Clinical pharmacokinetics (PK) and translational PK-pharmacodynamic (PD) modeling and simulation to predict antitumor response of various dosing schedules to guide the selection of a recommended phase II dose (RP2D) and schedule for the investigational agent MLN0128.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 2567-2567 ◽  
Author(s):  
Chirag G. Patel ◽  
Mayank Patel ◽  
Arijit Chakravarty ◽  
Esha A. Gangolli ◽  
Elly Barry ◽  
...  

2567 Background: MLN0128 (INK128) is an investigational oral, potent, and highly selective inhibitor of mammalian target of rapamycin complex 1 and 2 (mTORC1/2) currently in clinical investigation. In the phase1 study INK128-001, MLN0128 was administered once daily (QD), once weekly (QW), QDx3D/week, and QDx5D/week, with respective MTDs of 6, 40, 16, and 10 mg. To guide selection of dose/schedule for further investigation, PD modulation in skin (pS6, p4EBP1, pNDRG1, pPRAS40) was put into context of clinical PK in INK128-001. A preclinical translational dynamic-PK efficacy model was used to describe the relationship and determine PK drivers of efficacy in tumor xenograft models. This model was implemented using human PK parameters to predict tumor volume-time curves, which was utilized to help determine the optimal MLN0128 dose/schedule. Methods: Phoenix NLME v1.1 was used for compartmental modeling of clinical and preclinical PK data, and modeling the preclinical PK-efficacy relationship of MLN0128. PD activity in skin was measured by immunohistochemistry, reported as H scores. Tumor growth curves were simulated using NONMEM v7.2; predicted tumor growth curves were plotted in S-Plus v8.1. Results: Clinical skin PD data suggests exposure dependent inhibition of pS6, and p4EBP1. A two compartment PK model adequately described the PK characteristics of MLN0128 [mean (%CV) ka: ~5.305 h-1 (114), k12: ~0.490 h-1(85), k21: ~0.67 h-1(69), V/F: ~180 L (44), Tlag: 0.317 h (73)]. Simulation of human tumor volume-time curves suggest efficacy is dependent on schedule and that MLN0128 administered in more frequent schedules (QD, QDx5D) provides stronger antitumor effect vs less frequent schedules (QW, QDx3D). Conclusions: The results indicate that per unit MLN0128 plasma exposure, QD and QDx5D may be optimal in comparison with QDx3D and QW dosing. However, these results will also need to be put into context with the overall safety profile and respective MTDs and RP2Ds for each schedule with their resultant achievable total cycle dose by schedule. Clinical trial information: NCT01058707.

1988 ◽  
Vol 74 (3) ◽  
pp. 269-274 ◽  
Author(s):  
Romano Demicheli ◽  
Roberto Foroni ◽  
Fernando C. Giuliani ◽  
Giuseppina Savi

The influence of tumor growth kinetics on response to doxorubicin treatment of C3H mammary carcinoma was investigated. Gompertzian growth curves were obtained for the tumor mass of each mouse by a computerized best fit program. The response was assessed by evaluating: a) the total clonogenic cell reduction as a fraction of the initial tumor volume or the tumor volume that should result at the end of treatment in a free growth condition, and b) the partial clonogenic cell reduction at each drug administration, assuming a first order cell kill hypothesis. Slowly growing tumors at each dose level showed a significantly poorer response than rapidly growing tumors. Each response index exhibited a linear correlation with the specific instantaneous growth rate at the time of treatment. Data also suggested a dose-response dependence.


Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 3724-3724
Author(s):  
Jill Donelan ◽  
Bret Bannerman ◽  
Kristen Bano ◽  
Trisha Babcock ◽  
Paul Hales ◽  
...  

Abstract Abstract 3724 Poster Board III-660 Lymphomas account for about 5% of all cases of cancer in the US. In 2009, it is estimated that 74490 Americans will be diagnosed with lymphoma, which includes approximately 8510 new cases of Hodgkin's lymphoma and 65980 new cases of non-Hodgkin's lymphoma (NHL). An estimated 20790 men and women will die from lymphoma in 2009, the majority (93.8%) of which from NHL. Standard treatment includes chemotherapy and radiation to destroy the malignant lymphoma cells; however, newer therapies are currently being explored. Bortezomib is approved for multiple myeloma and relapsed mantle cell lymphoma, and is under clinical investigation in other types of NHL and other B-cell malignancies. Similar to bortezomib, MLN9708 is a modified dipeptidyl boronic acid that is a potent, reversible and specific inhibitor of the proteasome. MLN9708 preferentially binds to and inhibits b5 enzymatic activity of the 20S catalytic core. It is currently in Phase I trials for the treatment of solid and hematologic malignancies. MLN9708 immediately hydrolyzes to MLN2238, the biologically active form, on exposure to aqueous solutions or plasma. MLN2238 was used for all preclinical studies described below. We evaluated the ability of MLN2238 to inhibit tumor growth in two preclinical models of diffuse large B-cell lymphoma (DLBCL), an aggressive lymphoma that accounts for ∼40% of lymphomas in adults. OCI-LY10 and PHTX-22L are two examples of ABC-subtype of DLBCL. The antitumor activity of MLN2238 was evaluated in CB-17 Scid female mice bearing OCI-LY10 lymphoma xenografts. Tumor inhibition was determined by calculating the treatment over control (T/C) ratio of the mean tumor volume and the percentage of tumor growth inhibition (TGI) on the last day of the study. MLN2238 administered intravenous (IV) at 18 mg/kg once weekly (QW) resulted in tumor regression in 6 of 7 animals (T/C = 0.12; TGI = 88%) and a partial response in the remaining animal (43% reduction in tumor volume). MLN2238 administered at 8 mg/kg or 4 mg/kg IV QW resulted in a T/C of 0.42 and 0.36. Proteasome activity in the tumor was inhibited 49 and 44% 1 hour after a single IV dose of MLN2238 at 14 or 7 mg/kg, respectively. The other tumor model, PHTX-22L, is a primary tumor xenograft that was derived from a tumor surgically removed from the right lymph node of a 71-year-old Caucasian male. SCID NOD female mice implanted with PHTX-22L tumor fragments were treated twice weekly (BIW) with IV doses of vehicle, MLN2238 at 4 mg/kg SC once daily (QD), MLN2238 at 14 mg/kg IV BIW or bortezomib at 0.8 mg/kg IV BIW. The strongest antitumor activity was seen in PHTX-22L tumor bearing mice treated with IV MLN2238 14 mg/kg BIW (T/C = 0.14; TGI = 86%, p < 0.001) or SC MLN2238 4 mg/kg QD (T/C = 0.15; TGI = 85%, p < 0.01). These dosing regimens significantly inhibited tumor growth compared with vehicle treatment. In the same study, bortezomib treatment IV at 0.8 mg/kg on a BIW schedule had no antitumor effect (T/C = 0.88; TGI = 12%, p = 0.86) and was not statistically different from the vehicle treated group. Proteasome activity was significantly inhibited in both blood and tumor following a single dose of MLN2238 administered IV at 14 mg/kg or SC at 4 mg/kg. Proteasome activity was inhibited greater than 50% for up to 8 hrs following the IV dose in both blood and tumor, whereas proteasome activity recovered more quickly following the SC dose. In a separate preclinical study, the antitumor activity of MLN2238 administered at lower doses and on alternate schedules was examined. SCID NOD mice bearing PHTX-22L xenografts were administered MLN2238 IV at 11 mg/kg BIW, 7 mg/kg BIW, 11 mg/kg QW or 5 mg/kg QDx2/week resulted in significant antitumor activity (T/C = 0.04, 0.08, 0.15, 0.16; TGI = 96, 92, 85, 84%, respectively). More importantly, drug treatment caused tumor regression (tumor volume at the end of the study was less than 50% of the starting tumor volume) in 8 of 10 mice in the 11 mg/kg BIW, 5/10 in the 7 mg/kg BIW, 2/8 in the 11 mg/kg QW and 1/10 in the 5 mg/kg QDx2/week treatment groups. The efficacy of MLN2238 dosed IV either at 7 mg/kg QW or 3.5 mg/kg BIW in this model was less efficacious (T/C = 0.61 and 0.64). In addition to PHTX-22L, we have access to several other primary lymphoma tumor xenograft models that we plan to evaluate for sensitivity to MLN2238 treatment. These studies demonstrate that MLN2238 is active in preclinical models of lymphoma, and that MLN2238 has antitumor activity in a model of lymphoma that is refractory to bortezomib treatment. Disclosures: Donelan: Milllennium: Employment. Bannerman:Milllennium: Employment. Bano:Milllennium: Employment. Babcock:Milllennium: Employment. Hales:Millennium Pharmaceuticals: Employment. Stringer:Milllennium: Employment. Burke:Milllennium: Employment. Danaee:Milllennium: Employment, Equity Ownership. Faron-Yowe:Milllennium: Employment. Koenig:Milllennium: Employment. Lichter:Milllennium: Employment. Kupperman:Milllennium: Employment.


2021 ◽  
Author(s):  
Narmin Ghaffari Laleh ◽  
Chiara Maria Lavinia Loeffler ◽  
Julia Grajek ◽  
Katerina Stankova ◽  
Alexander T. Pearson ◽  
...  

Classical mathematical models of tumor growth have shaped our understanding of cancer and have broad practical implications for treatment scheduling and dosage. However, even the simplest text-book models have been barely validated in real world-data of human patients. In this study, we fitted a range of differential equation models to tumor volume measurements of patients undergoing chemo-therapy or cancer immunotherapy for solid tumors. We used a large dataset of 1472 patients with three or more measurements per target lesion, of which 652 patients had six or more data points. We show that the early treatment response shows only moderate correlation with the final treatment re-sponse, demonstrating the need for nuanced models. We then perform a head-to-head comparison of six classical models which are widely used in the field: the Exponential, Logistic, Classic Bertalanffy, General Bertalanffy, Classic Gompertz and General Gompertz model. Several models provide a good fit to tumor volume measurements, with the Gompertz model providing the best balance between goodness of fit and number of parameters. Similarly, when fitting to early treatment data, the general Bertalanffy and Gompertz models yield the lowest mean absolute error to forecasted data, indicating that these models could potentially be effective at predicting treatment outcome. In summary, we pro-vide a quantitative benchmark for classical textbook models and state-of-the art models of human tumor growth. We publicly release an anonymized version of our original data, providing the first benchmark set of human tumor growth data for evaluation of mathematical models.


2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 12031-12031
Author(s):  
B. Laquente ◽  
C. Lacasa ◽  
M. Morell ◽  
O. Casanovas ◽  
A. Figueras ◽  
...  

12031 Background: Human tumor xenografts in mice can be remarkably predictive of response in humans to cytotoxic chemotherapeutic drugs. Tumor endothelial cells are sensitive to the action of conventional cytotoxic drugs when they are regularly administrated at low doses. This concept, known as metronomic chemotherapy, has been demonstrated in preclinical studies using transplanted tumor models. We aim to investigate the potential anti-tumoral activity of Gemcitabine (G) when administered in a low-dose schedule in an ortothopic implantation model of human pancreatic carcinomas. Methods: Standard gemcitabine schedule: NP18 tumor orthotopically implanted nude mices were randomly distributed to experimental (n = 13, G100 mg/kg intraperitoneally on days 0, 3, 6 and 9 post-implantation) and control group (n = 13, saline). Animal were sacrificed after 4 weeks and we compared weigths (grams) and volume (cm3) of tumors betwen the two groups by the Mann-Whitney U test. Metronomic schedule: After a toxicological study an optimal metronomic dose of 1 mg G /kg per day was chosen. Thirty xenografted mices were randomly distributed to experimental group (n = 15, intraperitoneal G1 mg/kg) and control group (n = 15, saline) and treated for 30 days. Animal were analysed as described before. Results: Standard schedule: Tumor weight mean of treatment group was 0.01 grams ± 0.01 versus 0.54 grams ± 0.48 of the control group. Tumor volume mean in G group was 0.01 cm 3 ± 0.01 versus 0.51 cm 3 ± 0.67) in the control group.Treatment significantly inhibited NP18 tumour growth (p < 0.001). No differences in mice weight were observed between both groups. Metronomic schedule: Tumor weight mean in the treatment group was 0.04 grams ± 0.08 versus 0.53 grams ± 0.46 in control group. Tumor volume mean in G group was 011 cm 3 ± 0.19 versus 0.37 cm 3. Treatment with low-dose of G significantly inhibited NP18 tumour growth (p < 0.003). There were no differences in mice weight between the two groups. Conclusions: Our data show that G administered in a metronomic schedule is effective in inhibiting the growth of NP18 tumor orthotopically implanted in the nude mice. We now aim to study the angiogenic profile of tumors receiving the standard and metronomic schedule and to set up a new experiment to compare survival benefit in the animal model. No significant financial relationships to disclose.


Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 843-843
Author(s):  
Eric SancheZ ◽  
Richard A Campbell ◽  
Jeffrey A Steinberg ◽  
Mingjie Li ◽  
Haiming Chen ◽  
...  

Abstract Proteasome inhibitors (PI) have been shown to be effective agents for the treatment of multiple myeloma (MM) and enhance the anti-tumor effects of a variety of chemotherapeutic drugs including melphalan and doxorubicin as well as arsenic trioxide (ATO). The novel proteasome inhibitor CEP-18770 has recently been shown to induce cytotoxic effects across a broad panel of human tumor cell lines including MM in vitro. However, little data exists on the in vivo anti-MM effects of this PI either alone or in combination with other active anti-MM drugs. First, we examined the anti-proliferative effects of treating MM cell lines in vitro with CEP-18770 alone and in combination with melphalan, arsenic trioxide (ATO) and doxorubicin. MM cell lines were cultured without fetal bovine serum and incubated in the presence of CEP-18770 alone and in combination with these agents for 48 hours. Cell growth was then measured using an MTS assay. First, RPMI8226 and U266 cells were tested in vitro using a constant concentration of melphalan or doxorubicin in combination with varying concentrations of CEP-18770 or varying concentrations of the chemotherapeutic agent with constant CEP-18770. Although single agent treatment showed marked anti-proliferative effects, combination indexes as calculated by the Chou-Talalay method showed synergistic anti- MM effects of CEP-18770 with either melphalan or doxorubicin in these MM cell lines. In addition, similar experiments were carried out evaluating the combination of ATO plus CEP-18770 in RPMI8226 cells and also showed synergism with this combination. Next, a series of in vivo studies were conducted using our SCID-hu models of MM including LAGλ-1, LAGκ-1A and LAGκ-1B. Mice receiving CEP-18770 at 0.1, 0.3, 1, and 3 mg/kg were injected twice weekly via intravenous injection throughout the study. CEP-18770 dosed at 10 mg/kg was administered via oral gavage twice weekly and mice dosed with melphalan received injections once weekly via intraperitoneal injection. Mice bearing intramuscularly implanted LAGλ-1 were treated with CEP-18770 or vehicle alone. Mice treated with the PI inhibited tumor growth as determined by human immunoglobulin (hIg) G levels and measurement of tumor volume (P = 0.0008) compared to mice receiving vehicle. A significant inhibition of both human paraprotein secretion and reduction of tumor growth was also observed in LAGk-1A-bearing mice treated with CEP-18770 at 1, 3 and 10 mg/kg (hIgG: P = 0.0001, P = 0.0002 and P = 0.0001, respectively; tumor volume: P = 0.0001, P = 0.0001 and P = 0.0001, respectively) and LAGk-1B-bearing mice treated with CEP-18770 at 3 and 10 mg/kg (hIgG: P = 0.0008 and P = 0.0034, respectively; tumor volume: P = 0.0008 and P = 0.0028, respectively) compared to mice receiving vehicle. Finally, the combination of CEP-18770 (1 mg/kg) plus melphalan (3 mg/kg) was tested in LAGk-1B-bearing mice. Mice treated with the combination showed markedly smaller tumors compared to treatment with vehicle (P = 0.0008) or melphalan alone (P = 0.0204). Mice treated with the PI alone or in combination with melphalan did not show any observed toxicity. Thus, these studies provide promising preclinical data to suggest the potent anti-MM effects of CEP-18770 both in vitro and in vivo and also suggest that this new PI may enhance the anti-MM effects of several active anti-MM agents including melphalan, doxorubicin and ATO.


1984 ◽  
Vol 73 (1) ◽  
pp. 157-167 ◽  
Author(s):  
Dorothee Herlyn ◽  
Meenhard Herlyn ◽  
Alonzo H. Ross ◽  
Carolyn Ernst ◽  
Barbara Atkinson ◽  
...  

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 162-162
Author(s):  
Rebecca A. Miksad ◽  
Rohit Goyal ◽  
Jesse Wei ◽  
Raja Shaikh ◽  
Elkan F. Halpern ◽  
...  

162 Background: Understanding hepatocellular cancer (HCC) tumor growth patterns is important for determining optimal treatment strategy. However, growth of untreated HCC tumors is unclear and prior studies are limited by older imaging technologies and small samples. We evaluated HCC growth patterns and predictors in a cohort of patients with serial modern computed tomography (CT) and magnetic resonance imaging (MRI). Methods: Two radiologists retrospectively evaluated CT and MRI imaging for 56 patients with 83 HCC tumors with at least two images. Tumor Volume (TV) = 4/3* π *average short axis (X)*average long axis (Y)*X. To assess the relative change in size, normalized tumor volume (NTV) = TV/ baseline TV. Growth curves were fitted using an exponential growth model for tumor >2 observations. Univariate analysis explored clinical and pathologic predictors of NTV. A multivariate model was built by backward elimination of significant univariate variables. Results: Among 56 patients: 77% male, 96% cirrhotic, 50% Child-Pugh Class (CPC) B, 59% Hepatitis C, 32% obese, 37% diabetic, and 12% used metformin. Mean baseline and end TV were 98.8 cm3 and 213.0 cm3, respectively. Mean follow-up=8.3 months and mean number of serial images=3. Exponential TV growth was observed on visual inspection. Diabetes predicted lower NTV (i.e. slower TV growth) in univariate and multivariate analysis (Table). Obesity decreased the impact of diabetes. Conclusions: Diabetic patients had slower growing tumors than non-diabetics, even when clinical and pathologic factors were controlled. Tumor growth fit an exponential pattern. Further study of the impact of metabolic conditions on HCC tumor growth may provide insights into growth factors and identify potential treatment targets. [Table: see text]


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