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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Clin+Lymphoma+Myeloma+Leuk
2014 ; 14
(3
): 223-30
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A phase I and pharmacodynamic study of AT9283, a small-molecule inhibitor of
aurora kinases in patients with relapsed/refractory leukemia or myelofibrosis
#MMPMID24355079
Foran J
; Ravandi F
; Wierda W
; Garcia-Manero G
; Verstovsek S
; Kadia T
; Burger J
; Yule M
; Langford G
; Lyons J
; Ayrton J
; Lock V
; Borthakur G
; Cortes J
; Kantarjian H
Clin Lymphoma Myeloma Leuk
2014[Jun]; 14
(3
): 223-30
PMID24355079
show ga
BACKGROUND: This study sought to identify the maximum tolerated dose (MTD) of
AT9283, an inhibitor of Aurora kinases A and B, in patients with relapsed or
refractory leukemias. Other endpoints included pharmacokinetics, safety and
tolerability, pharmacodynamics, and preliminary evidence of efficacy. PATIENTS
AND METHODS: AT9283 was administered as a continuous 72-hour infusion every 21
days. Doses were escalated by a standard 3 + 3 design. After the MTD for the
72-hour infusion was identified, infusion duration was increased incrementally to
96 hours and 120 hours. In total, 48 patients received ? 1 cycle of AT9283.
Median age was 61 years (range, 22-86 years); 56% were men; 75% were diagnosed
with AML; and 89% had received ? 3 (up to 16) prior lines of therapy. RESULTS:
324 mg/m(2)/72 h AT9283 was determined to be the MTD. Dose-limiting toxicities
(DLTs) were myocardial infarction, hypertension, cardiomyopathy, tumor lysis
syndrome, pneumonia, and multiorgan failure. Other AT9283-related toxicities
(non-DLT) included myelosuppression, predominantly leukopenia and mucositis. Bone
marrow blasts decreased ? 38% after AT9283 treatment in approximately one-third
of patients with relapsed/refractory AML; however, this effect was transient and
no objective responses were achieved, despite evidence of Aurora kinase B
inhibition. Two patients with accelerated-phase chronic myeloid leukemia showed
evidence of benefit, manifested as a cytogenetic response in 1 case; 1 patient
completed 6 cycles of treatment. Exposure to AT9283 was generally dose
proportional. CONCLUSION: AT9283 tolerability was strongly dose-dependent, with
reversible myelosuppression predominating at lower doses and events such as
cardiovascular toxicities manifesting at higher doses. Clinical trials with
AT9283 are ongoing in alternative patient populations.
|Adult
[MESH]
|Aged
[MESH]
|Aged, 80 and over
[MESH]
|Antineoplastic Agents/pharmacology/*therapeutic use
[MESH]