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Beale P, Judson I, O'Donnell A, Trigo J, Rees C, Raynaud F, Turner A, Simmons L, Etterley L. A Phase I clinical and pharmacological study of cis-diamminedichloro(2-methylpyridine) platinum II (AMD473). Br J Cancer 2003; 88:1128-34. [PMID: 12671715 PMCID: PMC2376375 DOI: 10.1038/sj.bjc.6600854] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AMD473 is a novel sterically hindered platinum cytotoxic with demonstrated ability to overcome acquired resistance to cisplatin in vitro and in human tumour xenografts. A single-agent dose escalating Phase I study was performed. AMD473 was initially administered intravenously as a 1 h infusion every 21 days to patients with advanced solid tumours. In total, 42 patients received a total of 147 cycles (median 3, range 1-8) of treatment at doses of 12, 24, 48, 96, 110, 120, 130, and 150 mg m(-2). Dosing intervals of 21 and 28 days were explored at the recommended dose. Neutropenia and thrombocytopenia proved dose limiting. Other toxicities included moderate nausea, vomiting, anorexia, and a transient metallic taste. There was no significant alopecia. The maximum tolerated dose was 150 mg m(-2). Plasma pharmacokinetics were linear. Two patients with heavily pretreated ovarian cancer showed partial response. Five patients (mesothelioma, ovary, nonsmall cell lung, and melanoma) showed prolonged stable disease. AMD473 demonstrates encouraging activity in patients, including those with prior platinum exposure. Toxicity is predictable with linear pharmacokinetics, as was predicted by preclinical studies. A dose of 120 mg m(-2) every 21 days is recommended for Phase II evaluation although there is evidence that chemo-naive patients and those of good performance status may tolerate a higher dose.
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Affiliation(s)
- P Beale
- Sydney Cancer Centre, Royal Prince Alfred Hospital, Missenden Road, Camperdown, Sydney, New South Wales, Australia
| | - I Judson
- The Cancer Research UK Centre for Cancer Therapeutics, Institute of Cancer Research, 15 Cotswold Rd Belmont Sutton, Surrey SM2 5NG, UK
- The Cancer Research UK Centre for Cancer Therapeutics, Institute of Cancer Research, 15 Cotswold Rd Belmont Sutton, Surrey SM2 5NG, UK. E-mail:
| | - A O'Donnell
- The Cancer Research UK Centre for Cancer Therapeutics, Institute of Cancer Research, 15 Cotswold Rd Belmont Sutton, Surrey SM2 5NG, UK
| | - J Trigo
- Hospital Universitari de la Vall d'Hebron, Passeig de la Vall d'Hebron, Barcelona, Spain
| | - C Rees
- The Cancer Research UK Centre for Cancer Therapeutics, Institute of Cancer Research, 15 Cotswold Rd Belmont Sutton, Surrey SM2 5NG, UK
| | - F Raynaud
- The Cancer Research UK Centre for Cancer Therapeutics, Institute of Cancer Research, 15 Cotswold Rd Belmont Sutton, Surrey SM2 5NG, UK
| | - A Turner
- Cancer Research UK, PO Box 123, Lincoln's Inn Fields, London WC2A 3PX, UK
| | - L Simmons
- The Cancer Research UK Centre for Cancer Therapeutics, Institute of Cancer Research, 15 Cotswold Rd Belmont Sutton, Surrey SM2 5NG, UK
| | - L Etterley
- The Cancer Research UK Centre for Cancer Therapeutics, Institute of Cancer Research, 15 Cotswold Rd Belmont Sutton, Surrey SM2 5NG, UK
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Murakami H, Tamura T, Yamada Y, Yamamoto N, Ueda Y, Shimoyama T, Saijo N. ZD0473 pharmacokinetics in Japanese patients: a Phase I dose-escalation study. Eur J Cancer 2002; 38 Suppl 8:S1-5. [PMID: 12645906 DOI: 10.1016/s0959-8049(02)80012-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
ZD0473 is new platinum agent that was rationally designed to circumvent platinum resistance and reduce the potential for nephro-and neurotoxicity. This Phase I dose-escalating study investigated the pharmacokinetics, tolerability and efficacy of ZD0473 in Japanese patients with solid, refractory tumours. ZD0473 was administered as a 1-h intravenous infusion every 3 weeks. Nine patients received a total of 16 cycles of ZD0473 (median 1 cycle/patient), with 3 patients treated at each of 3 doses (60, 90, 120 mg/m2). The maximum plasma concentration (C(max)) and the area under the concentration-time curve to infinity (AUC(0-infinity)) increased with dose in a linear fashion for both total platinum and ZD0473 in plasma ultrafiltrate, suggesting that the pharmacokinetics of ZD0473 are linear. Haematological and non-haematological toxicities such as nausea and vomiting were mild (grade 1 or 2) and transient. No clinically significant nephro-, oto- or neurotoxicity was observed. Dose-limiting toxicity (DLT) was not observed and the maximum tolerated dose (MTD) was not identified. ZD0473 treatment showed evidence of disease stabilisation in 3 patients (33%). In conclusion, ZD0473 appears to have linear pharmacokinetics, and an acceptable tolerability profile at doses up to 120 mg/m2 in Japanese patients with refractory solid malignancies. Following evaluation of the data from all the Western trials, the ZD0473 development programme changed and this Japanese trial was stopped.
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Affiliation(s)
- H Murakami
- Division of Internal Medicine, National Cancer Center Hospital, Tokyo, Japan
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