Phase I Open-Label Study Evaluating the Safety, Pharmacokinetics, and Preliminary Efficacy of Dilpacimab in Patients with Advanced Solid Tumors.
Michael S GordonJohn J NemunaitisMinal BarveZev A WainbergErika P HamiltonRamesh K RamanathanGeorge W SledgeHuibin YueSusan E Morgan-LappeMartha BlaneySreeneeranj KasichayanulaMonica MotwaniLan WangLouie NaumovskiJohn H StricklerPublished in: Molecular cancer therapeutics (2021)
Dilpacimab (formerly ABT-165), a novel dual-variable domain immunoglobulin, targets both delta-like ligand 4 (DLL4) and VEGF pathways. Here, we present safety, pharmacokinetic (PK), pharmacodynamic (PD), and preliminary efficacy data from a phase I study (trial registration ID: NCT01946074) of dilpacimab in patients with advanced solid tumors. Eligible patients (≥18 years) received dilpacimab intravenously on days 1 and 15 in 28-day cycles at escalating dose levels (range, 1.25-7.5 mg/kg) until progressive disease or unacceptable toxicity. As of August 2018, 55 patients with solid tumors were enrolled in the dilpacimab monotherapy dose-escalation and dose-expansion cohorts. The most common treatment-related adverse events (TRAE) included hypertension (60.0%), headache (30.9%), and fatigue (21.8%). A TRAE of special interest was gastrointestinal perforation, occurring in 2 patients (3.6%; 1 with ovarian and 1 with prostate cancer) and resulting in 1 death. The PK of dilpacimab showed a half-life ranging from 4.9 to 9.5 days, and biomarker analysis demonstrated that the drug bound to both VEGF and DLL4 targets. The recommended phase II dose for dilpacimab monotherapy was established as 3.75 mg/kg, primarily on the basis of tolerability through multiple cycles. A partial response was achieved in 10.9% of patients (including 4 of 16 patients with ovarian cancer). The remaining patients had either stable disease (52.7%), progressive disease (23.6%), or were deemed unevaluable (12.7%). These results demonstrate that dilpacimab monotherapy has an acceptable safety profile, with clinical activity observed in patients with advanced solid tumors.
Keyphrases
- open label
- end stage renal disease
- phase ii
- prostate cancer
- clinical trial
- newly diagnosed
- ejection fraction
- chronic kidney disease
- multiple sclerosis
- phase iii
- blood pressure
- peritoneal dialysis
- endothelial cells
- squamous cell carcinoma
- oxidative stress
- vascular endothelial growth factor
- physical activity
- machine learning
- depressive symptoms
- smoking cessation