Rios A, Rosenblum M, Powell M, Hersh E
Cancer Treat Rep. 1983 Mar;67(3):239-43.
MVE-2, a polymer of maleic anhydride and divinyl-ether (molecular weight, 15,500), was given to 57 patients in a phase I study. The agent was selected for study because it was a potent macrophage activator, interferon inducer, and immunotherapeutic agent in animal tumor models. The drug was administered by iv infusion over a 1-hour period using three schedules of administration: (a) weekly at doses of 25-650 mg/m2, (b) every other week at doses of 500-1200 mg/m2, and (c) every 3 weeks at doses of 1200-1500 mg/m2. No cardiac, pulmonary, hematologic, or hepatic toxicity was observed. There were 25 episodes of asymptomatic proteinuria in 26 patients who received MVE-2 dose levels of greater than or equal to 500 mg/m2. It was not associated with changes in BUN or creatinine. The proteinuria began approximately 4 weeks after the start of therapy and lasted approximately 4-6 weeks after the therapy was terminated. Proteinuria resolved in all patients followed. At present, proteinuria appears to be the major dose-limiting toxicity. None of the patients had a partial or complete response although there was evidence of biologic activity with measurable tumor regression in five patients. No major modification of host defense parameters was noted. Further studies should be directed towards determining the nature of the proteinuria and whether changes in the rate or schedule of administration can modify the proteinuria or increase the host defense modification.
在一项I期研究中,将马来酸酐与二乙烯基醚的聚合物MVE - 2(分子量15,500)给予57例患者。选择该药物进行研究是因为它在动物肿瘤模型中是一种有效的巨噬细胞激活剂、干扰素诱导剂和免疫治疗剂。通过静脉输注在1小时内给药,使用三种给药方案:(a)每周一次,剂量为25 - 650mg/m²;(b)每两周一次,剂量为500 - 1200mg/m²;(c)每三周一次,剂量为1200 - 1500mg/m²。未观察到心脏、肺部、血液学或肝脏毒性。在接受MVE - 2剂量水平大于或等于500mg/m²的26例患者中有25例出现无症状蛋白尿。它与血尿素氮或肌酐的变化无关。蛋白尿在治疗开始后约4周开始,在治疗终止后持续约4 - 6周。所有随访患者的蛋白尿均消退。目前,蛋白尿似乎是主要的剂量限制性毒性。尽管有5例患者有可测量的肿瘤退缩的生物学活性证据,但没有患者出现部分或完全缓解。未观察到宿主防御参数的重大改变。进一步的研究应致力于确定蛋白尿的性质,以及给药速率或方案的改变是否可以改变蛋白尿或增加宿主防御的改变。