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Batist G, Chi K, Miller W, Chia S, Hasanbasic F, Fisic A, Mayer L, Swenson C, Janoff A, Gelmon K. Phase 1 study of CPX-1, a fixed ratio formulation of irinotecan (IRI) and floxuridine (FLOX), in patients with advanced solid tumors. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.2014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
2014 Background: In vitro studies have shown that varying the ratio of individual agents in drug combinations can result in synergistic, additive or antagonistic activity against tumor cells. CPX-1 is a liposomal formulation of IRI and FLOX in a fixed 1:1 molar ratio which was selected as optimal in vitro and confirmed to be synergistic in vivo in preclinical tumor models. CPX-1 overcomes the dissimilar pharmacokinetics (PK) of the individual drugs, enables sustained maintenance of this ratio after IV administration, and was evaluated in a Phase I open-label, dose-escalation study. Methods: Starting dose was 30 U/m2 (1 Unit of CPX-1 contains 1 mg IRI + 0.36 mg FLOX) given on day 1 and 15 of each 28-day cycle. Dose escalation was by modified Fibonacci with 4 subjects/cohort. Eligibility included: ≥ 18 yo; advanced solid tumor; ECOG PS ≤ 2; adequate bone marrow/liver/renal function. PK analysis was done on day 1 and 15 of the first cycle. Results: 26 subjects (16M:10F), median age 54.5 y (21–72), all with prior therapy, enrolled in 6 cohorts with the 5th cohort expanded to 6 subjects. Diagnoses: 8 colorectal, 3 pancreatic, 3 ovarian, 2 breast, 2 gastric, 2 esophageal, 2 sarcomas, 1 renal cell, 1 prostate, 1 NSCLC and 1 sphenoid sinus. Response: 20 subjects evaluable: 2 confirmed PRs (NSCLC 8+ wks; Colon 13+ wks, in a patient with prior IRI exposure) and 13 with SD (8–24+wks). Safety: DLTs were observed at the 6th dose level: 4 subjects with DLTs: 3 diarrhea (one resulting in death due to dehydration/ARF) and one neutropenia. Other possibly related grade 3 and 4 events included one each of: grade 3 diarrhea, grade 3 vomiting, grade 3 neutropenia, grade 3 fatigue, grade 3 compression fracture and arthralgia and pulmonary embolism grade 4. PK: In all 14 subjects analyzed to date the 1:1 molar ratio of IRI to FLOX was maintained for 24 hours and metabolites 5-FU and SN-38 were present in the plasma. Conclusions: CPX-1 represents a new approach to developing drug combinations in which drug ratios are pre-selected in vitro based on optimal antitumor activity and maintained systemically through pharmacokinetic control. Phase 2 studies are planned with a recommended dose of 210U/m2 of CPX-1. [Table: see text]
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Affiliation(s)
- G. Batist
- Jewish General Hospital, McGill University, Montreal, PQ, Canada; BC Cancer Agency, Vancouver, BC, Canada; Celator Pharmaceuticals, Princeton, NJ
| | - K. Chi
- Jewish General Hospital, McGill University, Montreal, PQ, Canada; BC Cancer Agency, Vancouver, BC, Canada; Celator Pharmaceuticals, Princeton, NJ
| | - W. Miller
- Jewish General Hospital, McGill University, Montreal, PQ, Canada; BC Cancer Agency, Vancouver, BC, Canada; Celator Pharmaceuticals, Princeton, NJ
| | - S. Chia
- Jewish General Hospital, McGill University, Montreal, PQ, Canada; BC Cancer Agency, Vancouver, BC, Canada; Celator Pharmaceuticals, Princeton, NJ
| | - F. Hasanbasic
- Jewish General Hospital, McGill University, Montreal, PQ, Canada; BC Cancer Agency, Vancouver, BC, Canada; Celator Pharmaceuticals, Princeton, NJ
| | - A. Fisic
- Jewish General Hospital, McGill University, Montreal, PQ, Canada; BC Cancer Agency, Vancouver, BC, Canada; Celator Pharmaceuticals, Princeton, NJ
| | - L. Mayer
- Jewish General Hospital, McGill University, Montreal, PQ, Canada; BC Cancer Agency, Vancouver, BC, Canada; Celator Pharmaceuticals, Princeton, NJ
| | - C. Swenson
- Jewish General Hospital, McGill University, Montreal, PQ, Canada; BC Cancer Agency, Vancouver, BC, Canada; Celator Pharmaceuticals, Princeton, NJ
| | - A. Janoff
- Jewish General Hospital, McGill University, Montreal, PQ, Canada; BC Cancer Agency, Vancouver, BC, Canada; Celator Pharmaceuticals, Princeton, NJ
| | - K. Gelmon
- Jewish General Hospital, McGill University, Montreal, PQ, Canada; BC Cancer Agency, Vancouver, BC, Canada; Celator Pharmaceuticals, Princeton, NJ
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