Abstract
Background
Hepatocellular carcinoma (HCC) is a common cancer in certain portions of the world. Currently no effective therapies exist for patients with advanced or metastatic HCC. KW-2189, a DNA minor groove-binding agent, has shown promising activity against HCC in preclinical evaluations.
Methods
A phase II study was conducted to evaluate the activity of KW-2189 in patients with histologic or cytologic confirmed advanced or metastatic HCC who had no prior systemic therapy. Patients received KW-2189 at a dose of 0.5 mg/m2 administered on day 1 of a 6-week cycle. The primary endpoint of the trial was objective regression. Other endpoints included toxicity, disease-free survival, and overall survival.
Results
Due to hematologic toxicity the dose of KW-2189 was reduced to 0.375 mg/m2 after 11 patients had been enrolled into the trial. Due to continued significant hematologic toxicity in the next five patients enrolled at the lower dose the trial was closed to accrual. Two responses were seen in patients enrolled at the higher dose, including one sustained CR.
Conclusion
KW-2189 showed evidence of anti-tumor activity in HCC. However, because of significant and prolonged hematologic toxicity, when given as a single dose every 6 weeks, further development of this drug in HCC is not possible. Further exploration of DNA minor groove-binding agents in the treatment of HCC appears warranted.
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References
Mor E, Kaspa RT, Sheiner P, Schwartz M. Treatment of hepatocellular carcinoma associated with cirrhosis in the era of liver transplantation. Ann Intern Med. 1998;129:643–53.
Simonetti RG, Liberati A, Angiolini C, Pagliaro L. Treatment of hepatocellular carcinoma: a systematic review of randomized controlled trials. Ann Oncol. 1997;8:117–36.
Ichimura M, Ogawa T, Katsumata S, Takahashi K-I, Takahashi I, Nakano H. Duocarmycins, new antitumor antibiotics produced by Streptomyces; producing organisms and improved production. J Antibiotics. 1991;44:1045–53.
Ichimura M, Ogawa T, Takahashi K-I, Kobayashi E, Kawamoto I, Yasuzawa T, et al. Duocarmycin SA, a new antitumor antibiotic from Streptomyces sp. J Antibiotics. 1990;43:1037–8.
Ogawa T, Ichimura M, Katsumata S, Morimoto M, Takahashi K. New antitumor antibiotics, duocarmycins B1 and B2. J Antibiotics. 1989;42:1299–301.
Takahashi I, Takahashi K-I, Ichimura M, Morimoto M, Asano K, Kawamoto I, et al. Duocarmycin A, a new antitumor antibiotic from Streptomyces. J Antibiotics. 1988;41:1915–7.
Boger DL, Johnson DS. CC-1065 and the duocarmycins: unraveling the keys to a new class of naturally derived DNA alkylating agents. Proc Natl Acad Sci USA. 1995;92:3642–9.
Okamoto A, Asai A, Saito H, Okabe M, Gomi K. Differential effect of duocarmycin A and its novel derivative DU-86 on DNA strand breaks in HeLa S3 cells. Jpn J Cancer Res. 1994;85:1304–11.
Hurley LH, Reynolds VL, Swenson DH, Petzold GL, Scahill TA. Reaction of the antitumor antibiotic CC-1065 with DNA: structure of a DNA adduct with DNA sequence specificity. Science. 1984;226:843–4.
Yasuzawa T, Muroi K-I, Ichimura M, Takahashi I, Ogawa T, Takahashi K, et al. Duocarmycins, potent antitumor antibiotics produced by Steptomyces sp. structures and chemistry. Chem Pharm Bull. 1995;43:378–91.
Kobayashi E, Okamoto A, Asada M, Okabe M, Nagamura S, Asai A, et al. Characteristics of antitumor activity of KW-2189, a novel water-soluble derivative of duocarmycin, against murine and human tumors. Cancer Res. 1994;54:2404–10.
Adams EG, Badiner GJ, Bhuyan BK. Effects of U-71,184 and several other CC-1065 analogues on cell survival and cell cycle of Chinese hamster ovary cells. Cancer Res. 1988;48:109–16.
Alberts SR, Erlichman C, Reid JM, Sloan JA, Ames MM, Richardson RL, et al. Phase I study of the duocarmycin semisynthetic derivative KW-2189 given daily for five days every six weeks. Clin Cancer Res. 1998;4:2111–7.
Abbruzzese J, Madden T, Newman R. Phase I clinical and pharmacokinetic trial of KW2189 in patients with solid tumors (meeting abstract). Proc Annu Meet Am Assoc Cancer Res. 1996;37:A1138.
Fleming TR. One-sample multiple testing procedure for phase II clinical trials. Biometrics. 1982;38:143–51.
Therneau T, Weiand H, Chang M. Optimal designs for a grouped sequential binomial trial. Biometrics. 1990;46:771–81.
Cristofanilli M, Bryan WJ, Miller LL, Chang AY, Gradishar WJ, Kufe DW, et al. Phase II study of adozelesin in untreated metastatic breast cancer. Anti-Cancer Drugs. 1998;9:779–82.
Burris HA, Dieras VC, Tunca M, Earhart RH, Eckardt JR, Rodriguez GI, et al. Phase I study with the DNA sequence-specific agent adozelesin. Anti-Cancer Drugs. 1997;8:588–96.
Foster BJ, LoRusso PM, Poplin E, Zalupski M, Valdivieso M, Wozniak A, et al. Phase I trial of Adozelesin using the treatment schedule of daily x5 every 3 weeks. Invest New Drugs. 1996;13:321–6.
Shamdas GJ, Alberts DS, Modiano M, Wiggins C, Power J, Kasunic DA, et al. Phase I study of adozelesin (U-73,975) in patients with solid tumors. Anti-Cancer Drugs. 1994;5:10–4.
Pitot HC, Reid JM, Sloan JA, Ames MM, Adjei AA, Rubin J, et al. A Phase I study of bizelesin (NSC 615291) in patients with advanced solid tumors. Clin Cancer Res. 2002;8:712–7.
Schwartz GH, Patnaik A, Hammond LA, Rizzo J, Berg K, Von Hoff DD, et al. A phase I study of bizelesin, a highly potent and selective DNA-interactive agent, in patients with advanced solid malignancies. Ann Oncol. 2003;14:775–82.
Pavlidis N, Aamdal S, Awada A, Calvert H, Fumoleau P, Sorio R, et al. Carzelesin phase II study in advanced breast, ovarian, colorectal, gastric, head and neck cancer, non-Hodgkin's lymphoma and malignant melanoma: a study of the EORTC early clinical studies group (ECSG). Cancer Chemother Pharmacol. 2000;46:167–71.
Awada A, Punt CJ, Piccart MJ, Van Tellingen O, Van Manen L, Kerger J, et al. Phase I study of Carzelesin (U-80,244) given (4-weekly) by intravenous bolus schedule. Brit J Cancer. 1999;79:1454–61.
van Tellingen O, Punt CJ, Awada A, Wagener DJ, Piccart MJ, Groot Y, et al. A clinical pharmacokinetics study of carzelesin given by short-term intravenous infusion in a phase I study. Cancer Chemother Pharmacol. 1998;41:377–84.
Markovic SN, Suman VJ, Vukov AM, Fitch TR, Hillman DW, Adjei AA, et al. Phase II trial of KW2189 in patients with advanced malignant melanoma. Am J Clin Oncol. 2002;25:308–12.
Small EJ, Figlin R, Petrylak D, Vaughn DJ, Sartor O, Horak I, et al. A phase II pilot study of KW-2189 in patients with advanced renal cell carcinoma. Invest New Drugs. 2000;18:193–7.
Acknowledgement
This study was conducted as a trial of the North Central Cancer Treatment Group and Mayo Clinic and was supported in part by Public Health Service grants CA-25224, CA-37404, and CA-60276 from the National Cancer Institute Department of Health and Human Services.
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Alberts, S.R., Suman, V.J., Pitot, H.C. et al. Use of KW-2189, a DNA Minor Groove-Binding Agent, in Patients with Hepatocellular Carcinoma: A North Central Cancer Treatment Group (NCCTG) Phase II Clinical Trial. J Gastrointest Canc 38, 10–14 (2007). https://doi.org/10.1007/s12029-007-9007-6
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DOI: https://doi.org/10.1007/s12029-007-9007-6