Safety, pharmacokinetics, and activity of EZN-2208, a novel conjugate of polyethylene glycol and SN38, in patients with advanced malignancies.

Abstract

BACKGROUND:

EZN-2208 is a water-soluble, polyethylene glycol drug conjugate of SN38, which is the active moiety of irinotecan. In this study, the authors evaluated the tolerability, pharmacokinetics (PK), and activity of EZN-2208 in adult patients with advanced solid tumors.

METHODS:

Patients in sequential cohorts (3 + 3 design) received intravenous EZN-2208 at doses between 1.25 mg/m(2) and 25 mg/m(2) once every 21 days.

RESULTS:

Thirty-nine patients received EZN-2208. The median number of prior therapies was 2 (range, 0-10 prior therapies). Seventeen patients received prior irinotecan. Two maximum tolerated doses (MTDs) were defined: EZN-2208 with (16.5 mg/m(2)) and without (10 mg/m(2)) granulocyte-colony-stimulating factor (G-CSF). The dose-limiting toxicity (DLT) was febrile neutropenia. Two of 19 patients who were heterozygous for a polymorphism in the uridine diphosphate glucuronosyltransferase 1 family, polypeptide A1 (UGT1A1) gene (UGT1A1*28) developed DLTs (dose, 25 mg/m(2) with G-CSF), and 2 patients who were homozygous for UGT1A1*28 were treated without DLTs (dose, 5 mg/m(2)). PK analysis indicated a mean terminal half-life of 19.4 ± 3.4 hours. Sixteen patients (41%) achieved stable disease, including 6 of 39 patients (15%) who had stable disease that lasted ≥ 4 months. One patient with cholangiocarcinoma (no prior irinotecan) achieved a short-lived 32% tumor regression. Among 6 patients who had stable disease that lasted for ≥ 4 months, 3 had received prior irinotecan, and 1 had KRAS-positive colorectal cancer.

CONCLUSIONS:

EZN-2208 was well tolerated and produced stable disease that lasted for ≥ 4 months/unconfirmed partial responses in 7 of 39 heavily pretreated patients (18%) with advanced solid tumors, including those who had failed prior irinotecan therapy.

• Authors: Razelle Kurzrock, Sanjay Goel, Jennifer Wheler, David Hong, Siqing Fu, Keyvan Rezai, Sonia K Morgan-Linnell, Saik Urien, Sridhar Mani, Imran Chaudhary, Mohammed H Ghalib, Aby Buchbinder, François Lokiec, Mary Mulcahy
• Journal: Cancer (Cancer) Vol. 118 Issue 24 Pg. 6144-51 (Dec 15 2012) ISSN: 1097-0142 [Electronic] United States
• PMID: 22674635 (Publication Type: Clinical Trial, Phase I, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2012 American Cancer Society.

Chemical References

• DNA, Neoplasm
• EZN-2208
• Polyethylene Glycols
• UGT1A1 enzyme
• Glucuronosyltransferase
• Camptothecin

Topics

• Adult
• Aged
• Camptothecin (analogs & derivatives, pharmacokinetics, therapeutic use)
• DNA, Neoplasm (genetics)
• Female
• Follow-Up Studies
• Glucuronosyltransferase (blood, genetics)
• Humans
• Male
• Maximum Tolerated Dose
• Middle Aged
• Neoplasm Staging
• Neoplasms (drug therapy, genetics)
• Polyethylene Glycols (pharmacokinetics, therapeutic use)
• Polymerase Chain Reaction
• Polymorphism, Genetic (genetics)
• Prognosis
• Safety
• Tissue Distribution