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Published on: November 2, 2011
Phase I Study of AMG 337, a Highly Selective Small-molecule MET Inhibitor, in Patients with Advanced Solid Tumors
David S Hong1, Patricia LoRusso2, Omid Hamid3
1Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, Texas. dshong@mdanderson.org.
Purpose:
This first-in-human, open-label phase I study evaluated AMG 337, an oral, highly selective small-molecule inhibitor of MET in advanced solid tumors.Patients and Methods: Patients enrolled into dose-escalation cohorts received AMG 337 up to 400 mg once daily or up to 250 mg twice daily, following a modified 3+3+3 design. Dose expansion was conducted in MET-amplified patients at the maximum tolerated dose (MTD). Primary endpoints included assessment of adverse events (AEs), establishment of the MTD, and pharmacokinetics; clinical response was a secondary endpoint.
Results:
The safety analysis set included 111 patients who received ≥1 dose of AMG 337. Thirteen patients had ≥1 AE qualifying as dose-limiting toxicity. The MTD was determined to be 300 mg once daily; the MTD for twice-daily dosing was not reached. Most frequent treatment-related AEs were headache (63%) and nausea (31%). Grade ≥3 treatment-related AEs occurred in 23 patients (21%), most commonly headache (n = 6) and fatigue (n = 5). Maximum plasma concentration occurred at 3.0 hours following 300-mg once-daily dosing, indicating AMG 337 absorption soon after treatment. Objective response rate was 9.9% (11/111; 95% CI, 5.1%-17.0%) in all patients and 29.6% (8/27; 95% CI, 13.8%-50.2%) in MET-amplified patients; median (range) duration of response was 202 (51-1,430+) days in all patients and 197 (64-1,430+) days in MET-amplified patients.
Conclusions:
Oral AMG 337 was tolerated with manageable toxicities, with an MTD and recommended phase II dose of 300 mg once daily. The promising response rate observed in patients with heavily pretreated MET-amplified tumors warrants further investigation.See related commentary by Ma, p. 2375.
Insights
AMG 337, an oral MET inhibitor, demonstrated manageable toxicity in a phase I trial. The recommended dose for further studies is 300 mg once daily, showing promise in MET-amplified tumors.
Area of Science:
- Oncology
- Pharmacology
- Clinical Trials
Background:
- MET signaling pathway dysregulation is implicated in various advanced solid tumors.
- Targeted therapies inhibiting MET are under investigation for cancer treatment.
Purpose of the Study:
- To evaluate the safety, tolerability, pharmacokinetics, and preliminary efficacy of AMG 337, a novel oral MET inhibitor.
- To determine the maximum tolerated dose (MTD) and recommended Phase II dose of AMG 337.
Main Methods:
- A first-in-human, open-label, Phase I dose-escalation study of AMG 337 in patients with advanced solid tumors.
- Modified 3+3+3 design for dose escalation, followed by dose expansion in MET-amplified patients.
- Assessment of adverse events (AEs), MTD, pharmacokinetics, and clinical response.
Main Results:
- 111 patients received AMG 337. The MTD was established at 300 mg once daily.
- Most frequent treatment-related AEs included headache (63%) and nausea (31%).
- Objective response rate was 9.9% overall and 29.6% in MET-amplified patients.
Conclusions:
- AMG 337 is orally administered and generally well-tolerated with manageable toxicities.
- The recommended Phase II dose is 300 mg once daily.
- Promising response rates in heavily pretreated MET-amplified tumors warrant further investigation.
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