未找到相关数据
Phase I and pharmacokinetic study of mitomycin C and celecoxib as potential modulators of tumor resistance to irinotecan in patients with solid malignancies
被引：8
|作者：
Xu, Y.
[1
]
Kolesar, J. M.
[3
]
Schaaf, L. J.
[4
]
Drengler, R.
[5
]
Duan, W.
[1
]
Otterson, G.
[1
]
Shapiro, C.
[1
]
Kuhn, J.
[5
]
Villalona-Calero, M. A.
[1
,2
]
机构：
[1] Ohio State Univ, Dept Internal Med, Div Hematol Oncol, Coll Med & Publ Hlth, Columbus, OH 43210 USA
[2] Ohio State Univ, Dept Pharmacol, Coll Med & Publ Hlth, Columbus, OH 43210 USA
[3] Univ Wisconsin, Madison, WI USA
[4] Ohio State Univ, Ctr Comprehens Canc, Columbus, OH 43210 USA
[5] Univ Texas Hlth Sci Ctr San Antonio, Canc Therapy & Res Ctr, San Antonio, TX 78229 USA
关键词：
Phase I;
Pharmacokinetic;
Mitomycin C;
Irinotecan;
Celecoxib;
Modulation;
NF-KAPPA-B;
DNA TOPOISOMERASE-I;
COLORECTAL-CANCER;
INDUCIBLE CHEMORESISTANCE;
RANDOMIZED-TRIAL;
DT-DIAPHORASE;
CAMPTOTHECIN;
CPT-11;
INHIBITION;
THERAPY;
D O I：
10.1007/s00280-008-0826-3
中图分类号：
R73 [肿瘤学];
学科分类号：
100214 ;
摘要：
Purpose Based on the preclinical evidence of topoisomerase I (Topo-1) upregulation by mitomycin C(MMC) and decreased NF-kappa B activation by celecoxib, we evaluated combinations of irinotecan/MMC and irinotecan/MMC/ celecoxib in patients with advanced solid malignancies. Patients-methods Initially, patients received MMC on day 1 and irinotecan on days 2, 8, 15 and 22, every 6 weeks. MMC dose was fixed at 6 mg/m 2 and cumulative doses of >36 mg/m 2 were not permitted. Irinotecan was escalated in 25 mg/m 2 increments. Due to late-onset diarrhea, the schedule was subsequently shortened to 4 weeks, omitting irinotecan on days 15 and 22. In the second part of the study, celecoxib 400 mg orally twice daily was added to irinotecan/MMC regimen. Potential pharmacokinetic interactions and Topo-1 and DT-diaphorase (NQ01) gene expressions in peripheral-mononuclear cells were evaluated. Results Forty-five patients were enrolled. Irinotecan 125 mg/m 2 on days 2 and 8 in combination with MMC 6 mg/m 2 on day 1 every 4 weeks is recommended for future studies; myelosuppression and diarrhea are dose-limiting. The addition of celecoxib resulted in unacceptable toxicities despite reductions on irinotecan's dose. No relevant pharmacokinetic interactions occurred between irinotecan and MMC, and mean increases in Topo-1, were observed. Sixteen of 36 patients evaluable for response-assessment had discernable anti-tumor activity, including 1 complete, 4 partial, 10 minor and 1 tumor marker response. Four patients had prolonged (> 4 months) disease-stability (stable disease, not included in CR or PR). Patients experiencing complete and partial responses had higher increments in Topo-1 expression. Conclusions Modulation of irinotecan by MMC is feasible, devoid of pharmacological interactions and active in solid malignancies. The lack of improvement in therapeutic index does not support the addition of celecoxib.
引用
收藏
页码：1073 / 1082
页数：10
相关论文