A Phase II Trial of Bryostatin-1 in Patients with Metastatic or Recurrent Squamous Cell Carcinoma of the Head and Neck
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Bryostatin-1 is a macrocyclic lactone thathas been shown to modulate Protein Kinase Cactivity and has demonstrated antitumoractivity in vitro and in vivo. Fifteen patients with metastatic orrecurrent squamous cell carcinoma of thehead and neck were treated withbryostatin-1 at a dose of 25 mcg/m2 bycontinuous intravenous infusion over 24hours once weekly for three weeks followedby a break week to complete a four-weekcycle. There were no major objectiveresponses in the 14 evaluable patients. One patient with nasopharynx cancer haddisease stabilization for 4 months prior tobeing removed from the study due to medicalissues. This clinical benefit correspondedto a radiographic decrease in metabolicactivity on positron emission tomograpy(PET) scan as well as molecular evidence oftumor apoptosis in a poly[ADP-ribose]polymerase (PARP) cleavage assay. Bryostatin-1 is not recommended for use asa single agent for the treatment ofsquamous cell head and neck cancer. Further investigation is warranted todetermine the strength of the correlationbetween bryostatin-1 activity and PARPcleavage as a surrogate molecular marker ofapoptosis.
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