Skip to main content

Advertisement

Log in

DE-310, a macromolecular prodrug of the topoisomerase-I-inhibitor exatecan (DX-8951), in patients with operable solid tumors

  • Published:
Investigational New Drugs Aims and scope Submit manuscript

Abstract

Background: DE-310 is composed of the topoisomerase-I-inhibitor DX-8951 (exatecan) and a biodegradable macromolecular carrier, which are covalently linked by a peptidyl spacer. In pre-clinical studies, high levels and prolonged retention of conjugated DX-8951 (carrier-bound DX-8951) have been observed in tumor tissues following DE-310 administration. This phenomenon is explained as the enhanced permeability and retention (EPR) effect. DX-8951 and G-DX-8951 (glycyl-DX-8951) exerting anti-tumor activity in vivo are released from DE-310 by enzymatic cleavage of the spacer. Methods: To quantify the concentration of conjugated DX-8951, DX-8951 and G-DX-8951 in human tissues, six patients with different solid tumor types received 6.0 mg/m2 of DE-310 (as equvalent of DX-8951) as a single three-hour infusion administered 7 days (±2 days) prior to scheduled tumor resection. Drug concentrations were then determined in the resected tissues. To evaluate the plasma PK of DE-310, plasma samples were taken up to 42 days post dosing. Results: There were no severe side effects of the DE-310 infusion. Concentrations of conjugated DX-8951, DX-8951 and G-DX-8951 were in general similar in tumor and relevant normal tissue samples and preferential accumulation of DE-310, DX-8951 and G-DX-8951 in human tumor tissues was not observed. Conclusions: These data indicate that there is distribution of DE-310 into tissue and that DX-8951 and G-DX-8951 are released slowly over an extended period from DE-310 providing prolonged exposure similar to a continuous infusion. However, the similarity in the concentrations in tumor and relevant normal tissues does not support the EPR concept in the studied human cancers.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Wall ME, Wani MC, Cook CE, Palmer KH: Plant antitumour agents, I: The isolation and structure of camptothecin, a novel alkaloidal leukemia and tumor inhibitor of Camptotheca acuminata. J Am Chem Soc 88: 3888–3890, 1966

    Article  Google Scholar 

  2. Garcia-Carbonero R, Supko JG: Current perspectives on the clinical experience, pharmacology, and continued development of the camptothecins. Clin Cancer Res 8: 641–661, 2002

    Google Scholar 

  3. Douillard JY, Cunningham D, Roth AD, Navarro M, James RD, Karasek P, Jandik P, Iveson T, Carmichael J, Alakl M, Gruia G, Awad L, Rougier P: Irinotecan combined with fluorouracil compared with fluorouracil alone as first-line treatment for metastatic colorectal cancer: a multicentre randomised trial. Lancet 355: 1041–1047, 2000

    Article  PubMed  Google Scholar 

  4. Drengler RL, Kuhn JG, Schaaf LJ, Rodriguez GI, Villalona-Calero MA, Hammond LA, Stephenson JA, Jr., Hodges S, Kraynak MA, Staton BA, Elfring GL, Locker PK, Miller LL, Von Hoff DD, Rothenberg ML: Phase I and pharmacokinetic trial of oral irinotecan administered daily for 5 days every 3 weeks in patients with solid tumors. J Clin Oncol 17: 685–696, 1999

    PubMed  Google Scholar 

  5. Rothenberg ML, Kuhn JG, Burris HA, III, Nelson J, Eckardt JR, Tristan-Morales M, Hilsenbeck SG, Weiss GR, Smith LS, Rodriguez GI: Phase I and pharmacokinetic trial of weekly CPT-11. J Clin Oncol 11: 2194–2204, 1993

    PubMed  Google Scholar 

  6. Rougier P, Van Cutsem E, Bajetta E, Niederle N, Possinger K, Labianca R, Navarro M, Morant R, Bleiberg H, Wils J, Awad L, Herait P, Jacques C: Randomised trial of irinotecan versus fluorouracil by continuous infusion after fluorouracil failure in patients with metastatic colorectal cancer. Lancet 352: 1407–1412, 1998

    Article  PubMed  Google Scholar 

  7. van Warmerdam LJ, Bokkel Huinink WW, Rodenhuis S, Koier I, Davies BE, Rosing H, Maes RA, Beijnen JH: Phase I clinical and pharmacokinetic study of topotecan administered by a 24-hour continuous infusion. J Clin Oncol 13: 1768–1776, 1995

    PubMed  Google Scholar 

  8. Creemers GJ, Gerrits CJ, Schellens JH, Planting AS, van der Burg ME, van Beurden VM, Boer-Dennert M, Harteveld M, Loos W, Hudson I, Stoter G, Verweij J: Phase II and pharmacologic study of topotecan administered as a 21-day continuous infusion to patients with colorectal cancer. J Clin Oncol 14: 2540–2545, 1996

    PubMed  Google Scholar 

  9. Takimoto CH, Morrison G, Harold N, Quinn M, Monahan BP, Band RA, Cottrell J, Guemei A, Llorens V, Hehman H, Ismail AS, Flemming D, Gosky DM, Hirota H, Berger SJ, Berger NA, Chen AP, Shapiro JD, Arbuck SG, Wright J, Hamilton JM, Allegra CJ, Grem JL: Phase I and pharmacologic study of irinotecan administered as a 96-hour infusion weekly to adult cancer patients. J Clin Oncol 18: 659–667, 2000

    PubMed  Google Scholar 

  10. Conover CD, Greenwald RB, Pendri A, Gilbert CW, Shum KL: Camptothecin delivery systems: Enhanced efficacy and tumor accumulation of camptothecin following its conjugation to polyethylene glycol via a glycine linker. Cancer Chemother Pharmacol 42: 407–414, 1998

    Article  PubMed  Google Scholar 

  11. Rowinsky EK, Rizzo J, Ochoa L, Takimoto CH, Forouzesh B, Schwartz G, Hammond LA, Patnaik A, Kwiatek J, Goetz A, Denis L, McGuire J, Tolcher AW: A phase I and pharmacokinetic study of pegylated camptothecin as a 1-hour infusion every 3 weeks in patients with advanced solid malignancies. J Clin Oncol 21: 148–157, 2003

    Article  PubMed  Google Scholar 

  12. Schoemaker NE, van Kesteren C, Rosing H, Jansen S, Swart M, Lieverst J, Fraier D, Breda M, Pellizzoni C, Spinelli R, Grazia PM, Beijnen JH, Schellens JH, Bokkel Huinink WW: A phase I and pharmacokinetic study of MAG-CPT, a water-soluble polymer conjugate of camptothecin. Br J Cancer 87: 608–614, 2002

    Google Scholar 

  13. Joto N, Ishii M, Minami M, Kuga H, Mitsui I, Tohgo A: DX-8951f, a water-soluble camptothecin analog, exhibits potent antitumor activity against a human lung cancer cell line and its SN-38-resistant variant. Int J Cancer 72: 680–686, 1997

    Article  PubMed  Google Scholar 

  14. Sun FX, Tohgo A, Bouvet M, Yagi S, Nassirpour R, Moossa AR, Hoffman RM: Efficacy of camptothecin analog DX-8951f (Exatecan Mesylate) on human pancreatic cancer in an orthotopic metastatic model. Cancer Res 63: 80–85, 2003

    PubMed  Google Scholar 

  15. De Jager R, Cheverton P, Tamanoi K, Coyle J, Ducharme M, Sakamoto N, Satomi M, Suzuki M: DX-8951f: summary of phase I clinical trials. Ann N Y Acad Sci 922: 260–273, 2000

    PubMed  Google Scholar 

  16. Braybrooke JP, Ranson M, Manegold C, Mattson K, Thatcher N, Cheverton P, Sekiguchi M, Suzuki M, Oyama R, Talbot DC: Phase II study of exatecan mesylate (DX-8951f) as first line therapy for advanced non-small cell lung cancer. Lung Cancer 41: 215–219, 2003

    Article  PubMed  Google Scholar 

  17. Esteva FJ, Rivera E, Cristofanilli M, Valero V, Royce M, Duggal A, Colucci P, DeJager R, Hortobagyi GN: A Phase II study of intravenous exatecan mesylate (DX-8951f) administered daily for 5 days every 3 weeks to patients with metastatic breast carcinoma. Cancer 98: 900–907, 2003

    Article  PubMed  Google Scholar 

  18. Royce ME, Rowinsky EK, Hoff PM, Coyle J, DeJager R, Pazdur R, Saltz LB: A Phase II study of intravenous exatecan mesylate (DX-8951f) administered daily for five days every three weeks to patients with metastatic adenocarcinoma of the colon or rectum. Invest New Drugs 22: 53–61, 2004

    Article  PubMed  Google Scholar 

  19. Verschraegen CF, Kudelka AP, Hu W, Vincent M, Kavanagh JJ, Loyer E, Bastien L, Duggal A, De Jager R: A phase II study of intravenous exatecan mesylate (DX-8951f) administered daily for 5 days every 3 weeks to patients with advanced ovarian, tubal or peritoneal cancer resistant to platinum, taxane and topotecan. Cancer Chemother Pharmacol 53: 1–7, 2004

    Article  PubMed  Google Scholar 

  20. Inoue K, Kumazawa E, Kuga H, Susaki H, Masubuchi N, Kajimura T: CM-dextran-polyalcohol-camptothecin conjugate: DE-310 with a novel carrier system and its preclinical data. Adv Exp Med Biol 519: 145–153, 2003

    PubMed  Google Scholar 

  21. Maeda H, Matsumura Y: Tumoritropic and lymphotropic principles of macromolecular drugs. Crit Rev Ther Drug Carrier Syst 6: 193–210, 1989

    PubMed  Google Scholar 

  22. Maeda H, Wu J, Sawa T, Matsumura Y, Hori K: Tumor vascular permeability and the EPR effect in macromolecular therapeutics: A review. J Control Release 65: 271–284, 2000

    Article  PubMed  Google Scholar 

  23. Maeda H: The enhanced permeability and retention (EPR) effect in tumor vasculature: The key role of tumor-selective macromolecular drug targeting. Adv Enzyme Regul 41: 189–207, 2001

    Article  PubMed  Google Scholar 

  24. Soepenberg O, de Bruijn P, Verweij J, Atsumi R, Sparreboom A: Liquid chromatographic assays for DE-310, a novel camptothecin analog, and two major enzymatic products in human matrices. J Chromatogr B Analyt Technol Biomed Life Sci 799: 15–22, 2004

    PubMed  Google Scholar 

  25. Masubuchi N: Pharmacokinetics of DE-310, a novel macromolecular carrier system for the camptothecin analog DX-8951f, in tumor-bearing mice. Pharmazie 59: 374–377, 2004

    PubMed  Google Scholar 

  26. Hsiang YH, Hertzberg R, Hecht S, Liu LF: Camptothecin induces protein-linked DNA breaks via mammalian DNA topoisomerase I. J Biol Chem 260: 14873–14878, 1985

    PubMed  Google Scholar 

  27. Mitsui I, Kumazawa E, Hirota Y, Aonuma M, Sugimori M, Ohsuki S, Uoto K, Ejima A, Terasawa H, Sato K: A new water-soluble camptothecin derivative, DX-8951f, exhibits potent antitumor activity against human tumors in vitro and in vivo. Jpn J Cancer Res 86: 776–782, 1995

    PubMed  Google Scholar 

  28. Joto N, Ishii M, Minami M, Kuga H, Mitsui I, Tohgo A: DX-8951f, a water-soluble camptothecin analog, exhibits potent antitumor activity against a human lung cancer cell line and its SN-38-resistant variant. Int J Cancer 72: 680–686, 1997

    Article  PubMed  Google Scholar 

  29. Kumazawa E, Jimbo T, Ochi Y, Tohgo A: Potent and broad antitumor effects of DX-8951f, a water-soluble camptothecin derivative, against various human tumors xenografted in nude mice. Cancer Chemother Pharmacol 42: 210–220, 1998

    Article  PubMed  Google Scholar 

  30. Mitsui I, Kumazawa E, Hirota Y, Aonuma M, Sugimori M, Ohsuki S, Uoto K, Ejima A, Terasawa H, Sato K: A new water-soluble camptothecin derivative, DX-8951f, exhibits potent antitumor activity against human tumors in vitro and in vivo. Jpn J Cancer Res 86: 776–782, 1995

    PubMed  Google Scholar 

  31. Nomoto T, Nishio K, Ishida T, Mori M, Saijo N: Characterization of a human small-cell lung cancer cell line resistant to a new water-soluble camptothecin derivative, DX-8951f. Jpn J Cancer Res 89: 1179–1186, 1998

    PubMed  Google Scholar 

  32. Garrison MA, Hammond LA, Geyer CE, Jr., Schwartz G, Tolcher AW, Smetzer L, Figueroa JA, Ducharme M, Coyle J, Takimoto CH, De Jager RL, Rowinsky EK: A Phase I and pharmocokinetic study of exatecan mesylate administered as a protracted 21-day infusion in patients with advanced solid malignancies. Clin Cancer Res 9: 2527–2537, 2003

    PubMed  Google Scholar 

  33. Minami H, Fujii H, Igarashi T, Itoh K, Tamanoi K, Oguma T, Sasaki Y: Phase I and pharmacological study of a new camptothecin derivative, exatecan mesylate (DX-8951f), infused over 30 minutes every three weeks. Clin Cancer Res 7: 3056–3064, 2001

    PubMed  Google Scholar 

  34. Rowinsky EK, Johnson TR, Geyer CE, Jr., Hammond LA, Eckhardt SG, Drengler R, Smetzer L, Coyle J, Rizzo J, Schwartz G, Tolcher A, Von Hoff DD, De Jager RL: DX-8951f, a hexacyclic camptothecin analog, on a daily-times-five schedule: A phase I and pharmacokinetic study in patients with advanced solid malignancies. J Clin Oncol 18: 3151–3163, 2000

    PubMed  Google Scholar 

  35. Sharma S, Kemeny N, Schwartz GK, Kelsen D, O’Reilly E, Ilson D, Coyle J, De Jager RL, Ducharme MP, Kleban S, Hollywood E, Saltz LB: Phase I study of topoisomerase I inhibitor exatecan mesylate (DX-8951f) given as weekly 24-hour infusions three of every four weeks. Clin Cancer Res 7: 3963–3970, 2001

    PubMed  Google Scholar 

  36. Boige V, Raymond E, Faivre S, Gatineau M, Meely K, Mekhaldi S, Pautier P, Ducreux M, Rixe O, Armand JP: Phase I and pharmacokinetic study of the camptothecin analog DX-8951f administered as a 30-minute infusion every 3 weeks in patients with advanced cancer. J Clin Oncol 18: 3986–3992, 2000

    PubMed  Google Scholar 

  37. Royce ME, Hoff PM, Dumas P, Lassere Y, Lee JJ, Coyle J, Ducharme MP, De Jager R, Pazdur R: Phase I and pharmacokinetic study of exatecan mesylate (DX-8951f): A novel camptothecin analog. J Clin Oncol 19: 1493–1500, 2001

    PubMed  Google Scholar 

  38. Ringsdorf H: Structure and properties of pharmacologically active polymers. J Polym Sci Polym Symp 20: 135–153, 1975

    Google Scholar 

  39. Maeda H, Wu J, Sawa T, Matsumura Y, Hori K: Tumor vascular permeability and the EPR effect in macromolecular therapeutics: A review. J Control Release 65: 271–284, 2000

    Article  PubMed  Google Scholar 

  40. Kumazawa E, Ochi Y: DE-310, a novel macromolecular carrier system for the camptothecin analog DX-8951f: Potent antitumor activities in various murine tumor models. Cancer Sci 95: 168–175, 2004

    PubMed  Google Scholar 

  41. Kumazawa E, Ochi Y: DE-310, a novel macromolecular carrier system for the camptothecin analog DX-8951f: Potent antitumor activities in various murine tumor models. Cancer Sci 95: 168–175, 2004

    PubMed  Google Scholar 

  42. Soepenberg O, De Jonge A, Sparreboom A, de Bruijn P, Eskens F, De Heus G, Langman S, Cheverton P, Bastien L, Verweij J: Phase I and PK study of DE-310 given once every 2 or 6 wks (w) in pts with solid tumors. Proc Am Soc Clin Oncol 22: 131, 2003

    Google Scholar 

  43. Takimoto CH, Forero L, Schwartz GH, Tolcher AW, Hammond LA, Patnaik A, Ducharme M, Cooke B, De Jager R, Rowinsky EK: A phase I and pharmacokinetic study of DE-310 administered as a 3 hour infusion every 4 weeks (wks) to patients (pts) with advanced solid tumors or lymphomas. Proc Am Soc Clin Oncol 22: 130, 2003

    Google Scholar 

  44. Kumazawa E, Ochi Y: DE-310, a novel macromolecular carrier system for the camptothecin analog DX-8951f: Potent antitumor activities in various murine tumor models. Cancer Sci 95: 168–175, 2004

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wente, M.N., Kleeff, J., Büchler, M.W. et al. DE-310, a macromolecular prodrug of the topoisomerase-I-inhibitor exatecan (DX-8951), in patients with operable solid tumors. Invest New Drugs 23, 339–347 (2005). https://doi.org/10.1007/s10637-005-1442-2

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10637-005-1442-2

Keywords

Navigation