Phase I dose escalation and pharmacokinetic study of pluronic polymer-bound doxorubicin (SP 1049C) in patients with advanced cancer

SPIO49C is a novel anticancer agent containing doxorubicin and two nonionic pluronic block copolymers. In preclinical studies, SPIO49C demonstrated increased efficacy compared to doxorubicin. The objectives of this first phase I study were to determine the toxicity profile, dose-limiting toxicity, maximum tolerated dose and pharmacokinetic profile of SPIO49C, and to document any antitumour activity, The starting dose was 5 mg m(-2) (doxorubicin content) as an intravenous infusion once every 3 weeks for up to six cycles. A total of 26 patients received 78 courses at seven dose levels. The dose-limiting toxicity was myelosuppression and DLT was reached at 90 mg m(-2). The maximum tolerated dose was 70 mg m(-2) and is recommended for future trials. The pharmacokinetic profile of SPIO49C showed a slower clearance than has been reported for conventional doxorubicin. Evidence of antitumour activity was seen in some patients with advanced resistant solid tumours. Phase II trials with this agent are now warranted to further define its antitumour activity and safety profile. (C) 2004 Cancer Research UK.