title: A phase I clinical trial of spicamycin derivative KRN5500 (NSC 650426) using a phase I accelerated titration "2B" design.
abstract: The spicamycin derivative KRN5500 was considered as a potential anti-cancer agent based on in vitro and preclinical studies. A Phase I study involving 24 cancer patients in whom tumors were refractory to all other conventional therapies was conducted to determine the dose limiting toxicity, maximum tolerated dose, effectiveness, and pharmacokinetic parameters of this drug administered by 1-h IV infusion daily for five consecutive days every 3 weeks. Using an accelerated dose titration strategy, 8.4 mg/m2/d x 5 days was the maximum administered dose. Severe gastrointestinal and hepatic toxicities were observed at doses at or above 4.3 mg/m2/d x 5. The recommended Phase II dose i s 4.3mg/m2/d x 5. The distribution of KRN5500 followed a two-compartment model, and clearance did not decrease significantly over the dose range 0.8-8.4 mg/m2/d x 5. No significant correlation was observed between plasma levels and toxicity. No tumor responses were observed among the 14 patients evaluable for response.
authors.affiliation: Barbara Ann Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA.
authors.forename: S M
authors.initials: SM
authors.lastname: Gadgeel
authors.forename: R R
authors.initials: RR
authors.lastname: Boinpally
authors.forename: L K
authors.initials: LK
authors.lastname: Heilbrun
authors.forename: A
authors.initials: A
authors.lastname: Wozniak
authors.forename: V
authors.initials: V
authors.lastname: Jain
authors.forename: B
authors.initials: B
authors.lastname: Redman
authors.forename: M
authors.initials: M
authors.lastname: Zalupski
authors.forename: R
authors.initials: R
authors.lastname: Wiegand
authors.forename: R
authors.initials: R
authors.lastname: Parchment
authors.forename: P M
authors.initials: PM
authors.lastname: LoRusso
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics* / Q000494:pharmacology; D002851:Chromatography, High Pressure Liquid; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D020714:Maximum Tolerated Dose; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*; D011684:Purine Nucleosides / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics* / Q000494:pharmacology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D011684:Purine Nucleosides; C092296:KRN 5500