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Phase I evaluation of carfilzomib (PR-171) in hematological malignancies: Responses in multiple myeloma and Waldenstrom's macroglobulinemia at well-tolerated doses.

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Sub-category:
Multiple Myeloma

Category:
Lymphoma and Plasma Cell Disorders

Meeting:
2007 ASCO Annual Meeting

Abstract No:
8003

Citation:
Journal of Clinical Oncology, 2007 ASCO Annual Meeting Proceedings Part I. Vol 25, No. 18S (June 20 Supplement), 2007: 8003

Author(s):
K. A. Stewart, O. A. O'Connor, M. Alsina, S. Trudel, P. R. Urquilla, M. K. Vallone, C. J. Molineaux, A. Goy, R. Z. Orlowski

Abstract:

Background: Carfilzomib is a novel, irreversible tetrapeptide proteasome inhibitor derived from the natural product epoxomicin. Carfilzomib was well tolerated in preclinical animal studies when administered on a two-week cycle, QDx5; proteasome inhibition one hour after dosing at the MTD was >80%. Two Phase I dose-escalation studies are ongoing, aimed at determining the safety, tolerability, and biological response to carfilzomib. Methods: Carfilzomib was administered according to two different dose-intensive schedules. In PX-171-001, carfilzomib was administered on a two week cycle, QDx5 with nine days rest; in PX-171-002, carfilzomib was administered on a four week cycle, QDx2 weekly for three weeks with 12 days rest. Eligible patients have multiple myeloma (MM), Non-Hodgkin's Lymphoma (NHL), Hodgkin's Disease (HD), or Waldenström's Macroglobulinemia (WM). Results: Thus far, a total of 54 subjects have been enrolled. Although the maximum tolerated dose (MTD) has not yet been identified on either study, responses seen on both protocols have established 11 and 15 mg/m2 as the minimal effective doses (MEDs) on PX-171-001 and 002, respectively. Of 3 patients with MM or WM treated on the 001 protocol, one MM patient has had a Partial Response (PR) and one WM patient had a Minimal Response (MR). Of 8 patients with MM treated on the 002 protocol, 3 patients have had PRs. 6 additional patients have had Stable Disease lasting longer than 6 months and symptomatic improvement has been seen in patients on both protocols. 11 subjects remain on study with stable disease or better. Proteasome inhibition in whole blood at the highest dose levels exceeded 80% one hour after the first dose. Carfilzomib has been well tolerated at doses at and above the MED thus far. There has been no incidence of painful peripheral neuropathy on either study. No dose-limiting toxicities (DLTs) have occurred on PX-171-001; one DLT (Gr 4 anemia and thrombocytopenia) was observed at 27 mg/m2 on PX-171-002. Conclusions: Thus far, intensive dosing with carfilzomib is well-tolerated at proteasome inhibition levels of more than 80%. Five responses have been observed, and several subjects have achieved long lasting SD and/or symptomatic improvement.


Abstract Disclosures

Abstracts that were granted an exception in accordance with ASCO's Conflict of Interest Policy and are designated with a caret symbol (^) here and in the print version.


  Associated Presentation(s):

    

1. Phase I evaluation of carfilzomib (PR-171) in hematological malignancies: Responses in multiple myeloma and Waldenstrom's macroglobulinemia at well-tolerated doses.

Meeting: 2007 ASCO Annual Meeting
Presenter: Keith A Stewart, MD
Session: How New Agents Work in Multiple Myeloma (Clinical Science Symposium)


  Other Abstracts in this Sub-Category:

    

1. Comparison of melphalan-prednisone-thalidomide (MP-T) to melphalan-prednisone (MP) in patients 75 years of age or older with untreated multiple myeloma (MM). Preliminary results of the randomized, double-blind, placebo controlled IFM 01-01 trial.

Meeting: 2007 ASCO Annual Meeting   Abstract No: 8001   First Author: c. hulin
Category: Lymphoma and Plasma Cell Disorders - Multiple Myeloma

    

2. Effect of the combination of pegylated liposomal doxorubicin and bortezomib on time to progression (TTP) and overall survival of patients with relapsed/refractory multiple myeloma compared with bortezomib alone.

Meeting: 2007 ASCO Annual Meeting   Abstract No: 8002   First Author: J. L. Harousseau
Category: Lymphoma and Plasma Cell Disorders - Multiple Myeloma

    

3. Prospective, multicenter, randomized GITMO-IIL trial comparing intensive (R-HDS) to conventional chemoimmunotherapy (CHOP-R) in high-risk follicular lymphoma (FL) at diagnosis.

Meeting: 2007 ASCO Annual Meeting   Abstract No: 8006   First Author: M. Ladetto
Category: Lymphoma and Plasma Cell Disorders - Multiple Myeloma

    

More...


  Abstracts by K. A. Stewart:

    

1. Phase I evaluation of carfilzomib (PR-171) in hematological malignancies: Responses in multiple myeloma and Waldenstrom's macroglobulinemia at well-tolerated doses.

Meeting: 2007 ASCO Annual Meeting   Abstract No: 8003   First Author: K. A. Stewart
Category: Lymphoma and Plasma Cell Disorders - Multiple Myeloma

    

More...


  Presentations by K. A. Stewart:

    

1. Risk-adapted therapy of multiple myeloma

Meeting: 2008 ASCO Annual Meeting
Speaker: Keith A. Stewart, MBchB
Session: Initial Therapy for Multiple Myeloma: Considerations for an Integrated Risk-Adapted Approach (Education Session)

    

2. Discussion

Meeting: 2007 ASCO Annual Meeting
Discussant: Keith A. Stewart, MD
Session: Myeloma (Oral Presentation)

    

3. Phase I evaluation of carfilzomib (PR-171) in hematological malignancies: Responses in multiple myeloma and Waldenstrom's macroglobulinemia at well-tolerated doses.

Meeting: 2007 ASCO Annual Meeting
Presenter: Keith A Stewart, MD
Session: How New Agents Work in Multiple Myeloma (Clinical Science Symposium)

    

More...


  Educational Book Manuscripts by K. A. Stewart:

    

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