A Phase I/IIA, Non-Randomized, Open Label, Single Dose, Dose-Escalation, Safety Study of BKT140, a CXCR4 Antagonist in Patients With Multiple Myeloma
The chemokine CXCL12 (also called SDF-1 - stromal-derived-factor-1) and its receptor, CXCR4
((CXC Chemokine Receptor 4), a molecule endowed with potent chemotactic activity for
hematopoietic cells, together play a pivotal role in the trafficking of hematopoietic stem
cells to the bone marrow 10,11. The CXCL12/CXCR4 axis is also critically involved in the
retention of hematopoietic cells within the BM microenvironment. Following chemotherapy and
irradiation, the CXCL12/CXCR4 axis delays the recovery of the BM progenitor cells and the
exit of mature cells such as neutrophils and monocytes to the periphery. Consequently,
disruption of the CXCL12/CXCR4 interaction results in mobilization of hematopoietic cells
including stem cells and a faster recovery of the treated BM.
BKT140 (4F-benzoyl-TN14003) is a highly selective and unique CXCR4 antagonist. Pre-clinical
studies showed that BKT140 binds CXCR4 with high affinity (1nM) 13. Biokine has demonstrated
the ability of the CXCR4 antagonist, BKT140, to mobilize various WBC such as neutrophils and
monocytes as well as progenitor and stem cells, from the BM. The ability of BKT140 to
stimulate the mobilization of these cells is superior to that of AMD3100, a CXCR4 antagonist
that is in clinical development for mobilization of stem cells in MM and lymphoma patients,
both qualitatively and quantitatively. BKT140 synergizes much more efficiently with G-CSF
when compared to AMD3100. Moreover, Biokine has shown that BKT140, in synergism with G-CSF
(NEUPOGEN®), is much more efficient in increasing the numbers of neutrophils and activated
monocytes in the blood, by several folds as compared to G-CSF alone. BKT140 also shortens
the neutropenic period due to an early release of neutrophils and monocytes from the BM.
More importantly, BKT140, in synergism with G-CSF, reduces the anemic period caused by
chemotherapy, due to a RBC production, which does not occur when G-CSF is given as a sole
treatment. More importantly, BKT140, but not G-CSF or AMD3100, is also capable of shortening
the period of cytopenia by boosting both the recovery of all hematopoietic cells in the BM
and their exit to the periphery, and therefore shortening the period of cytopenia following
chemotherapy or irradiation and BM transplantation. Importantly, Biokine has shown that upon
interaction with CXCR4, BKT140, but not AMD3100, selectively, specifically and rapidly
stimulates human leukemia and myeloma cell death in vitro and in vivo. Furthermore, BKT140
synergizes with other chemotherapeutic agents such as rapamycine to induce MM cell death.
Interventional
Endpoint Classification: Safety Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
White blood cell (WBC) count
24 hour
No
Arnon Nagler, MD
Principal Investigator
Chaim Sheba Medical Center
Israel: Ministry of Health
BKTSC001
NCT01010880
October 2008
July 2010
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