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AZD1480: a phase I study of a novel JAK2 inhibitor in solid tumors
Elizabeth R Plimack1, Patricia M Lorusso, Patricia McCoon
1Fox Chase Cancer Center, Temple Health, Philadelphia, Pennsylvania 19111, USA. elizabeth.plimack@fccc.edu
Background:
AZD1480 is a novel agent that inhibits Janus-associated kinases 1 and 2 (JAK1 and JAK2). The primary objective of this phase I study was to investigate the safety and tolerability of AZD1480 when administered as monotherapy to patients with solid tumors.
Methods:
Thirty-eight patients with advanced malignancies were treated at doses of 10-70 mg once daily (QD) and 20-45 mg b.i.d.
Results:
Pharmacokinetic (PK) analysis revealed rapid absorption and elimination with minimal accumulation after repeated QD or b.i.d. dosing. Exposure increased in a dose-dependent manner from 10-50 mg. Maximum plasma concentration (Cmax) was attained ∼1 hour after dose, and t1/2 was ∼5 hours. Pharmacodynamic analysis of circulating granulocytes demonstrated maximum phosphorylated STAT3 (pSTAT3) inhibition 1-2 hours after dose, coincident with Cmax, and greater pSTAT3 inhibition at higher doses. The average pSTAT3 inhibition in granulocytes at the highest dose tested, 70 mg QD, was 56% (standard deviation: ±21%) at steady-state drug levels. Dose-limiting toxicities (DLTs) consisted of pleiotropic neurologic adverse events (AEs), including dizziness, anxiety, ataxia, memory loss, hallucinations, and behavior changes. These AEs were generally reversible with dose reduction or treatment cessation.
Conclusions:
Whether the DLTs were due to inhibition of JAK-1/2 or to off-target effects is unknown. The unusual DLTs and the lack of clinical activity led to discontinuation of development.
Insights
AZD1480, a JAK1/2 inhibitor, showed dose-dependent pharmacokinetics and pSTAT3 inhibition in solid tumor patients. However, neurological toxicities led to development discontinuation.
Area of Science:
- Oncology
- Pharmacology
- Immunology
Background:
- AZD1480 is a novel Janus-associated kinase 1 and 2 (JAK1/2) inhibitor.
- Solid tumors represent a significant area of unmet medical need.
Purpose of the Study:
- To evaluate the safety and tolerability of AZD1480 as monotherapy in patients with solid tumors.
- To characterize the pharmacokinetic and pharmacodynamic profile of AZD1480.
Main Methods:
- Phase I clinical study involving 38 patients with advanced malignancies.
- Dosing regimens included 10-70 mg once daily (QD) and 20-45 mg twice daily (b.i.d.).
- Pharmacokinetic (PK) and pharmacodynamic (PD) analyses were performed, including pSTAT3 inhibition in granulocytes.
Main Results:
- AZD1480 exhibited rapid absorption and elimination with dose-dependent exposure up to 50 mg.
- Pharmacodynamic analysis showed maximum phosphorylated STAT3 (pSTAT3) inhibition at higher doses, reaching 56% at 70 mg QD.
- Dose-limiting toxicities (DLTs) included reversible neurological adverse events such as dizziness, anxiety, and hallucinations.
Conclusions:
- The exact cause of DLTs (JAK inhibition vs. off-target effects) remains undetermined.
- Development of AZD1480 was discontinued due to unusual DLTs and lack of clinical activity.
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