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Ref Type Journal Article
PMID (36424628)
Authors Xing P, Zhao Q, Zhang L, Wang H, Huang D, Hu P, Sun Y, Shi Y
Title Conteltinib (CT-707) in patients with advanced ALK-positive non-small cell lung cancer: a multicenter, open-label, first-in-human phase 1 study.
Journal Vol Issue Date Pages Journal Short Title
BMC medicine 20 1 2022 Nov 23 453 BMC Med
URL
Abstract Text Conteltinib (CT-707) is a potent second-generation anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitor (TKI) showing promising anti-tumor activities in preclinical studies. This study aimed to assess the safety, pharmacokinetic (PK), and efficacy of conteltinib in patients with ALK-positive non-small cell lung cancer (NSCLC).In this multicenter, single-arm, open-label, first-in-human phase 1 study, conteltinib was taken orally at doses of 50 to 800 mg quaque die (QD) in a dose-escalation phase. If the response was observed in a dose cohort of the dose-escalation phase, dose expansion was started. The primary endpoints were maximum tolerated dose (MTD), dose-limiting toxicity (DLT), and adverse events assessed by investigators.Between April 13, 2016, and February 8, 2020, 64 ALK-positive NSCLC patients were enrolled, including 41 (64.1%) patients with ALK TKI-naïve and 23 (35.9%) patients who received crizotinib previously. In the dose-escalation phase, 26 patients were treated with conteltinib at doses of 50 mg, 100 mg, 200 mg, 300 mg, 450 mg, 600 mg, and 800 mg QD. One DLT event was reported at the dose of 600 mg. MTD was not reached. Overall, 58 (90.6%) patients experienced treatment-related adverse events (TRAEs) and 9 (14.1%) patients had grade ≥ 3 TRAEs. The most common TRAEs were diarrhea (46 [71.9%]), serum creatinine elevated (29 [45.3%]), aspartate aminotransferase elevated (25 [39.1%]), and nausea (24 [37.5%]). Among 39 ALK TKI-naïve patients, the overall response rate (ORR) was 64.1% (25 of 39; 95% confidence interval [CI], 47.2-78.8), median progression-free survival (PFS) was 15.9 months (95% CI, 9.26-23.3), and median duration of response (DoR) was 15.0 months (95% CI, 9.06-25.8). Among 21 patients who received crizotinib previously, the ORR was 33.3% (7 of 21; 95% CI, 14.6-57.0), median PFS was 6.73 months (95% CI, 4.73-8.54), and median DoR was 6.60 months (95% CI, 3.77-13.3).In this study, conteltinib showed manageable safety profile, favorable PK properties, and anti-tumor activity in advanced ALK-positive NSCLC patients. The recommended phase 2 dose was determined to be 600 mg QD for ALK TKI-naïve patients and 300 mg bis in die (BID) for patients who received crizotinib previously.ClinicalTrials.gov, NCT02695550.

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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
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
ALK L1196M Advanced Solid Tumor predicted - sensitive Conteltinib Preclinical - Biochemical Actionable In a preclinical study, Conteltinib (CT-707) inhibited ALK L1196M activity in an in vitro assay (PMID: 36424628). 36424628
ALK G1269S Advanced Solid Tumor predicted - sensitive Conteltinib Preclinical - Biochemical Actionable In a preclinical study, Conteltinib (CT-707) inhibited ALK G1269S activity in an in vitro assay (PMID: 36424628). 36424628
ALK F1174L Advanced Solid Tumor predicted - sensitive Conteltinib Preclinical - Biochemical Actionable In a preclinical study, Conteltinib (CT-707) inhibited ALK F1174L activity in an in vitro assay (PMID: 36424628). 36424628
ALK G1202R Advanced Solid Tumor predicted - sensitive Conteltinib Preclinical - Biochemical Actionable In a preclinical study, Conteltinib (CT-707) inhibited ALK G1202R activity in an in vitro assay (PMID: 36424628). 36424628
ALK rearrange lung non-small cell carcinoma sensitive Conteltinib Phase I Actionable In a Phase I trial, Conteltinib (CT-707) demonstrated safety and efficacy in patients with ALK-positive non-small cell lung cancer, resulting in an overall response rate (ORR) of 53.3% (32/60), a disease control rate (DCR) of 80%, and a median progression-free survival of 9.26 months, with an ORR of 61.4% (25/39) and a DCR of 82.1% in ALK inhibitor-naive patients and an ORR of 33.3% (7/21) and a DCR of 76.2% (16/21) in patients previously treated with Xalkori (crizotinib) (PMID: 36424628; NCT02695550). 36424628
ALK R1275Q Advanced Solid Tumor predicted - sensitive Conteltinib Preclinical - Biochemical Actionable In a preclinical study, Conteltinib (CT-707) inhibited ALK R1275Q activity in an in vitro assay (PMID: 36424628). 36424628