title: Phase I clinical and pharmacokinetic study of perillyl alcohol administered four times a day.
abstract: We conducted a phase I dose-escalation trial of perillyl alcohol (POH; NSC 641066) given p.o. on a continuous four times a day basis to characterize the maximum tolerated dose, toxicities, pharmacokinetic profile, and antitumor activity. Sixteen evaluable patients with advanced refractory malignancies were treated at the following doses: level 1 (L1), 800 mg/m2/dose; L2, 1200 mg/m2/dose; L3, 1600 mg/m2/dose. POH was formulated in soft gelatin capsules containing 250 mg of POH and 250 mg of soybean oil. The predominant toxicities seen were gastrointestinal (nausea, vomiting, satiety, and eructation), which were dose limiting. There appeared to be a dose-dependent increase in levels of the two main metabolites, perillic acid and dihydroperillic acid. No significant differences were seen whether the drug was taken with or without food. There was a trend toward decreasing metabolite levels on day 29 compared with days 1 and 2. Peak metabolite levels were seen 1-3 h post ingestion. Metabolite half-lives were approximately 2 h. Approximately 9% of the total dose was recovered in the urine in the first 24 h, the majority as perillic acid. Evidence of antitumor activity was seen in a patient with metastatic colorectal cancer who has an ongoing near-complete response of > 2 years duration. Several other patients were on study for > or = 6 months with stable disease. The maximum tolerated dose of POH given continuously four times a day was 1200 mg/m2/dose. Gastrointestinal toxicity was dose limiting, although significant interpatient variability in drug tolerance was seen.
authors.affiliation: University of Wisconsin Comprehensive Cancer Center, Developmental Therapeutics Program, Madison 53792, USA.
authors.forename: G H
authors.initials: GH
authors.lastname: Ripple
authors.forename: M N
authors.initials: MN
authors.lastname: Gould
authors.forename: R Z
authors.initials: RZ
authors.lastname: Arzoomanian
authors.forename: D
authors.initials: D
authors.lastname: Alberti
authors.forename: C
authors.initials: C
authors.lastname: Feierabend
authors.forename: K
authors.initials: K
authors.lastname: Simon
authors.forename: K
authors.initials: K
authors.lastname: Binger
authors.forename: K D
authors.initials: KD
authors.lastname: Tutsch
authors.forename: M
authors.initials: M
authors.lastname: Pomplun
authors.forename: A
authors.initials: A
authors.lastname: Wahamaki
authors.forename: R
authors.initials: R
authors.lastname: Marnocha
authors.forename: G
authors.initials: G
authors.lastname: Wilding
authors.forename: H H
authors.initials: HH
authors.lastname: Bailey
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics*; D019540:Area Under Curve; D001711:Biotransformation; D004334:Drug Administration Schedule; D005260:Female; D006207:Half-Life; D006801:Humans; D008297:Male; D008875:Middle Aged; D039821:Monoterpenes; D009369:Neoplasms / Q000188:drug therapy*; D013729:Terpenes / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics*
chemical_list: D000970:Antineoplastic Agents; D039821:Monoterpenes; D013729:Terpenes; C032208:perillyl alcohol