Phase I clinical and magnetic resonance imaging study of the vascular agent NGR-hTNF in patients with advanced cancers (European Organization for Research and Treatment of Cancer Study 16041).

Abstract

PURPOSE:

This phase I trial investigating the vascular targeting agent NGR-hTNF aimed to determine the (a) dose-limiting toxicities, (b) maximum tolerated dose (MTD), (c) pharmacokinetics and pharmacodynamics, (d) vascular response by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), and (e) preliminary clinical activity in solid tumors.

EXPERIMENTAL DESIGN:

NGR-hTNF was administered once every 3 weeks by a 20- to 60-minute i.v. infusion to cohorts of three to six patients with solid tumors in escalating doses. Pharmacokinetic and pharmacodynamic analyses in blood were done during the first four cycles. DCE-MRI was done in cycle 1 at baseline and 2 hours after the start of the infusion.

RESULTS:

Sixty-nine patients received a total of 201 cycles of NGR-hTNF (0.2-60 microg/m(2)). Rigors and fever were the most frequently observed toxicities. Four dose-limiting toxicities were observed (at doses of 1.3, 8.1, and 60 microg/m(2)), of which three were infusion related. The MTD was 45 microg/m(2). The mean apparent terminal half-life ranged from 0.963 to 2.08 hours. DCE-MRI results of tumors showed a vascular response to NGR-hTNF. No objective responses were observed, but 27 patients showed stable disease with a median duration of 12 weeks.

CONCLUSIONS:

NGR-hTNF was well tolerated. The MTD was 45 microg/m(2) administered in 1 hour once every 3 weeks. DCE-MRI results showed the antivascular effect of NGR-hTNF. These findings call for further research for defining the optimal biological dose and clinical activity of NGR-hTNF as a single agent or in combination with cytotoxic drugs.

• Authors: Hanneke W M van Laarhoven, Walter Fiedler, Ingrid M E Desar, Jack J A van Asten, Sandrine Marréaud, Denis Lacombe, Anne-Sophie Govaerts, Jan Bogaerts, Peter Lasch, Johanna N H Timmer-Bonte, Antonio Lambiase, Claudio Bordignon, Cornelis J A Punt, Arend Heerschap, Carla M L van Herpen
• Journal: Clinical cancer research : an official journal of the American Association for Cancer Research (Clin Cancer Res) Vol. 16 Issue 4 Pg. 1315-23 (Feb 15 2010) ISSN: 1557-3265 [Electronic] United States
• PMID: 20145168 (Publication Type: Clinical Trial, Phase I, Journal Article)

Chemical References

• Antineoplastic Agents
• Recombinant Fusion Proteins
• Tumor Necrosis Factor-alpha
• tumor necrosis factor-alpha, CNGRC fusion protein, human

Topics

• Adult
• Aged
• Antineoplastic Agents (adverse effects, pharmacokinetics, therapeutic use)
• Capillary Permeability (drug effects)
• Drug Administration Schedule
• Female
• Humans
• Magnetic Resonance Imaging
• Male
• Maximum Tolerated Dose
• Middle Aged
• Neoplasms (drug therapy)
• Recombinant Fusion Proteins (adverse effects, pharmacokinetics, therapeutic use)
• Tumor Necrosis Factor-alpha (adverse effects, pharmacokinetics, therapeutic use)