O'Reilly S, Baker S D, Sartorius S, Rowinsky E K, Finizio M, Lubiniecki G M, Grochow L B, Gray J E, Pieniaszek H J, Donehower R C
Johns Hopkins Oncology Center, Baltimore, MD, USA.
Ann Oncol. 1998 Jan;9(1):101-4. doi: 10.1023/a:1008260515869.
DMP 840, a novel bisnaphthalimide, has demonstrated promising schedule dependent anti-tumor activity in vitro and in vivo against several tumor cell lines. A phase I study was conducted to evaluate the effect of a 24-hour infusion schedule repeated every three weeks, on the therapeutic efficacy of DMP 840.
Fourteen patients with refractory solid tumor malignancies were treated with DMP 840 at doses of 20, 40, 50 and 60 mg/m2.
A combination of neutropenia, thrombocytopenia and stomatitis were dose-limiting at doses of 50 and 60 mg/m2 in both minimally- and extensively-pretreated patients. In contrast, all courses at lower dose levels were well tolerated. Pharmacokinetic analysis demonstrated that DMP 840 had a prolonged terminal half life (median 39 hours; range 25-86) and that dose-limiting events were significantly related to several indices of systemic DMP 840 exposure (P < 0.01, Wilcoxon Rank Sum test).
The recommended dose of DMP 840 for further disease oriented evaluations is 40 mg/m2 administered over 24 hours every three weeks. The infusion duration evaluated in this study did not result in a substantial increase in the tolerable dose compared to shorter, less cumbersome schedules.
新型双萘二甲酰亚胺DMP 840在体外和体内对多种肿瘤细胞系已显示出有前景的时间依赖性抗肿瘤活性。进行了一项I期研究,以评估每三周重复一次的24小时输注方案对DMP 840治疗效果的影响。
14例难治性实体瘤恶性肿瘤患者接受了剂量为20、40、50和60 mg/m²的DMP 840治疗。
在最低预处理和广泛预处理的患者中,50和60 mg/m²剂量下,中性粒细胞减少、血小板减少和口腔炎的组合是剂量限制性的。相比之下,较低剂量水平的所有疗程耐受性良好。药代动力学分析表明,DMP 840的终末半衰期延长(中位数39小时;范围25 - 86),且剂量限制性事件与全身DMP 840暴露的几个指标显著相关(P < 0.01,Wilcoxon秩和检验)。
DMP 840用于进一步以疾病为导向评估的推荐剂量是每三周24小时给予40 mg/m²。与更短、更简便的方案相比,本研究评估的输注持续时间并未导致可耐受剂量大幅增加。