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A phase I pharmacokinetic and safety analysis of epothilone folate (BMS-753493), a folate receptor targeted chemotherapeutic agent in humans with advanced solid tumors

  • PHASE I STUDIES
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Summary

Background The folate receptor alpha is selectively over-expressed in a number of human cancers. BMS-753493 is a folate conjugate of the epothilone analog BMS-748285 that was designed to selectively target folate receptor expressing cancer cells. Methods BMS-753493 was investigated in two parallel multi-institutional first-in-human phase I/IIa studies in patients with advanced solid tumors. In Study 1, patients were treated on a schedule of once daily dosing of BMS-753493 administered on Days 1, 4, 8 and 11 every 21 days with a starting dose of 5 mg daily and in Study 2, patients were treated once daily on Days 1–4 every 21 days, with a starting dose of 2.5 mg daily. Results A total of 65 patients were treated across the two studies. The maximum tolerated dose (MTD) was 26 mg in Study 1 and 15 mg in Study 2. Fatigue, transaminitis, gastrointestinal toxicity, and mucositis were dose-limiting toxicities. One patient in Study 2 developed Stevens-Johnson syndrome attributed to BMS-753493. Plasma exposures of both the conjugated and free epothilone increased in a dose related fashion in both studies and the half-life of the conjugated epothilone was 0.2–0.6 h across dose levels. No objective tumor responses were seen in either study. Conclusions BMS-753493 was generally tolerable and toxicities known to be associated with epothilone class of anticancer agents were common, although peripheral neuropathy and neutropenia appear to have been less frequent and less severe as compared to epothilones. Antitumor activity was not demonstrated and further development of BMS-753493 has been discontinued.

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Acknowledgments

Ms. Raquel Ostby for invaluable help in preparation of manuscript. Ms. Gretchen Batzel, Clinical Research Coordinator at Mayo Clinic, Catherine Fortin at the Ottawa Hospital Cancer Centre, and Angela Robinson at NCCC for outstanding work throughout the study. Bristol-Myers Squibb for support.

Conflicts of interest

V Teslenko, PL Clemens, LJ Cohen and CM Ahlers and L. Alland are current or former employees of Bristol-Myers Squibb; LC Hartmann is a partial patent holder in the immunogenicity of the folate receptor. The remaining authors have reported no conflicts of interest.

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Author notes

  1. L. Alland

    Present address: AstraZeneca Pharmaceuticals, 35 Gatehouse Drive, Waltham, MA, 02451, USA

Authors and Affiliations

  1. Mayo Clinic Cancer Center, Rochester, MN, USA

    P. P. Peethambaram & L. C. Hartmann

  2. Fox Chase Cancer Center, Philadelphia, PA, USA

    L. Martin

  3. The Ottawa Hospital Cancer Centre, Ottawa, ON, Canada

    D. J. Jonker & G. D. Goss

  4. The Northern Centre for Cancer Care, Newcastle upon Tyne, United Kingdom

    E. R. Plummer

  5. Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    J. Konner

  6. Erasmus MC-Daniel den Hoek Kliniek, Rotterdam, The Netherlands

    M. de Jonge

  7. Georgetown University, Georgetown, Washington D.C., USA

    J. Marshall

  8. Bristol-Myers Squibb Research and Development, Princeton, NJ, USA

    V. Teslenko, P. L. Clemens, L. J. Cohen, C. M. Ahlers & L. Alland

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  1. P. P. Peethambaram
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Correspondence to L. Alland.

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Peethambaram, P.P., Hartmann, L.C., Jonker, D.J. et al. A phase I pharmacokinetic and safety analysis of epothilone folate (BMS-753493), a folate receptor targeted chemotherapeutic agent in humans with advanced solid tumors. Invest New Drugs 33, 321–331 (2015). https://doi.org/10.1007/s10637-014-0171-9

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  • DOI: https://doi.org/10.1007/s10637-014-0171-9

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