Abstract:
:Mutations in Janus kinase 2 (JAK2) are implicated in the pathogenesis of Philadelphia-chromosome negative myeloproliferative neoplasms, including primary myelofibrosis, polycythemia vera, and essential thrombocythemia. Gandotinib (LY2784544), a potent inhibitor of JAK2 activity, shows increased potency for the JAK2V617F mutation. The study had a standard 3+3 dose-escalation design to define the maximum-tolerated dose. Primary objectives were to determine safety, tolerability, and recommended oral daily dose of gandotinib for patients with JAK2V617F-positive myelofibrosis, essential thrombocythemia, or polycythemia vera. Secondary objectives included estimating pharmacokinetic parameters and documenting evidence of efficacy by measuring clinical improvement. Thirty-eight patients were enrolled and treated (31 myelofibrosis, 6 polycythemia vera, 1 essential thrombocythemia). The maximum-tolerated dose of gandotinib was 120mg daily, based on dose-limiting toxicities of blood creatinine increase or hyperuricemia at higher doses. Maximum plasma concentration was reached 4h after single and multiple doses, and mean half-life on day 1 was approximately 6h. Most common treatment-emergent adverse events were diarrhea (55.3%) and nausea (42.1%), a majority of which were of grade 1 severity. Best response of clinical improvement was achieved by 29% of myelofibrosis patients. A ≥50% palpable spleen length reduction was observed at any time during therapy in 20/32 evaluable patients. Additionally, ≥50% reduction in the Total Symptom Myeloproliferative Neoplasm Symptom Assessment Form Score was seen in 11/21 (52%) and 6/14 patients (43%) receiving ≥120mg at 12 and 24 weeks respectively. Gandotinib demonstrated an acceptable safety and tolerability profile, and findings at the maximum-tolerated dose of 120mg supported further clinical testing. Clinicaltrials.gov identifier: NCT01134120.
journal_name
Leuk Resjournal_title
Leukemia researchauthors
Verstovsek S,Mesa RA,Salama ME,Li L,Pitou C,Nunes FP,Price GL,Giles JL,D'Souza DN,Walgren RA,Prchal JTdoi
10.1016/j.leukres.2017.08.010subject
Has Abstractpub_date
2017-10-01 00:00:00pages
89-95eissn
0145-2126issn
1873-5835pii
S0145-2126(17)30491-5journal_volume
61pub_type
杂志文章,多中心研究abstract::We investigated the therapeutic activity of recombinant erythropoietin (r-EPO) in association with thalidomide in 30 patients with myelodysplastic syndromes (MDS), previously treated with r-EPO (n.15, group A) or thalidomide (n.15, group B) as single agents, respectively, without any significant benefit on their anemi...
journal_title:Leukemia research
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journal_title:Leukemia research
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journal_title:Leukemia research
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doi:10.1016/0145-2126(92)90114-m
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journal_title:Leukemia research
pub_type: 历史文章,杂志文章
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更新日期:1985-01-01 00:00:00
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journal_title:Leukemia research
pub_type: 杂志文章,多中心研究
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journal_title:Leukemia research
pub_type: 杂志文章
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journal_title:Leukemia research
pub_type: 杂志文章
doi:10.1016/0145-2126(93)90088-3
更新日期:1993-07-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2017-09-01 00:00:00
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doi:10.1016/s0145-2126(99)00139-3
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更新日期:2011-02-01 00:00:00
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journal_title:Leukemia research
pub_type: 杂志文章
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journal_title:Leukemia research
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journal_title:Leukemia research
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journal_title:Leukemia research
pub_type: 杂志文章
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journal_title:Leukemia research
pub_type: 杂志文章
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更新日期:2014-08-01 00:00:00
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journal_title:Leukemia research
pub_type: 杂志文章
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更新日期:1991-01-01 00:00:00
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journal_title:Leukemia research
pub_type: 杂志文章
doi:10.1016/s0145-2126(00)00095-3
更新日期:2001-02-01 00:00:00
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journal_title:Leukemia research
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更新日期:2013-09-01 00:00:00
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journal_title:Leukemia research
pub_type: 杂志文章
doi:10.1016/j.leukres.2003.10.022
更新日期:2004-06-01 00:00:00
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journal_title:Leukemia research
pub_type: 临床试验,杂志文章
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更新日期:2003-01-01 00:00:00
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journal_title:Leukemia research
pub_type: 杂志文章
doi:10.1016/0145-2126(91)90014-k
更新日期:1991-01-01 00:00:00