Debio-1143. Inhibitor of apoptosis protein (IAP) antagonist, Cancer therapy
作者:I. Ray-Coquard、J. Bourhis、J-P. Delord、G. Vuagniaux、C. Zanna、B. Lu、S. Wang
DOI:10.1358/dof.2017.042.12.2702829
日期:——
Inhibitors of apoptosis proteins (IAPs) block caspases, modulate nuclear factor NF-kappa B signaling pathways and are involved in resistance to cancer therapies. Debio-1143, a mimetic of an endogenous IAP inhibitor (second mitochondria-derived activator of caspases [SMAC]), may help to overcome treatment resistance and has demonstrated antitumor activity in various cancer cell lines and xenograft models, alone or in combination with chemotherapy, radiotherapy or immunotherapies. So far, about 150 cancer patients have been enrolled in 5 registered early-phase clinical trials testing Debio-1143. Tolerability was acceptable even when the drug was used in combination therapies. In monotherapy, pharmacokinetics was linear, but varied considerably among patients in combination settings. High tumor penetration and on-target activity were consistently shown in patient surrogate tissues and tumor biopsies. Tumor responses to second-(or higher) line monotherapy in patients with various advanced cancers were rather weak, but currently followed approaches as an adjunct to existing cancer therapies look[GRAPHICS]encouraging. Still, to identify ideal target populations and concomitant regimens remains challenging.