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A phase I pharmacokinetic study of bexarotene with paclitaxel and carboplatin in patients with advanced non-small cell lung cancer (NSCLC)

  • Clinical Trial Report
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Abstract

Purpose

Preclinical data suggest that the synthetic retinoid bexarotene may be an effective chemopreventive agent and that it may act synergistically in combination with platinum-based chemotherapy. The primary objective of this study was to determine whether repeated doses of bexarotene capsules affect pharmacokinetic parameters of paclitaxel or carboplatin in patients with advanced non-small cell lung cancer.

Methods

Patients received treatment with paclitaxel (200 mg/m2) and carboplatin to provide a target AUC of 6 mg min/mL (day 1) every 3 weeks. Continuous oral bexarotene therapy (400 mg/m2/day) was initiated on Day 4, and patients started lipid-lowering therapy prior to beginning chemotherapy. Blood sampling to characterize the pharmacokinetic profiles of the chemotherapeutic agents with or without bexarotene was performed during cycle 1 (without concomitant bexarotene) and during cycle 2 (with concomitant bexarotene).

Results

An analysis of drug concentration data from 16 patients indicated that bexarotene did not affect the pharmacokinetics of paclitaxel, free carboplatin, or total carboplatin concentrations. However, both maximal plasma concentrations and total exposure of bexarotene increased by 80% in the presence of paclitaxel–carboplatin by an, as of yet, unexplained mechanism. The toxicities observed resembled those of either the chemotherapy regimen or bexarotene alone, and there was no evidence for an enhancement of any drug-related toxicity with the combined treatment.

Conclusions

The administration of bexarotene, paclitaxel, and carboplatin is feasible and safe; however, the increased bexarotene plasma concentrations and exposure warrant further investigation if this combination is to be utilized clinically.

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Acknowledgments

This investigation was supported by Ligand Pharmaceuticals, and after this investigation was completed, Eisai Inc acquired Targretin® Capsules from Ligand Pharmaceuticals. This investigation was supported in part by the National Center for Research Resources, National Institutes of Health grant M01 RR-00070 (Stanford University, GCRC). The authors appreciate the efforts of many former employees of Ligand Pharmaceuticals in the conduct and analysis of this trial, most notably Gordon Loewen who did the primary PK analysis. The authors acknowledge the work of Lisa A. Hammond-Thelin MD with manuscript preparation and with patient enrollment at the Institute for Drug Development, Cancer Therapy and Research Center at The University of Texas Health Science Center San Antonio, TX, USA.

Conflicts of interest

Dr. Arturo Lopez-Anaya was an employee of Eisai, Inc. at the time of his work on this manuscript. All other authors have no conflict of interest with regard to financial or personal relationships with other people or organizations that could inappropriately influence this work.

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Author notes

  1. Jordi Rodon

    Present address: Vall d’Hebron University Hospital and Vall d’Hebron Institute of Oncology, Barcelona, Spain

  2. Quincy Chu

    Present address: Cross Cancer Institute, University of Alberta, Edmonton, AB, Canada

  3. Eric K. Rowinsky

    Present address: Oncodrugs Consulting, Warren, NJ, USA

  4. Arturo Lopez-Anaya

    Present address: Forest Laboratories, Inc., New Haven, CT, USA

  5. Chris H. Takimoto

    Present address: Ortho Biotech Oncology R&D/Johnson & Johnson, Radnor, PA, USA

Authors and Affiliations

  1. Institute for Drug Development, Cancer Therapy and Research Center at The University of Texas Health Science Center, San Antonio, TX, USA

    Jordi Rodon, Quincy Chu, Eric K. Rowinsky & Chris H. Takimoto

  2. Division of Oncology, Department of Medicine, Stanford University and Stanford Cancer Institute, 875 Blake Wilbur Drive, Stanford, CA, 94305-5826, USA

    Charlotte D. Jacobs & Heather A. Wakelee

  3. Eisai, Inc., Woodcliff Lakes, NJ, USA

    Arturo Lopez-Anaya

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  1. Jordi Rodon
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  2. Charlotte D. Jacobs
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Corresponding author

Correspondence to Heather A. Wakelee.

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Rodon, J., Jacobs, C.D., Chu, Q. et al. A phase I pharmacokinetic study of bexarotene with paclitaxel and carboplatin in patients with advanced non-small cell lung cancer (NSCLC). Cancer Chemother Pharmacol 69, 825–834 (2012). https://doi.org/10.1007/s00280-011-1770-1

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  • DOI: https://doi.org/10.1007/s00280-011-1770-1

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