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PMID
Authors Wenbo Tang, Ye Guo, Liqiong Xue, Wei Peng, Xiaoxiao Ge, Junli Xue, Wei Wei, Juncai Xu, Yongguo Li, Jin Li
Title WX390, a high-potent PI3K-mTOR dual inhibitor, first-in-human (FIH) phase I study in advanced relapsed or refractory solid tumor, and lymphoma.
Journal Journal of Clinical Oncology
Vol 39
Issue no. 15_suppl
Date
URL https://ascopubs.org/doi/abs/10.1200/JCO.2021.39.15_suppl.3106
Abstract Text Background: WX390 is a high potent PI3K-mTOR dual inhibitor targeting pan-PI3K and mTOR. WX390 exhibited anti-tumor activity and high potency in xenograft models with inhibition of AKT phosphorylation. Methods: Patients (pts) with advanced lymphoma and solid tumors who have failed standard therapies were enrolled in dose escalation cohorts and received WX390 administered daily orally in 28-day cycles until confirmed progressive disease, intolerable toxicity or withdrawal of consent. Plasma samples were collected up to 7 days after the first dose and up to 24 hours at C1D28. Results: As of the cut-off date 2021 Feb 10, 25 patients (median age 52 years) were enrolled in 6 dose levels (0.1mg, 0.2mg, 0.4mg, 0.7mg, 1.1mg and 1.4mg) of the dose-escalation cohorts. Cohorts 0.1 mg to 1.1 mg were completed without dose-limiting toxicities (DLT), cohort 1.4 mg was completed with 1 DLT (Diabetic ketoacidosis combined with grade 3 hyperglycemia) out of 4 evaluable patients. Common treatment-related adverse events (TRAEs) (all grades, ≥20%) included hyperglycemia (20 pts, 80%), proteinuria (10 pts, 40%), creatinine increased (11 pts, 44%), hypophosphatemia (10 pts, 25%), anemia (8 pts, 33.3%), thrombocytopenia (7 pts, 29.2%), and aspartate aminotransferase increased (25%). Grade≥3 TRAEs were hyperglycemia (7 pts, 28%, 1 pt combined with diabetic ketoacidosis), hypophosphatemia (2 pts, 8%), neutropenia (2 pts, 8%), dermatitis (1 pt, 4%), and maculopapular rash (1 pt, 4%). PK showed fast absorption (Tmax 0.5-4 h) and dose proportionality for Cmax and AUC0-∞. The mean multiple dose T1/2 was approximately 12.4 hours across all cohorts with minimum accumulation. Among 14 tumor response evaluable patients, there were 3 patients with confirmed PIK3CA mutation. All 3 patients experienced tumor shrinkage and were still on treatment by the cut-off date. 2 (1 pt with head and neck cancer and 1 pt with cervical cancer) of them have achieved partial response (PR). The head and neck cancer patient (PR) was treated with WX390 0.7mg/day without any severe AE and the duration of response was beyond 15 months. Stable disease (SD) was observed in 6 patients (n = 5 with unknown PIK3CA mutation status and n = 1 with confirmed PIK3CA mutation). Of note, 1 patient (follicular lymphoma) treated with 0.1mg experienced SD for 14 months. Another patient (SD, head and neck cancer with PIK3CA mutation) experienced tumor shrinkage for more than 8 months and was still receiving WX390 treatment by the cut-off date. Conclusions: the PI3K-mTOR dual inhibitor WX390 was well tolerated with manageable safety profile, and showed encouraging antitumor activity. A RP2D of 1.1 mg qd is selected to be explored for different indications in solid tumor clinical studies. Clinical trial information: NCT03730142.

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Molecular Profile Treatment Approach
Gene Name Source Synonyms Protein Domains Gene Description Gene Role
Therapy Name Drugs Efficacy Evidence Clinical Trials
Drug Name Trade Name Synonyms Drug Classes Drug Description
WX390 WXFL10030390|WXFL 10030390|WXFL-10030390|WX 390|WX-390 mTOR Inhibitor 51 PI3K Inhibitor (Pan) 40 WX390 is a dual inhibitor of PI3K and mTOR, which may block downstream signaling and lead to tumor growth inhibition (J Clin Oncol 39, no. 15_suppl (May 20, 2021) 3106-3106).
Gene Variant Impact Protein Effect Variant Description Associated with drug Resistance
Molecular Profile Indication/Tumor Type Response Type Therapy Name Approval Status Evidence Type Efficacy Evidence References
PIK3CA mutant cervical cancer predicted - sensitive WX390 Case Reports/Case Series Actionable In a Phase I trial, WX390 treatment resulted in a partial responses in a patient with cervical cancer harboring PIK3CA mutation (J Clin Oncol 39, no. 15_suppl (May 20, 2021) 3106-3106; NCT03730142). detail...
PIK3CA mutant head and neck cancer predicted - sensitive WX390 Case Reports/Case Series Actionable In a Phase I trial, WX390 treatment resulted in a partial responses in a patient with head and neck cancer harboring PIK3CA mutation, and stable disease with tumor shrinkage for 8 months in another patient with PIK3CA-mutant head and neck cancer (J Clin Oncol 39, no. 15_suppl (May 20, 2021) 3106-3106; NCT03730142). detail...