Effect of ulixertinib, a novel ERK1/2 inhibitor, on the QT/QTc interval in patients with advanced solid tumor malignancies Journal Article


Authors: Mendzelevski, B.; Ferber, G.; Janku, F.; Li, B. T.; Sullivan, R. J.; Welsch, D.; Chi, W.; Jackson, J.; Weng, O.; Sager, P. T.
Article Title: Effect of ulixertinib, a novel ERK1/2 inhibitor, on the QT/QTc interval in patients with advanced solid tumor malignancies
Abstract: Purpose: The aim of this analysis was to investigate the potential for ulixertinib (BVD-523) to prolong cardiac repolarization. The mean prolongation of the corrected QT (QTc) interval was predicted at the mean maximum drug concentrations of the recommended phase 2 dose (RP2D; 600 mg BID) and of higher concentrations. In addition, the effect of ulixertinib on other quantitative ECG parameters was assessed. Methods: In a two-part, phase 1, open-label study in adults with advanced solid tumors, 105 patients [24 in Part 1 (dose escalation) and 81 in Part 2 (cohort expansion)] were included in a QT prolongation analysis. Electrocardiograms (ECGs) extracted from 12-lead Holter monitors, along with time-matched pharmacokinetic blood samples, were collected over 12 h on cycle 1 day 1 and cycle 1 day 15 and analyzed by a core ECG laboratory. Results: A small increase in heart rate was observed on both study days (up to 5.6 bpm on day 1 and up to 7 bpm on day 15). The estimated mean changes from baseline in the study-specific QTc interval (QTcSS), at the ulixertinib Cmax, were − 0.529 ms (90% CI − 6.621, 5.562) on day 1 and − 9.202 ms (90% CI − 22.505, 4.101) on day 15. The concentration: QTc regression slopes were mildly positive but not statistically significant [0.53 (90% CI − 1.343, 2.412) and 1.16 (90% CI − 1.732, 4.042) ms per μg/mL for days 1 and 15, respectively]. Ulixertinib had no meaningful effect on PR or QRS intervals. Conclusions: Ulixertinib administered to patients with solid tumors at clinically relevant doses has a low risk for QT/QTc prolongation or any other effects on ECG parameters. Registration: The study is registered at Clinicaltrials.gov (NCT01781429) and was sponsored by BioMed Valley Discoveries. © 2018, The Author(s).
Keywords: adult; cancer chemotherapy; middle aged; major clinical study; advanced cancer; drug megadose; low drug dose; multiple cycle treatment; qt prolongation; oncology; drug dose escalation; blood sampling; open study; drug blood level; phase 1 clinical trial; electrocardiography; heart rate; cardiac safety; human; male; female; priority journal; article; qt; ecg; solid malignant neoplasm; ulixertinib; maximum concentration; exposure:response modeling; holter; qtc; pr interval; qrs interval; qtc interval
Journal Title: Cancer Chemotherapy and Pharmacology
Volume: 81
Issue: 6
ISSN: 0344-5704
Publisher: Springer  
Date Published: 2018-06-01
Start Page: 1129
End Page: 1141
Language: English
DOI: 10.1007/s00280-018-3564-1
PROVIDER: scopus
PMCID: PMC5973962
PUBMED: 29603015
DOI/URL:
Notes: Article -- Export Date: 2 July 2018 -- Source: Scopus
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  1. Bob Tingkan Li
    278 Li