title: Phase I study of LY2181308, an antisense oligonucleotide against survivin, in patients with advanced solid tumors.
abstract: OBJECTIVE
  LY2181308 is an antisense oligonucleotide that complementarily binds to survivin mRNA and inhibits its expression in tumor tissue. This phase I dose escalation study evaluated the tolerability, pharmacokinetics, and anticancer activity of LY2181308 in Japanese.
  
  
  METHODS
  Patients with solid tumors refractory to standard therapy received LY2181308 (400, 600, or 750 mg) as a 3-h intravenous infusion for 3 consecutive days and thereafter once a week.
  
  
  RESULTS
  LY2181308 was administered to 14 patients, aged 44-73 (median 60) years. Flu-like syndrome, prolonged prothrombin time-international normalized ratio (PT-INR), thrombocytopenia, and fatigue were common reversible grade 1/2 toxicities. The dose-limiting toxicity was reversible grade 3 elevation of ALT/AST/γ-GTP in 1 patient treated at the 750-mg dose. Pharmacokinetic analysis showed a long terminal half-life of 21 days and an extensive tissue distribution of LY2181308. In 12 evaluable patients, one patient had stable disease, while the remaining 11 patients had progressive disease.
  
  
  CONCLUSIONS
  LY2181308 monotherapy is well tolerated up to 750 mg with a manageable toxicity, the pharmacokinetic profile warrants further evaluation of LY2181308 in combination with cytotoxic agents or radiotherapy.
authors.affiliation: Division of Internal Medicine, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Tanioka
authors.forename: H
authors.initials: H
authors.lastname: Nokihara
authors.forename: N
authors.initials: N
authors.lastname: Yamamoto
authors.forename: Y
authors.initials: Y
authors.lastname: Yamada
authors.forename: K
authors.initials: K
authors.lastname: Yamada
authors.forename: Y
authors.initials: Y
authors.lastname: Goto
authors.forename: T
authors.initials: T
authors.lastname: Fujimoto
authors.forename: R
authors.initials: R
authors.lastname: Sekiguchi
authors.forename: K
authors.initials: K
authors.lastname: Uenaka
authors.forename: S
authors.initials: S
authors.lastname: Callies
authors.forename: T
authors.initials: T
authors.lastname: Tamura
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use; D018450:Disease Progression; D019008:Drug Resistance, Neoplasm; D005260:Female; D006207:Half-Life; D006801:Humans; D051034:Inhibitor of Apoptosis Proteins / Q000037:antagonists & inhibitors*; D007564:Japan; D008175:Lung Neoplasms / Q000097:blood / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009369:Neoplasms / Q000097:blood / Q000188:drug therapy*; D009841:Oligonucleotides / Q000008:administration & dosage* / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use; D016376:Oligonucleotides, Antisense / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D000077022:Survivin; D014018:Tissue Distribution
chemical_list: D000970:Antineoplastic Agents; C107489:BIRC5 protein, human; D051034:Inhibitor of Apoptosis Proteins; C529350:LY 2181308; D009841:Oligonucleotides; D016376:Oligonucleotides, Antisense; D000077022:Survivin