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Assessing the translational value of pre-clinical studies for clinical response rate in oncology: an exploratory investigation of 42 FDA-approved small-molecule targeted anticancer drugs

机译:评估肿瘤学前临床反应率预临床研究的翻译价值:42个FDA批准的小分子靶向抗癌药物的探索性研究

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Purpose To assess the translational value of anticancer preclinical models, we retrospectively investigated the relationships between preclinical data and clinical response rate for 42 small-molecule targeted anticancer drugs approved by the US FDA from 2001 to 2018. Methods For 42 FDA-approved drugs, relevant pre-clinical (IC50, mouse PK/efficacy) and clinical (overall response rates [ORR], PK) data were extracted from the public domain. Relationships were investigated overall and separately by mechanism of action and solid vs liquid tumors. Binomial-normal regression analysis was performed using R. Results A significant correlation was found between the ratio of free human average plasma concentration (hC(ave)) at the approved clinical dose to biochemical IC50 and ORR for kinase inhibitors with solid tumor indications (KIST). We also identified that, for KIST, the ratios of (i) total and (ii) free human-to-mouse average plasma concentration at efficacious doses were correlated to ORR ((i) R-2 = 0.72, n = 10; (ii) R-2 = 0.78, n = 10)). Conclusion Relationships were identified for ratios of efficacious clinical exposures to typical preclinical pharmacology data and ORR for KIST in this retrospective analysis. Although the obtained datasets are limited, the relationships demonstrate that a systemic exposure relative to established pre-clinical pharmacology experiments for an investigational KIST could be used as a reference to assess if desired efficacy could be achieved. This approach may assist selection of the recommended phase 2 dose (RP2D) of an investigational drug.
机译:目的为了评估抗癌临床前模型的转化价值,我们回顾性研究了2001年至2018年美国FDA批准的42种小分子靶向抗癌药物的临床前数据与临床反应率之间的关系。方法对42种FDA批准的药物,从公共领域提取相关的临床前(IC50、小鼠PK/疗效)和临床(总有效率[ORR],PK)数据。通过作用机制和实体瘤与液体瘤的关系进行全面和单独的研究。结果在批准的临床剂量下,游离人体平均血浆浓度(hC(ave))与具有实体瘤指征的激酶抑制剂(KIST)的生化IC50和ORR之间存在显著相关性。我们还发现,对于KIST,有效剂量下(i)总和(ii)游离人与小鼠平均血浆浓度的比率与ORR相关((i)R-2=0.72,n=10;(ii)R-2=0.78,n=10)。结论在这项回顾性分析中,确定了有效临床暴露与典型临床前药理学数据的比率以及KIST的ORR之间的关系。尽管获得的数据集有限,但这些关系表明,与研究性KIST的临床前药理学实验相关的系统性暴露可作为评估是否能达到预期疗效的参考。这种方法可能有助于选择研究药物的推荐二期剂量(RP2D)。

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