A phase I dose-escalation study of SYHA1813, a VEGFR and CSF1R inhibitor, in patients with recurrent High-Grade Gliomas or Advanced Solid Tumors

Invest New Drugs. 2023 Apr;41(2):296-305. doi: 10.1007/s10637-022-01325-4. Epub 2023 Mar 8.

Abstract

SYHA1813 is a potent multikinase inhibitor that targets vascular endothelial growth factor receptors (VEGFRs)/colony-stimulating factor 1 receptor (CSF1R). This study aimed to evaluate the safety, pharmacokinetics (PK), and antitumor activity of escalating doses of SYHA1813 in patients with recurrent high-grade gliomas (HGGs) or advanced solid tumors. This study adopted a combination of accelerated titration and a 3 + 3 design for dose escalation, with a starting dose of 5 mg once daily. The dose escalation continued at successive dose levels until the maximum tolerated dose (MTD) was determined. A total of 14 patients were enrolled and treated, including 13 with WHO grade III or IV gliomas and 1 with colorectal cancer. Two patients experienced dose-limiting toxicities (grade 4 hypertension and grade 3 mucositis oral) at 30 mg SYHA1813. The MTD was defined as 15 mg once daily. Hypertension (n = 6, 42.9%) was the most frequent treatment-related adverse event. Among evaluable patients (n = 10), 2 (20%) patients achieved partial response, and 7 (70%) had stable disease. The exposure increased with increasing doses within the studied dose range of 5 to 30 mg. Biomarker assessments demonstrated significant reductions in the levels of soluble VEGFR2 (P = .0023) and increases in the levels of VEGFA (P = .0092) and placental growth factor (P = .0484). The toxicities of SYHA1813 were manageable, and encouraging antitumor efficacy was observed in patients with recurrent malignant glioma. This study is registered with the Chinese Clinical Trial Registry ( www.chictr.org.cn/index.aspx ; identifier ChiCTR2100045380).

Keywords: CSF1R; Dose escalation; High-grade glioma; Phase I; Solid tumor; VEGFR.

Publication types

  • Clinical Trial, Phase I
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Female
  • Glioma* / drug therapy
  • Humans
  • Hypertension*
  • Maximum Tolerated Dose
  • Neoplasm Recurrence, Local / drug therapy
  • Neoplasms* / drug therapy
  • Placenta Growth Factor / therapeutic use
  • Receptors, Colony-Stimulating Factor
  • Vascular Endothelial Growth Factor A

Substances

  • Vascular Endothelial Growth Factor A
  • Placenta Growth Factor
  • Receptors, Colony-Stimulating Factor

Associated data

  • ChiCTR/ChiCTR2100045380