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Phase I Dose-Escalation Study of SCB01A, a Microtubule Inhibitor with Vascular Disrupting Activity, in Patients with
Her-Shyong Shiah1,2, Nai-Jung Chiang3,4, Chia-Chi Lin5,6
1Graduate Institute of Cancer Molecular Biology and Drug Discovery, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.
Lessons Learned:
SCB01A is a novel microtubule inhibitor with vascular disrupting activity. This first-in-human study demonstrated SCB01A safety, pharmacokinetics, and preliminary antitumor activity. SCB01A is safe and well tolerated in patients with advanced solid malignancies with manageable neurotoxicity.
Background:
SCB01A, a novel microtubule inhibitor, has vascular disrupting activity.
Methods:
In this phase I dose-escalation and extension study, patients with advanced solid tumors were administered intravenous SCB01A infusions for 3 hours once every 21 days. Rapid titration and a 3 + 3 design escalated the dose from 2 mg/m2 to the maximum tolerated dose (MTD) based on dose-limiting toxicity (DLT). SCB01A-induced cellular neurotoxicity was evaluated in dorsal root ganglion cells. The primary endpoint was MTD. Safety, pharmacokinetics (PK), and tumor response were secondary endpoints.
Results:
Treatment-related adverse events included anemia, nausea, vomiting, fatigue, fever, and peripheral sensorimotor neuropathy. DLTs included grade 4 elevated creatine phosphokinase (CPK) in the 4 mg/m2 cohort; grade 3 gastric hemorrhage in the 6.5 mg/m2 cohort; grade 2 thromboembolic event in the 24 mg/m2 cohort; and grade 3 peripheral sensorimotor neuropathy, grade 3 elevated aspartate aminotransferase, and grade 3 hypertension in the 32 mg/m2 cohort. The MTD was 24 mg/m2 , and average half-life was ~2.5 hours. The area under the curve-dose response relationship was linear. Nineteen subjects were stable after two cycles. The longest treatment lasted 24 cycles. SCB01A-induced neurotoxicity was reversible in vitro.
Conclusion:
The MTD of SCB01A was 24 mg/m2 every 21 days; it is safe and tolerable in patients with solid tumors.
Insights
SCB01A, a novel microtubule inhibitor, is safe and well-tolerated in patients with advanced solid tumors. This first-in-human study established the maximum tolerated dose (MTD) at 24 mg/m² with manageable neurotoxicity.
Area of Science:
- Oncology
- Pharmacology
- Clinical Trials
Background:
- SCB01A is a novel microtubule inhibitor with vascular disrupting activity.
- Microtubule inhibitors are crucial in cancer therapy.
- Vascular disrupting agents offer a unique approach to tumor treatment.
Purpose of the Study:
- To evaluate the safety, pharmacokinetics (PK), and preliminary antitumor activity of SCB01A.
- To determine the maximum tolerated dose (MTD) of SCB01A in patients with advanced solid tumors.
- To assess SCB01A-induced neurotoxicity.
Main Methods:
- Phase I, dose-escalation and extension study.
- Intravenous SCB01A infusions administered every 21 days.
- 3+3 design used for dose escalation from 2 mg/m² to MTD, based on dose-limiting toxicity (DLT).
Main Results:
- The MTD was determined to be 24 mg/m².
- Common adverse events included anemia, nausea, vomiting, fatigue, fever, and peripheral sensorimotor neuropathy.
- SCB01A demonstrated a linear PK profile with an average half-life of approximately 2.5 hours; neurotoxicity was reversible in vitro.
Conclusions:
- SCB01A is safe and well-tolerated in patients with advanced solid malignancies.
- The MTD of 24 mg/m² every 21 days was established.
- Manageable neurotoxicity and preliminary antitumor activity were observed.
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