RT Journal Article SR Electronic T1 A Phase I Pharmacokinetic and Pharmacodynamic Study of TKI258, an Oral, Multitargeted Receptor Tyrosine Kinase Inhibitor in Patients with Advanced Solid Tumors JF Clinical Cancer Research JO Clin Cancer Res FD American Association for Cancer Research SP 2075 OP 2081 DO 10.1158/1078-0432.CCR-07-1466 VO 14 IS 7 A1 Sarker, Debashis A1 Molife, Rhoda A1 Evans, T.R. Jeffrey A1 Hardie, Maryon A1 Marriott, Cheryl A1 Butzberger-Zimmerli, Priska A1 Morrison, Rosemary A1 Fox, Judith A. A1 Heise, Carla A1 Louie, Sharianne A1 Aziz, Natasha A1 Garzon, Felix A1 Michelson, Glenn A1 Judson, Ian R. A1 Jadayel, Dalal A1 Braendle, Edgar A1 de Bono, Johann S. YR 2008 UL http://clincancerres.aacrjournals.org/content/14/7/2075.abstract AB Purpose: To determine the maximum tolerated dose (MTD) dose-limiting toxicity, and pharmacokinetic and pharmacodynamic profile of TKI258 (formerly CHIR-258). Experimental Design: A phase I dose escalating trial in patients with advanced solid tumors was performed. Treatment was initially as single daily doses on an intermittent 7-day on/7-day off schedule. Following a protocol amendment, a second schedule comprised, during cycle 1, 7-day on/7-day off treatment followed by 14 days of continuous daily dosing; subsequent cycles comprised 28 days of daily dosing. Pharmacokinetics and evaluation of phosphorylated extracellular signal-regulated kinase (ERK) in peripheral blood mononuclear cells were done during the first 28 days of each schedule. Results: Thirty-five patients were treated in four intermittent (25-100 mg/d) and three continuous (100-175 mg/d) dosing cohorts. Observed drug-related toxicities were nausea and vomiting, fatigue, headache, anorexia, and diarrhea. Dose-limiting toxicities were grade 3 hypertension in one patient at 100 mg continuous dosing, grade 3 anorexia in a second patient at 175 mg, and grade 3 alkaline phosphatase elevation in a third patient at 175 mg. One patient had a partial response (melanoma) and two patients had stable disease >6 months. TKI258 pharmacokinetics were linear over the dose range of 25 to 175 mg. Five of 14 evaluable patients had modulation of phosphorylated ERK levels. Conclusions: The MTD was defined as 125 mg/d. Evidence of antitumor activity in melanoma and gastrointestinal stromal tumors warrants further investigation, and other phase I studies are ongoing. Further pharmacodynamic evaluation is required in these studies to evaluate the biological effects of TKI258.