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Cancer Chemotherapy and Pharmacology

, Volume 66, Issue 6, pp 1019–1029 | Cite as

Phase I trial of non-cytotoxic suramin as a modulator of docetaxel and gemcitabine therapy in previously treated patients with non-small cell lung cancer

  • Elaine T. Lam
  • Jessie L.- S. Au
  • Gregory A. Otterson
  • M. Guillaume Wientjes
  • Ling Chen
  • Tong Shen
  • Yong Wei
  • Xiaobai Li
  • Tanios Bekaii-Saab
  • Anthony J. Murgo
  • Rhonda R. Jensen
  • Michael Grever
  • Miguel A. Villalona-Calero
Original Article

Abstract

Purpose

In preclinical models, non-cytotoxic suramin (concentrations <50 μM) potentiates the activity of multiple chemotherapeutic agents. The present study evaluated the safety and tolerability of suramin in combination with docetaxel or gemcitabine in previously chemotherapy-treated patients with advanced non-small cell lung cancer.

Methods

Patients received suramin intravenously in combination with either docetaxel on day 1 or gemcitabine on days 1 and 8, of each 21-day treatment cycle. After 3 cycles, patients with partial response (PR) or better continued on the same combination, whereas patients with stable disease (SD) or worse crossed-over to the other combination. Pharmacokinetic analyses were performed before and after each treatment.

Results

Eighteen patients received a total of 79 courses (37 suramin plus docetaxel, 42 suramin plus gemcitabine). The dose-limiting toxicity (DLT) was febrile neutropenia, observed in three of six patients treated with suramin and docetaxel 75 mg/m2. No DLTs were observed with suramin plus docetaxel 56 mg/m2 or suramin plus gemcitabine 1,250 mg/m2. Common adverse events included neutropenia, thrombocytopenia, anemia, fatigue, nausea, vomiting, skin rash, hyperglycemia, and electrolyte abnormalities. The target plasma suramin concentration range of 10–50 μM was achieved in 90% of treatments. Discernable antitumor activity was noted in 11 patients (2 PR, 9 SD).

Conclusions

Non-cytotoxic suramin, in combination with docetaxel 56 mg/m2 or gemcitabine 1,250 mg/m2, was reasonably well-tolerated with a manageable toxicity profile. Target plasma concentrations were correctly predicted by our previously described dosing nomogram. The observed preliminary evidence of antitumor activity encourages evaluation of this strategy in efficacy trials.

Keywords

Suramin Docetaxel Gemcitabine Chemosensitizer Modulator Non-small cell lung cancer 

Notes

Acknowledgments

This study was supported by the National Institutes of Health Research Project Cooperative Agreement U01 CA 76576 (PI, Grever) and Research Project Grant R01 CA 93871 (PI, Au). Au and Wientjes have been awarded patents on the use of suramin as a chemosensitizer.

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Elaine T. Lam
    • 1
  • Jessie L.- S. Au
    • 2
  • Gregory A. Otterson
    • 1
  • M. Guillaume Wientjes
    • 2
  • Ling Chen
    • 2
  • Tong Shen
    • 2
  • Yong Wei
    • 2
  • Xiaobai Li
    • 4
  • Tanios Bekaii-Saab
    • 1
  • Anthony J. Murgo
    • 5
  • Rhonda R. Jensen
    • 1
  • Michael Grever
    • 1
  • Miguel A. Villalona-Calero
    • 1
    • 3
    • 6
  1. 1.Department of Internal Medicine, Division of Hematology and OncologyThe Ohio State UniversityColumbusUSA
  2. 2.College of PharmacyThe Ohio State UniversityColumbusUSA
  3. 3.Department of PharmacologyThe Ohio State UniversityColumbusUSA
  4. 4.Center for BiostatisticsThe Ohio State UniversityColumbusUSA
  5. 5.Cancer Therapy Evaluation Program, Division of Cancer Treatment and DiagnosisThe National Cancer InstituteBethesdaUSA
  6. 6.Arthur G. James Cancer HospitalThe Ohio State UniversityColumbusUSA

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