title: A phase II study of piritrexim in patients with advanced squamous head and neck cancer.
abstract: Piritrexim (PTX) is a newly developed lipid-soluble folate antagonist that crosses the cell membrane by a simple, rapid, carrier-independent diffusion process. A Phase II study was conducted to evaluate the activity of PTX in 34 patients with previously chemotherapy-naive squamous cell cancer of the head and neck area (SCCHN). Among them, 30 patients had received previous radiation therapy and/or surgery. Of 33 patients who could be examined, 3 had a complete response (CR), 6 had a partial response (PR), 11 had no change, and 13 had disease progression. The overall response rate (CR + PR) was 27% (9 of 33; 95% confidence interval, 13% to 46%). The response duration ranged from 36 to 360 + days (median, 162) and was similar to the best studies reported with methotrexate. The three most severe side effects (Grades 3 and 4 by World Health Organization criteria) were leukopenia, thrombocytopenia, and mucositis. These occurred in 41%, 26%, and 15% of the 34 patients, respectively. This study established PTX as an agent with some activity in SCCHN. The use of PTX in combination chemotherapeutic regimens needs to be explored.
authors.affiliation: Division of Hematology/Oncology, Duke University Medical Center, Durham, North Carolina 27710.
authors.forename: W C
authors.initials: WC
authors.lastname: Uen
authors.forename: A T
authors.initials: AT
authors.lastname: Huang
authors.forename: R
authors.initials: R
authors.lastname: Mennel
authors.forename: S E
authors.initials: SE
authors.lastname: Jones
authors.forename: M B
authors.initials: MB
authors.lastname: Spaulding
authors.forename: K
authors.initials: K
authors.lastname: Killion
authors.forename: K
authors.initials: K
authors.lastname: Havlin
authors.forename: P
authors.initials: P
authors.lastname: Keegan
authors.forename: N J
authors.initials: NJ
authors.lastname: Clendeninn
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000473:pathology; D004341:Drug Evaluation; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D011743:Pyrimidines / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000970:Antineoplastic Agents; D011743:Pyrimidines; C024530:piritrexim; D008727:Methotrexate