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Cited by 98

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Phase 1b study of the MDM2 inhibitor AMG 232 with or without trametinib in relapsed/refractory acute myeloid leukemia

Erba, Harry P., Becker, Pamela S., Shami, Paul J., Grunwald, Michael R., Flesher, Donna L., Zhu, Min, Rasmussen, Erik, Henary, Haby A., Anderson, Abraham A., Wang, Eunice S.·2019·Blood Advances
DOI 10.1182/bloodadvances.2019030916
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Abstract

This open-label, phase 1 study evaluated the safety, pharmacokinetics, and maximum tolerated dose of AMG 232, an investigational oral, selective mouse double minute 2 homolog inhibitor in relapsed/refractory acute myeloid leukemia (AML). AMG 232 was administered orally once daily for 7 days every 2 weeks (7 on/off) at 60, 120, 240, 360, 480, or 960 mg as monotherapy (arm 1) or at 60 mg with trametinib 2 mg (arm 2). Dose-limiting toxicities (DLTs), adverse events (AEs), pharmacokinetics, clinical and pharmacodynamic response, and expression of p53 target genes were assessed. All 36 patients received AMG 232. No DLTs occurred in arm 1, and 360 mg was the highest test dose; dose escalation was halted due to gastrointestinal AEs at higher doses. One of ten patients in arm 2 had a DLT (grade 3 fatigue); 60 mg was the highest dose tested with trametinib. Common treatment-related AEs (any grade) included nausea (58%), diarrhea (56%), vomiting (33%), and decreased appetite (25%). AMG 232 exhibited linear pharmacokinetics unaffected by coadministration with trametinib. Serum macrophage inhibitor cytokine-1 and bone marrow expression of BAX, PUMA, P21, and MDM2 increased during treatment. Of 30 evaluable patients, 1 achieved complete remission, 4 had morphologic leukemia-free state, and 1 had partial remission. Four of 13 (31%) TP53-wild-type patients and 0 of 3 (0%) TP53-mutant patients were responders. AMG 232 was associated with gastrointestinal AEs at higher doses but had acceptable pharmacokinetics, on-target effects, and promising clinical activity warranting further investigation in patients with relapsed/refractory AML. This trial was registered at www.clinicaltrials.gov as #NCT02016729.

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Metadata

Authors
Erba, H. P., Becker, P. S., Shami, P. J., Grunwald, M. R., Flesher, D. L., Zhu, M., Rasmussen, E., Henary, H. A., Anderson, A. A., & Wang, E. S.
Venue
Blood Advances
Publisher
American Society of Hematology
Published
2019-06-28
Volume
3
Issue
13
Pages
1939-1949
ISSN
  • 2473-9529
  • 2473-9537
DOI
10.1182/bloodadvances.2019030916
Cited by
98
References
8
Language
en

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CoChat. (2026). Citation check: Phase 1b study of the MDM2 inhibitor AMG 232 with or without trametinib in relapsed/refractory acute myeloid leukemia. https://app.cochat.ai/papers/10.1182/bloodadvances.2019030916
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Erba, H. P., Becker, P. S., Shami, P. J., Grunwald, M. R., Flesher, D. L., Zhu, M., Rasmussen, E., Henary, H. A., Anderson, A. A., & Wang, E. S. (2019). Phase 1b study of the MDM2 inhibitor AMG 232 with or without trametinib in relapsed/refractory acute myeloid leukemia. Blood Advances. https://doi.org/10.1182/bloodadvances.2019030916

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