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Anticancer activity of stabilized palifosfamide in vivo: schedule effects, oral bioavailability, and enhanced activity with docetaxel and doxorubicin.

Abstract
Palifosfamide, the DNA-alkylating metabolite of ifosfamide (IFOS), has been synthesized as a stabilized tris or lysine salt and found to have preclinical and clinical antitumor activity. Stabilized palifosfamide overcomes limitations of IFOS because of patient-to-patient variability in response resulting from variable prodrug activation, resistance and toxicities of metabolic byproducts, acrolein and chloroacetaldehyde. Palifosfamide represents an effective alternative to IFOS and other DNA-alkylating prodrugs. The antitumor activities of stabilized palifosfamide were investigated in vivo. Dose response, route and schedule of administration, and interaction with docetaxel or doxorubicin were investigated in NCr-nu/nu mice bearing established orthotopic mammary MX-1 tumor xenografts. Oral activity was investigated in P388-1 leukemia in CD2F1 mice. Oral and intraperitoneal bioavailabilities were compared in Sprague-Dawley rats. Stabilized palifosfamide administered by optimized regimens suppressed MX-1 tumor growth (P<0.05) by greater than 80% with 17% complete antitumor responses and up to three-fold increase in time to three tumor doublings over controls. Median survival in the P388-1 (P<0.001) model was increased by 9 days over controls. Oral bioavailability in rats was 48-73% of parenteral administration, and antitumor activity in mice was equivalent by both routes. Treatment with palifosfamide-tris combined with docetaxel or doxorubicin at optimal regimens resulted in complete tumor regression in 62-75% of mice. These studies support investigation of stabilized palifosfamide in human cancers by parenteral or oral administration as a single agent and in combination with other approved drugs. The potential for clinical translation of the cooperative interaction of palifosfamide-tris with doxorubicin by intravenous administration is supported by results from a recent randomized Phase-II study in unresectable or metastatic soft-tissue sarcoma.
AuthorsBarry Jones, Philip Komarnitsky, Glenn T Miller, John Amedio, Barbara P Wallner
JournalAnti-cancer drugs (Anticancer Drugs) Vol. 23 Issue 2 Pg. 173-84 (Feb 2012) ISSN: 1473-5741 [Electronic] England
PMID22027537 (Publication Type: Journal Article)
Chemical References
  • Antineoplastic Agents
  • Phosphoramide Mustards
  • Taxoids
  • palifosfamide lysine
  • Docetaxel
  • isophosphamide mustard
  • Doxorubicin
  • Lysine
  • Ifosfamide
Topics
  • Administration, Oral
  • Animals
  • Antineoplastic Agents (administration & dosage, pharmacokinetics, therapeutic use)
  • Antineoplastic Combined Chemotherapy Protocols (administration & dosage, pharmacokinetics, therapeutic use)
  • Biological Availability
  • Disease-Free Survival
  • Docetaxel
  • Dose-Response Relationship, Drug
  • Doxorubicin (administration & dosage, therapeutic use)
  • Drug Administration Schedule
  • Female
  • Ifosfamide (administration & dosage, analogs & derivatives, pharmacokinetics, therapeutic use)
  • Injections, Intravenous
  • Leukemia, Experimental (drug therapy)
  • Lysine (administration & dosage, analogs & derivatives, pharmacokinetics, therapeutic use)
  • Male
  • Mammary Neoplasms, Experimental (drug therapy)
  • Mice
  • Mice, Nude
  • Phosphoramide Mustards (administration & dosage, pharmacokinetics, therapeutic use)
  • Rats
  • Rats, Sprague-Dawley
  • Taxoids (administration & dosage, therapeutic use)
  • Xenograft Model Antitumor Assays

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