학술논문

Phase I and pharmacokinetic study of XR11576, an oral topoisomerase I and II inhibitor, administered on days 1-5 of a 3-weekly cycle in patients with advanced solid tumours.
Document Type
Journal Article
Source
British Journal of Cancer. 10/18/2004, Vol. 91 Issue 8, p1459-1465. 7p.
Subject
*DNA topoisomerase I
*DNA topoisomerase II
*PHARMACOKINETICS
*PHARMACOLOGY
*TUMORS
*LIQUID chromatography
*PATIENTS
*RESEARCH
*HIGH performance liquid chromatography
*DRUG dosage
*CLINICAL trials
*HETEROCYCLIC compounds
*ORAL drug administration
*RESEARCH methodology
*EVALUATION research
*COMPARATIVE studies
*MASS spectrometry
*DOSE-effect relationship in pharmacology
*ENZYME inhibitors
*DRUG toxicity
Language
ISSN
0007-0920
Abstract
XR11576 is an oral topoisomerase I and II inhibitor. The objectives of this phase I study were to assess the dose-limiting toxicities (DLTs), to determine the maximum tolerated dose (MTD) and to describe the pharmacokinetics (PKs) of XR11576 when administered orally on days 1-5 every 3 weeks to patients with advanced solid tumours. Patients were treated with escalating doses of XR11576 at doses ranging from 30 to 180 mg day(-1). For PK analysis, plasma sampling was performed during the first and second courses of treatment and XR11576 concentrations were assayed using a validated high-performance liquid chromatographic assay with mass spectrometric detection. In all, 21 patients received a total of 47 courses. The MTD was reached at 180 mg day(-1), with diarrhoea and fatigue as DLT. Nausea and vomiting, although not qualifying for DLT, was ubiquitous. Only in combination with an extensive prophylactic antiemetic regimen consisting of a combination of both dexamethasone and a 5HT3 antagonist was treatment with XR11576 at 120 mg day(-1) tolerable. The systemic exposure of XR11576 increased more than proportionally with increasing dose, with a large interpatient variability. No objective responses were seen; four patients experienced stable disease for periods of 12-30 weeks. In this study, the DLTs of XR11576 were diarrhoea and fatigue. The recommended dose for phase II studies of XR11576 is 120 mg administered orally, on days 1-5 every 21 days. Alternative regimens are currently being explored. [ABSTRACT FROM AUTHOR]