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Published on: July 30, 2020
A phase I dose escalation study of AT9283, a small molecule inhibitor of aurora kinases, in patients with advanced
H-T Arkenau1, R Plummer2, L R Molife1
1Drug Development Unit, Royal Marsden NHS Foundation Trust, Surrey, London.
Background:
AT9283 is an inhibitor of aurora kinases A and B with antitumor activity in preclinical models. This a First in Human phase I study assessed the safety, tolerability, pharmacokinetic and pharmacodynamic properties and preliminary efficacy of AT9283.
Patients And Methods:
Patients with advanced tumors received AT9283 as a continuous central venous infusion over 3 days in cohorts of three to six patients starting at 1.5 mg/m(2)/day (equivalent to 4.5 mg/m(2)/72 h). The oral bioavailability of AT9283 was assessed in a cohort of seven patients. Pharmacodynamic analysis of biomarkers included phosphorylation of histone H3 on serine 10, proliferating cell nuclear antigen, Ki67, M30 and M65 in skin and plasma.
Results:
Forty patients were included in all analyses. AT9283 was generally well tolerated with main toxic effects of reversible dose-related myelosuppression, gastrointestinal disturbance, fatigue and alopecia. The dose-limiting toxicity of AT9283 was grade 3 febrile neutropenia in two patients at 36 mg/m(2)/72 h and the maximum tolerated dose (MTD) was established at 27 mg/m(2)/72 h. Systemic exposure was dose proportional. The mean oral bioavailability of a 0.9 mg/m(2) dose was 29.4% (range 11.2%-36.7%). Pharmacodynamic analyses indicated antiproliferative and apoptotic activity of AT9283. Four patients with esophageal, non-small-cell lung cancer (n = 2) and colorectal cancer demonstrated RECIST stable disease ≥ 6 months.
Conclusion:
AT9283 was well tolerated up to the MTD of 27 mg/m(2)/72 h. AT9283 is currently assessed in phase II trials.
Insights
AT9283, an aurora kinase inhibitor, showed antitumor potential in early trials. This phase I study found it well-tolerated up to 27 mg/m(2)/72 h, with preliminary efficacy in advanced cancers.
Area of Science:
- Oncology
- Pharmacology
- Clinical Trials
Background:
- AT9283 is an inhibitor of aurora kinases A and B.
- It has demonstrated antitumor activity in preclinical models.
Purpose of the Study:
- To assess the safety and tolerability of AT9283 in a First in Human phase I study.
- To evaluate pharmacokinetic and pharmacodynamic properties.
- To determine preliminary efficacy of AT9283 in patients with advanced tumors.
Main Methods:
- Patients received AT9283 via continuous central venous infusion over 3 days.
- Dose escalation cohorts were used, starting at 1.5 mg/m(2)/day.
- Oral bioavailability was assessed, and pharmacodynamic biomarkers were analyzed.
Main Results:
- AT9283 was generally well tolerated, with dose-related myelosuppression and gastrointestinal issues as main toxicities.
- The maximum tolerated dose (MTD) was established at 27 mg/m(2)/72 h.
- Preliminary efficacy was observed, with four patients achieving RECIST stable disease for ≥ 6 months.
Conclusions:
- AT9283 is well tolerated up to the MTD of 27 mg/m(2)/72 h.
- Pharmacodynamic analyses indicated antiproliferative and apoptotic activity.
- AT9283 is currently being evaluated in phase II trials.
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