A phase I study of recombinant human leukemia inhibitory factor in patients with advanced cancer.
OBJECTIVE
Leukemia inhibitory factor (LIF) is a pleiotropic molecule of the interleukin 6 family of cytokines. We aimed to examine the safety, pharmacokinetics, and biological effects of recombinant human LIF (rhLIF, emfilermin) in patients with advanced cancer.


METHODS
In stage 1 of the study, 34 patients received rhLIF or placebo (3:1 ratio) at doses of 0.25-16.0 micro g/kg/day or 4.0 micro g/kg three times daily for 7 days. In stage 2, 40 patients received rhLIF or placebo, either once daily for 14 days commencing the day after chemotherapy (0.25-8.0 micro g/kg/day) or for 7 days commencing the day before chemotherapy (4.0 micro g/kg three times daily). The chemotherapy was cisplatin 75 mg/m(2) and paclitaxel 135 mg/m(2).


RESULTS
In stage 1, platelet counts increased in most patients, including those who received placebo. Blood progenitor cells increased in response to rhLIF. In stage 2, platelet recovery to baseline levels was earlier for patients receiving higher doses of rhLIF (>/=4.0 micro g/kg/day; P = 0.02). The neutrophil nadir after chemotherapy was less severe in patients receiving >/=4.0 micro g/kg/day of rhLIF. In stages 1 and 2, increases in C reactive protein were seen at higher doses. Several patients developed evidence of autonomic dysfunction, in particular impotence and episodic hypotension. The dose-limiting toxicities were hypotension and rigors. Pharmacokinetic studies demonstrated a short half-life (1-5 h) independent of dose.


CONCLUSIONS
We demonstrated a biological effect of rhLIF on blood progenitor cells, C reactive protein levels, and hemopoietic recovery after chemotherapy.
Gunawardana
Dishan H
DH
Centre for Developmental Cancer Therapeutics, Parkville, Victoria 3050, Australia. dgunn@ozemail.com
Basser
Russell L
RL
Davis
Ian D
ID
Cebon
Jonathan
J
Mitchell
Paul
P
Underhill
Craig
C
Kilpatrick
Trevor J
TJ
Reardon
Katrina
K
Green
Michael D
MD
Bardy
Peter
P
Amor
Pene
P
Crump
David
D
Ng
Siobhan
S
Nation
Roger L
RL
Begley
C Glenn
CG
D000328:Adult; D000368:Aged; D004311:Double-Blind Method; D005260:Female; D006412:Hematopoietic Stem Cells / Q000187:drug effects; D006801:Humans; D015850:Interleukin-6 / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D053605:Leukemia Inhibitory Factor; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009369:Neoplasms / Q000188:drug therapy*; D011994:Recombinant Proteins / Q000627:therapeutic use
D015850:Interleukin-6; C507837:LIF protein, human; D053605:Leukemia Inhibitory Factor; D011994:Recombinant Proteins