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10.1007/s10637-014-0192-4

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C4387272!4387272!25529192
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suck abstract from ncbi


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pmid25529192      Invest+New+Drugs 2015 ; 33 (2): 357-70
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  • Pharmacokinetic, pharmacodynamic and biomarker evaluation of transforming growth factor-? receptor I kinase inhibitor, galunisertib, in phase 1 study in patients with advanced cancer #MMPMID25529192
  • Rodón J; Carducci M; Sepulveda-Sánchez JM; Azaro A; Calvo E; Seoane J; Braña I; Sicart E; Gueorguieva I; Cleverly A; Pillay NS; Desaiah D; Estrem ST; Paz-Ares L; Holdhoff M; Blakeley J; Lahn MM; Baselga J
  • Invest New Drugs 2015[]; 33 (2): 357-70 PMID25529192show ga
  • Purpose Transforming growth factor-beta (TGF-?) signaling plays a key role in epithelial-mesenchymal transition (EMT) of tumors, including malignant glioma. Small molecule inhibitors (SMI) blocking TGF-? signaling reverse EMT and arrest tumor progression. Several SMIs were developed, but currently only LY2157299 monohydrate (galunisertib) was advanced to clinical investigation. Design The first-in-human dose study had three parts (Part A, dose escalation, n?=?39; Part B, safety combination with lomustine, n?=?26; Part C, relative bioavailability study, n?=?14). Results A preclinical pharmacokinetic/pharmacodynamic (PK/PD) model predicted a therapeutic window up to 300 mg/day and was confirmed in Part A after continuous PK/PD. PK was not affected by co-medications such as enzyme-inducing anti-epileptic drugs or proton pump inhibitors. Changes in pSMAD2 levels in peripheral blood mononuclear cells were associated with exposure indicating target-related pharmacological activity of galunisertib. Twelve (12/79; 15 %) patients with refractory/relapsed malignant glioma had durable stable disease (SD) for 6 or more cycles, partial responses (PR), or complete responses (CR). These patients with clinical benefit had high plasma baseline levels of MDC/CCL22 and low protein expression of pSMAD2 in their tumors. Of the 5 patients with IDH1/2 mutation, 4 patients had a clinical benefit as defined by CR/PR and SD ?6 cycles. Galunisertib had a favorable toxicity profile and no cardiac adverse events. Conclusion Based on the PK, PD, and biomarker evaluations, the intermittent administration of galunisertib at 300 mg/day is safe for future clinical investigation.
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