A phase I dose escalation study of a pharmacobiologically based scheduling of capecitabine and mitomycin C in patients with gastrointestinal malignancies

作者：Bekaii Saab Tanios^*; Hill Marisa; Campbell Angela; Kosuri Kavitha; Thomas James; Villalona Calero Miguel

来源：Cancer Chemotherapy and Pharmacology, 2010, 65(5): 863-869.

DOI：10.1007/s00280-009-1091-9

• Capecitabine
• Mitomycin C
• Gastrointestinal malignancies

Mitomycin C (MMC) produces significant upregulation of thymidine phosphorylase, a principal determinant of the therapeutic index of capecitabine-based treatment, starting 4-6 days after treatment. On the basis of the time-dependency of this upregulation, we performed a phase I dose escalation study of capecitabine and MMC in patients with gastrointestinal malignancies.
A total of 29 patients with advanced gastrointestinal malignancies received MMC at 6 mg/m(2) on day 1 and capecitabine escalated in four successive patient cohorts of doses 500-1,000 mg/m(2)/day twice daily on days 8-21, every 28 days. MMC was capped at 36 mg/m(2).
A total of 29 patients were enrolled and 90% had at least one prior treatment in the metastatic setting. There was one DLT, grade 3 hand and foot syndrome, at dose level four. The most common toxicity was fatigue (61%). No patients experienced grade 4 toxicities. Nine patients experienced prolonged stability of disease.
Capecitabine in combination with MMC in the proposed schedule is well-tolerated with evidence of preliminary activity. The recommended dose for phase II studies are MMC at 6 mg/m(2) on day 1 of a 28-day cycle with the dose capped at 36 mg/m(2), in combination with capecitabine at 1,000 mg/m(2) twice daily on days 8-21.

• 出版日期2010-4