Phase 1 trial of bemcentinib (BGB324), a first-in-class, selective AXL inhibitor, with docetaxel in patients with previously treated advanced non-small cell lung cancer

Objectives: AXL, a transmembrane receptor tyrosine kinase, is highly expressed and associated with poor prog-nosis in non-small cell lung cancer (NSCLC). Bemcentinib (BGB324), a selective orally bioavailable small molecule AXL inhibitor, synergizes with docetaxel in preclinical models. We performed a phase I trial of bem-centinib plus docetaxel in previously treated advanced NSCLC.Materials and Methods: Escalation of two dose levels of bemcentinib (200 mg load x 3 days then 100 mg daily, or 400 mg load x 3 days then 200 mg daily) in combination with docetaxel (60 or 75 mg/m2 every 3 weeks) followed a 3+3 study design. Due to hematologic toxicity, prophylactic G-CSF was added. Bemcentinib mono-therapy was administered for one week prior to docetaxel initiation to assess pharmacodynamic and pharma-cokinetic effects alone and in combination. Plasma protein biomarker levels were measured. Results: 21 patients were enrolled (median age 62 years, 67% male). Median treatment duration was 2.8 months (range 0.7-10.9 months). The main treatment-related adverse events were neutropenia (86%, 76% & GE;G3), diarrhea (57%, 0% & GE;G3), fatigue (57%, 5% & GE;G3), and nausea (52%, 0% & GE;G3). Neutropenic fever occurred in 8 (38%) patients. The maximum tolerated dose was docetaxel 60 mg/m2 with prophylactic G-CSF support plus bemcentinib 400 mg load x 3 days followed by 200 mg daily thereafter. Bemcentinib and docetaxel pharma-cokinetics resembled prior monotherapy data. Among 17 patients evaluable for radiographic response, 6 (35%) patients had partial response and 8 (47%) patients had stable disease as best response. Bemcentinib adminis-tration was associated with modulation of proteins involved in protein kinase B signaling, reactive oxygen species metabolism, and other processes. Conclusion: Bemcentinib plus docetaxel with G-CSF support demonstrates anti-tumor activity in previously treated, advanced NSCLC. The role of AXL inhibition in the treatment of NSCLC remains under investigation.

Automated summary

This study evaluated the efficacy and safety of bemcentinib in combination with docetaxel in advanced NSCLC patients. The results showed that bemcentinib plus docetaxel could inhibit tumor growth and produce partial responses in some patients.