Pharmacokinetics of intravenous ATP in cancer patients

Abstract

Objective: To characterise the pharmacokinetics of adenosine 5′-triphosphate (ATP) in patients with lung cancer after i.v. administration of different ATP dosages.

Methods: Twenty-eight patients received a total of 176 i.v. ATP courses of 30 h. Fifty-two infusions were given as low-dose infusions of 25–40 μg kg⁻¹ min⁻¹, 47 as middle-dose infusions of 45–60 μg kg⁻¹ min⁻¹ and 77 as high-dose infusions of 65–75 μg kg⁻¹ min⁻¹ ATP. Kinetic data of ATP concentrations in erythrocytes were available from 124 ATP courses. Results are expressed as mean ± SEM.

Results: Most ATP courses in cancer patients were without side effects (64%), and side effects occurring in the remaining courses were mild and transient, resolving within minutes after decreasing the infusion rate. Baseline ATP concentration in erythrocytes was 1554 ± 51 μmol l⁻¹. ATP plateau levels at 24 h were significantly increased by 53 ± 3, 56 ± 3 and 69 ± 2% after low-dose, middle-dose and high-dose ATP infusions, respectively. At the same time, significant increases in plasma uric acid concentrations were observed: 0.06 ± 0.01, 0.11 ± 0.01 and 0.16 ± 0.01 mmol l⁻¹, respectively. The mean half-time for disappearance of ATP from erythrocytes, measured in five patients, was 5.9 ± 0.5 h.

Conclusions: During constant i.v. infusion of ATP in lung cancer patients, ATP is taken up by erythrocytes and reaches dose-dependent plateau levels 50–70% above basal concentrations at approximately 24 h.