Abstract LB-231: A phase I pharmacokinetic study of OTX015 for the treatment of patients with hematologic malignancies
Authors: Odore Elodie , Rezai Keyvan , Riveiro Eugenia , Bourdel Fabrice , Herait Patrice , Cvitkovic Esteban , Dombret Herve , Lokiec Francois 
Published: May 2015

Background: OTX015 is a novel inhibitor of the bromodomain and extra-terminal (BET) protein family. This synthetic oral small molecule targets the BET transcriptional co-activator proteins BRD2/3/4, which are potential cancer targets particularly in hematologic malignancies. A phase Ib study with OTX015 administered to patients with hematologic malignancies was performed including a pharmacokinetic (PK) investigation. The PK objectives of this study were to determine the PK profile and perform a PK/PD modeling of oral OTX015 using a population approach.

Materials and Methods: A multicenter, dose escalation study is underway in cohorts of 3 to 6 patients with acute leukemia and other hematologic malignancies. Patients received oral OTX015 at a starting dose of 10 mg once daily (QD). PK blood samples from 7 time points were collected over 24 h post-administration (complete PK) on Day 1 for leukemia patients and 4 blood samples over 8 h post-administration were collected for patients with other malignancies (limited sampling PK). Plasma concentrations of OTX015 were measured using validated Ultra Performance Liquid Chromatography with tandem Mass Spectrometry detection (UPLC-MS/MS) with a concentration range 1 - 250 ng/mL. Analyses and population PK (PPK) modeling were performed with the nonlinear mixed effect modeling software program Monolix version 4.2.

Results: From January 2013 to January 2014, 36 patients were treated at four dose levels (10, 20, 40, 80 mg) QD and 40 mg BID. 302 plasma concentrations (289 + 13 BLQ) were analyzed. A 1-compartment open model adequately described the total OTX015 time-concentration curve. The PPK parameters obtained for the structural model were: Ka (absorption constant) = 1.12 h-1; V (distribution volume) = 68.6 L and CL (clearance) = 6.65 L/h with a relative standard error of 27%, 9% and 10% respectively. AUC values for all patients increased dose-proportionally (R²= 0.995). The absorption phase was linear and Tmax was between 1 and 4 hours. Mean elimination half-life of OTX015 for all patients was 7.16 h. The main covariate effects in PPK modeling were body weight (BW) which influenced CL, V. No significant gender influence on PK parameters was observed.

Conclusions: The PK of OTX015 is best described by a one-compartment model. BW influenced significantly PK parameters of OTX015. AUC-dose proportionality was observed. Evaluation of glucuronidated metabolite concentrations is ongoing and will contribute to understanding the pathways involved in OTX015 metabolism. PK/PD modeling will be performed to describe toxicity and efficacy (6 experienced clinically meaningful activities) in terms of OTX015 PK. A comparison between QD and BID schemes will be performed in order to verify PK profile of OTX015 for each administration.

Citation Format: Elodie Odore, Keyvan Rezai, Eugenia Riveiro, Fabrice Bourdel, Patrice Herait, Esteban Cvitkovic, Herve Dombret, Francois Lokiec. A phase I pharmacokinetic study of OTX015 for the treatment of patients with hematologic malignancies. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr LB-231. doi:10.1158/1538-7445.AM2014-LB-231