TY - JOUR
T1 - Phase I study of procaspase-activating compound-1 (PAC-1) in the treatment of advanced malignancies
AU - Danciu, Oana C.
AU - Holdhoff, Matthias
AU - Peterson, Richard A.
AU - Fischer, James H.
AU - Liu, Li C.
AU - Wang, Heng
AU - Venepalli, Neeta K.
AU - Chowdhery, Rozina
AU - Nicholas, M. Kelly
AU - Russell, Meredith J.
AU - Fan, Timothy M.
AU - Hergenrother, Paul J.
AU - Tarasow, Theodore M.
AU - Dudek, Arkadiusz Z.
N1 - Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Nature Limited.
PY - 2023/3/23
Y1 - 2023/3/23
N2 - Background: Procaspase-3 (PC-3) is overexpressed in multiple tumour types and procaspase-activating compound 1 (PAC-1) directly activates PC-3 and induces apoptosis in cancer cells. This report describes the first-in-human, phase I study of PAC-1 assessing maximum tolerated dose, safety, and pharmacokinetics. Methods: Modified-Fibonacci dose-escalation 3 + 3 design was used. PAC-1 was administered orally at 7 dose levels (DL) on days 1–21 of a 28-day cycle. Dose-limiting toxicity (DLT) was assessed during the first two cycles of therapy, and pharmacokinetics analysis was conducted on days 1 and 21 of the first cycle. Neurologic and neurocognitive function (NNCF) tests were performed throughout the study. Results: Forty-eight patients were enrolled with 33 completing ≥2 cycles of therapy and evaluable for DLT. DL 7 (750 mg/day) was established as the recommended phase 2 dose, with grade 1 and 2 neurological adverse events noted, while NNCF testing showed stable neurologic and cognitive evaluations. PAC-1’s t1/2 was 28.5 h after multi-dosing, and systemic drug exposures achieved predicted therapeutic concentrations. PAC-1 clinical activity was observed in patients with neuroendocrine tumour (NET) with 2/5 patients achieving durable partial response. Conclusions: PAC-1 dose at 750 mg/day was recommended for phase 2 studies. Activity of PAC-1 in treatment-refractory NET warrants further investigation. Clinical trial registration: Clinical Trials.gov: NCT02355535.
AB - Background: Procaspase-3 (PC-3) is overexpressed in multiple tumour types and procaspase-activating compound 1 (PAC-1) directly activates PC-3 and induces apoptosis in cancer cells. This report describes the first-in-human, phase I study of PAC-1 assessing maximum tolerated dose, safety, and pharmacokinetics. Methods: Modified-Fibonacci dose-escalation 3 + 3 design was used. PAC-1 was administered orally at 7 dose levels (DL) on days 1–21 of a 28-day cycle. Dose-limiting toxicity (DLT) was assessed during the first two cycles of therapy, and pharmacokinetics analysis was conducted on days 1 and 21 of the first cycle. Neurologic and neurocognitive function (NNCF) tests were performed throughout the study. Results: Forty-eight patients were enrolled with 33 completing ≥2 cycles of therapy and evaluable for DLT. DL 7 (750 mg/day) was established as the recommended phase 2 dose, with grade 1 and 2 neurological adverse events noted, while NNCF testing showed stable neurologic and cognitive evaluations. PAC-1’s t1/2 was 28.5 h after multi-dosing, and systemic drug exposures achieved predicted therapeutic concentrations. PAC-1 clinical activity was observed in patients with neuroendocrine tumour (NET) with 2/5 patients achieving durable partial response. Conclusions: PAC-1 dose at 750 mg/day was recommended for phase 2 studies. Activity of PAC-1 in treatment-refractory NET warrants further investigation. Clinical trial registration: Clinical Trials.gov: NCT02355535.
UR - http://www.scopus.com/inward/record.url?scp=85143291130&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85143291130&partnerID=8YFLogxK
U2 - 10.1038/s41416-022-02089-7
DO - 10.1038/s41416-022-02089-7
M3 - Article
C2 - 36470974
AN - SCOPUS:85143291130
SN - 0007-0920
VL - 128
SP - 783
EP - 792
JO - British journal of cancer
JF - British journal of cancer
IS - 5
ER -