A phase I first-in-human study with tefinostat - A monocyte/macrophage targeted histone deacetylase inhibitor - In patients with advanced haematological malignancies
British Journal of Haematology , Volume 162 - Issue 2 p. 191- 201
Tefinostat (CHR-2845) is a monocyte/macrophage targeted histone deacetylase inhibitor (HDACi). This first-in-human, standard 3 + 3 dose escalating trial of oral, once daily tefinostat was conducted to determine the safety, tolerability, pharmacokinetic and pharmacodynamic profile of tefinostat in relapsed/refractory haematological diseases. Eighteen patients were enrolled at doses of 20-640 mg. Plasma concentrations of tefinostat exceeded those demonstrated to give in vitro anti-proliferative activity. Flow cytometric pharmacodynamic assays demonstrated monocyte-targeted increases in protein acetylation, without corresponding changes in lymphocytes. Dose-limiting toxicities (DLTs) were not observed and dose escalation was halted at 640 mg without identification of the maximum tolerated dose. Drug-related toxicities were largely Common Toxicity Criteria for Adverse Events grade 1/2 and included nausea, anorexia, fatigue, constipation, rash and increased blood creatinine. A patient with chronic monomyelocytic leukaemia achieved a bone marrow response, with no change in peripheral monocytes. An acute myeloid leukaemia type M2 patient showed a >50% decrease in bone marrow blasts and clearance of peripheral blasts. In conclusion, tefinostat produces monocyte-targeted HDACi activity and is well tolerated, without the DLTs, e.g. fatigue, diarrhoea, thrombocytopenia, commonly seen with non-targeted HDACi. The early signs of efficacy and absence of significant toxicity warrant further evaluation of tefinostat in larger studies. (clinicaltrials.gov identifier: NCT00820508).
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|British Journal of Haematology|
|Organisation||Erasmus MC: University Medical Center Rotterdam|
Ossenkoppele, G.J, Löwenberg, B, Zachée, P, Vey, N, Breems, D.A, van de Loosdrecht, A.A, … Debnam, P.M. (2013). A phase I first-in-human study with tefinostat - A monocyte/macrophage targeted histone deacetylase inhibitor - In patients with advanced haematological malignancies. British Journal of Haematology, 162(2), 191–201. doi:10.1111/bjh.12359