A phase I and pharmacologic study of DMP 840 administered by 24-hour infusion.
OBJECTIVE
DMP 840, a novel bisnaphthalimide, has demonstrated promising schedule dependent anti-tumor activity in vitro and in vivo against several tumor cell lines. A phase I study was conducted to evaluate the effect of a 24-hour infusion schedule repeated every three weeks, on the therapeutic efficacy of DMP 840.


METHODS
Fourteen patients with refractory solid tumor malignancies were treated with DMP 840 at doses of 20, 40, 50 and 60 mg/m2.


RESULTS
A combination of neutropenia, thrombocytopenia and stomatitis were dose-limiting at doses of 50 and 60 mg/m2 in both minimally- and extensively-pretreated patients. In contrast, all courses at lower dose levels were well tolerated. Pharmacokinetic analysis demonstrated that DMP 840 had a prolonged terminal half life (median 39 hours; range 25-86) and that dose-limiting events were significantly related to several indices of systemic DMP 840 exposure (P < 0.01, Wilcoxon Rank Sum test).


CONCLUSIONS
The recommended dose of DMP 840 for further disease oriented evaluations is 40 mg/m2 administered over 24 hours every three weeks. The infusion duration evaluated in this study did not result in a substantial increase in the tolerable dose compared to shorter, less cumbersome schedules.
O'Reilly
S
S
Johns Hopkins Oncology Center, Baltimore, MD, USA. oreilse@welchlink.jhu.edu
Baker
S D
SD
Sartorius
S
S
Rowinsky
E K
EK
Finizio
M
M
Lubiniecki
G M
GM
Grochow
L B
LB
Gray
J E
JE
Pieniaszek
H J
HJ
Donehower
R C
RC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D006207:Half-Life; D006403:Hematologic Tests; D006801:Humans; D007262:Infusions, Intravenous; D007546:Isoquinolines / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D008698:Mesylates / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D008875:Middle Aged
D000970:Antineoplastic Agents; D007546:Isoquinolines; D008698:Mesylates; C084899:bisnafide