Phase I pharmacological and bioavailability study of oral diflomotecan (BN80915), a novel E-ring-modified camptothecin analogue in adults with solid tumors

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dc.contributor.authorGelderblom, H.en
dc.contributor.authorSalazar, R.en
dc.contributor.authorVerweij, J.en
dc.contributor.authorPentheroudakis, G.en
dc.contributor.authorde Jonge, M. J.en
dc.contributor.authorDevlin, M.en
dc.contributor.authorvan Hooije, C.en
dc.contributor.authorSeguy, F.en
dc.contributor.authorObach, R.en
dc.contributor.authorPrunonosa, J.en
dc.contributor.authorPrincipe, P.en
dc.contributor.authorTwelves, C.en
dc.date.accessioned2015-11-24T18:58:59Z
dc.date.available2015-11-24T18:58:59Z
dc.identifier.issn1078-0432-
dc.identifier.urihttps://olympias.lib.uoi.gr/jspui/handle/123456789/19330
dc.rightsDefault Licence-
dc.subjectAdministration, Oralen
dc.subjectAdulten
dc.subjectAgeden
dc.subjectAlopecia/chemically induceden
dc.subjectAntineoplastic Agents, Phytogenic/administration &en
dc.subjectdosage/blood/*pharmacokinetics/*toxicityen
dc.subjectBiological Availabilityen
dc.subjectCamptothecin/administration & dosage/*analogs &en
dc.subjectderivatives/blood/*pharmacokinetics/*toxicityen
dc.subjectDrug Administration Scheduleen
dc.subjectFemaleen
dc.subjectHematologic Diseases/chemically induceden
dc.subjectHumansen
dc.subjectMaleen
dc.subjectMetabolic Clearance Rateen
dc.subjectMiddle Ageden
dc.subjectNeoplasms/*drug therapyen
dc.titlePhase I pharmacological and bioavailability study of oral diflomotecan (BN80915), a novel E-ring-modified camptothecin analogue in adults with solid tumorsen
heal.abstractPURPOSE: Diflomotecan (BN80915) is an E-ring modified camptothecin analogue that possesses greater lactone stability in plasma compared with other topoisomerase I inhibitors, a potential advantage for antitumor activity. As with other camptothecins, oral administration has pharmacological and clinical advantages. This Phase I study was performed to assess the feasibility of the administration of oral diflomotecan, to determine the maximum-tolerated, dose its bioavailability, and to explore the pharmacokinetics. EXPERIMENTAL DESIGN: An initial i.v. bolus was administered to assess the bioavailability of diflomotecan. Fourteen days later, diflomotecan was administered p.o. once daily for 5 days to adult patients with solid malignant tumors and repeated every 3 weeks. BN80915 and its open lactone form BN80942 were measured. RESULTS: Twenty-two patients entered the study and received a total of 57 cycles of oral diflomotecan at flat dose levels of 0.10, 0.20, 0.27, and 0.35 mg. The main toxicity was hematological, but some patients experienced alopecia, mild gastrointestinal toxicity, and fatigue. At the 0.35-mg dose level, 2 of 4 patients experienced dose-limiting toxicity comprising grade 3 thrombocytopenia with epistaxis and febrile neutropenia in 1 patient and uncomplicated grade 4 neutropenia lasting for >7 days in another. Toxicity was acceptable at the 0.27-mg dose level at which dose-limiting toxicities were observed in 3 of 12 patients (grade 4 neutropenia > 7 days, complicated by fever in 1 patient but without other signs of infection). After two cycles of diflomotecan, 6 patients had disease stabilization, which was maintained in 2 patients for 9 months and >1 year, respectively. Diflomotecan pharmacokinetics were linear over the dose range studied. Systemic exposure correlated with the fall in WBC counts. The mean oral bioavailability (+/-SD) was 72.24 +/- 59.2% across all dose levels. Urinary excretion of BN80915 was very low. CONCLUSIONS: The recommended oral diflomotecan dose for Phase II studies is 0.27 mg/day x 5 every 3 weeks. This regimen is convenient and generally well tolerated with a favorable pharmacokinetic profile and high but variable bioavailability.en
heal.accesscampus-
heal.fullTextAvailabilityTRUE-
heal.identifier.secondaryhttp://www.ncbi.nlm.nih.gov/pubmed/14519632-
heal.identifier.secondaryhttp://clincancerres.aacrjournals.org/content/9/11/4101.full.pdf-
heal.journalNameClin Cancer Resen
heal.journalTypepeer-reviewed-
heal.languageen-
heal.publicationDate2003-
heal.recordProviderΠανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικήςel
heal.typejournalArticle-
heal.type.elΆρθρο Περιοδικούel
heal.type.enJournal articleen

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