A Multicenter, Phase I, Dose-Escalation Study to Assess the Safety, Tolerability, and Pharmacokinetics of Etirinotecan Pegol in Patients with Refractory Solid Tumors

作者：Gayle Jameson, John Turner Hamm, Glen J. Weiss, Carlos A. Alemany, Stephen Patrick Anthony, M. Basche, Ramesh K. Ramanathan, Mitesh J. Borad, Raoul Tibes, Allen Lee Cohn, Ioana Hinshaw, Robert M. Jotte, Lee S. Rosen, Ute Hoch, Michael A. Eldon, Robert A. Medve, Katrina Schroeder, Erica White, Daniel D. Von Hoff · 发表于：Clinical Cancer Research · 年份：2012 · DOI：10.1158/1078-0432.ccr-12-1201 · 被引用次数：55 · 研究领域：Cancer therapeutics and mechanisms、Synthesis and Biological Activity、Cancer Treatment and Pharmacology

PURPOSE: This study was designed to establish the maximum tolerated dose (MTD) and to evaluate tolerability, pharmacokinetics, and antitumor activity of etirinotecan pegol. EXPERIMENTAL DESIGN: Patients with refractory solid malignancies were enrolled and assigned to escalating-dose cohorts. Patients received 1 infusion of etirinotecan pegol weekly 3 times every 4 weeks (w × 3q4w), or every 14 days (q14d), or every 21 days (q21d), with MTD as the primary end point using a standard 3 + 3 design. RESULTS: Seventy-six patients were entered onto 3 dosing schedules (58-245 mg/m(2)). The MTD was 115 mg/m(2) for the w × 3q4w schedule and 145 mg/m(2) for both the q14d and q21d schedules. Most adverse events related to study drug were gastrointestinal disorders and were more frequent at higher doses of etirinotecan pegol. Late onset diarrhea was observed in some patients, the frequency of which generally correlated with dose density. Cholinergic diarrhea commonly seen with irinotecan treatment did not occur in patients treated with etirinotecan pegol. Etirinotecan pegol administration resulted in sustained and controlled systemic exposure to SN-38, which had a mean half-life of approximately 50 days. Overall, the pharmacokinetics of etirinotecan pegol are predictable and do not require complex dosing adjustments. Confirmed partial responses were observed in 8 patients with breast, colon, lung (small and squamous cell), bladder, cervical, and neuroendocrine cancer. CONCLUSION: Etirinot...