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Phase II Trial of 9-Aminocamptothecin as a 72-h Infusion in Cutaneous T-Cell Lymphoma

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Abstract

Purpose: To evaluate the role of9-aminocamptothecin (9-AC), a syntheticcamptothecin analog, in advanced cutaneousT-cell lymphoma (CTCL). Methods: Eligible patientshad stage IIB-IV CTCL. 9-AC was infused over 72 h at adose of 1,100 μg/m2 per day (approximately46 μg/m2/h) every 2 weeks, withgranulocyte-colony stimulating factor(G-CSF) support. Results: Twelve patients received atotal of 30 cycles of 9-AC. Nine patients hadstage IV disease, 5 patients hadcirculating Sezary cells, and 2 patientshad evidence of tranformation to alarge cell lymphoma. Most of the patientswere heavily pretreated: 10 had receivedprior chemotherapy (83%), 5 of whom hadreceived 2 or more prior regimens,including a patient who had receivedhigh-dose chemotherapy, and 7 hadpreviously received total-skin electronbeam therapy. The study was prematurelyterminated due to substantial toxicity. Sixpatients (50%) developed an indwellingcentral venous catheter-related infection,5 during a period of neutropenia. Threepatients died due to sepsis 4-8 weeks aftertheir last 9-AC treatment. Two of thesepatients had a previous history ofbacterial sepsis. Four patients (33%)developed grade IV thrombocytopenia. Twopartial responses were observed (responserate 17%), but the duration of responsewas brief, 4-8 weeks. Conclusion: 9-AC at thisschedule and route of administration had activity but resultedin an unacceptable rate of complicatedneutropenia and septic deaths in heavilypretreated patients with advanced CTCL whoare susceptible to catheter-relatedinfections.

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Authors and Affiliations

  1. Northwestern University Medical School, USA

    Athanassios Argiris & Timothy Kuzel

  2. Robert H. Lurie Comprehensive Cancer Center, Chicago, IL, U.S.A.

    Athanassios Argiris & Timothy Kuzel

  3. Yale University School of Medicine, New Haven, CT, U.S.A.

    Peter Heald, Susan DiStasio, Dennis L. Cooper & John R. Murren

  4. New England Medical Center, Boston University Medical School, Boston, MA, U.S.A.

    Francine M. Foss

  5. NCI, Investigational Drug Branch, National Cancer Institute, Rockville, MD, U.S.A.

    Susan Arbuck

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  1. Athanassios Argiris
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  2. Peter Heald
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Argiris, A., Heald, P., Kuzel, T. et al. Phase II Trial of 9-Aminocamptothecin as a 72-h Infusion in Cutaneous T-Cell Lymphoma. Invest New Drugs 19, 321–326 (2001). https://doi.org/10.1023/A:1010613912335

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