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Published in: Cancer Chemotherapy and Pharmacology 2/2019

01-08-2019 | Solid Tumor | Short Communication

An open label phase 1 study evaluation safety, tolerability, and maximum tolerated dose of oral administration of irinotecan in combination with capecitabine

Published in: Cancer Chemotherapy and Pharmacology | Issue 2/2019

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Abstract

Purpose

Oral administration of chemotherapy offers several advantages in comparison with intravenous administration. Previously, data on a new oral formulation of irinotecan have been published. The aim of the present study was to evaluate the safety, tolerability, and Maximum Tolerated Dose (MTD) of the new oral irinotecan formulation in combination with oral capecitabine.

Methods

The study was an open label, phase 1, single center, extension part in which oral irinotecan was investigated in combination with capecitabine. The MTD of irinotecan in combination with capecitabine was 17.5 mg/m2 once daily for 14 consecutive days in combination with capecitabine 800 mg/m2 twice daily. Eligible patients were adults with metastatic or unresectable solid tumors for which no standard curative or palliative therapies existed.

Results

14 patients were included in the extension part. No grade 3 or 4 hematologic toxicities were observed. Non-hematological toxicities included grade 1 and 2 diarrhea, fatigue, cholinergic syndrome, vomiting, and weight loss. Totally, 3 grade 3 toxicities and no grade 4 event were reported. No objective responses were observed. Five patients had stable disease lasting median 14 weeks.

Conclusions

Capecitabine in combination with oral irinotecan could be a new treatment option offering a more convenient and patient friendly treatment strategy compared to intravenous irinotecan. The combination is fairly tolerated; however, further investigations are needed to assess the efficacy of this regimen.
Literature
2.
go back to reference Ducreux M, Cuhna AS, Caramella C, Hollebecque A, Burtin P, Goere D, Seufferlein T, Haustermans K, Van Laethem JL, Conroy T, Arnold D, Committee EG (2015) Cancer of the pancreas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 26(Suppl 5):v56–68. https://doi.org/10.1093/annonc/mdv295 CrossRefPubMed Ducreux M, Cuhna AS, Caramella C, Hollebecque A, Burtin P, Goere D, Seufferlein T, Haustermans K, Van Laethem JL, Conroy T, Arnold D, Committee EG (2015) Cancer of the pancreas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 26(Suppl 5):v56–68. https://​doi.​org/​10.​1093/​annonc/​mdv295 CrossRefPubMed
4.
go back to reference Berlin J, Benson AB, Rubin EH et al (2003) Phase I safety, pharmacokinetic and bioavailability study of a semi-solid matrix formulations of oral irinotecan i pateitns with advanced solid tumors. Proc Am Soc Clin Oncol 22:130 (abstract 521) Berlin J, Benson AB, Rubin EH et al (2003) Phase I safety, pharmacokinetic and bioavailability study of a semi-solid matrix formulations of oral irinotecan i pateitns with advanced solid tumors. Proc Am Soc Clin Oncol 22:130 (abstract 521)
5.
go back to reference Dumez H, Awada A, Piccart M, Assadourian S, Semiond D, Guetens G, de Boeck G, Maes RA, de Bruijn EA, van Oosterom A (2006) A phase I dose-finding clinical pharmacokinetic study of an oral formulation of irinotecan (CPT-11) administered for 5 days every 3 weeks in patients with advanced solid tumours. Ann Oncol 17(7):1158–1165. https://doi.org/10.1093/annonc/mdl071 CrossRefPubMed Dumez H, Awada A, Piccart M, Assadourian S, Semiond D, Guetens G, de Boeck G, Maes RA, de Bruijn EA, van Oosterom A (2006) A phase I dose-finding clinical pharmacokinetic study of an oral formulation of irinotecan (CPT-11) administered for 5 days every 3 weeks in patients with advanced solid tumours. Ann Oncol 17(7):1158–1165. https://​doi.​org/​10.​1093/​annonc/​mdl071 CrossRefPubMed
7.
go back to reference Schoemaker NE, Kuppens IE, Huinink WW, Lefebvre P, Beijnen JH, Assadourian S, Sanderink GJ, Schellens JH (2005) Phase I study of an oral formulation of irinotecan administered daily for 14 days every 3 weeks in patients with advanced solid tumours. Cancer Chemother Pharmacol 55(3):263–270. https://doi.org/10.1007/s00280-004-0874-2 CrossRefPubMed Schoemaker NE, Kuppens IE, Huinink WW, Lefebvre P, Beijnen JH, Assadourian S, Sanderink GJ, Schellens JH (2005) Phase I study of an oral formulation of irinotecan administered daily for 14 days every 3 weeks in patients with advanced solid tumours. Cancer Chemother Pharmacol 55(3):263–270. https://​doi.​org/​10.​1007/​s00280-004-0874-2 CrossRefPubMed
9.
go back to reference Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET, Carbone PP (1982) Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 5(6):649–655CrossRefPubMed Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET, Carbone PP (1982) Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 5(6):649–655CrossRefPubMed
14.
go back to reference Park IH, Im SA, Jung KH, Sohn JH, Park YH, Lee KS, Sim SH, Park KH, Kim JH, Nam BH, Kim HJ, Kim TY, Lee KH, Kim SB, Ahn JH, Lee S, Ro J (2018) Randomized open label phase III trial of irinotecan plus capecitabine versus capecitabine monotherapy in patients with metastatic breast cancer previously treated with anthracycline and taxane: PROCEED Trial (KCSG BR 11 – 01). Cancer Res Treat. https://doi.org/10.4143/crt.2017.562 CrossRefPubMedPubMedCentral Park IH, Im SA, Jung KH, Sohn JH, Park YH, Lee KS, Sim SH, Park KH, Kim JH, Nam BH, Kim HJ, Kim TY, Lee KH, Kim SB, Ahn JH, Lee S, Ro J (2018) Randomized open label phase III trial of irinotecan plus capecitabine versus capecitabine monotherapy in patients with metastatic breast cancer previously treated with anthracycline and taxane: PROCEED Trial (KCSG BR 11 – 01). Cancer Res Treat. https://​doi.​org/​10.​4143/​crt.​2017.​562 CrossRefPubMedPubMedCentral
17.
go back to reference Gennatas C, Michalaki V, Gennatas S, Papalambros E (2008) Irinotecan plus capecitabine as first-line chemotherapy in advanced colorectal cancer. Anticancer Res 28(3B):1923–1926PubMed Gennatas C, Michalaki V, Gennatas S, Papalambros E (2008) Irinotecan plus capecitabine as first-line chemotherapy in advanced colorectal cancer. Anticancer Res 28(3B):1923–1926PubMed
18.
go back to reference Xu RH, Muro K, Morita S, Iwasa S, Han SW, Wang W, Kotaka M, Nakamura M, Ahn JB, Deng YH, Kato T, Cho SH, Ba Y, Matsuoka H, Lee KW, Zhang T, Yamada Y, Sakamoto J, Park YS, Kim TW (2018) Modified XELIRI (capecitabine plus irinotecan) versus FOLFIRI (leucovorin, fluorouracil, and irinotecan), both either with or without bevacizumab, as second-line therapy for metastatic colorectal cancer (AXEPT): a multicentre, open-label, randomised, non-inferiority, phase 3 trial. Lancet Oncol 19(5):660–671. https://doi.org/10.1016/S1470-2045(18)30140-2 CrossRefPubMed Xu RH, Muro K, Morita S, Iwasa S, Han SW, Wang W, Kotaka M, Nakamura M, Ahn JB, Deng YH, Kato T, Cho SH, Ba Y, Matsuoka H, Lee KW, Zhang T, Yamada Y, Sakamoto J, Park YS, Kim TW (2018) Modified XELIRI (capecitabine plus irinotecan) versus FOLFIRI (leucovorin, fluorouracil, and irinotecan), both either with or without bevacizumab, as second-line therapy for metastatic colorectal cancer (AXEPT): a multicentre, open-label, randomised, non-inferiority, phase 3 trial. Lancet Oncol 19(5):660–671. https://​doi.​org/​10.​1016/​S1470-2045(18)30140-2 CrossRefPubMed
Metadata
Title
An open label phase 1 study evaluation safety, tolerability, and maximum tolerated dose of oral administration of irinotecan in combination with capecitabine
Publication date
01-08-2019
Published in
Cancer Chemotherapy and Pharmacology / Issue 2/2019
Print ISSN: 0344-5704
Electronic ISSN: 1432-0843
DOI
https://doi.org/10.1007/s00280-019-03819-0

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