590P - Phase 1b study of a novel oral PPAR-gamma agonist, efatutazone in combination with FOLFIRI in Japanese patients with metastatic colorectal cancer wh...

Date 01 October 2012
Event ESMO Congress 2012
Session Poster presentation III
Topics Drug Development
Colon Cancer
Rectal Cancer
Presenter Takayuki Yoshino
Authors T. Yoshino1, S. Yuki2, K. Yamazaki3, N. Machida4, Y. Komatsu5, R. Oyama6, Y. Yachi6, H. Onuma6, A. Ohtsu7
  • 1Gastroenterology & Gastrointestinal Oncology, National Cancer Center Hospital East, JP-277-8577 - Kashiwa/JP
  • 2Gastroenterology, Hokkaido University Hospital, Hokkaido/JP
  • 3Gastrointestinal Oncology And Endoscop, Shizuoka Cancer Center, 411-8777 - Shizuoka/JP
  • 4Division Of Gastrointestinal Oncology, Shizuoka Cancer Center, 411-8777 - Shizuoka/JP
  • 5Cancer Center, Hokkaido University Hospital, Hokkaido/JP
  • 6Clinical Developmental Department Ii, Daiichisankyo CO.,LTD, JP-140-8710 - Tokyo/JP
  • 7Research Center For Innovative Oncology, National Cancer Center Hospital East, JP-277-8577 - kashiwa/JP

Abstract

Background

Efatutazone is a highly-selective peroxisome proliferator-activated receptor gamma (PPAR-gamma) agonist of thiazolidinedione (TZD) class, which shows higher potency than rosiglitazone. The recommended dose (RD) is 0.50 mg twice-daily (BID) in accordance with pharmacokinetics (PK), pharmacodynamics (PD, adiponectin) and safety analyses in US and Japanese phase 1 studies. This study assessed the safety, tolerability, antitumor activity, PK, PD, and determined the RD of efatutazone in combination with FOLFIRI in Japanese patients.

Materials and methods

This was an open-label, dose-escalation study using a 3 + 3 design. Each patient participated in only 1 dose group and received oral efatutazone 0.25 or 0.50 mg BID with every 2-week administration of FOLFIRI (Irinotecan 180 mg/m2 IV infusion over 90 minutes,l-LV 200 mg/m2 IV infusion over 120 minutes, and 5-FU IV continuous infusion 2400 mg/m2 over 46 hours). After determining the RD of efatutazone, 9 additional patients were enrolled for the further assessment of efatutazone. PK samples for efatutazone, Irinotecan and SN-38 were collected to assess the drug–drug interaction. PD samples were also collected. All patients provided written informed consent.

Results

A total of 15 patients were enrolled (7 male and 8 female; median age of 63 years old, range: 41–73 years). Dose-limiting toxicities were not observed, and the maximum tolerated dose (MTD) was not reached. Most patients experienced edema (80.0%) and weight increase (100.0%) which were manageable with diuretics. The most common haematological toxicities were neutropenia and anaemia, managed with supportive therapy and/or modification of FOLFIRI. Seven out of 15 patients showed stable disease (SD). Efatutazone increased plasma adiponectin levels. Plasma concentration of efatutazone increased according to dose. Efatutazone doesn't affect plasma concentration of Irinotecan and SN-38.

Conclusions

Efatutazone in combination with FOLFIRI is a novel anticancer therapy, which is tolerated in Japanese patients with metastatic colorectal cancer. Although the MTD was not reached, 0.50 mg BID, corresponding to the RD in western patients, was selected as the RD for Japanese patients based on safety analyses. Full safety data and clinical activity data will be presented.

Disclosure

T. Yoshino: I have honoraria with Chugai, Takeda, Bristol-Myers Squibb, Yakult and Merck Serono. I have research funding from Bayer,Taiho, Daiichi-sankyo and Quintiles. I have received consulting fee from Takeda.

Y. Komatsu: Y.Komatsu has honoraria with DAIICHI SANKYO COMPANY, LIMITED, YAKULT HONSHA CO., LTD, Pfizer. Y.Komatsu has research funding from DAIICHI SANKYO COMPANY, LIMITED, YAKULT HONSHA CO., LTD, Pfizer.

R. Oyama: R.Oyama is an employee of Daiichisankyo CO.,LTD.

Y. Yachi: Y.Yachi is an employee of Daiichisankyo CO.,LTD.

H. Onuma: H.Onuma is an employee of Daiichisankyo CO., LTD.

A. Ohtsu: A.Ohtsu has an advisory role and/or honoraria with Takeda Pharmaceutical Co., Ltd, DAIICHI SANKYO, Novartis, CHUGAI PHARMACEUTICAL CO., LTD, TAIHO Pharmaceutical Co., Ltd, Glaxosmithkline, Pfizer, YAKULT HONSHA, Merck Serono, Bristol-Myers Squibb.

All other authors have declared no conflicts of interest.