A phase I trial of imexon, a pro-oxidant, in combination with docetaxel for the treatment of patients with advanced breast, non-small cell lung and prostate cancer.

Abstract

PURPOSE:

Imexon is an iminopyrrolidone that induces apoptosis and has synergistic activity with docetaxel in preclinical models. This trial was designed to establish the maximum tolerated dose (MTD) of imexon given with docetaxel in breast, prostate and non-small cell lung cancer (NSCLC).

PATIENTS AND METHODS:

34 patients received protocol therapy. 26 patients received escalating doses of imexon given intravenously over 60 min on days 1-5 every 21 days. Docetaxel was administered intravenously at a fixed dose of 75 mg/m(2) immediately following imexon on day 1 every 21 days. A 3+3 design was used with eight additional patients treated at MTD. Response was measured using RECIST.

RESULTS:

Seven dose levels of imexon were evaluated (390 mg/m(2) to 1,700 mg/m(2)). The MTD was imexon 1,300 mg/m(2) IV on days 1-5 in combination with docetaxel. Dose limiting toxicities were grade 3 non-cardiac chest pain and grade 3 diarrhea. Activity was seen in 4 patients [2 partial responses (NSCLC (PR=1), prostate cancer (PR=1)), 2 minor responses (MR=breast, NSCLC)]. Eleven patients had stable disease by RECIST (including the patients with MR; prostate cancer=6, NSCLC=3). Six (one with breast cancer, two with prostate cancer and three with NSCLC) demonstrated stable disease (SD) for > or = 3 months.

CONCLUSION:

The MTD of combination therapy is imexon 1,300 mg/m(2) IV on days 1-5 with docetaxel 75 mg/m(2) IV on day 1 of a 21 day treatment cycle. Demonstrated responses warrant further investigation in phase II trials of which a phase II trial in NSCLC is planned.

• Authors: Stacy Moulder, Navneet Dhillon, Chaan Ng, David Hong, Jennifer Wheler, Aung Naing, Susan Tse, Amy La Paglia, Robert Dorr, Evan Hersh, Michelle Boytim, Razelle Kurzrock
• Journal: Investigational new drugs (Invest New Drugs) Vol. 28 Issue 5 Pg. 634-40 (Oct 2010) ISSN: 1573-0646 [Electronic] United States
• PMID: 19499186 (Publication Type: Clinical Trial, Phase I, Journal Article)

Chemical References

• Antineoplastic Agents
• Hexanones
• Reactive Oxygen Species
• Taxoids
• Docetaxel
• 4-imino-1,3-diazabicyclo(3.1.0)hexan-2-one

Topics

• Adult
• Aged
• Antineoplastic Agents (adverse effects, pharmacology, therapeutic use)
• Antineoplastic Combined Chemotherapy Protocols (adverse effects, pharmacology, therapeutic use)
• Breast Neoplasms (drug therapy)
• Carcinoma, Non-Small-Cell Lung (drug therapy, pathology)
• Demography
• Docetaxel
• Female
• Hexanones (adverse effects, pharmacology, therapeutic use)
• Humans
• Lung Neoplasms (drug therapy, pathology)
• Male
• Middle Aged
• Neoplasm Staging
• Prostatic Neoplasms (drug therapy, pathology)
• Reactive Oxygen Species (adverse effects, pharmacology, therapeutic use)
• Taxoids (therapeutic use)
• Treatment Outcome