥治療復(fù)發(fā)性或晚期實體腫瘤患者初步的抗腫瘤活性(PTS)。GDC-0919劑量在50–800mg(每日兩次)連續(xù)服藥21天/停7天日程管理,連續(xù)服藥治療12個月以上。單劑量給藥組和多劑量給藥組的藥代動力學(xué)和藥效學(xué)參數(shù)指標(血漿犬尿氨酸:色氨酸比值)進行評價。 每2個周期對腫瘤療效進行評價,評價標準參照《實體瘤療效評價標準(RECIST) 1.1版和免疫治療相關(guān)療效評價分類體系(irRC)》。 【結(jié)果】 數(shù)據(jù)顯示,GDC-0919是一個可以接受的安全性,病情穩(wěn)定和初步證據(jù)的外周藥效調(diào)制。GDC-0919耐受性良好,高達800mg(兩次/日)在21天服藥,28天為一療程。37%的患者(7 / 17)達到了病情穩(wěn)定。最大耐受劑量(MTD)沒有達到。單劑量組和多劑量組暴露劑量從50-800mg按劑量比例方式增加GCD-0919進行控制,調(diào)節(jié)高劑量組GCD-0919劑量后血漿的犬尿氨酸與GCD-0919半衰期一致。 據(jù)摘要,截至2015年3月26日,19例參與治療和3例保持活躍(16例停止治療,由于疾病進展)。患者接受了3周期的中位數(shù)(范圍1–11)的GDC-0919并維持77天的治療(范圍13–289天)。初始的PK結(jié)果顯示到GDC-0919600mg(兩次/日)迅速吸收,表明在暴露劑量比例增加條件下,半衰期支持每日兩次劑量。最好的實體瘤療效評價標準(RECIST) 響應(yīng)間的16例參與治療腫瘤的評估,7例(44%)病情穩(wěn)定(SD,持續(xù)穩(wěn)定的≥4周期4例)和9例(56%)疾病進展。IRRC和PD標記數(shù)據(jù)待定。 【常見的不良反應(yīng) 】 據(jù)摘要,與GCD-0919治療相關(guān)最常見的較低等級的不良反應(yīng)包括瘙癢(37%)、疲勞(26%)、食欲下降(21%)。劑量限制性毒性(DLT)4級不良反應(yīng)以下,有一例69歲男性患者W /m腎癌且廣泛的胃腸漿膜轉(zhuǎn)移時消化道出血的報道(只有一例≥3級不良反應(yīng)評估與GCD-0919治療相關(guān))。不良事件(AE)無論與本藥治療是否關(guān)聯(lián)的報道≥4例,疲勞(9例,47%),咳嗽、食欲下降、惡心(共8例,42%),皮膚瘙癢(7例,37%),嘔吐(6例,32%),谷草轉(zhuǎn)氨酶上升(AST)(5例,26%) 低鉀血癥和呼吸困難(4例,21%)!莶涣挤磻(yīng)3級無論與本藥是否關(guān)聯(lián)發(fā)生的11例(58%),及≥2例患者腫瘤惡化(3例,16%)和谷草轉(zhuǎn)氨酶升高(2例,10.5%)。3級的谷草轉(zhuǎn)氨酶升高正好與肝轉(zhuǎn)移的惡化(2例,10%)和報道無關(guān);與2級的AST / ALT(谷草轉(zhuǎn)氨酶 /谷丙轉(zhuǎn)氨酶)升高在2周期1天第三例評估相關(guān)的GCD-0919。沒有因不良反應(yīng)停藥 【討論】 據(jù)摘要,GCD-0919有很好的耐受性高達800mg(兩次/日)服藥21天/ 停7天。藥效學(xué)的線性與劑量成正比。4例患者病情持續(xù)穩(wěn)定。更新數(shù)據(jù)將被陸續(xù)提交。 |
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