A Phase I Study of the Pan Bcl-2 Family Inhibitor Obatoclax Mesylate in Patients with Advanced Hematologic Malignancies

作者:Schimmer Aaron D*; O'Brien Susan; Kantarjian Hagop; Brandwein Joseph; Cheson Bruce D; Minden Mark D; Yee Karen; Ravandi Farhad; Giles Francis; Schuh Andre; Gupta Vikas; Andreeff Michael; Koller Charles; Chang Hong; Kamel Reid Suzanne; Berger Mark; Viallet Jean; Borthakur Gautam
来源:Clinical Cancer Research, 2008, 14(24): 8295-8301.
DOI:10.1158/1078-0432.CCR-08-0999

摘要

Purpose: The outcome of patients with refractory leukemia and myelodysplasia is poor, and new therapies are needed. The antiapoptotic proteins of the Bcl-2 family are overexpressed in these malignancies and are potential therapeutic targets. Therefore, we conducted a phase I clinical trial of the small-molecule pan-Bcl-2 inhibitor, obatoclax mesylate, in patients with refractory leukemia and myelodysplasia to assess its safety and define its optimal dose.
Experimental Design: Forty-four patients with refractory leukemia or myelodysplasia were treated with obatoclax mesylate by continuous intravenous infusion at increasing doses and frequencies.
Results: A total of 306 infusions of obatoclax mesylate were administered with a median of 5 infusions per patient. The study drug was well tolerated up to the highest dose planned without dose-limiting toxicity. Grade 1/2 central nervous system symptoms were the most common adverse events attributable to the study drug. One patient with acute myeloid leukemia with mixed lineage leukemia t(9;11) rearrangement achieved a complete remission, which lasted 8 months. Three of 14 patients with myelodysplasia showed hematologic improvement with RBC or platelet transfusion independence.
Conclusions: Obatoclax mesylate is well tolerated and these results support its further investigation in patients with leukemia and myelodysplasia.

  • 出版日期2008-12-15

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