Gao Ge, Shu Pei, Tan Youzhen, Zheng Tongsen, Fan Wenmao, Lu Luding, Zhou Huan, Wang Zishu, Liu Ling, Liu Zhiqiang, Wang Yongsheng
Clinical Trial Center, National Medical Products Administration key Laboratory for Clinical Research and Evaluation of Innovative Drugs, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Division of Abdominal Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Cancer Med. 2025 Jul;14(14):e71039. doi: 10.1002/cam4.71039.
PURPOSE: A novel paclitaxel delivery system has the potential to avoid the side effects associated with Cremophor EL and thus enhance therapeutic efficacy. Here, we report the results of a preclinical and phase I clinical study investigating ZSYY001, a nanoparticle formulation of polymeric micellar paclitaxel (PM-paclitaxel). METHODS: In preclinical studies, A549, MDA-MB-231, and SKOV3 xenograft tumor models were developed. Various concentrations of ZSYY001 were administered, and tumor growth and body weight were measured. Sprague-Dawley (SD) rats and Beagle dogs were used to evaluate the toxicity. In the phase I study, a dose-escalation study using a 3 + 3 design was conducted in patients with solid tumors. The PM-paclitaxel dose was escalated from 175 mg/m to 390 mg/m. PM-paclitaxel was intravenously administered over 3 h every 21 days without any premedication. This study was registered with number CTR20210347. RESULTS: Preclinical studies showed that ZSYY001 significantly inhibited tumor growth without causing weight loss. In the phase I study, all patients were evaluable for toxicity and pharmacokinetic analysis, and 18 patients were evaluable for tumor response. Acute hypersensitivity reactions were not observed. Anemia and hair loss were the most common toxicities. Dose-limiting toxicity events were not observed at any dose levels. Dose escalation to 390 mg/m did not identify a maximum-tolerated dose. There were two partial responses (11.11%) and seven cases of stable disease (38.89%) among the 18 patients, five of whom had prior exposure to paclitaxel chemotherapy. The paclitaxel area under the curve and peak paclitaxel concentration suggest that PM-paclitaxel does not exhibit linear pharmacokinetics. CONCLUSIONS: ZSYY001 was safe and well tolerated without additional toxicity and exhibited desirable antitumor activity, making it a promising treatment. TRIAL REGISTRATION: CTR20210347.
目的:一种新型紫杉醇递送系统有可能避免与聚氧乙烯蓖麻油(Cremophor EL)相关的副作用,从而提高治疗效果。在此,我们报告了一项临床前和I期临床研究的结果,该研究调查了ZSYY001,一种聚合物胶束紫杉醇(PM-紫杉醇)的纳米颗粒制剂。 方法:在临床前研究中,建立了A549、MDA-MB-231和SKOV3异种移植肿瘤模型。给予不同浓度的ZSYY001,并测量肿瘤生长和体重。使用Sprague-Dawley(SD)大鼠和比格犬评估毒性。在I期研究中,对实体瘤患者进行了采用3+3设计的剂量递增研究。PM-紫杉醇剂量从175mg/m²递增至390mg/m²。每21天静脉输注PM-紫杉醇3小时,无需任何预处理。本研究的注册号为CTR20210347。 结果:临床前研究表明,ZSYY001显著抑制肿瘤生长且未导致体重减轻。在I期研究中,所有患者均可进行毒性和药代动力学分析,18例患者可进行肿瘤反应评估。未观察到急性过敏反应。贫血和脱发是最常见的毒性反应。在任何剂量水平均未观察到剂量限制性毒性事件。剂量递增至390mg/m²未确定最大耐受剂量。18例患者中有2例部分缓解(11.11%),7例病情稳定(38.89%),其中5例曾接受过紫杉醇化疗。紫杉醇曲线下面积和紫杉醇峰值浓度表明PM-紫杉醇不呈现线性药代动力学。 结论:ZSYY001安全且耐受性良好,无额外毒性,并表现出理想的抗肿瘤活性,使其成为一种有前景的治疗方法。 试验注册:CTR20210347。
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