Safety, dose tolerance, pharmacokinetics, and pharmacodynamics of fosciclopirox (CPX-POM) in patients with advanced solid tumors.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 518-518
Author(s):  
Manish R. Patel ◽  
Susanna Varkey Ulahannan ◽  
Scott James Weir ◽  
Robyn Wood ◽  
Tammy Ham ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Day Treatment ◽  
Invasive Bladder Cancer ◽  
Open Label ◽  
Muscle Invasive Bladder Cancer ◽  
Dose Escalation Study ◽  
Lower Stage ◽  
Muscle Invasive ◽  
Dose Tolerance

518 Background: Fosciclopirox (CPX-POM) is being developed for the treatment of non-muscle invasive and muscle invasive bladder cancer. CPX-POM selectively delivers its active metabolite, ciclopirox (CPX), to the entire urinary tract following systemic administration. In a chemical carcinogen mouse model of bladder cancer, CPX-POM treatment resulted in significant decreases in bladder weight, migration to lower stage tumors, inhibition of cell proliferation as well as Notch 1 and Wnt signaling pathways. Methods: Study CPX-POM-001 (NCT03348514) is US multi-site, Phase I, open-label, dose escalation study characterizing the safety, dose tolerance, pharmacokinetics (PK) and pharmacodynamics of IV CPX-POM in advanced solid tumor patients. The PK of CPX-POM, CPX and ciclopirox glucuronide (CPX-G), were characterized in plasma and urine. Circulating biomarkers of Wnt and Notch, IL-6, IL-8 and VEGF were determined. Results: Nineteen patients were enrolled in the study. The starting dose of 30 mg/m2 was administered once daily on Days 1-5 of each 21-day treatment cycle. Doses were escalated to 1200 mg/m2. The MTD was determined to be 900 mg/m2. Overall, the number of treatment-related AE's tended to increase in frequency with dose, nausea and vomiting being the most common. Grade 3 confusion was observed in the 1200 mg/m2 cohort. Four AE's of Grade 1 confusion at 600 and 900 mg/m2. There was no evidence of QTc prolongation or other ECG abnormality. One patient in the 240 mg/m2 dose cohort, with a diagnosis of indolent primary fallopian tube tumor, achieved a partial response per RECIST 1.1. Metabolism of CPX-POM was rapid and complete. The clearance of CPX was dose proportional and time-independent. At MTD, steady-state 24-hour urine CPX concentrations of 215 µM were achieved. Evidence of Notch and Wnt inhibition was observed. Conclusions: IV CPX-POM was well tolerated with treatment-related AEs primarily CNS-related. At MTD, systemic and urinary CPX exposures exceeding in vitro IC50 values by several-fold. The 900 mg/m2 dose is currently being evaluated in an expansion cohort study in cisplatin-ineligible muscle invasive bladder cancer patients scheduled for cystectomy. Clinical trial information: NCT03348514.

Evans blue as a selective dye marker for white-light diagnosis of non-muscle-invasive bladder cancer: an in vitro study

2011 ◽  
Vol 109 (2) ◽  
pp. 300-305 ◽  
Author(s):  
Mieke Roelants ◽  
Ann Huygens ◽  
Ivo Crnolatac ◽  
Ben Van Cleynenbreugel ◽  
Evelyne Lerut ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
White Light ◽  
Evans Blue ◽  
In Vitro Study ◽  
Vitro Study ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
Muscle Invasive

Pembrolizumab and chemoradiotherapy for muscle invasive bladder cancer: The ANZUP 1502 PCR-MIB trial.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. TPS531-TPS531 ◽  
Author(s):  
Andrew James Weickhardt ◽  
Farshad Foroudi ◽  
Shomik Sengupta ◽  
Laura Galletta ◽  
Alan Herschtal ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Molecular Genetic ◽  
Response To Therapy ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
Bladder Preservation ◽  
Immunological Parameters ◽  
Muscle Invasive

TPS531 Background: Pembrolizumab leads to responses in ~20% of metastatic bladder cancer patients. Irradiation of bladder cancer cells in-vitro and in-vivo leads to upregulation of PD-L1, and in immunocompetent mouse models blockade of PD-L1 leads to delayed tumour growth following irradiation. Randomised data from PACIFIC trial in NSCLC shows the addition of PD-L1 inhibition to chemoradiation significantly prolongs PFS. A trial of chemoradiotherapy with pembrolizumab will assess safety and synergy of the combination in localised bladder cancer. Methods: This pilot study enrols patients with maximally resected non-metastatic muscle invasive bladder cancer, who either wish for bladder preservation or are ineligible for cystectomy. This study will assess the safety and feasibility of combining pembrolizumab with chemoradiotherapy in ECOG 0-1 patients without contraindications to pembrolizumab. The study has enrolled 4 of a planned 30 patients. All patients treated with 64Gy of radiation therapy in 32 fractions over 6 weeks, 2 days. Cisplatin 35mg/m2 IV concurrently weekly for 6 doses with radiation. Pembrolizumab commences concurrently with radiation and is given 200mg IV q21 days for 7 doses. Surveillance cystoscopy is performed 12 & 24 weeks after the commencement of chemoradiotherapy to assess response to therapy. Patients will enter follow up with clinical assessment, cystoscopy and CT staging performed at intervals until close of study. The primary endpoint assessed will be safety, as defined by a satisfactorily low rate of unacceptable toxicity (G3-4 adverse events or failure of completion of planned chemotherapy and radiotherapy according to defined parameters). The secondary endpoint will be efficacy, as assessed by the proportion of patients achieving a best response of complete response based on the first two 12 and 24 week post chemoradiotherapy cystoscopic assessments. Exploratory analysis will include assessment of tumour histopathological, molecular, genetic and immunological parameters. It is expected that it will take two years to accrue the 30 patients across 5 Australian centres. NCT02662062. Clinical trial information: NCT02662062.

A phase I trial of intravesical antisense oligonucleotide targeting heat shock protein 27 (OGX-427) for the treatment of non-muscle-invasive bladder cancer.

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 286-286 ◽  
Author(s):  
Alan I. So ◽  
Peter C. Black ◽  
Kim N. Chi ◽  
Antonio Hurtado-Col ◽  
Martin E. Gleave
Keyword(s):  
Bladder Cancer ◽  
Heat Shock ◽  
Heat Shock Protein ◽  
Phase I ◽  
Antisense Oligonucleotide ◽  
Heat Shock Protein 27 ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
Muscle Invasive

286 Background: The treatment options to prevent recurrence and progression in patients with non-muscle invasive bladder cancer (NMIBC) are limited. Heat Shock Protein 27 (Hsp27) is a cytoprotective protein that has been shown to be important in a variety of malignancies, including bladder cancer (BCa), where it has been linked to therapeutic resistance and disease progression. OGX-427 is a 2nd generation (2’-MOE) antisense oligonucleotide that potently inhibits Hsp27 expression in vitro and in vivo. Methods: We initiated a phase I clinical study to assess the safety, pharmacokinetic (pk), pharmacodynamic (pd) and biologic effects of intravesical treatments of OGX-427 using a presurgical dose-escalating design for patients with BCa. Eligible patients include patients with Ta, T1 or carcinoma-in-situ and candidates for transurethral resection of the bladder tumor (TURBT), or patients with muscle invasive BCa (>cT2) and candidates for radical cystectomy (RC). Patients are treated with intravesical OGX-427 on days 1,3,5, and 8 and then undergo surgery on day 9-12. Dose is escalated after tolerability and safety assessment for each cohort at 20uM, 50 uM, 100uM, 250uM, 500uM, and 750uM. Results: To date, we have enrolled 13 patients in the trial and have completed the 250uM cohort. 12 patients had NMIBC and one had cT2 disease and underwent a cystectomy. No significant drug-related adverse events have been reported; no dose limiting toxicity was observed and only one patient developed gross hematuria (grade 1) within 24 hours of administration of drug that spontaneously resolved. Pathological staging of surgical specimens revealed that five patients (38%) had complete responses (p0). The remaining NMIBC patients had pTa tumors that ranged from G1-G2; the sole patient undergoing cystectomy had pT2aG3 bladder cancer. Accrual of the two remaining cohorts will be complete shortly and the pd and pk analysis will be performed once all specimens are available. Conclusions: OGX-427 is well tolerated intravesically with minimal toxicity. Our results indicate early evidence of activity of OGX-427 against bladder cancer that requires confirmation in phase II/III studies.

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