A Phase 1 study of UCN-01 in combination with irinotecan in patients with resistant solid tumor malignancies

作者：Fracasso Paula M^*; Williams Kerry J; Chen Ronald C; Picus Joel; Ma Cynthia X; Ellis Matthew J; Tan Benjamin R; Pluard Timothy J; Adkins Douglas R; Naughton Michael J; Rader Janet S; Arquette Matthew A; Fleshman James W; Creekmore Allison N; Goodner Sherry A; Wright Lisa P; Guo Zhanfang; Ryan Christine E; Tao Yu; Soares Eliane M; Cai Shi rong; Lin Li; Dancey Janet; Rudek Michelle A; McLeod Howard L; Piwnica Worms Helen

来源：Cancer Chemotherapy and Pharmacology, 2011, 67(6): 1225-1237.

DOI：10.1007/s00280-010-1410-1

• Phase 1
• Irinotecan
• UCN-01
• Chk1
• Ribosomal protein S6

UCN-01 (7-hydroxystaurosporine) is a multi-targeted protein kinase inhibitor that exhibits synergistic activity with DNA-damaging agents in preclinical studies. We conducted a Phase I study to determine the maximum-tolerated dose (MTD), dose-limiting toxicity (DLT), pharmacokinetic, and pharmacodynamic effects of UCN-01 and irinotecan in patients with resistant solid tumors.
Patients received irinotecan (75-125 mg/m(2) IV on days 1, 8, 15, 22) and UCN-01 (50-90 mg/m(2) IV on day 2 and 25-45 mg/m(2) on day 23 and subsequent doses) every 42 days. Blood for pharmacokinetics of UCN-01 and irinotecan, and blood, normal rectal mucosa, and tumor biopsies for pharmacodynamic studies were obtained.
Twenty-five patients enrolled to 5 dose levels. The MTD was irinotecan 125 mg/m(2) on days 1, 8, 15, 22 and UCN-01 70 mg/m(2) on day 2 and 35 mg/m(2) on day 23. DLTs included grade 3 diarrhea/dehydration and dyspnea. UCN-01 had a prolonged half-life and a low clearance rate. There was a significant reduction in SN-38 C-max and aminopentanocarboxylic acid (APC) and SN-38 glucuronide half-lives. Phosphorylated ribosomal protein S6 was reduced in blood, normal rectal mucosa, and tumor biopsies at 24 h post-UCN-01. Two partial responses were observed in women with ER, PgR, and HER2-negative breast cancers (TBNC). Both tumors were defective for p53. Twelve patients had stable disease (mean duration 18 weeks, range 7-30 weeks).
UCN-01 and irinotecan demonstrated acceptable toxicity and target inhibition. Anti-tumor activity was observed and a study of this combination in women with TNBC is underway.

• 出版日期2011-6