Grunberg S M, Kempf R A, Venturi C L, Mitchell M S
Cancer Res. 1987 Feb 15;47(4):1174-8.
Twelve patients with advanced malignant disease were entered onto a Phase I study of escalating doses of beta-interferon serine given by 4-h i.v. infusion twice a wk. Three patients each were entered at starting doses of 0.01, 1, 10, and 30 million units (MU)/m2. Doses escalation within individual patients was allowed to a maximum dose of 400 MU/m2. Fever, chills, fatigue, and acral cyanosis were commonly seen and increased in frequency at higher doses. Myalgia, nausea, diarrhea, headache, and confusion were seen at lesser frequencies. Mild leukopenia, paresthesia, infusion site erythema, and hypotension were each seen in one patient. No conventional maximal tolerated dose could be defined, since several patients underwent escalation to the highest allowable dose and seemed to develop tolerance to acute toxicities. However, a maximal starting dose of 10 MU/m2 was identified, such that those begun at this level or below tolerated semiweekly dose escalation, while those begun at 30 MU/m2 could not tolerate continued therapy. Detectable serum interferon levels were noted during treatment at 10 and 30 MU/m2, the levels at which significant toxicity also first appeared. A maximal starting dose of 10 MU/m2, with gradual escalation as tolerance to side effects develops, is suggested if therapy with high-dose beta-interferon serine is given by 4-h infusion.
12例晚期恶性疾病患者进入了一项I期研究,该研究采用每周两次、每次4小时静脉输注的方式,递增剂量给予β-干扰素丝氨酸。分别有3例患者以0.01、1、10和30百万单位(MU)/m²的起始剂量入组。允许个体患者的剂量递增至最大剂量400 MU/m²。发热、寒战、疲劳和手足发绀常见,且在较高剂量时频率增加。肌痛、恶心、腹泻、头痛和意识模糊出现的频率较低。轻度白细胞减少、感觉异常、输注部位红斑和低血压各在1例患者中出现。由于有几名患者剂量递增至最高允许剂量且似乎对急性毒性产生了耐受性,因此无法确定传统的最大耐受剂量。然而,确定了10 MU/m²的最大起始剂量,即从该水平或更低水平开始的患者能够耐受每半周一次的剂量递增,而从30 MU/m²开始的患者则无法耐受持续治疗。在10和30 MU/m²治疗期间可检测到血清干扰素水平,这也是首次出现明显毒性的水平。如果采用4小时输注方式给予高剂量β-干扰素丝氨酸治疗,建议起始最大剂量为10 MU/m²,并随着对副作用耐受性的发展逐渐递增剂量。