title: A Phase I study of bizelesin (NSC 615291) in patients with advanced solid tumors.
abstract: OBJECTIVE
  To evaluate the toxicities, characterize the pharmacokinetics, and determine the maximum-tolerated dose of bizelesin administered once every 4 weeks.
  
  
  METHODS
  Patients with advanced solid tumors received escalating doses of bizelesin as an i.v. push every 4 weeks. Pharmacokinetic studies were performed with the first treatment cycle.
  
  
  RESULTS
  Nineteen eligible patients received a total of 54 courses of bizelesin at doses ranging from 0.1 to 1 microg/m(2). Dose-limiting toxicity of neutropenia was seen in 2 of 4 patients treated at the 1 microg/m(2) dose level. Nonhematological toxicity was generally mild with maximum toxicity being <or= grade 2 per National Cancer Institute Common Toxicity Criteria. No objective responses were seen in the 19 eligible patients. An L1210 bioassay was used to determine bizelesin plasma levels. The terminal elimination half-life was 140 min at the recommended Phase II dose. The area under the concentration time curve increased in proportion to administered dose, and the clearance remained constant over the dose range studied. Correlation analysis demonstrated relationships between dose and area under the concentration with cycle 1 hematological parameters, including absolute neutrophil and leukocyte nadirs.
  
  
  CONCLUSIONS
  Bizelesin administered every 4 weeks as an i.v. push is well tolerated with dose-limiting toxicity of neutropenia. The maximum-tolerated dose (and recommended Phase II dose) is 0.8 microg/m(2) administered once every 4 weeks.
authors.affiliation: Division of Medical Oncology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA. pitot.henry@mayo.edu
authors.forename: Henry C
authors.initials: HC
authors.lastname: Pitot
authors.forename: Joel M
authors.initials: JM
authors.lastname: Reid
authors.forename: Jeff A
authors.initials: JA
authors.lastname: Sloan
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Ames
authors.forename: Alex A
authors.initials: AA
authors.lastname: Adjei
authors.forename: Joseph
authors.initials: J
authors.lastname: Rubin
authors.forename: Pamela G
authors.initials: PG
authors.lastname: Bagniewski
authors.forename: Pamela
authors.initials: P
authors.lastname: Atherton
authors.forename: Daniel
authors.initials: D
authors.lastname: Rayson
authors.forename: Richard M
authors.initials: RM
authors.lastname: Goldberg
authors.forename: Charles
authors.initials: C
authors.lastname: Erlichman
mesh_terms: D000328:Adult; D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D019540:Area Under Curve; D001682:Biological Availability; D000080890:Duocarmycins; D005260:Female; D006801:Humans; D007211:Indoles / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D007275:Injections, Intravenous; D007958:Leukocyte Count; D008297:Male; D020714:Maximum Tolerated Dose; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000378:metabolism; D009504:Neutrophils / Q000378:metabolism; D014508:Urea / Q000008:administration & dosage* / Q000009:adverse effects / Q000031:analogs & derivatives / Q000493:pharmacokinetics
chemical_list: D018906:Antineoplastic Agents, Alkylating; D000080890:Duocarmycins; D007211:Indoles; D014508:Urea; C072257:bizelesin