Phase I clinical trial of a novel procaspase-3 activator SM-1 with temozolomide in recurrent high-grade gliomas

Objective: Despite a standard of care, the mortality of recurrent high-grade gliomas (HGGs) remains high. SM-1 is a novel molecular activator that has shown to target procaspase-3, which is overexpressed in HGGs. A phase I clinical trial was conducted to evaluate the safety, pharmacokinetics, and pr...

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Main Authors: Mengqian Huang, Zhuang Kang, Shenglan Li, Botao Zhang, Yantao Xiao, Shangwei Li, Wenbin Li
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:Neoplasia: An International Journal for Oncology Research
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Online Access:http://www.sciencedirect.com/science/article/pii/S147655862500020X
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author Mengqian Huang
Zhuang Kang
Shenglan Li
Botao Zhang
Yantao Xiao
Shangwei Li
Wenbin Li
author_facet Mengqian Huang
Zhuang Kang
Shenglan Li
Botao Zhang
Yantao Xiao
Shangwei Li
Wenbin Li
author_sort Mengqian Huang
collection DOAJ
description Objective: Despite a standard of care, the mortality of recurrent high-grade gliomas (HGGs) remains high. SM-1 is a novel molecular activator that has shown to target procaspase-3, which is overexpressed in HGGs. A phase I clinical trial was conducted to evaluate the safety, pharmacokinetics, and primary clinical efficacy of SM-1 plus TMZ. Participants received escalating doses of daily oral SM-1 (450, 600, and 800 mg) plus standard TMZ therapy. Methods: In the preclinical study, the synergistic effects of SM-1 and temozolomide (TMZ) in rodent models were evaluated. In the clinical study, adult patients received SM-1 therapy in various doses in combination with a standard TMZ dosing. The tolerability and pharmacokinetics data of the combination therapy were tested. The primary efficacy was measured by tumor response in accordance with the RANO criteria. Results: A total of 13 patients with recurrent HGG were enrolled, with 11 patients completed ≥ two cycles of therapy and received tumor assessment. Among them, one patient had complete response, whereas two patients had partial response for the best change from baseline. No dose-limited toxicities were observed, and no maximum tolerated dose was reached. Conclusion: SM-1 has the potential to enhance antitumor activity while alleviating the side effects of TMZ. SM-1 exhibited mild toxicity in patients with recurrent HGG. The combination of SM-1 and TMZ warrants further investigation, with promising clinical outcomes. The monotherapy phase and expansion phase of SM-1 are still ongoing. (ClinicalTrials.gov number, CTR20221641).
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series Neoplasia: An International Journal for Oncology Research
spelling doaj-art-d8a4ee338a2246199717a1ab29bb19e72025-08-20T02:00:45ZengElsevierNeoplasia: An International Journal for Oncology Research1476-55862025-03-016110114110.1016/j.neo.2025.101141Phase I clinical trial of a novel procaspase-3 activator SM-1 with temozolomide in recurrent high-grade gliomasMengqian Huang0Zhuang Kang1Shenglan Li2Botao Zhang3Yantao Xiao4Shangwei Li5Wenbin Li6Cancer Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, PR ChinaCancer Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, PR ChinaCancer Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, PR ChinaCancer Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, PR ChinaClinical R&D Department, Shenzhen Zhenxing Pharmaceutical Technology Co., Ltd. , PR ChinaClinical R&D Department, Shenzhen Zhenxing Pharmaceutical Technology Co., Ltd. , PR ChinaCancer Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, PR China; Corresponding author at: Cancer Center, Beijing Tiantan Hospital, Capital Medical University, No.119, Nansihuan West Road, Fengtai District, Beijing 100070, PR China.Objective: Despite a standard of care, the mortality of recurrent high-grade gliomas (HGGs) remains high. SM-1 is a novel molecular activator that has shown to target procaspase-3, which is overexpressed in HGGs. A phase I clinical trial was conducted to evaluate the safety, pharmacokinetics, and primary clinical efficacy of SM-1 plus TMZ. Participants received escalating doses of daily oral SM-1 (450, 600, and 800 mg) plus standard TMZ therapy. Methods: In the preclinical study, the synergistic effects of SM-1 and temozolomide (TMZ) in rodent models were evaluated. In the clinical study, adult patients received SM-1 therapy in various doses in combination with a standard TMZ dosing. The tolerability and pharmacokinetics data of the combination therapy were tested. The primary efficacy was measured by tumor response in accordance with the RANO criteria. Results: A total of 13 patients with recurrent HGG were enrolled, with 11 patients completed ≥ two cycles of therapy and received tumor assessment. Among them, one patient had complete response, whereas two patients had partial response for the best change from baseline. No dose-limited toxicities were observed, and no maximum tolerated dose was reached. Conclusion: SM-1 has the potential to enhance antitumor activity while alleviating the side effects of TMZ. SM-1 exhibited mild toxicity in patients with recurrent HGG. The combination of SM-1 and TMZ warrants further investigation, with promising clinical outcomes. The monotherapy phase and expansion phase of SM-1 are still ongoing. (ClinicalTrials.gov number, CTR20221641).http://www.sciencedirect.com/science/article/pii/S147655862500020XGlioblastomaProcaspase-3High-grade gliomaTemozolomideTargeted therapy
spellingShingle Mengqian Huang
Zhuang Kang
Shenglan Li
Botao Zhang
Yantao Xiao
Shangwei Li
Wenbin Li
Phase I clinical trial of a novel procaspase-3 activator SM-1 with temozolomide in recurrent high-grade gliomas
Neoplasia: An International Journal for Oncology Research
Glioblastoma
Procaspase-3
High-grade glioma
Temozolomide
Targeted therapy
title Phase I clinical trial of a novel procaspase-3 activator SM-1 with temozolomide in recurrent high-grade gliomas
title_full Phase I clinical trial of a novel procaspase-3 activator SM-1 with temozolomide in recurrent high-grade gliomas
title_fullStr Phase I clinical trial of a novel procaspase-3 activator SM-1 with temozolomide in recurrent high-grade gliomas
title_full_unstemmed Phase I clinical trial of a novel procaspase-3 activator SM-1 with temozolomide in recurrent high-grade gliomas
title_short Phase I clinical trial of a novel procaspase-3 activator SM-1 with temozolomide in recurrent high-grade gliomas
title_sort phase i clinical trial of a novel procaspase 3 activator sm 1 with temozolomide in recurrent high grade gliomas
topic Glioblastoma
Procaspase-3
High-grade glioma
Temozolomide
Targeted therapy
url http://www.sciencedirect.com/science/article/pii/S147655862500020X
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