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Phase I Trial of the Matrix Metalloproteinase Inhibitor Marimastat Combined with Carboplatin and Paclitaxel in Patients with Advanced Non–Small Cell Lung Cancer
Ist Teil von
Clinical cancer research, 2005-05, Vol.11 (9), p.3417-3424
Ort / Verlag
Philadelphia, PA: American Association for Cancer Research
Erscheinungsjahr
2005
Quelle
MEDLINE
Beschreibungen/Notizen
Purpose: Marimastat is an orally bioavailable inhibitor of matrix metalloproteinases. A phase I study was initiated to determine whether
conventional doses of carboplatin and paclitaxel are tolerated when combined with marimastat and to assess the influence of
marimastat on paclitaxel pharmacokinetics.
Experimental Design: Three dose levels were evaluated. Marimastat (10 or 20 mg oral administration b.i.d.) was administered continuously with
paclitaxel (175 or 200 mg/m 2 as a 3-hour i.v. infusion) and carboplatin (at a dose providing an area under the free drug plasma concentration-time curve
of 7 mg min/mL) administered each 3 weeks. Toxicity and response were evaluated throughout the intended four cycles of combined
therapy. The plasma pharmacokinetics of paclitaxel was determined in each patient both without concurrent marimastat and after
receiving marimastat for 1 week.
Results: Twenty-two chemotherapy-naive patients with stage IIIb (27%) or stage IV (73%) non–small cell lung cancer were enrolled.
Their median age was 56 years (range, 39-73 years), 50% were female, and their performance status (Eastern Cooperative Oncology
Group) ranged from 0 to 2. Treatment was well tolerated, as 18 (82%) of the patients completed all four cycles of chemotherapy
without dose-limiting toxicity. Grade 2 musculoskeletal toxicities were reported in 3 of 12 patients receiving marimastat
(20 mg b.i.d.). Nine patients required dose reductions, predominantly related to low-grade myelosuppression. Partial responses
occurred in 12 of 21 (57%) evaluable patients with disease stabilization in another 5 (19%). Marimastat had no effect on paclitaxel
pharmacokinetics.
Conclusions: The administration of marimastat (10 mg b.i.d.) with paclitaxel (200 mg/m 2 ) and carboplatin at an area under the free drug plasma concentration-time curve of 7 mg min/mL was well tolerated with no
apparent pharmacokinetic interaction. Study of this drug combination in the adjuvant setting should be considered if tissue
inhibition of matrix metalloproteinase activity can first be shown.