Purpose:To determine the tolerability and pharmacokinetics of oral CI-1033, a pan-erbB tyrosine kinase inhibitor, administered over 14 consecutive days of a 21-day cycle. Design: Phase 1, multicenter trial involving patients with solid tumors that are refractory to standard therapy. CI-1033 was administered initially at 300 mg/day to a minimum cohort of three patients. Dose escalation proceeded at V40% increments. Patients were evaluated for toxicity, pharmacokinetic profile, and evidence of response. Results: Thirty-two patients entered the trial and were evaluable for safety assessment. Doselimiting toxicity (diarrhea, rash, and/or anorexia) occurred at the 560 mg dose level; the maximum tolerated dose was 450 mg. No patients achieved objective responses and six patients achieved stable disease. Plasma CI-1033 concentrations increased with increasing dose. CI-1033 was not eliminated in urine to any appreciable extent. Conclusions: CI-1033 is suitable for phase 2 testing at the 450 mg/day dose level when administered for 14 days in a 21-day cycle. The pharmacokinetic profile is consistent with biologically relevant plasma concentrations over the dosing interval.CI-1033, an orally available 4-anilinoquinazoline derivative, is a highly potent and selective pan-erbB tyrosine kinase inhibitor that irreversibly blocks intracellular signaling through all members of the erbB receptor family [erbB-1 (epidermal growth factor receptor, EGFR), erbB-2 (HER-2/neu), erbB-3, erbB-4, and the erbB-1 truncate, EGFR vIII; refs. (1 -3)]. The erbB family of tyrosine-specific protein kinases is involved in the regulation of many malignant cell functions, including proliferation, differentiation, survival, induction of angiogenesis, metastatic spread, and resistance to chemotherapy and radiotherapy (4,5). Over 90% of all solid tumors express at least one member of the erbB receptor family (6 -8) and erbB receptor/ligand overexpression correlates with poor prognosis and reduced survival in patients with a variety of cancers including breast cancer, melanoma, and head and neck cancer (3, 9 -15). In vitro work also shows that overexpression of two or more erbB family members has been correlated with a further worsening of prognosis (16 -20).Numerous anticancer therapeutic approaches to blocking signal transduction through erbB-mediated pathways have been attempted, including antibodies targeting the erbB extracellular domain, small molecule tyrosine kinase inhibitors specifically targeting one or more erbB family members, antisense oligonucleotides, ligand-linked toxins, and immunotoxin conjugates (21 -25). Trastuzumab (Herceptin), a monoclonal antibody that specifically targets the erbB-2 extracellular domain, was the first effective clinical translation of this approach and is approved for the treatment of erbB-2 overexpressing metastatic breast cancer-as second-line monotherapy and as first-line therapy when combined with paclitaxel (26 -31). More recently, an erbB-1-specific monoclonal antibody, cetuximab (Erbitux, IMC-C225...