Clinical Research Papers:
Phase I dose-escalation study of the c-Met tyrosine kinase inhibitor SAR125844 in Asian patients with advanced solid tumors, including patients with MET-amplified gastric cancer
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Kohei Shitara1, Tae Min Kim2, Tomoya Yokota3, Masahiro Goto4, Taroh Satoh5, Jin-Hee Ahn6, Hyo Song Kim7, Sylvie Assadourian8, Corinne Gomez9, Marzia Harnois8, Satoshi Hamauchi3, Toshihiro Kudo5, Toshihido Doi1 and Yung-Jue Bang2
1Department of Experimental Therapeutics and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
2Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
3Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka, Japan
4Cancer Chemotherapy Center, Osaka Medical College Hospital, Osaka, Japan
5Department of Frontier Science for Cancer and Chemotherapy, Osaka University Graduate School of Medicine, Osaka, Japan
6Department of Oncology, Asan Medical Center, Seoul, Korea
7Division of Medical Oncology, Yonsei University College of Medicine, Seoul, Korea
8Research and Development, Sanofi, Paris, France
9Pharmacokinetics and Distribution, Sanofi, Paris, France
Yung-Jue Bang, email: [email protected]
Keywords: gastric cancer, MET amplification, Asian population, phase I trial
Received: January 17, 2017 Accepted: June 04, 2017 Published: June 16, 2017
SAR125844 is a potent and selective inhibitor of the c-Met kinase receptor. This was an open-label, phase I, multicenter, dose-escalation, and dose-expansion trial of SAR125844 in Asian patients with solid tumors, a subgroup of whom had gastric cancer and MET amplification (NCT01657214). SAR125844 was administered by intravenous infusion (260–570 mg/m2) on days 1, 8, 15, and 22 of each 28-day cycle. Objectives were to determine the maximum tolerated dose (MTD) and to evaluate SAR125844 safety and pharmacokinetic profile. Antitumor activity was also assessed. Of 38 patients enrolled (median age 64.0 years), 22 had gastric cancer, including 14 with MET amplification. In the dose-escalation cohort (N = 19; unselected population, including three patients with MET-amplification [two with gastric cancer and one with lung cancer]), the MTD was not reached, and the recommended dose was established at 570 mg/m2. Most frequent treatment-emergent adverse events (AEs) were nausea (36.8%), vomiting (34.2%), decreased appetite (28.9%), and fatigue or asthenia, constipation, and abdominal pains (each 21.1%); none appeared to be dose-dependent. Grade ≥ 3 AEs were observed in 39.5% of patients and considered drug-related in 7.9%. SAR125844 exposure increased slightly more than expected by dose proportionality; dose had no significant effect on clearance. No objective responses were observed in the dose-escalation cohort, with seven patients (three gastric cancer, two colorectal cancer, one breast cancer, and one with cancer of unknown primary origin) having stable disease. Modest antitumor activity was observed at 570 mg/m2 in the dose-expansion cohort, comprising patients with MET-amplified tumors (N = 19). Two gastric cancer patients had partial responses, seven patients had stable disease (six gastric cancer and one kidney cancer), and 10 patients had progressive disease. Single-agent SAR125844 administered up to 570 mg/m2 has acceptable tolerability and modest antitumor activity in patients with MET-amplified gastric cancer.
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