|
|
||||
|
|
||||
|
||||
Clinical Therapy TrialsDrug |
Nova Scotia Cancer Centre, Halifax, NS B3H 1V7, Canada (S.K.); Ottawa Regional Cancer Centre, Ottawa, ON K1H 8L6, Canada (S.Z.G.); Princess Margaret Hospital, Toronto, ON M5G 2M9, Canada (W.M.); London Regional Cancer Centre, London, ON N6A 4L6, Canada (C.W.); Tom Baker Cancer Centre, Calgary, AB T2N 4N2, Canada (P.F.); Tularik, Inc., South San Francisco, CA 94080, USA (J.A., R.S., M.W.); National Cancer Institute of Canada, Clinical Trials Group, and Queen's University Kingston, ON K7L 3N6, Canada (J.P., E.A.E.)
2 Address correspondence to Sarah Kirby, Nova Scotia Cancer Centre, Dalhousie University, 464 Bethune Building, 1278 Tower Road, Halifax, NS B3H 2Y9, Canada (skirby2{at}dal.ca).
Abstract
We studied the activity of T138067-sodium in patients with malignant gliomas. T138067-sodium is a unique new chemotherapy agent that inhibits microtubule formation by binding irreversibly and specifically to ß1, ß2, and ß4 isotypes of ß-tubulin, causing cell arrest at G2/M and inducing apoptosis. Patients with recurrent anaplastic astrocytoma or glioblastoma multiforme were treated intravenously with 330 mg/m2 of T138067-sodium weekly. Treatment was continued until the patient experienced either unacceptable toxicity or progressive disease. Patients had to have histologically proven glioma, have bidimensionally measurable disease at least 1 cm x 1 cm, and have received no more than one prior adjuvant chemotherapy. No chemotherapy or radiotherapy for recurrent disease was permitted. Nineteen patients entered the trial. One patient was found to be ineligible. There were two patients with anaplastic astrocytoma and 16 with glioblastoma multiforme. Only two patients had received prior adjuvant chemotherapy. The first seven patients had full pharmacokinetic sampling. No dose-limiting toxicity was seen, and pharmacokinetic results were consistent with those from nonglioma patients. The most common drug-related effects were fatigue (33%), nausea (28%), neutropenia (28%), and anorexia (17%). No patients stopped the study because of toxicity. No responses were seen in the 15 eligible patients who completed at least one cycle. Three patients had stable disease with a median duration of 2.6 months. Our results suggest that given in this dose and schedule T138067-sodium does not have activity in this population of anaplastic astrocytoma and glioblastoma multiforme.
References
Burkhart, C.A., Kavallaris, M., and Horwitz, S.B.
(2001) The role of
-tubulin isotypes in resistance to
antimitotic drugs. Biochim. Biophys. Acta
1471,O1
-O9.[Medline]
Cancer Therapy Evaluation Program (1998) Common Toxicity Criteria, version 2.0. National Institutes of Health, National Cancer Institute, Bethesda, Md.
Curran, W.J., Jr., Scott, C.B., Horton, J., Nelson, J.S.,
Weinstein, A.S., Fischbach, A.J., Chang, C.H., Rotman, M., Asbell, S.O.,
Krisch, R.E., and Nelson, D.F. (1993) Recursive partitioning
analysis of prognostic factors in three Radiation Therapy Oncology Group
malignant glioma trials. J. Natl. Cancer Inst.
85,704
-710.
Donehower, R.C., Schwartz, G.H., Wolff, A.C., Olivo, N., Burks, K.L., Wright, M., Walling, J., and Rowinsky, E.K. (2001) A phase I pharmacokinetic study of T138067 administered as a weekly 3-hour infusion. Abstract 438. Paper presented at the American Society of Clinical Oncology 2001 ASCO Annual Meeting. Available at www.asco.org.
Fleming, T. (1982) One-sample multiple testing procedure for phase II clinical trials. Biometrics 38,143 -151.[CrossRef][Web of Science][Medline]
GMT Group. Glioma Meta-Analysis Trialists Group (2002) Chemotherapy for high-grade glioma. Cochrane Database Syst. Rev. 4,CD003913 .
Hari, M., Yang, H., Zeng, C., Canizales, M., and Cabral, F. (2003) Expression of class III ß-tubulin reduces microtubule assembly and confers resistance to paclitaxel. Cell Motil. Cytoskeleton 56,45 -56.[CrossRef][Web of Science][Medline]
Katsetos, C.D., Del Valle, L., Geddes, J.F., Assimakopoulou, M., Legido, A., Boyd, J.C., Balin, B., Parikh, N.A., Maraziotis, T., de Chadarevian, J.P., Varakis, J.N., Matsas, R., Spano, A., Frankfurter, A., Herman, M.M., and Khalili, K. (2001) Aberrant localization of the neuronal class III ß-tubulin in astrocytomas. Arch. Pathol. Lab. Med. 125,613 -624.[Web of Science][Medline]
Levin, V.A., Crafts, D.C., Norman, D.M., Hoffer, P.B., Spire, J.P., and Wilson, C.B. (1977) Criteria for evaluating patients undergoing chemotherapy for malignant brain tumors. J. Neurosurg. 47,329 -335.[Web of Science][Medline]
MacDonald, D.R., Cascino, T.L., Schold, S.C., Jr., Cairncross, J.G. (1990) Response criteria for phase II studies of supratentorial malignant glioma. J. Clin. Oncol. 8,1277 -1280.[Abstract]
Preston, G., Schwartz, G., Garrison, M., Olivio, N., Wright, M., Walling, J., Gallagher, M., Stevenson, J., Rowinsky, E.K., and O'Dwyer, P. (2001) A phase I pharmacokinetic study of T138067, a synthetic microtubule depolymerizing agent, administered as a 3-hour infusion daily x 5 every 3 weeks. Abstract 443. Paper presented at the American Society of Clinical Oncology 2001 ASCO Annual Meeting. Available at www.asco.org.
Rubenstein, S.M., Baichwal, V., Beckmann, H., Clark, D.L., Frankmoelle, W., Roche, D., Santha, E., Schwender, S., Thoolen, M., Ye, Q., and Jaen, J.C. (2001) Hydrophilic, pro-drug analogues of T138067 are efficacious in controlling tumor growth in vivo and show a decreased ability to cross the blood brain barrier. J. Med. Chem. 44,3599 -3605.[CrossRef][Web of Science][Medline]
Shan, B., Medina, J.C., Santha, E., Frankmoelle, W.P., Chou, T.C.,
Learned, R.M., Narbut, M.R., Stott, D., Wu, P., Jaen, J.C., Rosen, T.,
Timmermans, P.B., and Beckman, H. (1999) Selective, covalent
modification of ß-tubulin residue Cys-239 by T138067, an antitumor agent
with in vivo efficacy against multi-drug resistant tumors. Proc.
Natl. Acad. Sci. USA 96,5686
-5691.
Stupp, R., Mason, W.P., Van Den Bent, M.J., Weller, M., Fisher, B., Taphoorn, M., Brandes, A.A., Cairncross, G., Lacombe, D., and Mirimanoff, R.O. (2004) Concomitant and adjuvant temozolomide (TMZ) and radiotherapy (RT) for newly diagnosed glioblastoma multiforme (GBM). Conclusive results of a randomized phase III trial by the EORTC Brain & RT Groups and NCIC Clinical Trials Group. J. Clin. Oncol. 22 (14S), 2 (suppl.).
Yung, W.K., Albright, R.E., Olson, J., Fredericks, R., Fink, K., Prados, M.D., Brada, M., Spence, A., Hohl, R.J., Shapiro, W., Glantz, M., Greenberg, H., Selker, R.G., Vick, N.A., Rampling, R., Friedman, H., Phillips, P., Bruner, J., Yue, N., Osoba, D., Zaknoen, S., and Levin, V.A. (2000) A phase II study of temozolomide vs. procarbazine in patients with glioblastoma multiforme at first relapse. Br. J. Cancer 83,588 -593.[CrossRef][Web of Science][Medline]
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|