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Published in: Cancer Chemotherapy and Pharmacology 2/2005

01-08-2005 | Original Article

Phase I study of the multidrug resistance inhibitor zosuquidar administered in combination with vinorelbine in patients with advanced solid tumours

Authors: Lyly H. Lê, Malcolm J. Moore, Lillian L. Siu, Amit M. Oza, Martha MacLean, Bryn Fisher, Ajai Chaudhary, Dinesh P. de. Alwis, Christopher Slapak, Lesley Seymour

Published in: Cancer Chemotherapy and Pharmacology | Issue 2/2005

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Abstract

Background

Zosuquidar (LY335979) is an oral P-glycoprotein modulator. This phase I study was designed to determine the maximum tolerated dose (MTD) of zosuquidar in combination with vinorelbine. The effects of zosuquidar on vinorelbine pharmacokinetics were also examined.

Design

Patients with advanced solid tumours were treated with escalating doses of zosuquidar administered every 8–12 h on days 7–9 and 14–16 during cycle 1 then days 0–2, 7–9, and 14–16 from cycle 2 onwards, with vinorelbine 22.5–30 mg/m2 IV on days 1, 8 and 15 every 28 days.

Results

Of 21 patients registered, 19 were treated at four dose levels (zosuquidar 100–300 mg/m2). Two patients had prolonged and febrile neutropenia at the second dose level resulting in a reduction of the dose of vinorelbine in subsequent dose levels. There was another patient with dose-limiting febrile neutropenia at dose level four which resulted in the expansion of the dose level three. Eight patients had stable disease and no objective responses were seen. Vinorelbine pharmacokinetic studies showed reduced clearance when given with zosuquidar.

Conclusions

The MTD was zosuquidar 300 mg/m2 orally every 12 h for 3 days weekly for 3 weeks with vinorelbine 22.5 mg/m2 IV weekly for 3 weeks every 28 days. Zosuquidar may inhibit vinorelbine clearance to a modest degree.
Literature
1.
go back to reference Thomas H, Coley HM (2003) Overcoming multidrug resistance in cancer: an update on the clinical strategy of inhibiting p-glycoprotein. Cancer Control 10(2):159–165PubMed Thomas H, Coley HM (2003) Overcoming multidrug resistance in cancer: an update on the clinical strategy of inhibiting p-glycoprotein. Cancer Control 10(2):159–165PubMed
2.
go back to reference Dean M, Rzhetsky A, Allikmets R (2001) The human ATP-binding cassette (ABC) transporter superfamily. Genome Res 11(7):1156–1166CrossRef Dean M, Rzhetsky A, Allikmets R (2001) The human ATP-binding cassette (ABC) transporter superfamily. Genome Res 11(7):1156–1166CrossRef
3.
go back to reference Linn SC, Honkoop AH, Hoekman K, et al (1996) p53 and P-glycoprotein are often co-expressed and are associated with poor prognosis in breast cancer. Br J Cancer 74(1):63–68 Linn SC, Honkoop AH, Hoekman K, et al (1996) p53 and P-glycoprotein are often co-expressed and are associated with poor prognosis in breast cancer. Br J Cancer 74(1):63–68
4.
go back to reference Khalifa MA, Abdoh AA, Mannel RS, et al (1997) P-glycoprotein as a prognostic indicator in pre- and postchemotherapy ovarian adenocarcinoma. Int J Gynecol Pathol 16(1):69–75 Khalifa MA, Abdoh AA, Mannel RS, et al (1997) P-glycoprotein as a prognostic indicator in pre- and postchemotherapy ovarian adenocarcinoma. Int J Gynecol Pathol 16(1):69–75
5.
go back to reference Willman CL (1997) The prognostic significance of the expression and function of multidrug resistance transporter proteins in acute myeloid leukemia: studies of the Southwest Oncology Group Leukemia Research Program. Semin Hematol 34 [4 Suppl 5]:25–33 Willman CL (1997) The prognostic significance of the expression and function of multidrug resistance transporter proteins in acute myeloid leukemia: studies of the Southwest Oncology Group Leukemia Research Program. Semin Hematol 34 [4 Suppl 5]:25–33
6.
go back to reference Serra M, Maurici D, Scotlandi K, et al (1999) Relationship between P-glycoprotein expression and p53 status in high-grade osteosarcoma. Int J Oncol 14(2):301–307 Serra M, Maurici D, Scotlandi K, et al (1999) Relationship between P-glycoprotein expression and p53 status in high-grade osteosarcoma. Int J Oncol 14(2):301–307
7.
go back to reference Holzmayer TA, Hilsenbeck S, Von Hoff DD, Roninson IB (1992) Clinical correlates of MDR1 (P-glycoprotein) gene expression in ovarian and small-cell lung carcinomas. J Natl Cancer Inst 84(19):1486–1491PubMed Holzmayer TA, Hilsenbeck S, Von Hoff DD, Roninson IB (1992) Clinical correlates of MDR1 (P-glycoprotein) gene expression in ovarian and small-cell lung carcinomas. J Natl Cancer Inst 84(19):1486–1491PubMed
8.
go back to reference Wood P, Burgess R, MacGregor A, Yin JA (1994) P-glycoprotein expression on acute myeloid leukaemia blast cells at diagnosis predicts response to chemotherapy and survival. Br J Haematol 87(3):509–514 Wood P, Burgess R, MacGregor A, Yin JA (1994) P-glycoprotein expression on acute myeloid leukaemia blast cells at diagnosis predicts response to chemotherapy and survival. Br J Haematol 87(3):509–514
9.
go back to reference Hsia TC, Lin CC, Wang JJ, et al (2002) Relationship between chemotherapy response of small cell lung cancer and P-glycoprotein or multidrug resistance-related protein expression. Lung 180(3):173–179 Hsia TC, Lin CC, Wang JJ, et al (2002) Relationship between chemotherapy response of small cell lung cancer and P-glycoprotein or multidrug resistance-related protein expression. Lung 180(3):173–179
10.
go back to reference Dantzig AH, Shepard RL, Cao J, et al (1996) Reversal of P-glycoprotein-mediated multidrug resistance by a potent cyclopropyldibenzosuberane modulator, LY335979. Cancer Res 56(18):4171–4179 Dantzig AH, Shepard RL, Cao J, et al (1996) Reversal of P-glycoprotein-mediated multidrug resistance by a potent cyclopropyldibenzosuberane modulator, LY335979. Cancer Res 56(18):4171–4179
11.
go back to reference Sandler A, Gordon M, de Alwis DP, et al (2004) A phase I trial of a potent P-glycoprotein inhibitor, zosuquidar trihydrochloride (LY335979), administered intravenously in combination with doxorubicin in patients with advanced malignancy. Clin Cancer Res 10(5):3265–3272 Sandler A, Gordon M, de Alwis DP, et al (2004) A phase I trial of a potent P-glycoprotein inhibitor, zosuquidar trihydrochloride (LY335979), administered intravenously in combination with doxorubicin in patients with advanced malignancy. Clin Cancer Res 10(5):3265–3272
12.
go back to reference Rubin EH, de Alwis DP, Pouliquen I, et al (2002) A phase I trial of a potent P-glycoprotein inhibitor, Zosuquidar.3HCl trihydrochloride (LY335979), administered orally in combination with doxorubicin in patients with advanced malignancies. Clin Cancer Res 8(12):3710–3717 Rubin EH, de Alwis DP, Pouliquen I, et al (2002) A phase I trial of a potent P-glycoprotein inhibitor, Zosuquidar.3HCl trihydrochloride (LY335979), administered orally in combination with doxorubicin in patients with advanced malignancies. Clin Cancer Res 8(12):3710–3717
13.
go back to reference Eli Lilly (1997) LY335979 clinical investigator’s brochure. Eli Lilly and Company, Indianapolis, IN Eli Lilly (1997) LY335979 clinical investigator’s brochure. Eli Lilly and Company, Indianapolis, IN
14.
go back to reference Gregory RK, Smith IE (2000) Vinorelbine—a clinical review. Br J Cancer 82(12):1907–1913 Gregory RK, Smith IE (2000) Vinorelbine—a clinical review. Br J Cancer 82(12):1907–1913
15.
go back to reference Jehl F, Quoix E, Leveque D, et al (1991) Pharmacokinetic and preliminary metabolic fate of navelbine in humans as determined by high performance liquid chromatography. Cancer Res 51(8):2073–2076 Jehl F, Quoix E, Leveque D, et al (1991) Pharmacokinetic and preliminary metabolic fate of navelbine in humans as determined by high performance liquid chromatography. Cancer Res 51(8):2073–2076
16.
go back to reference Leveque D, Jehl F (1996) Clinical pharmacokinetics of vinorelbine. Clin Pharmacokinet 31(3):184–197 Leveque D, Jehl F (1996) Clinical pharmacokinetics of vinorelbine. Clin Pharmacokinet 31(3):184–197
17.
go back to reference Kajita J, Kuwabara T, Kobayashi H, Kobayashi S (2000) CYP3A4 is mainly responsible for the metabolism of a new vinca alkaloid, vinorelbine, in human liver microsomes. Drug Metab Dispos 28(9):1121–1127 Kajita J, Kuwabara T, Kobayashi H, Kobayashi S (2000) CYP3A4 is mainly responsible for the metabolism of a new vinca alkaloid, vinorelbine, in human liver microsomes. Drug Metab Dispos 28(9):1121–1127
Metadata
Title
Phase I study of the multidrug resistance inhibitor zosuquidar administered in combination with vinorelbine in patients with advanced solid tumours
Authors
Lyly H. Lê
Malcolm J. Moore
Lillian L. Siu
Amit M. Oza
Martha MacLean
Bryn Fisher
Ajai Chaudhary
Dinesh P. de. Alwis
Christopher Slapak
Lesley Seymour
Publication date
01-08-2005
Publisher
Springer-Verlag
Published in
Cancer Chemotherapy and Pharmacology / Issue 2/2005
Print ISSN: 0344-5704
Electronic ISSN: 1432-0843
DOI
https://doi.org/10.1007/s00280-004-0942-7

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