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Modulation of plasma thiols and mixed disulfides by BNP7787 in patients receiving paclitaxel/cisplatin therapy

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Abstract

Background

BNP7787 (disodium 2,2′-dithio-bis-ethane sulfonate) was evaluated in a phase I clinical trial with paclitaxel and cisplatin to assess the safety and potential efficacy for preventing or reducing cisplatin- and paclitaxel-induced toxicities. During this trial the effects of BNP7787 administration on the total concentrations (oxidized plus free) of cysteine, homocysteine and GSH in plasma, free and total GSH in WBC and rate of urinary excretion of cysteine were studied. The pharmacokinetics of ultrafilterable (free, non-protein bound) platinum were also determined after cisplatin (75 mg/m2) treatment which followed paclitaxel (175 mg/m2) and BNP7787 (8.2 to 27.6 g/m2).

Methods

Plasma thiols were measured by HPLC with fluorescence detection and platinum was measured by atomic absorption spectrophotometry.

Results

BNP7787 administration produced a significant depletion of all plasma thiols in all the patients studied. Differences were noted in the kinetics of BNP7787-induced depletion of cysteine and other thiols. A significant depletion of cysteine occurred with a time lag of about 2 h after the end of BNP7787 infusion, while a reversible depletion of GSH and homocysteine occurred immediately following the start of BNP7787 infusion, with the plasma thiol/disulfide nadir corresponding to the end of infusion. The mean half-life of cysteine depletion following BNP7787 administration was 2.2 h, significantly longer than for homocysteine (0.23 h), or GSH (0.18 h; P<0.05 for both). A several-fold increase in the urinary excretion of cysteine occurred following BNP7787 administration in all patients. The BNP7787-induced thiol/disulfide depletion in plasma was not affected by cisplatin administration (P>0.05). BNP7787 administration had no effect on the ultrafilterable platinum pharmacokinetics. The 2-h lag in the depletion of cysteine, the most abundant thiol in plasma, suggests that the process may be related to the formation of free mesna from BNP7787 and that increased levels of mesna are not in circulation until after 2 h after BNP7787 administration. No effect of BNP7787 was seen on the GSH concentration in WBC, possibly reflecting the inability of these cells to take up BNP7787.

Conclusion

The results suggest that BNP7787 has the potential to enhance cisplatin antitumor activity by depleting the reactive thiols in plasma.

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Abbreviations

BSO:

Buthionine sulfoximine

DTT:

Dithiothreitol

GSH:

Glutathione

Mesna:

2-Mercapto ethane sulfonate sodium

MRT:

Mean residence time

PUF:

Plasma ultrafiltrate

WBC:

White blood cells

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Author notes

  1. Gary Schwartz

    Present address: Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA

Authors and Affiliations

  1. Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY 14263, USA

    Lakshmi Pendyala, Gary Schwartz, Patrick Smith, Joseph Zdanowicz & Michael Murphy

  2. BioNumerik Pharmaceuticals, Inc., San Antonio, TX 78229, USA

    Frederick Hausheer

Authors
  1. Lakshmi Pendyala
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  2. Gary Schwartz
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  3. Patrick Smith
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  4. Joseph Zdanowicz
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  5. Michael Murphy
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  6. Frederick Hausheer
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Corresponding author

Correspondence to Lakshmi Pendyala.

Additional information

This study was supported by a grant from BioNumerik Pharmaceuticals, Inc. This research utilized core facilities supported in part by RPCI's NCI-funded Cancer Center Support Grant, CA16056

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Pendyala, L., Schwartz, G., Smith, P. et al. Modulation of plasma thiols and mixed disulfides by BNP7787 in patients receiving paclitaxel/cisplatin therapy. Cancer Chemother Pharmacol 51, 376–384 (2003). https://doi.org/10.1007/s00280-003-0587-y

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  • DOI: https://doi.org/10.1007/s00280-003-0587-y

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