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A phase I study of the safety and pharmacokinetics of edotecarin (J-107088), a novel topoisomerase I inhibitor, in patients with advanced solid tumors

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Abstract

Purpose

To assess the maximum tolerated dose, safety, and pharmacokinetic (PK) profile of escalating doses of the novel topoisomerase I (topo I) inhibitor edotecarin (J-107088) given as a 2-h intravenous (IV) infusion once every 21 days in patients with advanced solid tumors who had not responded to standard therapy.

Patients and methods

Twenty-nine patients (18M:11F) received a 2-h IV infusion of edotecarin in doses of 6, 8, 11, 13, or 15 mg/m2 every 21 days (with an additional 1–2 weeks permitted for recovery) and were evaluated for safety, PK, and tumor response.

Results

The most common non-hematologic toxicities were grade 1–2 nausea, fatigue, anorexia, vomiting, and fever. The most common hematologic toxicities were grade 1–2 thrombocytopenia and grade 3–4 neutropenia, leukopenia, and anemia. No grade 3–4 diarrhea was reported. Dose-limiting toxicities were observed in four patients at the 15 mg/m2 dose and one patient at the 13 mg/m2 dose. These toxicities included grade 3 nausea, vomiting, headache, and fatigue, as well as grade 4 neutropenia and febrile neutropenia. The maximum tolerated dose was declared at 15 mg/m2. One patient with bladder cancer had a confirmed partial response at a dose of 13 mg/m2. There was a trend to dose-proportional increases in edotecarin peak plasma concentrations and area under the curve values. Renal excretion of edotecarin was minimal (3–8% of the dose).

Conclusion

The recommended Phase II dose of edotecarin is 13 mg/m2 once every 21 days. The toxicities in this study were those typical of cytotoxic chemotherapy and less severe than those associated with other topo I inhibitors. The observed safety profile and preliminary evidence of clinical benefit warrant further investigation of this drug as monotherapy or part of combination therapy in patients with solid tumors.

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References

  1. Rougier P, Van Cutsem E, Bajetta E, et al. (1998) Randomised trial of irinotecan versus fluorouracil by continuous infusion after fluorouracil failure in patients with metastatic colorectal cancer. Lancet 352:1407–1412

    Article  PubMed  CAS  Google Scholar 

  2. Cunningham D, Pyrhonen S, James RD, et al. (1998) Randomised trial of irinotecan plus supportive care versus supportive care alone after fluorouracil failure for patients with metastatic colorectal cancer. Lancet 352:1413–1418

    Article  PubMed  CAS  Google Scholar 

  3. Saltz LB, Cox JV, Blanke C, et al. (2000) Irinotecan Study Group: Irinotecan plus fluorouracil and leucovorin for metastatic colorectal cancer. N Engl J Med 343:905–914

    Article  PubMed  CAS  Google Scholar 

  4. Douillard JY, Cunningham D, Roth AD, et al. (2000) Irinotecan combined with fluorouracil compared with fluorouracil alone as first-line treatment for metastatic colorectal cancer: a multicentre randomized trial. Lancet 355:1041–1047

    Article  PubMed  CAS  Google Scholar 

  5. Huinink WTB, Gore M, et al. (1997) Topotecan versus paclitaxel for the treatment of recurrent epithelial ovarian cancer. J Clin Oncol 15:2183–2193

    Google Scholar 

  6. Scheller JH, Kim K, Hutson P, et al. (1996) Phase II study of topotecan in patients with extensive-stage small-cell carcinoma of the lung: an Eastern Cooperative Oncology Group Trial. J Clin Oncol 14:2345–2352

    Google Scholar 

  7. Ardizzoni A, Hansen H, Bombemoswky P, et al. (1997) Topotecan, a new active drug in the second-line treatment of small-cell lung cancer: a Phase II study in patients with refractory and sensitive disease. J Clin Oncol 15:2090–2096

    PubMed  CAS  Google Scholar 

  8. Bailly C (2000) Topoisomerase I poisons and suppressors as anticancer drugs. Current Med Chem 7:39–58

    CAS  Google Scholar 

  9. Long BH, Balasubramanian BN (2000) Non-camptothecin topoisomerase I compounds as potential anticancer agents. Exp Opin Ther Patents 10:635–666

    Article  CAS  Google Scholar 

  10. Yoshinari T, Ohkubo M, Fukasawa K, et al. (1999) Mode of action of a new indolocarbazole anticancer agent, J-107088, targeting topoisomerase I. Cancer Res 59:4271–4275

    PubMed  CAS  Google Scholar 

  11. Arakawa H, Morita M, Kodera T, et al. (1999) In vivo anti-tumor activity of a novel indolocarbazole compound, J-107088, on murine and human tumors transplanted into mice. Jpn J Canc Res 90:1163–1170

    CAS  Google Scholar 

  12. Arakawa H, Iguchi T, Morita M, et al. (1995) Novel antitumor indolocarbazole compound 6-N-formylamino-12,13-dihydro-1,11-dihydroxy-13-(β-D-glucopyranosyl) 5H-indolo[2,3-a]pyrrolo[3,4-c]carbazole-5,7-(6H)-dione(NB-506): Its potent antitumor activity in mice. Cancer Res 55:1316–1320

    PubMed  CAS  Google Scholar 

  13. Komatani H, Kotani H, Hara Y, et al. (2001) Identification of breast cancer resistance protein/mitoxantrone resistance/placenta-specific, ATP-binding cassette transporter as a transporter of NB-506 and J-107088, topoisomerase I inhibitors with an indolocarbazole structure. Cancer Res 61:2827–2832

    PubMed  CAS  Google Scholar 

  14. Declaration of Helsinki (2001) Recommendations guiding medical physicians in biomedical research involving human subjects. Republic of South Africa Revision

  15. International Conference on Harmonization (ICH) (1996) Guideline for Good Clinical Practice. As part of the ICH Harmonized Tripartite Guideline (European Union, Japan and USA)

  16. Gibaldi M, Perrier D (1982) Pharmacokinetics. 2nd edn. Marcel Dekker, New York

    Google Scholar 

  17. Yamada Y, Tamura T, Yamamoto N, et al. (2006) Phase I and pharmacokinetic study of edotecarin, a novel topoisomerase I inhibitor, administered once every 3 weeks in patients with solid tumors. Cancer Chemother Pharmacol 58:173–182

    Article  PubMed  CAS  Google Scholar 

  18. Camptosar US prescribing information: http://www.pfizeroncology.com/hcp/camptosar_resources.aspx

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Acknowledgment

This study was sponsored by Banyu Pharmaceutical Co. Ltd.

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Correspondence to Herbert I. Hurwitz.

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Hurwitz, H.I., Cohen, R.B., McGovren, J.P. et al. A phase I study of the safety and pharmacokinetics of edotecarin (J-107088), a novel topoisomerase I inhibitor, in patients with advanced solid tumors. Cancer Chemother Pharmacol 59, 139–147 (2007). https://doi.org/10.1007/s00280-006-0267-9

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  • DOI: https://doi.org/10.1007/s00280-006-0267-9

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