Abstract | PURPOSE: Because there is a compelling need to develop new agents for intrathecal use, we investigated the safety, efficacy, and CSF pharmacokinetics of diaziquone ( AZQ) following intrathecal administration in patients with refractory meningeal malignancies. PATIENTS AND METHODS: Thirty-nine patients received 45 courses of intrathecal AZQ. Two schedules were studied; twice-weekly administration of a 1- or 2-mg dose and "concentration times time" (C x T) administration of 0.5 mg every 6 hours for three doses, administered once weekly. RESULTS: Dose-limiting toxicity consisting of headache, nausea, or vomiting occurred in only three patients and only at the 2-mg, twice weekly dose. The schedules of 1 mg twice-weekly and 0.5 mg every 6 hours for three doses were well tolerated. Thirty-seven courses were assessable for response. The overall response rate was 62%. Complete responses (CRs) occurred in 14 of 37 courses (38%) and partial responses (PRs) occurred in nine of 37 courses (24%). Among patients with meningeal leukemia, CRs were observed in 11 of 26 courses (42%) and PRs in nine of 26 courses (35%). There was no difference in response rate related to dose or schedule. The pharmacokinetic behavior of intrathecally administered AZQ was characterized by biexponential disappearance from ventricular CSF, with mean half-lives of 18.2 and 78.6 minutes. The mean clearance rate was 0.37 mL/min. CONCLUSION: Intrathecal AZQ is safe, well tolerated, and highly active against refractory meningeal malignancies.
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Authors | S L Berg, F M Balis, S Zimm, R F Murphy, J Holcenberg, J Sato, G Reaman, P Steinherz, A Gillespie, K Doherty |
Journal | Journal of clinical oncology : official journal of the American Society of Clinical Oncology
(J Clin Oncol)
Vol. 10
Issue 1
Pg. 143-8
(Jan 1992)
ISSN: 0732-183X [Print] United States |
PMID | 1727916
(Publication Type: Clinical Trial, Journal Article)
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Chemical References |
- Antineoplastic Agents
- Aziridines
- Benzoquinones
- diaziquone
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Topics |
- Adolescent
- Adult
- Antineoplastic Agents
(pharmacokinetics, therapeutic use)
- Aziridines
(pharmacokinetics, therapeutic use)
- Benzoquinones
(pharmacokinetics, therapeutic use)
- Child
- Child, Preschool
- Drug Administration Schedule
- Drug Evaluation
- Female
- Humans
- Injections, Spinal
- Male
- Meningeal Neoplasms
(drug therapy, secondary)
- Precursor Cell Lymphoblastic Leukemia-Lymphoma
(drug therapy)
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