Skip to main content
Top
Published in: Journal of Hematology & Oncology 1/2011

Open Access 01-12-2011 | Research

Two-dose-level confirmatory study of the pharmacokinetics and tolerability of everolimus in Chinese patients with advanced solid tumors

Authors: BingHe Xu, YiLong Wu, Lin Shen, DingWei Ye, Annette Jappe, Azzeddine Cherfi, Hui Wang, RuiRong Yuan

Published in: Journal of Hematology & Oncology | Issue 1/2011

Login to get access

Abstract

Background

This phase I, randomized, multicenter, open-label study investigated the pharmacokinetics, safety, and efficacy of the oral mammalian target of rapamycin inhibitor everolimus in Chinese patients with advanced solid tumors.

Methods

A total of 24 patients with advanced breast cancer (n = 6), gastric cancer (n = 6), non-small cell lung cancer (n = 6), or renal cell carcinoma (n = 6) who were refractory to/unsuitable for standard therapy were randomized 1:1 to oral everolimus 5 or 10 mg/day. Primary end points were pharmacokinetic parameters and safety and tolerability. Pharmacokinetic 24-h profiles were measured on day 15; trough level was measured on days 2, 8, 15, 16, and 22. Tolerability was assessed continuously. This final analysis was performed after all patients had received 6 months of study drug or had discontinued.

Results

Everolimus was absorbed rapidly; median Tmax was 3 h (range, 1-4) and 2 h (range, 0.9-6) in the 5 and 10 mg/day groups, respectively. Pharmacokinetic parameters increased dose proportionally from the 5 and 10 mg/day doses. Steady-state levels were achieved by day 8 or earlier. The most common adverse events suspected to be related to everolimus therapy were increased blood glucose (16.7% and 41.7%) and fatigue (16.7% and 33.3%) in the everolimus 5 and 10 mg/day dose cohorts, respectively. Best tumor response was stable disease in 10 (83%) and 6 (50%) patients in the 5 and 10 mg/day groups, respectively.

Conclusions

Everolimus 5 or 10 mg/day was well tolerated in Chinese patients with advanced solid tumors. The observed safety and pharmacokinetic profile of everolimus from this study were consistent with previous studies.

Trial registration

Chinese Health Authorities 2008L09346
Appendix
Available only for authorised users
Literature
1.
go back to reference Hay N, Sonenberg N: Upstream and downstream of mTOR. Genes Dev. 2004, 18: 1926-1945. 10.1101/gad.1212704.CrossRefPubMed Hay N, Sonenberg N: Upstream and downstream of mTOR. Genes Dev. 2004, 18: 1926-1945. 10.1101/gad.1212704.CrossRefPubMed
2.
go back to reference Wullschleger S, Loewith R, Hall MN: TOR signaling in growth and metabolism. Cell. 2006, 124: 471-484. 10.1016/j.cell.2006.01.016.CrossRefPubMed Wullschleger S, Loewith R, Hall MN: TOR signaling in growth and metabolism. Cell. 2006, 124: 471-484. 10.1016/j.cell.2006.01.016.CrossRefPubMed
3.
go back to reference Patel PH, Chadalavada RS, Chaganti RS, Motzer RJ: Targeting von Hippel-Lindau pathway in renal cell carcinoma. Clin Cancer Res. 2006, 12: 7215-7220. 10.1158/1078-0432.CCR-06-2254.CrossRefPubMed Patel PH, Chadalavada RS, Chaganti RS, Motzer RJ: Targeting von Hippel-Lindau pathway in renal cell carcinoma. Clin Cancer Res. 2006, 12: 7215-7220. 10.1158/1078-0432.CCR-06-2254.CrossRefPubMed
4.
go back to reference Yuan R, Kay A, Berg WJ, Lebwohl D: Targeting tumorigenesis: development and use of mTOR inhibitors in cancer therapy. J Hematol Oncol. 2009, 2: 45-10.1186/1756-8722-2-45.PubMedCentralCrossRefPubMed Yuan R, Kay A, Berg WJ, Lebwohl D: Targeting tumorigenesis: development and use of mTOR inhibitors in cancer therapy. J Hematol Oncol. 2009, 2: 45-10.1186/1756-8722-2-45.PubMedCentralCrossRefPubMed
5.
go back to reference Albanell J, Dalmases A, Rovira A, Rojo F: mTOR signalling in human cancer. Clin Transl Onco. 2007, 9: 484-493. 10.1007/s12094-007-0092-6.CrossRef Albanell J, Dalmases A, Rovira A, Rojo F: mTOR signalling in human cancer. Clin Transl Onco. 2007, 9: 484-493. 10.1007/s12094-007-0092-6.CrossRef
6.
7.
go back to reference Jiang BH, Liu LZ: Role of mTOR in anticancer drug resistance: perspectives for improved drug treatment. Drug Resist Updat. 2008, 11: 63-76. 10.1016/j.drup.2008.03.001.PubMedCentralCrossRefPubMed Jiang BH, Liu LZ: Role of mTOR in anticancer drug resistance: perspectives for improved drug treatment. Drug Resist Updat. 2008, 11: 63-76. 10.1016/j.drup.2008.03.001.PubMedCentralCrossRefPubMed
8.
go back to reference Wang L, Shi WY, Wu ZY, Varna M, Wang AH, Zhou L, Chen L, Shen ZX, Lu H, Zhao WL, Janin A: Cytostatic and anti-angiogenic effects of temsirolimus in refractory mantle cell lymphoma. J Hematol Oncol. 2010, 3: 30-10.1186/1756-8722-3-30.PubMedCentralCrossRefPubMed Wang L, Shi WY, Wu ZY, Varna M, Wang AH, Zhou L, Chen L, Shen ZX, Lu H, Zhao WL, Janin A: Cytostatic and anti-angiogenic effects of temsirolimus in refractory mantle cell lymphoma. J Hematol Oncol. 2010, 3: 30-10.1186/1756-8722-3-30.PubMedCentralCrossRefPubMed
9.
go back to reference O'Donnell A, Faivre S, Burris HA, Rea D, Papadimitrakopoulou V, Shand N, Lane HA, Hazell K, Zoellner U, Kovarik JM, Brock C, Jones S, Raymond E, Judson I: Phase I pharmacokinetic and pharmacodynamic study of the oral mammalian target of rapamycin inhibitor everolimus in patients with advanced solid tumors. J Clin Oncol. 2008, 26: 1588-1595.CrossRefPubMed O'Donnell A, Faivre S, Burris HA, Rea D, Papadimitrakopoulou V, Shand N, Lane HA, Hazell K, Zoellner U, Kovarik JM, Brock C, Jones S, Raymond E, Judson I: Phase I pharmacokinetic and pharmacodynamic study of the oral mammalian target of rapamycin inhibitor everolimus in patients with advanced solid tumors. J Clin Oncol. 2008, 26: 1588-1595.CrossRefPubMed
10.
go back to reference Afinitor (everolimus) tablets for oral administration [prescribing information]. 2009, Stein, Switzerland: Novartis Pharma Stein AG Afinitor (everolimus) tablets for oral administration [prescribing information]. 2009, Stein, Switzerland: Novartis Pharma Stein AG
11.
go back to reference Motzer RJ, Escudier B, Oudard S, Hutson TE, Porta C, Bracarda S, Grünwald V, Thompson JA, Figlin RA, Hollaender N, Kay A, Ravaud A, RECORD-1 Study Group: Phase 3 trial of everolimus for metastatic renal cell carcinoma: final results and analysis of prognostic factors. Cancer. 2010, 116: 4256-4265. 10.1002/cncr.25219.CrossRefPubMed Motzer RJ, Escudier B, Oudard S, Hutson TE, Porta C, Bracarda S, Grünwald V, Thompson JA, Figlin RA, Hollaender N, Kay A, Ravaud A, RECORD-1 Study Group: Phase 3 trial of everolimus for metastatic renal cell carcinoma: final results and analysis of prognostic factors. Cancer. 2010, 116: 4256-4265. 10.1002/cncr.25219.CrossRefPubMed
12.
go back to reference Beuvink I, Boulay A, Fumagalli S, Zilbermann F, Ruetz S, O'Reilly T, Natt F, Hall J, Lane HA, Thomas G: The mTOR inhibitor RAD001 sensitizes tumor cells to DNA-damaged induced apoptosis through inhibition of p21 translation. Cell. 2005, 120: 747-759. 10.1016/j.cell.2004.12.040.CrossRefPubMed Beuvink I, Boulay A, Fumagalli S, Zilbermann F, Ruetz S, O'Reilly T, Natt F, Hall J, Lane HA, Thomas G: The mTOR inhibitor RAD001 sensitizes tumor cells to DNA-damaged induced apoptosis through inhibition of p21 translation. Cell. 2005, 120: 747-759. 10.1016/j.cell.2004.12.040.CrossRefPubMed
13.
go back to reference Beuvink I, O'Reilly T, Zumstein S, Zilbermann F, Sedrani R, Kozma S, Thomas G, Lane HA: Antitumor activity of RAD001, an orally active rapamycin derivative [abstract 1972]. Proc Am Assoc Cancer Res. 2001, 42: 366- Beuvink I, O'Reilly T, Zumstein S, Zilbermann F, Sedrani R, Kozma S, Thomas G, Lane HA: Antitumor activity of RAD001, an orally active rapamycin derivative [abstract 1972]. Proc Am Assoc Cancer Res. 2001, 42: 366-
14.
go back to reference O'Reilly T, Vaxelaire J, Muller M, Fiebig HH, Hattenberger M, Lane HA: In vivo activity of RAD001, an orally active rapamycin derivative, in experimental tumor models [abstract 349]. Proc Am Assoc Cancer Res. 2002, 43: 71- O'Reilly T, Vaxelaire J, Muller M, Fiebig HH, Hattenberger M, Lane HA: In vivo activity of RAD001, an orally active rapamycin derivative, in experimental tumor models [abstract 349]. Proc Am Assoc Cancer Res. 2002, 43: 71-
15.
go back to reference Tabernero J, Rojo F, Calvo E, Burris H, Judson I, Hazell K, Martinelli E, Ramon y Cajal S, Jones S, Vidal L, Shand N, Macarulla T, Ramos FJ, Dimitrijevic S, Zoellner U, Tang P, Stumm M, Lane HA, Lebwohl D, Baselga J: Dose- and schedule-dependent inhibition of the mammalian target of rapamycin pathway with everolimus: a phase I tumor pharmacodynamic study in patients with advanced solid tumors. J Clin Oncol. 2008, 26: 1603-1610. 10.1200/JCO.2007.14.5482.CrossRefPubMed Tabernero J, Rojo F, Calvo E, Burris H, Judson I, Hazell K, Martinelli E, Ramon y Cajal S, Jones S, Vidal L, Shand N, Macarulla T, Ramos FJ, Dimitrijevic S, Zoellner U, Tang P, Stumm M, Lane HA, Lebwohl D, Baselga J: Dose- and schedule-dependent inhibition of the mammalian target of rapamycin pathway with everolimus: a phase I tumor pharmacodynamic study in patients with advanced solid tumors. J Clin Oncol. 2008, 26: 1603-1610. 10.1200/JCO.2007.14.5482.CrossRefPubMed
16.
go back to reference Tanaka C, O'Reilly T, Kovarik JM, Shand N, Hazell K, Judson I, Raymond E, Zumstein-Mecker S, Stephan C, Boulay A, Hattenberger M, Thomas G, Lane HA: Identifying optimal biologic doses of everolimus (RAD001) in patients with cancer based on the modeling of preclinical and clinical pharmacokinetic and pharmacodynamic data. J Clin Oncol. 2008, 26: 1596-1602.PubMed Tanaka C, O'Reilly T, Kovarik JM, Shand N, Hazell K, Judson I, Raymond E, Zumstein-Mecker S, Stephan C, Boulay A, Hattenberger M, Thomas G, Lane HA: Identifying optimal biologic doses of everolimus (RAD001) in patients with cancer based on the modeling of preclinical and clinical pharmacokinetic and pharmacodynamic data. J Clin Oncol. 2008, 26: 1596-1602.PubMed
17.
go back to reference Okamoto I, Doi T, Ohtsu A, Miyazaki M, Tsuya A, Kurei K, Kobayashi K, Nakagawa K: Phase I clinical and pharmacokinetic study of RAD001 (everolimus) administered daily to Japanese patients with advanced solid tumors. Jpn J Clin Oncol. 2010, 40: 17-23. 10.1093/jjco/hyp120.PubMedCentralCrossRefPubMed Okamoto I, Doi T, Ohtsu A, Miyazaki M, Tsuya A, Kurei K, Kobayashi K, Nakagawa K: Phase I clinical and pharmacokinetic study of RAD001 (everolimus) administered daily to Japanese patients with advanced solid tumors. Jpn J Clin Oncol. 2010, 40: 17-23. 10.1093/jjco/hyp120.PubMedCentralCrossRefPubMed
19.
go back to reference Doi T, Muro K, Boku N, Yamada Y, Nishina T, Takiuchi H, Komatsu Y, Hamamoto Y, Ohno N, Fujita Y, Robson M, Ohtsu A: Multicenter phase II study of everolimus in patients with previously treated metastatic gastric cancer. J Clin Oncol. 2010, 28: 1904-1910. 10.1200/JCO.2009.26.2923.CrossRefPubMed Doi T, Muro K, Boku N, Yamada Y, Nishina T, Takiuchi H, Komatsu Y, Hamamoto Y, Ohno N, Fujita Y, Robson M, Ohtsu A: Multicenter phase II study of everolimus in patients with previously treated metastatic gastric cancer. J Clin Oncol. 2010, 28: 1904-1910. 10.1200/JCO.2009.26.2923.CrossRefPubMed
20.
go back to reference Ellard SL, Clemons M, Gelmon KA, Norris B, Kennecke H, Chia S, Pritchard K, Eisen A, Vandenberg T, Taylor M, Sauerbrei E, Mishaeli M, Huntsman D, Walsh W, Olivo M, McIntosh L, Seymour L: Randomized phase II study comparing two schedules of everolimus in patients with recurrent/metastatic breast cancer: NCIC Clinical Trials Group IND.163. J Clin Oncol. 2009, 27: 4536-4541. 10.1200/JCO.2008.21.3033.CrossRefPubMed Ellard SL, Clemons M, Gelmon KA, Norris B, Kennecke H, Chia S, Pritchard K, Eisen A, Vandenberg T, Taylor M, Sauerbrei E, Mishaeli M, Huntsman D, Walsh W, Olivo M, McIntosh L, Seymour L: Randomized phase II study comparing two schedules of everolimus in patients with recurrent/metastatic breast cancer: NCIC Clinical Trials Group IND.163. J Clin Oncol. 2009, 27: 4536-4541. 10.1200/JCO.2008.21.3033.CrossRefPubMed
21.
go back to reference Soria JC, Shepherd FA, Douillard JY, Wolf J, Giaccone G, Crino L, Cappuzzo F, Sharma S, Gross SH, Dimitrijevic S, Di Scala L, Gardner H, Nogova L, Papadimitrakopoulou V: Efficacy of everolimus (RAD001) in patients with advanced NSCLC previously treated with chemotherapy alone or with chemotherapy and EGFR inhibitors. Ann Oncol. 2009, 20: 1674-1681. 10.1093/annonc/mdp060.CrossRefPubMed Soria JC, Shepherd FA, Douillard JY, Wolf J, Giaccone G, Crino L, Cappuzzo F, Sharma S, Gross SH, Dimitrijevic S, Di Scala L, Gardner H, Nogova L, Papadimitrakopoulou V: Efficacy of everolimus (RAD001) in patients with advanced NSCLC previously treated with chemotherapy alone or with chemotherapy and EGFR inhibitors. Ann Oncol. 2009, 20: 1674-1681. 10.1093/annonc/mdp060.CrossRefPubMed
22.
go back to reference Cancer Therapy Evaluation Program: Common Terminology Criteria for Adverse Events, Version 3.0. 2006, National Cancer Institute Cancer Therapy Evaluation Program: Common Terminology Criteria for Adverse Events, Version 3.0. 2006, National Cancer Institute
23.
go back to reference Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, Verweij J, Van Glabbeke M, van Oosterom AT, Christian MC, Gwyther SG: New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst. 2000, 92: 205-216. 10.1093/jnci/92.3.205.CrossRefPubMed Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, Verweij J, Van Glabbeke M, van Oosterom AT, Christian MC, Gwyther SG: New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst. 2000, 92: 205-216. 10.1093/jnci/92.3.205.CrossRefPubMed
24.
go back to reference Mita MM, Mita AC, Chu QS, Rowinsky EK, Fetterly GJ, Goldston M, Patnaik A, Mathews L, Ricart AD, Mays T, Knowles H, Rivera VM, Kreisberg J, Bedrosian CL, Tolcher AW: Phase I trial of the novel mammalian target of rapamycin inhibitor deforolimus (AP23573; MK-8669) administered intravenously daily for 5 days every 2 weeks to patients with advanced malignancies. J Clin Oncol. 2008, 26: 361-367. 10.1200/JCO.2007.12.0345.CrossRefPubMed Mita MM, Mita AC, Chu QS, Rowinsky EK, Fetterly GJ, Goldston M, Patnaik A, Mathews L, Ricart AD, Mays T, Knowles H, Rivera VM, Kreisberg J, Bedrosian CL, Tolcher AW: Phase I trial of the novel mammalian target of rapamycin inhibitor deforolimus (AP23573; MK-8669) administered intravenously daily for 5 days every 2 weeks to patients with advanced malignancies. J Clin Oncol. 2008, 26: 361-367. 10.1200/JCO.2007.12.0345.CrossRefPubMed
25.
go back to reference Raymond E, Alexandre J, Faivre S, Vera K, Materman E, Boni J, Leister C, Korth-Bradley J, Hanauske A, Armand JP: Safety and pharmacokinetics of escalated doses of weekly intravenous infusion of CCI-779, a novel mTOR inhibitor, in patients with cancer. J Clin Oncol. 2004, 22: 2336-2347. 10.1200/JCO.2004.08.116.CrossRefPubMed Raymond E, Alexandre J, Faivre S, Vera K, Materman E, Boni J, Leister C, Korth-Bradley J, Hanauske A, Armand JP: Safety and pharmacokinetics of escalated doses of weekly intravenous infusion of CCI-779, a novel mTOR inhibitor, in patients with cancer. J Clin Oncol. 2004, 22: 2336-2347. 10.1200/JCO.2004.08.116.CrossRefPubMed
26.
go back to reference Desai AA, Janisch L, Berk LR, Knowles L, Rivera VM, Bedrosian CL, Ratain MJ: A phase I trial of a novel mTOR inhibitor AP23573 administered weekly (wkly) in patients (pts) with refractory or advanced malignancies: a pharmacokinetic (PK) and pharmacodynamic (PD) analysis [abstract 3150]. J Clin Oncol. 2004, 22: 232- Desai AA, Janisch L, Berk LR, Knowles L, Rivera VM, Bedrosian CL, Ratain MJ: A phase I trial of a novel mTOR inhibitor AP23573 administered weekly (wkly) in patients (pts) with refractory or advanced malignancies: a pharmacokinetic (PK) and pharmacodynamic (PD) analysis [abstract 3150]. J Clin Oncol. 2004, 22: 232-
27.
go back to reference Hartford CM, Ratain MJ: Rapamycin: something old, something new, sometimes borrowed and now renewed. Clin Pharmacol Ther. 2007, 82: 381-388. 10.1038/sj.clpt.6100317.CrossRefPubMed Hartford CM, Ratain MJ: Rapamycin: something old, something new, sometimes borrowed and now renewed. Clin Pharmacol Ther. 2007, 82: 381-388. 10.1038/sj.clpt.6100317.CrossRefPubMed
Metadata
Title
Two-dose-level confirmatory study of the pharmacokinetics and tolerability of everolimus in Chinese patients with advanced solid tumors
Authors
BingHe Xu
YiLong Wu
Lin Shen
DingWei Ye
Annette Jappe
Azzeddine Cherfi
Hui Wang
RuiRong Yuan
Publication date
01-12-2011
Publisher
BioMed Central
Published in
Journal of Hematology & Oncology / Issue 1/2011
Electronic ISSN: 1756-8722
DOI
https://doi.org/10.1186/1756-8722-4-3

Other articles of this Issue 1/2011

Journal of Hematology & Oncology 1/2011 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine