Cited by 616Cell death mechanisms and regulationLung Cancer Research StudiesCancer-related Molecular Pathways

Phase I Study of Navitoclax (ABT-263), a Novel Bcl-2 Family Inhibitor, in Patients With Small-Cell Lung Cancer and Other Solid Tumors

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Gandhi, Leena, Camidge, D. Ross, Ribeiro de Oliveira, Moacyr, Bonomi, Philip, Gandara, David, Khaira, Divis, Hann, Christine L., McKeegan, Evelyn M. +12 more·2011·Journal of Clinical Oncology

Abstract

Purpose: Resistance to chemotherapy-induced apoptosis represents a major obstacle to cancer control. Overexpression of Bcl-2 is seen in multiple tumor types and targeting Bcl-2 may provide therapeutic benefit. A phase I study of navitoclax, a novel inhibitor of Bcl-2 family proteins, was conducted to evaluate safety, pharmacokinetics, and preliminary efficacy in patients with solid tumors. Patients and Methods: Patients enrolled to intermittent dosing cohorts received navitoclax on day −3, followed by dosing on days 1 to 14 of a 21-day cycle. Patients on continuous dosing received a 1-week lead-in dose of 150 mg followed by continuous daily administration. Blood samples were collected for pharmacokinetic analyses, biomarker analyses, and platelet monitoring. Results: Forty-seven patients, including 29 with small-cell lung cancer (SCLC) or pulmonary carcinoid, were enrolled between 2007 and 2008, 35 on intermittent and 12 on continuous dosing cohorts. Primary toxicities included diarrhea (40%), nausea (34%), vomiting (36%), and fatigue (34%); most were grade 1 or 2. Dose- and schedule-dependent thrombocytopenia was seen in all patients. One patient with SCLC had a confirmed partial response lasting longer than 2 years, and eight patients with SCLC or carcinoid had stable disease (one remained on study for 13 months). Pro-gastrin releasing peptide (pro-GRP) was identified as a surrogate marker of Bcl-2 amplification and changes correlated with changes in tumor volume. Conclusion: Navitoclax is safe and well tolerated, with dose-dependent thrombocytopenia as the major adverse effect. Preliminary efficacy data are encouraging in SCLC. Efficacy in SCLC and the utility of pro-GRP as a marker of treatment response will be further evaluated in phase II studies.

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Authors
Gandhi, L., Camidge, D. R., Ribeiro de Oliveira, M., Bonomi, P., Gandara, D., Khaira, D., Hann, C. L., McKeegan, E. M., Litvinovich, E., Hemken, P. M., Dive, C., Enschede, S. H., Nolan, C., Chiu, Y.-L., Busman, T., Xiong, H., Krivoshik, A. P., Humerickhouse, R., Shapiro, G. I., & Rudin, C. M.
Affiliations
  • Rush University Medical Center (US)
  • From the Dana-Farber Cancer Institute, Boston, MA; University of Colorado Cancer Center, Aurora, CO; Northwest Medical Specialties, Tacoma, WA; Rush University Medical Center, Chicago; Abbott Laboratories, Abbott Park, IL; University of California Davis Cancer Center, Sacramento, CA; Sunterra Oncology Associates, Phoenix, AZ; Johns Hopkins University, Baltimore, MD; and Paterson Institute for Cancer Research, University of Manchester, United Kingdom.
Venue
Journal of Clinical Oncology
Published
2011-03-01
Volume
29
Issue
7
Pages
909-916
ISSN
  • 0732-183X (ISSN-L)
  • 1527-7755
OpenAlex
W2119316461
Cited by
603
References
39
Citations by year
2026: 35 · 2025: 28 · 2024: 30 · 2023: 34 · 2022: 32 · 2021: 37 · 2020: 39 · 2019: 29 · 2018: 33 · 2017: 31 · 2016: 40 · 2015: 46 · 2014: 57 · 2013: 54 · 2012: 51
FWCI
24.82
Type
journal article
Language
en
Open access
Locations
  • Journal of Clinical Oncology (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Research Explorer (The University of Manchester) (publishedVersion)
Funders
National Cancer Institute (P30CA006973)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Cell death mechanisms and regulation
  • Health Sciences › Medicine › Oncology › Lung Cancer Research Studies
  • Health Sciences › Medicine › Oncology › Cancer-related Molecular Pathways
Keywords
navitoclax, BCL-2 inhibitor, small cell lung cancer, bronchial carcinoid, thrombocytopenia, progastrin-releasing peptide, apoptosis resistance, pharmacokinetics, safety and tolerability, intermittent dosing, continuous dosing, surrogate markers
MeSH terms
Administration, Oral, Aged, Aged, 80 and over, Aniline Compounds, Dose-Response Relationship, Drug, Drug Administration Schedule, Female, Humans, Male, Middle Aged, Neoplasms, Prognosis, Sulfonamides, Survival Analysis, Treatment Outcome, Risk Assessment, Genes, bcl-2, Maximum Tolerated Dose, Small Cell Lung Carcinoma

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