title: Enhanced antitumor activity of irofulven in combination with irinotecan in pediatric solid tumor xenograft models.
abstract: OBJECTIVE
  Irofulven, a novel chemotherapeutic agent with a broad spectrum of activity, is effective against preclinical models of pediatric tumors. The cytotoxic activity of irofulven is augmented when combined with agents that interact with DNA topoisomerase I; however, none of the reported studies have used the protracted dosing schedule found to be active clinically in treatment of childhood cancers. The objective of this study was to evaluate the antitumor activity of irofulven in combination with irinotecan administered on a protracted schedule in a panel of pediatric solid tumor xenografts.
  
  
  METHODS
  Irofulven and irinotecan were evaluated alone or in combination against eight independent xenografts, which included childhood brain tumors (n=5), neuroblastoma (n=1), and rhabdomyosarcoma (n=2). Irofulven was administered i.v. daily for 5 days with courses repeated every 21 days for a total of three cycles. Doses of irofulven ranged from 1.33 to 4.6 mg/kg. Irinotecan was given i.v. daily for 5 days each week for 2 weeks repeated every 21 days for three cycles at doses between 0.28 and 1.25 mg/kg.
  
  
  RESULTS
  Irofulven and irinotecan, given as single agents, induced few responses in pediatric solid tumor xenografts at the selected doses. At the same doses, irofulven in combination with irinotecan demonstrated superior antitumor activity, inducing complete responses in seven of the eight xenograft lines.
  
  
  CONCLUSIONS
  These studies show that the cytotoxic activity of irofulven is greater when combined with protracted administration of irinotecan. Although the systemic exposure of irofulven required to induce objective responses in this panel of pediatric solid tumors was in excess of that achievable in patients receiving maximally tolerated doses using this schedule of drug administration, the enhanced activity of irofulven in combination with irinotecan supports the pursuit of alternative administration strategies and combinations.
authors.affiliation: Clinical Discovery, Bristol Myers Squibb, P.O. Box 4000, Princeton, NJ 08543, USA.
authors.forename: Michael H
authors.initials: MH
authors.lastname: Woo
authors.forename: Jennifer K
authors.initials: JK
authors.lastname: Peterson
authors.forename: Catherine
authors.initials: C
authors.lastname: Billups
authors.forename: Hua
authors.initials: H
authors.lastname: Liang
authors.forename: Mary-Ann
authors.initials: MA
authors.lastname: Bjornsti
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Houghton
mesh_terms: D000818:Animals; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy*; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives*; D004334:Drug Administration Schedule; D005260:Female; D000077146:Irinotecan; D051379:Mice; D008813:Mice, Inbred ICR; D012717:Sesquiterpenes / Q000008:administration & dosage; D017211:Treatment Failure; D023041:Xenograft Model Antitumor Assays / Q000379:methods*
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D012717:Sesquiterpenes; C102714:irofulven; D000077146:Irinotecan; D002166:Camptothecin