title: A Phase I study of CHS 828 in patients with solid tumor malignancy.
abstract: CHS 828 is a cyanoguanidine, which has demonstrated potent antitumor activity in preclinical tumor models. The activity of CHS 828 in vitro showed only low to moderate correlation to other antineoplastic agents suggesting a unique mechanism of action. Ten females and 6 males (median age 58 years) with solid tumors refractory to standard therapy were included in this Phase I study. The study drug was administered to fasting patients as a single oral dose on days 1-5 of each treatment cycle. Patients received one to six cycles of treatment. The doses ranged from 30 mg to 200 mg (total dose within a cycle). Hematological toxicity was generally mild and dominated by transient thrombocytopenia and lymphocytopenia. Nonhematological toxicity most frequently consisted of nausea, vomiting, diarrhea, fatigue, and localized genital mucositis. The dose-limiting toxicities were thrombocytopenia, thrombosis, esophagitis, diarrhea, and constipation. The recommended Phase II dose of CHS 828 was 20 mg once daily for 5 days in cycles of 28 days duration. The extent of systemic exposure of CHS 828 across patients was approximately dose proportional. The time at which the highest drug concentration occurs was 2.2 +/- 1.3 h and half-life was 2.1 +/- 0.52 h (mean +/- SD). Large intra- and interindividual variation in dose level-adjusted maximum plasma concentration and the area under the curve from time 0 h to infinity were observed. There was an apparent inverse relationship between systemic exposure of CHS 828, and thrombocyte and lymphocyte nadir levels. No objective tumor responses were observed, and 7 patients showed stable disease after two courses of therapy.
authors.affiliation: Department of Clinical Pharmacology, Uppsala University, S-751 85 Uppsala, Sweden. peter.hovstadius@medsci.uu.se
authors.forename: Peter
authors.initials: P
authors.lastname: Hovstadius
authors.forename: Rolf
authors.initials: R
authors.lastname: Larsson
authors.forename: Elin
authors.initials: E
authors.lastname: Jonsson
authors.forename: Torsten
authors.initials: T
authors.lastname: Skov
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Kissmeyer
authors.forename: Klaus
authors.initials: K
authors.lastname: Krasilnikoff
authors.forename: Jonas
authors.initials: J
authors.lastname: Bergh
authors.forename: Mats O
authors.initials: MO
authors.lastname: Karlsson
authors.forename: Anna
authors.initials: A
authors.lastname: Lönnebo
authors.forename: Johan
authors.initials: J
authors.lastname: Ahlgren
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D003486:Cyanides / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D005260:Female; D005767:Gastrointestinal Diseases / Q000139:chemically induced; D006146:Guanidines / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D006801:Humans; D008231:Lymphopenia / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*; D012107:Research Design; D013921:Thrombocytopenia / Q000139:chemically induced; D017211:Treatment Failure
chemical_list: D000970:Antineoplastic Agents; D003486:Cyanides; D006146:Guanidines; C401312:N-(6-chlorophenoxyhexyl)-N''-cyano-N''-4-pyridylguanidine