title: A phase 1 trial dose-escalation study of tipifarnib on a week-on, week-off schedule in relapsed, refractory or high-risk myeloid leukemia.
abstract: Inhibition of farnesyltransferase (FT) activity has been associated with in vitro and in vivo anti-leukemia activity. We report the results of a phase 1 dose-escalation study of tipifarnib, an oral FT inhibitor, in patients with relapsed, refractory or newly diagnosed (if over age 70) acute myelogenous leukemia (AML), on a week-on, week-off schedule. Forty-four patients were enrolled, two patients were newly diagnosed, and the rest were relapsed or refractory to previous treatment, with a median age of 61 (range 33-79). The maximum tolerated dose was determined to be 1200 mg given orally twice daily (b.i.d.) on this schedule. Cycle 1 dose-limiting toxicities were hepatic and renal. There were three complete remissions seen, two at the 1200 mg b.i.d. dose and one at the 1000 mg b.i.d. dose, with minor responses seen at the 1400 mg b.i.d. dose level. Pharmacokinetic studies performed at doses of 1400 mg b.i.d. showed linear behavior with minimal accumulation between days 1-5. Tipifarnib administered on a week-on, week-off schedule shows activity at higher doses, and represents an option for future clinical trials in AML.
authors.affiliation: Department of Hematology/HCT, City of Hope, Duarte, CA, USA. mkirschb@yahoo.com
authors.forename: M H
authors.initials: MH
authors.lastname: Kirschbaum
authors.forename: T
authors.initials: T
authors.lastname: Synold
authors.forename: A S
authors.initials: AS
authors.lastname: Stein
authors.forename: J
authors.initials: J
authors.lastname: Tuscano
authors.forename: J M
authors.initials: JM
authors.lastname: Zain
authors.forename: L
authors.initials: L
authors.lastname: Popplewell
authors.forename: C
authors.initials: C
authors.lastname: Karanes
authors.forename: M R
authors.initials: MR
authors.lastname: O'Donnell
authors.forename: B
authors.initials: B
authors.lastname: Pulone
authors.forename: A
authors.initials: A
authors.lastname: Rincon
authors.forename: J
authors.initials: J
authors.lastname: Wright
authors.forename: P
authors.initials: P
authors.lastname: Frankel
authors.forename: S J
authors.initials: SJ
authors.lastname: Forman
authors.forename: E M
authors.initials: EM
authors.lastname: Newman
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy*; D008297:Male; D020714:Maximum Tolerated Dose; D008875:Middle Aged; D015363:Quinolones / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D012008:Recurrence; D012307:Risk Factors
chemical_list: D000970:Antineoplastic Agents; D015363:Quinolones; C402769:tipifarnib