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TTI-237 治疗晚期恶性实体瘤患者的 I 期剂量递增研究。

A phase I dose escalation study of TTI-237 in patients with advanced malignant solid tumors.

机构信息

Department of Internal Medicine, Division of Medical Oncology, Washington University School of Medicine, St. Louis, MO 63110, USA.

出版信息

Invest New Drugs. 2012 Feb;30(1):266-72. doi: 10.1007/s10637-010-9506-3. Epub 2010 Aug 10.

Abstract

PURPOSE

This study was to determine the maximum tolerated dose, dose-limiting toxicities, and pharmacokinetic profile of TTI-237, a novel anti-tubulin drug, administered weekly in patients with refractory solid tumors.

PATIENTS AND METHODS

Using an accelerated dose escalation design, patients with refractory solid tumors were enrolled in this study and treated with TTI-237 intravenously on days 1, 8 and 15 of a 28-day cycle. The starting dose was 4.5 mg/m(2). Pharmacokinetic studies were performed in patients at all dose levels.

RESULT

Twenty-eight patients were enrolled and treated with TTI-237 at dose of 4.5, 9, 15, 22.5 and 31.5 mg/m(2). One dose-limiting toxicity neutropenia fever was observed at 31.5 mg/m(2), and all seven patients developed grade 3 or 4 neutropenia at that dose level. TTI-237 dosage was de-escalated to 22.5 and 18 mg/m(2). Six patients were treated at the 18 mg/m(2) dose level without dose-limiting toxicity prior to trial termination. The mean terminal-phase elimination half-life (t(1/2)) for TTI-237 was 25-29 h, and the mean area under the concentration time curve at 31.5 mg/m(2) was 2,768 ng•h/mL.

CONCLUSION

A protocol defined maximum tolerated dose was not determined because of early termination of the TTI-237 trial by the sponsor. 18 mg/m(2) may be a tolerable dose of TTI-237.

摘要

目的

本研究旨在确定每周给药的新型抗微管药物 TTI-237 在难治性实体瘤患者中的最大耐受剂量、剂量限制性毒性和药代动力学特征。

方法

采用加速剂量递增设计,入组难治性实体瘤患者,每 28 天周期的第 1、8 和 15 天静脉注射 TTI-237。起始剂量为 4.5mg/m2。在所有剂量水平的患者中进行药代动力学研究。

结果

28 例患者接受了 TTI-237 治疗,剂量分别为 4.5、9、15、22.5 和 31.5mg/m2。在 31.5mg/m2 时观察到 1 例剂量限制性毒性中性粒细胞减少发热,该剂量水平的所有 7 例患者均发生 3 或 4 级中性粒细胞减少。TTI-237 剂量下调至 22.5 和 18mg/m2。在试验终止前,6 例患者在 18mg/m2 剂量水平下未发生剂量限制性毒性。TTI-237 的平均终末相消除半衰期(t1/2)为 25-29h,31.5mg/m2 时的平均浓度时间曲线下面积为 2768ng•h/mL。

结论

由于研究发起者提前终止了 TTI-237 试验,因此未确定方案定义的最大耐受剂量。18mg/m2 可能是 TTI-237 的可耐受剂量。

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