title: Phase I clinical trial of fazarabine as a twenty-four-hour continuous infusion.
abstract: A phase I trial of fazarabine (ara-AC, 1-beta-D-arabinofuranosyl-5-azacytosine, NSC 281272) administered as a 24-h continuous infusion was performed in 24 adults with solid tumor malignancies. The majority of patients had received prior marrow-suppressive therapy. Level 7 (54.5 mg/m2/h for 24 h) was the maximum tolerated dose since during 6 evaluable first courses, 2 episodes of grade 4 granulocytopenia and 3 episodes of grade 3 occurred. Moderate thrombocytopenia also occurred at level 7 with 3 episodes of grade 1 and 1 episode of grade 4 thrombocytopenia during 6 first course treatments. Minimal myelosuppression, principally leukopenia, was seen prior to level 7. The nadir WBC through 47 courses had a linear relationship with plasma steady-state concentrations of ara-AC. The only other toxicity noted was moderate nausea/vomiting, which did not appear to be dose related. Plasma steady-state concentrations of ara-AC were reached in all patients within 4-6 h and ranged from 1.1 microM (11 mg/m2/h for 24 h) to 7.5 microM (54.5 mg/m2/h for 24 h). The mean total body clearance of ara-AC for 47 courses, levels 1-7, was 592 +/- 147 (SD) ml/min/m2 which is similar to prior pharmacokinetic data from the 24-h and 72-h infusion trials of the Pediatric and Medicine Branches, respectively. There were no objective disease responses during the trial. The recommended adult phase II dose for a 24-h infusion of ara-AC is 45-50 mg/m2/h.
authors.affiliation: University of Wisconsin Clinical Cancer Center, Madison 53792.
authors.forename: H
authors.initials: H
authors.lastname: Bailey
authors.forename: K D
authors.initials: KD
authors.lastname: Tutsch
authors.forename: R Z
authors.initials: RZ
authors.lastname: Arzoomanian
authors.forename: M B
authors.initials: MB
authors.lastname: Tombes
authors.forename: D
authors.initials: D
authors.lastname: Alberti
authors.forename: J
authors.initials: J
authors.lastname: Bruggink
authors.forename: G
authors.initials: G
authors.lastname: Wilding
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000633:toxicity*; D001374:Azacitidine / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use / Q000031:analogs & derivatives; D004305:Dose-Response Relationship, Drug; D006801:Humans; D007262:Infusions, Intravenous; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*
chemical_list: D000970:Antineoplastic Agents; C022121:fazarabine; D001374:Azacitidine