Safety, antitumor activity, and biomarker analysis in a phase I trial of the once-daily wee1 inhibitor adavosertib (AZD1775) in patients with advanced solid tumors A C

Naoko Takebe, Abdul Rafeh Naqash, Geraldine O’Sullivan Coyne, Shivaani Kummar, Khanh Do, Ashley Bruns, Lamin Juwara, Jennifer Zlott, Larry Rubinstein, Richard Piekarz, Elad Sharon, Howard Streicher, Arjun Mittra, Sarah B. Miller, Jiuping Ji, Deborah Wilsker, Robert J. Kinders, Ralph E. Parchment, Li Chen, Ting Chia ChangBiswajit Das, Ganesh Mugundu, James H. Doroshow, Alice P. Chen

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Purpose: The Wee1 kinase inhibitor adavosertib abrogates cell-cycle arrest, leading to cell death. Prior testing of twice-daily adavosertib in patients with advanced solid tumors determined the recommended phase II dose (RPh2D). Here, we report results for once-daily adavosertib. Patients and Methods: A 3 þ 3 dose-escalation design was used, with adavosertib given once daily on days 1 to 5 and 8 to 12 in 21-day cycles. Molecular biomarkers of Wee1 activity, including tyrosine 15–phosphorylated Cdk1/2 (pY15-Cdk), were assessed in paired tumor biopsies. Whole-exome sequencing and RNA sequencing of remaining tumor tissue identified potential predictive biomarkers. Results: Among the 42 patients enrolled, the most common toxicities were gastrointestinal and hematologic; dose-limiting toxicities were grade 4 hematologic toxicity and grade 3 fatigue. The once-daily RPh2D was 300 mg. Six patients (14%) had confirmed partial responses: four ovarian, two endometrial. Adavosertib plasma exposures were similar to those from twice-daily dosing. On cycle 1 day 8 (pre-dose), tumor pY15-Cdk levels were higher than baseline in four of eight patients, suggesting target rebound during the day 5 to 8 dosing break. One patient who progressed rapidly had a tumor WEE1 mutation and potentially compensatory PKMYT1 overexpression. Baseline CCNE1 overexpression occurred in both of two responding patients, only one of whom had CCNE1 amplification, and in zero of three nonresponding patients. Conclusions: We determined the once-daily adavosertib RPh2D and observed activity in patients with ovarian or endometrial carcinoma, including two with baseline CCNE1 mRNA overexpression. Future studies will determine whether CCNE1 overexpression is a predictive biomarker for adavosertib.

Original languageEnglish (US)
Pages (from-to)3834
Number of pages1
JournalClinical Cancer Research
Volume27
Issue number14
DOIs
StatePublished - Jul 15 2021
Externally publishedYes

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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