Phase 1b study of IGF-methotrexate conjugate in the treatment of high-grade myelodysplastic syndromes

Hassan B. Alkhateeb, Mrinal M. Patnaik, Aref Al-Kali, Darci L. Zblewski, Samantha Wallerich, Hugh McTavish, Arkadiusz Z. Dudek

Research output: Contribution to journalArticlepeer-review


Background/Aim: The insulin-like growth factor type 1 receptor (IGF-1R) is overexpressed in myelodysplastic syndrome (MDS) cells, and 765IGF-Methotrexate (IGF-MTX) is a conjugate of methotrexate and a variant of insulin-like growth factor-1 (IGF-1) designed to selectively target cancer cells through binding to IGF-1R. The aim of this study was to determine whether IGF-MTX would be effective to treat MDS. Patients and Methods: In this phase I clinical trial, two patients with high grade MDS or oligoblastic acute myeloid leukemia (O-AML) that had failed standard therapy were treated with IGF-MTX. Results: No dose-limiting toxicity was observed. Both patients had stable or improved cell counts and CD34+ myelodysplastic cell counts and exceeded their life expectancy (both alive at 1.9 years despite a life expectancy of less than 6 months). Bone marrow blast counts decreased from 22% to 5% in one patient, and from 17% to 16% in the other. Conclusion: In conclusion, IGF-MTX at 0.20 μM equivalents per kg was well tolerated, caused no cytopenia, and produced stable disease and extension of life.

Original languageEnglish (US)
Pages (from-to)3883-3888
Number of pages6
JournalAnticancer research
Issue number7
StatePublished - Jul 2020


  • Chronic myelomonocytic leukemia
  • IGF-1R
  • Myelodysplastic syndrome
  • Oligoblastic acute myeloid leukemia
  • Phase 1 study

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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