Woll P J, Ranson M, Margison J, Thomson Y, van der Water L, George N, Howell A
CRC Department of Medical Oncology, Christie Hospital, Manchester, UK.
Ann Oncol. 1994 Sep;5(7):597-600. doi: 10.1093/oxfordjournals.annonc.a058930.
Suramin has shown promising activity against prostate and breast cancer but is severely neurotoxic. Complex adaptive pharmacokinetics have previously been used to adjust doses. We have undertaken a pilot study to assess the feasibility of administering suramin to outpatients with advanced cancer, using simple peak and trough monitoring.
Nine patients with cancer refractory to conventional therapy were studied, eight with breast cancer and one with prostate cancer. Two received continuous infusions of suramin 350 mg/m2/day through an indwelling central venous catheter. Both sustained axillary vein thromboses. Subsequent patients received suramin 500 mg/m2 as a one hour intravenous infusion thrice weekly until a trough serum level of 200 micrograms/ml was achieved. Treatment was repeated at 8 week intervals. Serum suramin levels were checked before and after each dose.
Suramin treatment was well tolerated. Despite peak serum levels of up to 506 micrograms/ml, no serious toxicity was seen. No tumour responses were seen.
We conclude that suramin can be safely and conveniently administered to outpatients by intermittent infusion without using complex adaptive dosing strategies. Suramin merits further study in less heavily pretreated breast cancer patients.
苏拉明已显示出对前列腺癌和乳腺癌有良好的活性，但具有严重的神经毒性。此前曾采用复杂的适应性药代动力学来调整剂量。我们进行了一项试点研究，以评估使用简单的峰浓度和谷浓度监测对晚期癌症门诊患者给予苏拉明的可行性。
研究了9例对传统治疗难治的癌症患者，其中8例为乳腺癌患者，1例为前列腺癌患者。2例患者通过留置中心静脉导管持续输注苏拉明350mg/m²/天。两人均发生腋窝静脉血栓形成。随后的患者接受苏拉明500mg/m²，每周三次，静脉输注1小时，直至谷血清水平达到200μg/ml。每8周重复治疗一次。每次给药前后检查血清苏拉明水平。
苏拉明治疗耐受性良好。尽管血清峰浓度高达506μg/ml，但未观察到严重毒性。未观察到肿瘤反应。
我们得出结论，苏拉明可以通过间歇性输注安全方便地给予门诊患者，而无需使用复杂的适应性给药策略。苏拉明在预处理较轻的乳腺癌患者中值得进一步研究。
