Data was presented at the American Association for Cancer Research-National selleckchem Cancer Institute-European Organization for Research and Treatment of Cancer Annual Meeting in 2009. One patient with medulloblastoma continues on study for more than 10 months with stable disease. A second subject with Gorlin syndrome had a partial response to therapy which was ongoing at the time of the report.100 At the 2011 American Society of Hematology meeting, Huff et al presented Phase I data on BMS-833293 in patients with MM. BMS-833923 was given either as monotherapy, or in combination with lenalidomide plus dexamethasone, or with bortezomib in patients with relapsed or refractory MM. No clinical response data had been analyzed to date.101 In both trials, the drug was well-tolerated with the most common side effects being dysgeusia, muscle spasms, and nausea.
There was one episode of grade 2 lipase elevation and pancreatitis. PF-04449913 Preliminary data was presented in abstract form with PF-04449913 (Pfizer, Manhattan, NY) at the 2011 American Society of Hematology Annual Meeting. The drug was administered as a single agent in escalating doses in a Phase Ia study of 32 patients with various hematologic malignancies including acute myeloid leukemia, CML in lymphoid blast crisis, myelodysplastic syndrome, myelofibrosis, and chronic myelomonocytic leukemia. Some evidence of response was seen in all disease subsets, and one patient with acute myeloid leukemia evolved from chronic myelomonocytic leukemia achieved a complete remission with incomplete blood count recovery.
Five patients with acute myeloid leukemia had significant reduction in circulating blast counts, and one patient with T315I mutation CML in lymphoid blast crisis achieved a major cytogenetic response with loss of the T315I mutation. Other patients had hematologic improvement or disease stabilization. The drug was relatively well-tolerated with the most common side effects being dysgeusia, alopecia, nausea, and arthralgias.102 An expanded multicenter Phase Ib/II study is planned in combination with chemotherapy in hematologic malignancies Cilengitide as well. Discussion Preclinical in vitro and in vivo data with Hh signaling demonstrate a role for the pathway in the pathogenesis, self-renewal, and chemotherapy resistance in a variety of human cancers. Years of laboratory investigations have led to Phase I trials of several Smo inhibitors which appear to be relatively well-tolerated either as single agents or in combination regimens with conventional chemotherapy. Modest side effects include nausea, dysgeusia, muscle cramps, and fatigue, with rare grade 3 adverse events observed.