title: Clinical trials with the topoisomerase I inhibitors.
abstract: Topoisomerase I represents a unique new target that can be exploited for development of new antineoplastic agents. There are now two new topoisomerase I inhibitors that are in early clinical trials that have generated a tremendous amount of interest. Topotecan (SKF 104864-A) is a topoisomerase I inhibitor that has been explored in phase I trials using a variety of dosages and schedules. The dose-limiting toxicity of the agent is neutropenia. Other toxicities include alopecia, very mild nausea and vomiting, anemia, and occasional fever. Responses have already been noted in patients with advanced, refractory ovarian cancer and non--small-cell lung cancer. The drug is currently undergoing intense phase II testing. Irinotecan (CPT-11) is also a topoisomerase I inhibitor, which has already undergone extensive phase I and early phase II clinical testing in both Japan and the United States. Dose-limiting toxicities of the agent have included neutropenia and diarrhea. Responses have been noted in patients with refractory colorectal cancer, non--small-cell lung cancer, lymphoma, ovarian cancer, head and neck cancer, pancreatic cancer, and breast cancer. There is no doubt both of these agents will be important additions to our chemotherapy armamentarium.
authors.affiliation: Department of Medicine, Brooke Army Medical Center, Fort Sam Houston, TX.
authors.forename: H A
authors.initials: HA
authors.lastname: Burris
authors.forename: M L
authors.initials: ML
authors.lastname: Rothenberg
authors.forename: J G
authors.initials: JG
authors.lastname: Kuhn
authors.forename: D D
authors.initials: DD
authors.lastname: Von Hoff
mesh_terms: D000818:Animals; D000970:Antineoplastic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use; D002166:Camptothecin / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D005544:Forecasting; D006801:Humans; D000077146:Irinotecan; D009369:Neoplasms / Q000188:drug therapy; D059004:Topoisomerase I Inhibitors; D019772:Topotecan
chemical_list: D000970:Antineoplastic Agents; D000972:Antineoplastic Agents, Phytogenic; D059004:Topoisomerase I Inhibitors; D000077146:Irinotecan; D019772:Topotecan; D002166:Camptothecin