Phase I clinical evaluation of weekly administration of the novel vascular-targeting agent, ZD6126, in patients with solid tumors - PubMed (original) (raw)
Clinical Trial
. 2006 Apr 1;24(10):1491-8.
doi: 10.1200/JCO.2005.02.7458.
Affiliations
- PMID: 16574998
- DOI: 10.1200/JCO.2005.02.7458
Clinical Trial
Phase I clinical evaluation of weekly administration of the novel vascular-targeting agent, ZD6126, in patients with solid tumors
Laurens V Beerepoot et al. J Clin Oncol. 2006.
Abstract
Purpose: ZD6126 is a novel vascular-targeting agent that induces selective effects on the morphology of endothelial cells by disrupting the tubulin cytoskeleton. This leads to cell detachment and tumor vessel congestion, resulting in extensive central necrosis in a range of tumor xenograft models. Results from a phase I dose-escalation study of ZD6126 are reported.
Patients and methods: Thirty-two patients with advanced cancer received weekly ZD6126 infusion (5 to 28 mg/m2). Assessments for safety and pharmacokinetics were performed. Circulating endothelial cells (CECs) were quantified as a pharmacodynamic marker of vascular damage.
Results: Maximum concentrations of the active species were observed 5 to 25 minutes from the start of infusion, and decayed in a biexponential manner with a half-life of 1 to 3 hours. Maximum serum concentration and area under the time-concentration curve increased with dose in a linear fashion across the dose range of 5 to 28 mg/m2. One patient treated at 10 mg/m2 with a history of ischemic heart disease experienced acute myocardial infarction 2 weeks after drug discontinuation. Four others had asymptomatic creatine phosphokinase-muscle-brain elevation. Maximum-tolerated dose (MTD) was reached at 20 mg/m2/wk. Dose-limiting toxicities at 28 mg/m2 were hypoxia caused by pulmonary embolism and an asymptomatic decrease in left ventricular ejection fraction. No objective antitumor responses were observed. CEC levels increased in the hours after infusion, indicating potential effect of the compound on the vasculature. CONCLUSION ZD6126 administered as a weekly infusion was clinically well tolerated. The MTD was reached at 20 mg/m2.
Comment in
- Promise of new vascular-disrupting agents balanced with cardiac toxicity: is it time for oncologists to get to know their cardiologists?
van Heeckeren WJ, Bhakta S, Ortiz J, Duerk J, Cooney MM, Dowlati A, McCrae K, Remick SC. van Heeckeren WJ, et al. J Clin Oncol. 2006 Apr 1;24(10):1485-8. doi: 10.1200/JCO.2005.04.8801. J Clin Oncol. 2006. PMID: 16574996 No abstract available. - On the origin and nature of elevated levels of circulating endothelial cells after treatment with a vascular disrupting agent.
Shaked Y, Bertolini F, Emmenegger U, Lee CR, Kerbel RS. Shaked Y, et al. J Clin Oncol. 2006 Aug 20;24(24):4040; author reply 4040-1. doi: 10.1200/JCO.2006.07.1175. J Clin Oncol. 2006. PMID: 16921064 No abstract available.
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