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Phase II study on 9-nitrocamptothecin (RFS 2000) in patients with advanced or metastatic urothelial tract tumors

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Abstract

Objective: To investigate the antitumor activity and the safety of RFS2000, an oral topoisomerase I inhibitor, in patients with advanced or metastatic urothelial tract tumors refractory to one prior chemotherapy regimen. Patients and methods: Eligible patients were to have failed first line treatment for advanced or metastatic disease. Patients received RFS2000 as one daily oral intake at the dose of 1.5 mg/m2/day according to a “5 days on/2 days” off schedule continuously. One cycle was arbitrarily defined as a 3 week period. Sufficient oral fluid intake to prevent cystitis previously described in phase I trials with RFS2000 was recommended. Gehan design was used for sample size determination. Anti-tumor activity was evaluated according to the RECIST criteria and toxicity according to CTC version 2. Results: Twenty patients received a total of 57 cycles (range 1–8). Grade 3–4 toxicity was observed in 10 patients requiring dose or schedule modifications. Hematological grade 3–4 toxicity was observed in 16% of the cycles. Only one patient experienced a partial response. Conclusions: RFS2000 could be administered orally as a “5 days on/2 days off” schedule continuously with a median dose intensity of 90.6% with an acceptable toxicity profile. However, RFS2000 did not exert significant activity in patients with advanced/metastatic urothelial tract tumors failing prior chemotherapy. The results of this study do not suggest further investigation of RFS2000 at the present dose and schedule for the treatment of urothelial tract tumors in this refractory population.

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References

  1. Parker DM, Pisani P, Ferlay J: Global cancer statistics. CA Cancer J Clin 49: 33–64, 1999

    CAS  PubMed  Google Scholar 

  2. Sternberg CN, Yagoda A, Scher HI, Watson RC, Ahmed T, Weiselberg LR, Geller N, Hollander PS, Herr HW, Sogani PC: Preliminary results of M-VAC (methotrexate, vinblastine, doxorubicin, and cisplatin) for transitional cell carcinoma of the urothelium. J Urol 133: 403–407, 1985

    CAS  PubMed  Google Scholar 

  3. Sternberg CN, Yagoda A, Scher HI, Watson RC, Herr HW, Morse MJ, Sogani PC, Vaughan ED Jr, Bander N, Weiselberg LR: MVAC (methotrexate, vinblastine, doxorubicin and cisplatinum) for advanced transitional cell carcinoma of the urothelium. J Urol 139(3): 461–469, 1988

    CAS  PubMed  Google Scholar 

  4. Sternberg CN, de Mulder PH, Schornagel JH, Theodore C, Fossa SD, Van Oosterom AT, Witjes F, Spina M, Van Groeningen CJ, De Balincourt C, Collette L: Randomized phase III trial of high-dose-intensity methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) chemotherapy and recombinant human granulocyte colony-stimulating factor versus classic MVAC in advanced urothelial tract tumors: European Organization for Research and Treatment of Cancer Protocol no. 30924. J Clin Oncol 19(10): 2638–2646, 2001

    CAS  PubMed  Google Scholar 

  5. Loehrer P, Einhorn LH, Elson PJ, Crawford ED, Kuebler P, Tannock I, Raghavan D, Stuart-Harris R, Sarosdy MF, Lowe BA: A randomized comparison of cisplatin alone or in combination with methotrexate, vinblastine and doxorubicin in patients with metastatic urothelial carcinoma: A cooperative group study. J Clin Oncology 10: 1066–1073, 1992

    Google Scholar 

  6. von der Maase H, Hansen SW, Roberts JT, Dogliotti L, Oliver T, Moore MJ, Bodrogi I, Albers P, Knuth A, Lippert CM, Kerbrat P, Sanchez Rovira P, Wersall P, Cleall SP, Roychowdhury DF, Tomlin I, Visseren-Grul CM, Conte PF: Gemcitabine and cisplatin versus methotreaxte, vinblastine, doxorubicin, and cisplatin in advanced or metastatic bladder cancer: Results of a large, randomized, multinational, multicenter, phase III study. J Clin Oncol 17: 3068–3077, 2000

    Google Scholar 

  7. Khorsand M, Lange J, Feun L, Clendeninn NJ, Collier M, Wilding G: Phase II trial of oral piritrexim in advanced, previously treated transitional cell cancer of the bladder. Invest New Drugs 15(2): 157–163, 1997

    CAS  PubMed  Google Scholar 

  8. Papamichael D, Gallagher CJ, Oliver RTD, Johnson PW, Waxman J: Phase II study of paclitaxel in pretreated patients with locally advanced/metastatic cancer of the bladder and ureter. Br J Cancer 75: 606–607, 1997

    CAS  PubMed  Google Scholar 

  9. Vaughn DJ, Broome CM, Hussain M, Gutheil J, Markowitz AB: Phase II trial of weekly paclitaxel in patients with previously treated advanced urothelial cancer. J Clin Oncol 20(4): 937–940, 2002

    CAS  PubMed  Google Scholar 

  10. McCaffrey JA, Hilton S, Mazumdar M, Sadan S, Heineman M, Hirsch J, Kelly WK, Scher HI, Bajorin DF: Phase II trial of docetaxel in patients with advanced or metastatic transitional-cell carcinoma. J Clin Oncol 15: 1853–1857, 1997

    CAS  PubMed  Google Scholar 

  11. Manola JB, Dreicer R, Wilding G: Abstract: Gemcitabine and docetaxel in advanced carcinoma of the urothelium: Report of a phase II Eastern Cooperative Oncology Group trial. Proc Am Soc Clin Oncol 21: 200a, 2002

    Google Scholar 

  12. Pantazis P, Kozielski AJ, Vardeman DM, Petry ER, Giovanella BC: Efficacy of camptothecin congeners in the treatment of human breast carcinoma xenografts. Oncol Res 5(8): 273–281, 1993

    CAS  PubMed  Google Scholar 

  13. Giovanella BC, Stehlin JS, Hinz HR, Vardeman D, Mendoza JT, Potmesil M: Abstract: Studies on time/dose intensity in treatment of human cancer xenografts with camptothecin analogues. Proc Am Assoc Cancer Res 35: 455, 1994

    Google Scholar 

  14. Pantazis P, Hinz HR, Mendoza JT, Kozielski AJ, Williams LJ Jr, Stehlin JS Jr, Giovanella BC: Complete inhibition of growth followed by death of human malignant melanoma cells in vitro and regression of human melanoma xenografts in immunodeficient mice induced by camptothecins. Cancer Res 52: 3980–3987, 1992

    CAS  PubMed  Google Scholar 

  15. Supko JG, Malspeis L: Pharmacokinetics of the 9-amino and 10,11-methylenedioxy derivatives of camptothecin in mice. Cancer Res 53: 3062–3069, 1993

    CAS  PubMed  Google Scholar 

  16. Supko JG, Plowman J, Dykes DJ, Zaharko DS: Abstract: Relationship between the schedule dependence of 9-amino-20(S)-camptothecin (AC; NSC603071) antitumor activity in mice and its plasma pharmacokinetics. Proc Am Assoc Cancer Res 33: 432, 1992

    Google Scholar 

  17. Gerrits CJH, de Jonge MJA, Schellens JHM, Stoter G, Verweij J: Topoisomerase I inhibitors: The relevance of prolonged exposure for present clinical development. Br J Cancer 76: 952–962, 1997

    CAS  PubMed  Google Scholar 

  18. Verschaegen CF, Natelson EA, Giovanella BC, Kavanagh JJ, Kudelka AP, Freedman RS, Edwards CL, Ende K, Stehlin JS: A phase I clinical and pharmacological study of oral 9-nitrocamptothecin, a novel water-insoluble topoisomerase inhibitor. Anticancer Drugs 9: 36–44, 1998

    PubMed  Google Scholar 

  19. Konstadoulakis MM, Antonakis PT, Tsibloulis BG, Stathopoulos GP, Manouras AP, Mylonaki DB, Golematis BX: A phase II study of 9-nitrocamptothecin in patients with advanced pancreatic adenocarcinoma. Cancer Chemother Pharmacol 48: 417–420, 2001

    CAS  PubMed  Google Scholar 

  20. Raymond E, Campone M, Stupp R, Menten J, Chollet P, Lesimple T, Fety-Deoporte R, Lacombe D, Paoletti X, Fumoleau P: EORTC Early Clinical Studies Group (ECSG); Brain Tumor Studies Group (BTSG) New Drug Development Program (NDDP): Multicentre phase II and pharmacokinetic study of RFS2000 (9-nitrocamptothecin) administered orally 5 days a week in patients with glioblastoma multiforme. Eur J Cancer 38: 1348–1350, 2002

    CAS  PubMed  Google Scholar 

  21. Schöffski P, Herr A, Vermorken JB, Van den Brande J, Beijnen JH, Rosing H, Volk J, Ganser A, Adank S, Botma HJ, Wanders J: Clinical phase II study and pharmacological evaluation of rubitecan in non-pretreated patients with metastatic colorectal cancer-significant effect of food intake on the bioavailability of the oral camptothecin analogue. Eur J Cancer 38: 807–813, 2002

    PubMed  Google Scholar 

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de Jonge, M., Droz, J., Paz-Ares, L. et al. Phase II study on 9-nitrocamptothecin (RFS 2000) in patients with advanced or metastatic urothelial tract tumors. Invest New Drugs 22, 329–333 (2004). https://doi.org/10.1023/B:DRUG.0000026260.24275.02

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  • DOI: https://doi.org/10.1023/B:DRUG.0000026260.24275.02

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