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Dose Escalation and Expansion Study of GSK3359609 in Participants With Selected Advanced Solid Tumors (INDUCE-1)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT02723955
Recruitment Status : Active, not recruiting
First Posted : March 31, 2016
Last Update Posted : April 12, 2022
Sponsor:
Collaborator:
Merck Sharp & Dohme LLC
Information provided by (Responsible Party):
GlaxoSmithKline

Brief Summary:
GSK3359609 is an anti-Inducible T cell Co-Stimulator (ICOS) receptor agonist antibody intended for the treatment of cancers of different histology. This is a first-time-in-human (FTIH), open-label, multicenter study designed to investigate the safety, pharmacology, and preliminary antitumor activity in participants with selected, advanced or recurrent solid tumors with the aim to establish recommended dose(s) of GSK3359609 for further exploration as monotherapy and in combination with pembrolizumab or chemotherapy regimens. The study is comprised of two primary parts, each composed of two phases: Part 1: GSK3359609 monotherapy with Part 1A as dose escalation phase and Part 1B as cohort expansion phase; Part 2: GSK3359609 combination therapy with Part 2A pembrolizumab or GSK3174998 or dostarlimab or dostarlimab plus cobolimab or Bintrafusp alfa combination dose escalation phase and Part 2B expansion phase with pembrolizumab. Part 2A GSK3359609 combinations with chemotherapy will only consist of safety run-in cohorts. Each part and phase of the study includes a screening period, a treatment period, and a follow-up period. The primary objective of the study is to determine the safety, tolerability, maximum tolerated dose or the maximum administered dose of GSK3359609 alone or in combination.

Condition or disease Intervention/treatment Phase
Neoplasms Drug: feladilimab (GSK3359609) Drug: GSK3174998 Drug: Pembrolizumab Drug: Docetaxel Drug: Pemetrexed Drug: Paclitaxel plus Carboplatin Drug: Gemcitabine plus Carboplatin Drug: Fluorouracil (5-FU) plus carboplatin or cisplatin Drug: Dostarlimab Drug: Cobolimab Drug: Bintrafusp alfa Phase 1

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 829 participants
Allocation: Non-Randomized
Intervention Model: Sequential Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase I Open Label Study of GSK3359609 Administered Alone and in Combination With Anticancer Agents in Subjects With Selected Advanced Solid Tumors
Actual Study Start Date : June 23, 2016
Estimated Primary Completion Date : June 20, 2023
Estimated Study Completion Date : June 20, 2023

Arm Intervention/treatment
Experimental: Part 1A: Dose escalation feladilimab (GSK3359609)
Participants will receive feladilimab (GSK3359609) administered continuously at a dose level dependent on to which dose level the participant is accrued.
Drug: feladilimab (GSK3359609)
Experimental: Part 1B: Expansion feladilimab (GSK3359609)
Participants will receive feladilimab (GSK3359609) administered continuously at a dose level chosen for further exploration in dose expansion cohorts.
Drug: feladilimab (GSK3359609)
Experimental: Part 2A: Dose escalation (feladilimab (GSK3359609)+pembrolizumab)
Participants will receive feladilimab (GSK3359609) administered continuously in combination with pembrolizumab.
Drug: feladilimab (GSK3359609)
Drug: Pembrolizumab
Experimental: Part 2A: Dose escalation (feladilimab (GSK3359609)+GSK3174998)
Participants will receive feladilimab (GSK3359609) administered continuously in combination with GSK3174998.
Drug: feladilimab (GSK3359609)
Drug: GSK3174998
Experimental: Part 2A: Safety run-in (feladilimab (GSK3359609)+chemotherapy)
Participants participating in Part 2A chemotherapy combination cohorts will receive feladilimab (GSK3359609) in combination with chemotherapy at doses and schedules based on standard of care practice.
Drug: feladilimab (GSK3359609)
Drug: Docetaxel
Drug: Pemetrexed
Drug: Paclitaxel plus Carboplatin
Drug: Gemcitabine plus Carboplatin
Drug: Fluorouracil (5-FU) plus carboplatin or cisplatin
Experimental: Part 2B: Expansion-feladilimab (GSK3359609)
Participants will receive feladilimab (GSK3359609) administered continuously in combination with pembrolizumab.
Drug: feladilimab (GSK3359609)
Drug: Pembrolizumab
Experimental: Part 2A: Dose escalation (feladilimab (GSK3359609)+ dostarlimab)
Participants will receive feladilimab (GSK3359609) administered continuously in combination with dostarlimab.
Drug: feladilimab (GSK3359609)
Drug: Dostarlimab
Experimental: Part 2A: Dose escalation (feladilimab (GSK3359609)+dostarlimab+cobolimab)
Participants will receive feladilimab (GSK3359609) administered continuously in combination with dostarlimab followed by cobolimab.
Drug: feladilimab (GSK3359609)
Drug: Dostarlimab
Drug: Cobolimab
Experimental: Part 2A: Dose escalation (feladilimab (GSK3359609)+bintrafusp alfa)
Participants will receive feladilimab (GSK3359609) administered continuously in combination with bintrafusp alfa.
Drug: feladilimab (GSK3359609)
Drug: Bintrafusp alfa



Primary Outcome Measures :
  1. Parts 1 and 2: Number of participants with any months adverse event(s) (AE) and serious adverse event(s) (SAE) [ Time Frame: Up to 27 months ]
    AEs and SAEs will be collected.

  2. Parts 1 and 2: Number of participants with dose limiting toxicity (DLT) [ Time Frame: Up to 28 days ]
    Number of participants with DLTs will be assessed.

  3. Parts 1 and 2: Number of participants with clinically significant changes in laboratory parameters and vital signs [ Time Frame: Up to 24 months ]
    Number of participants with clinically significant changes in laboratory parameters and vital signs will be assessed.

  4. Parts 1 and 2: Number of participants requiring dose modifications [ Time Frame: Up to 24 months ]
    All dose modifications due to any reason(s) will be recorded.


Secondary Outcome Measures :
  1. Parts 1 and 2: Disease control rate (DCR) [ Time Frame: Up to 27 months ]
    DCR is defined as the percentage of participants with a confirmed complete response (CR) + partial response (PR) at any time, plus stable disease (SD) >=18 weeks.

  2. Parts 1 and 2: Overall survival (OS) [ Time Frame: Up to 4 years ]
    OS is defined as time from the date of first dose of study treatment to the date of death due to any cause.

  3. Parts 1 and 2: Progression-free survival (PFS) [ Time Frame: Up to 27 months ]
    PFS is defined as time from the date of first dose of study treatment to the date of disease progression according to clinical or radiographic assessment or death due to any cause, whichever occurs earliest.

  4. Parts 1 and 2: Time to overall response (TTR) [ Time Frame: Up to 27 months ]
    TTR will be summarized for participants with a confirmed CR or PR and is defined as the time from date of first dose of study treatment to date of first documented confirmed CR or PR.

  5. Parts 1 and 2: Duration of response (DOR) [ Time Frame: Up to 27 months ]
    DOR will be summarized for participants with a confirmed CR or PR and is defined as the time from date of initial confirmed response to the date of disease progression or death due to any cause.

  6. Parts 1 and 2: Overall response rate (ORR) [ Time Frame: Up to 27 months ]
    ORR is defined as the percentage of participants with a best overall confirmed CR or a PR at any time as per disease-specific criteria.

  7. Parts 1 and 2: Maximum observed plasma concentration (Cmax) and minimum observed plasma concentration (Cmin) of GSK3359609 [ Time Frame: Up to 27 months ]
    Blood samples will be collected for the concentrations of GSK3359609.

  8. Parts 1 and 2: Area under the concentration-time curve over the dosing interval (AUC[0-tau]) of GSK3359609 in plasma [ Time Frame: Up to 27 months ]
    Blood samples will be collected for the concentrations of GSK3359609.

  9. Parts 1 and 2: Number of participants with positive results in Anti-drug antibody (ADA) test by GSK3359609 dose level [ Time Frame: Up to 27 months ]
    Blood samples will be collected up to 27 months for ADA test.

  10. Part 1 and 2: Number of participants with positive results in GSK3359609 [ Time Frame: Up to 27 months ]
    Blood samples will be collected up to 27 months for immunogenicity.

  11. Part 2: Number of participants with DLT following administration of GSK3359609 in combination with chemotherapies [ Time Frame: Up to 28 days ]
    Number of participants with DLTs will be assessed.

  12. Part 2: Cmax and Cmin of GSK3174998 [ Time Frame: Up to 24 months ]
    Blood samples will be collected for the concentrations of GSK3174998.

  13. Part 2: AUC(0-tau) of GSK3174998 [ Time Frame: Up to 24months ]
    Blood samples will be collected for the concentrations of GSK3174998.

  14. Part 2: Cmax and Cmin of Pembrolizumab [ Time Frame: Up to 27 months ]
    Blood samples will be collected for the concentrations of Pembrolizumab.

  15. Part 2: AUC(0-tau) of Pembrolizumab [ Time Frame: Up to 27 months ]
    Blood samples will be collected for the concentrations of Pembrolizumab.

  16. Part 2: Number of participants with positive results in ADA test by GSK3359609 in combination with pembrolizumab or GSK3174998 dose level [ Time Frame: Up to 27 months ]
    Blood samples will be collected up to 27 months for ADA test.

  17. Part 2: Number of participants with positive results in Pembrolizumab [ Time Frame: Up to 27 months ]
    Blood samples will be collected up to 27 months for immunogenicity.

  18. Part 2: Number of participants with positive results in GSK3174998 [ Time Frame: Up to 27 months ]
    Blood samples will be collected up to 27 months for immunogenicity.

  19. Part 2: Cmax and Cmin of GSK3359609 combination with chemotherapies [ Time Frame: Up to 27 months ]
    Blood samples will be collected for the concentrations of GSK3359606 in combination with chemotherapies.

  20. Part 2: Number of participants with positive results in ADA test by GSK3359609 combination with chemotherapies dose level [ Time Frame: Up to 27 months ]
    Blood samples will be collected up to 27 months for ADA test.

  21. Part 2: Cmax and Cmin of dostarlimab [ Time Frame: Up to 27 months ]
    Blood samples will be collected for the concentrations of dostarlimab.

  22. Part 2: AUC(0-tau) of dostarlimab [ Time Frame: Up to 27 months ]
    Blood samples will be collected for the concentrations of dostarlimab.

  23. Part 2: Cmax and Cmin of cobolimab [ Time Frame: Up to 27 months ]
    Blood samples will be collected for the concentrations of cobolimab.

  24. Part 2: AUC(0-tau) of cobolimab [ Time Frame: Up to 27 months ]
    Blood samples will be collected for the concentrations of cobolimab.

  25. Part 2: Cmax and Cmin of bintrafusp alfa [ Time Frame: Up to 27 months ]
    Blood samples will be collected for the concentrations of bintrafusp alfa.

  26. Part 2: AUC(0-tau) of bintrafusp alfa [ Time Frame: Up to 27 months ]
    Blood samples will be collected for the concentrations of bintrafusp alfa.



Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria

  • Capable of giving signed, written informed consent.
  • Male or female, age >=18 years (at the time consent is obtained).
  • Histological or cytological documentation of an invasive malignancy that was diagnosed as locally advanced/metastatic or relapsed/refractory and is of one of the following tumor types: bladder/urothelial cancer of the upper and lower urinary tract; cervical; colorectal (includes appendix); esophagus, squamous cell; head and neck carcinoma; melanoma; malignant pleural mesothelioma (MPM); non-small-cell lung cancer (NSCLC), prostate; Microsatellite Instability-High/deficient mismatch repair (MSI-H/dMMR) tumor (Part 1B and Part 2B) and Human Papilloma Virus (HPV)-positive or Epstein-Barr (EBV)-positive tumor (Part 1B and Part 2B).
  • Disease that has progressed after standard therapy for the specific tumor type, or for which standard therapy has proven to be ineffective, intolerable, or is considered inappropriate, or if no further standard therapy exists; exceptions are in these tumor types in which pembrolizumab single agent may be a standard: NSCLC, head and neck squamous cell cancer (HNSCC), bladder/urothelial cancer, MSI-H/dMMR cancers and melanoma and cervical cancer. In Part 2B pembrolizumab combination expansion cohorts, prior treatment with anti-Programmed cell death protein 1(PD-1)/ Ligand-1 (L1) may not be required. 1) Participants must not have received more than 5 prior lines of therapy for advanced disease including both standards of care and investigational therapies. 2) Participants who received prior PD-1/L1 therapy must fulfill the following requirements (Part 1B [except PK/PD cohort]/ Part 2B):a) Have achieved a CR, PR or SD and subsequently had disease progression while still on PD-1/L1 therapy; b) Have received at least 2 doses of an approved PD-1/L1 inhibitor (by any regulatory authority), c) Have demonstrated disease progression as defined by Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 within 18 weeks from the last dose of the PD-1/L1 inhibitor. The initial evidence of disease progression is to be confirmed by a second assessment no less than four weeks from the date of the first documented Progressive Disease (PD) (the confirmatory scan could be the Baseline eligibility scan for this study). 3) In Part 2A 5-fluorouracil (FU)/platinum combination with GSK3359609 and pembrolizumab cohort, participants must not have received prior systemic therapy administered in the recurrent or metastatic setting (with the exception of systemic therapy given as part of multimodal treatment for locally advanced disease).
  • Archival tumor tissue obtained at any time from the initial diagnosis to study entry; a fresh tumor biopsy using a procedure that is safe for the participant on a lesion not previously irradiated unless lesion progressed will be required if archival tissue is unavailable.
  • Agree to undergo a pre-treatment and on treatment biopsy and have disease amenable to biopsy required in pharmacokinetic (PK) / pharmacodynamics (PD), dose randomized HNSCC, Melanoma dose expansion and Biomarker cohorts..
  • Measurable disease per RECIST version 1.1. Palpable lesions that are not measurable by radiographic or photographic evaluations may not be utilized as the only measurable lesion. Any measurable lesion biopsied at Screening cannot be followed as a target/index lesion unless agreed upon by GlaxoSmithKline (GSK).
  • Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0-1.
  • Life expectancy of at least 12 weeks.
  • Adequate organ function.
  • QT interval corrected for heart rate according to Fridericia's formula (QTcF) <450 milliseconds (msec) or QTcF <480 msec for participants with bundle branch block.
  • A female participant is eligible to participate if she is not pregnant (as confirmed by a negative serum beta-human chorionic gonadotrophin [beta-hCG] test in females of reproductive potential), and not lactating or reproductive potential agrees to follow one of the options listed in protocol from 30 days prior to the first dose of study medication and until 120 days after the last dose of study treatment.
  • Male participants with female partners of child bearing potential must agree to use one of the methods of contraception specified in protocol from time of first dose of study treatment until 120 days after the last dose of study treatment.
  • Documented HPV/ EBV-positive tumor as determined by a local laboratory for Part 1B and Part 2B pembrolizumab combination viral-positive expansion cohorts only.
  • Documented MSI-H or dMMR-positive tumor as determined by local laboratory for Part 1B and Part 2B pembrolizumab combination MSI-H/dMMR expansion cohorts only.
  • ICOS expression result using an analytically validated immunohistochemistry (IHC) assay by central laboratory for Part 1B biomarker cohort only.
  • Gene expression (GEX) result using an analytically validated method by central laboratory (Part 1B Biomarker Cohort only).
  • PD-L1 combined positive score (CPS) <1 using the Food and Drug Administration (FDA) approved PD-L1 IHC 22C3 pharmdx assay by central laboratory testing for Part 2B HNSCC PD-L1 CPS <1 Cohort. Documented test result from FDA approved PD-L1 IHC 22C3 pharmDx assay in local laboratory, if available, may be accepted in lieu of the central laboratory test result.

Exclusion Criteria

  • Prior treatment with the following therapies:

    • Anticancer therapy within 30 days or 5 half-lives of the drug, whichever is shorter. At least 14 days must have elapsed between the last dose of prior anticancer agent and the first dose of study drug is administered.
    • Part 2B (GSK3359609/pembrolizumab combination): prior pembrolizumab washout is not required.
    • Prior radiation therapy: permissible if at least one non-irradiated measurable lesion is available for assessment according to RECIST version 1.1 or if a solitary measurable lesion was irradiated, objective progression is documented. A wash out of at least two weeks before start of study drug for radiation of any intended use to the extremities for bone metastases and 4 weeks for radiation to the chest, brain, or visceral organs is required. • Investigational therapy within 30 days or 5 half-lives of the investigational product (whichever is shorter). At least 14 days must have elapsed between the last dose of investigational agent and the first dose of study drug is administered.
  • Prior allogeneic or autologous bone marrow transplantation or other solid organ transplantation.
  • Toxicity from previous anticancer treatment
  • Invasive malignancy or history of invasive malignancy other than disease under study within the last two years except: Any other invasive malignancy for which the participant was definitively treated, has been disease-free for <=2 years and in the opinion of the principal investigator and GSK Medical Monitor will not affect the evaluation of the effects of the study treatment on the currently targeted malignancy, may be included in this clinical trial; and curatively treated non-melanoma skin cancer.
  • Central nervous system (CNS) metastases, with the following exception: • Participants who have previously-treated CNS metastases, are asymptomatic, and have no requirement for steroids at least 14 days prior to first dose of study drug. Participants with carcinomatous meningitis or leptomeningeal spread are excluded regardless of clinical stability.
  • Received transfusion of blood products (including platelets or red blood cells) or administration of colony stimulating factors (including granulocyte colony-stimulating factor [G-CSF], granulocyte-macrophage colony-stimulating factor, recombinant erythropoietin) within 14 days prior to the first dose of GSK3359609.
  • Major surgery <=4 weeks before the first dose of study treatment. Participants must have also fully recovered from any surgery (major or minor) and/or its complications before initiating study treatment.
  • Active autoimmune disease that has required systemic treatment within the last two years (i.e., with use of disease modifying agents, corticosteroids or immunosuppressive drugs). Replacement therapy (e.g., thyroxine or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment.
  • Concurrent medical condition requiring the use of systemic immunosuppressive medications within 7 days before the first dose of study treatment. Physiologic doses of corticosteroids for treatment of endocrinopathies or steroids with minimal systemic absorption, including topical, inhaled, or intranasal corticosteroids may be continued if the participant is on a stable dose.
  • Condition requiring treatment with strong inhibitors/inducers of cytochrome p (CYP) 450 3A4 within 7 days prior to first dose of chemotherapy (requirement applies to participants enrolled to Part 2 chemotherapy combination with docetaxel).
  • Active infection requiring systemic therapy, known human immunodeficiency virus infection, or positive test for hepatitis B active infection or hepatitis C active infection.
  • Current active liver or biliary disease (with the exception of Gilbert's syndrome or asymptomatic gallstones, liver metastases, or otherwise stable chronic liver disease per investigator assessment).
  • Recent history (within the past 6 months) of acute diverticulitis, inflammatory bowel disease, intra-abdominal abscess, or gastrointestinal obstruction that required surgery.
  • Receipt of any live vaccine within 4 weeks prior to first dose of study treatment.
  • Recent history of allergen desensitization therapy within 4 weeks of starting study treatment.
  • History of severe hypersensitivity to monoclonal antibodies or to the chemotherapies under investigation including any ingredient used in the formulation.
  • History or evidence of cardiac abnormalities.
  • History of (current and past) idiopathic pulmonary fibrosis, pneumonitis (for past pneumonitis exclusion only if steroids were required for treatment), interstitial lung disease, or organizing pneumonia. Note: post-radiation changes in the lung related to prior radiotherapy and/or asymptomatic radiation-induced pneumonitis not requiring treatment may be permitted if agreed by the investigator and Medical Monitor.
  • Recent history (within 6 months) of uncontrolled symptomatic ascites or pleural effusions.
  • Any serious and/or unstable pre-existing medical, psychiatric disorder, or other condition that could interfere with the participant's safety, obtaining informed consent, or compliance to the study procedures.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02723955


Locations
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United States, California
GSK Investigational Site
Duarte, California, United States, 91010
GSK Investigational Site
Los Angeles, California, United States, 90025
United States, Florida
GSK Investigational Site
Sarasota, Florida, United States, 34232
United States, New York
GSK Investigational Site
New York, New York, United States, 10016
GSK Investigational Site
New York, New York, United States, 10032
United States, Oklahoma
GSK Investigational Site
Oklahoma City, Oklahoma, United States, 73104
United States, Pennsylvania
GSK Investigational Site
Philadelphia, Pennsylvania, United States, 19111
United States, Tennessee
GSK Investigational Site
Nashville, Tennessee, United States, 37203
GSK Investigational Site
Nashville, Tennessee, United States, 37232-6307
Australia, Victoria
GSK Investigational Site
Heidelberg, Victoria, Australia, 3084
GSK Investigational Site
Melbourne, Victoria, Australia, 3000
Australia, Western Australia
GSK Investigational Site
Nedlands, Western Australia, Australia, 6009
Canada, Ontario
GSK Investigational Site
Toronto, Ontario, Canada, M5G 2M9
China
GSK Investigational Site
Shnghai, China, 200126
France
GSK Investigational Site
Bordeaux Cedex, France, 33076
GSK Investigational Site
Lyon cedex 08, France, 69373
GSK Investigational Site
Paris, France, 75005
GSK Investigational Site
Villejuif cedex, France, 94805
Italy
GSK Investigational Site
Siena, Toscana, Italy, 53100
Japan
GSK Investigational Site
Chiba, Japan, 277-8577
GSK Investigational Site
Osaka, Japan, 589-8511
GSK Investigational Site
Tokyo, Japan, 104-0045
Netherlands
GSK Investigational Site
Amsterdam, Netherlands, 1066 CX
Spain
GSK Investigational Site
Barcelona, Spain, 08035
GSK Investigational Site
Barcelona, Spain, 08036
GSK Investigational Site
Madrid, Spain, 28040
GSK Investigational Site
Málaga, Spain, 29010
GSK Investigational Site
Sevilla, Spain, 41009
Sponsors and Collaborators
GlaxoSmithKline
Merck Sharp & Dohme LLC
Investigators
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Study Director: GSK Clinical Trials GlaxoSmithKline
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Responsible Party: GlaxoSmithKline
ClinicalTrials.gov Identifier: NCT02723955    
Other Study ID Numbers: 204691
2016-000148-32 ( EudraCT Number )
First Posted: March 31, 2016    Key Record Dates
Last Update Posted: April 12, 2022
Last Verified: April 2022
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Yes
Plan Description: IPD for this study will be made available via the Clinical Study Data Request site.
Supporting Materials: Study Protocol
Statistical Analysis Plan (SAP)
Informed Consent Form (ICF)
Clinical Study Report (CSR)
Time Frame: IPD will be made available within 6 months of publishing the results of the primary endpoints, key secondary endpoints and safety data of the study.
Access Criteria: Access is provided after a research proposal is submitted and has received approval from the Independent Review Panel and after a Data Sharing Agreement is in place. Access is provided for an initial period of 12 months but an extension can be granted, when justified, for up to another 12 months.
URL: http://clinicalstudydatarequest.com

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by GlaxoSmithKline:
ICOS receptor agonist antibody
Pembrolizumab
KEYNOTE-478
GSK3359609
Cohort expansion
Dose escalation
Dostarlimab
Cobolimab
Bintrafusp alfa
Additional relevant MeSH terms:
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Gemcitabine
Paclitaxel
Docetaxel
Carboplatin
Pembrolizumab
Fluorouracil
Pemetrexed
Antineoplastic Agents, Phytogenic
Antineoplastic Agents
Tubulin Modulators
Antimitotic Agents
Mitosis Modulators
Molecular Mechanisms of Pharmacological Action
Antimetabolites, Antineoplastic
Antimetabolites
Antiviral Agents
Anti-Infective Agents
Enzyme Inhibitors
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs
Antineoplastic Agents, Immunological
Folic Acid Antagonists
Nucleic Acid Synthesis Inhibitors