Hahm Hillary A, Ettinger David S, Bowling Kathy, Hoker Beth, Chen Tian Ling, Zabelina Yelena, Casero Robert A
The Johns Hopkins Oncology Center, Baltimore, Maryland 21231, USA.
Clin Cancer Res. 2002 Mar;8(3):684-90.
Polyamines are essential for tumor growth; consequently, agents that interfere with their metabolisms have been developed as antineoplastic agents. Diethylnorspermine (DENSPM) is one such agent. A focused Phase I clinical trial in patients with advanced non-small cell lung cancer was undertaken.
Twenty-nine patients were treated with DENSPM using a dosing schedule of once daily for 5 days. Doses ranged from 25 mg/m(2)/day to 231 mg/m(2)/day.
The dose-limiting toxicity was determined to be gastrointestinal including asthenia, abdominal cramps, diarrhea, and nausea. The maximal tolerated dose was 185 mg/m(2)/day for 5 days. At drug dosages for which it was possible to estimate, serum half-life ranged from 0.5 to 3.7 h without apparent dose dependence. Maximal serum concentrations increased with dosage. However, the increase was greater than the proportional increase of the administered dose. There were no objective disease responses observed during the Phase I trial.
The results of the Phase I clinical trial suggest that DENSPM can safely be administered to patients with minimal toxicity. Furthermore, the observed dose-limiting toxicity is unique to DENSPM, thus underscoring the potential for DENSPM to be a suitable agent for chemotherapy in combination with agents possessing different spectrums of toxicities.
多胺对肿瘤生长至关重要;因此,已开发出干扰其代谢的药物作为抗肿瘤药。二乙去甲精胺(DENSPM)就是这样一种药物。对晚期非小细胞肺癌患者进行了一项重点I期临床试验。
29例患者接受DENSPM治疗,给药方案为每日1次,共5天。剂量范围为25mg/m²/天至231mg/m²/天。
确定剂量限制性毒性为胃肠道毒性,包括乏力、腹部绞痛、腹泻和恶心。最大耐受剂量为185mg/m²/天,持续5天。在可估算药物剂量的情况下,血清半衰期为0.5至3.7小时,无明显剂量依赖性。最大血清浓度随剂量增加而升高。然而,升高幅度大于给药剂量的比例增加幅度。在I期试验期间未观察到客观疾病反应。
I期临床试验结果表明,DENSPM可安全给药于患者,毒性极小。此外,观察到的剂量限制性毒性是DENSPM所特有的,因此突出了DENSPM作为与具有不同毒性谱的药物联合化疗的合适药物的潜力。