Medical Oncology Clinical Trial
Official title:
An Open-label Phase I Dose-escalation Study to Characterize the Safety, Tolerability, Pharmacokinetics, and Maximum Tolerated Dose of Oral BAY1161909 in Combination With Weekly Intravenous Paclitaxel Given in an Intermittent Dosing Schedule in Subjects With Advanced Malignancies
Determine the safety, tolerability, maximum tolerated dose (MTD), and recommended Phase II dose (RP2D) of BAY1161909 in combination with paclitaxel in subjects with advanced malignancies.
BAY1161909 is a potent and highly selective inhibitor of monopolar spindle 1 (Mps1) kinase
activity. Human Mps1 is a serine threonine kinase which functions as a core component of the
spindle assembly checkpoint (SAC), a key surveillance mechanism that monitors the attachment
of spindle microtubules to the kinetochores of the chromosomes during pro-metaphase and halts
the transitions to anaphase until all chromosomes are bi-oriented, fully attached, and
correctly tensed at the metaphase plate. Mps1 is expressed in the mitosis phase of the cell
cycle in proliferating cells. Overexpression of Mps1 has been observed in several cancer cell
lines and tumor types including lung and breast cancers.
Established anti-mitotic drugs such as vinca alkaloids, taxanes, or epothilones activate the
SAC either by destabilizing or stabilizing spindle microtubules resulting in mitotic arrest.
Prolonged arrest in mitosis forces a cell either into a mitotic exit without cytokinesis or
into a mitotic catastrophe leading to cell death. In contrast, Mps1 inhibitors inactivate the
SAC and accelerate progression of cells through mitosis eventually resulting in severe
chromosomal missegregation, mitotic catastrophe, and cell death. Consequently, Mps1
inhibition leads to failure of cells to arrest in mitosis in response to anti-mitotic drugs.
Thus, the combination of microtubule-interfering agents and Mps1 inhibition strongly
increases chromosomal segregation errors and cell death and therefore, constitutes an
efficient strategy for selectively eliminating tumor cells.
This study will attempt to answer the following questions:
- What are the side effects of BAY1161909 when given at different dose levels and
schedules with paclitaxel?
- What dose level and schedule of BAY1161909 should be tested in future clinical research
studies?
- How much BAY1161909 and paclitaxel is in the blood at specific times after
administration?
- Does the treatment with BAY1161909 with paclitaxel show any effect on the tumor growth?
- Are there specific biomarkers that might be able to explain why some patients respond to
treatment and others do not.
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