Abstract | PURPOSE: The antimalarial drug artesunate (ART) is a promising candidate for cancer treatment as it displays anticancer effects in various models. While in short-term treatment of malaria, an excellent safety profile has been found for ART, the potential long-term treatment of cancer patients demands a phase I dose-finding clinical trial determining the daily ART dose which would be well tolerated as add-on therapy. METHODS: Patients with metastatic breast cancer were to receive either 100 or 150 or 200 mg oral ART daily as add-on to their guideline-based oncological therapy for a study period of four weeks with frequent clinical and laboratory monitoring until 4-8 weeks thereafter. According to the statistical design, recruitment was scheduled in groups of three patients in order not to miss a more than 33% frequency of dose-limiting adverse events (DL-AE) prior to dose escalation. RESULTS: Twenty-three patients were recruited, and all planned dose levels were applied. During the actual trial period of 4 ± 1 weeks, three patients experienced six DL-AEs altogether (leucopenia, neutropenia, asthenia, anemia) possibly related to ART (not exceeding 33% in any dose level). CONCLUSIONS: Up to 200 mg/d (2.2-3.9 mg/kg/d) oral ART were safe and well tolerated; therefore, 200 mg/d are recommended for phase II/III trials. Safety monitoring should include reticulocytes, NTproBNP, as well as audiological and neurological exploration.
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Authors | Cornelia von Hagens, Ingeborg Walter-Sack, Maren Goeckenjan, Julia Osburg, Brigitte Storch-Hagenlocher, Serkan Sertel, Michael Elsässer, Bjoern Andrew Remppis, Lutz Edler, Judith Munzinger, Thomas Efferth, Andreas Schneeweiss, Thomas Strowitzki |
Journal | Breast cancer research and treatment
(Breast Cancer Res Treat)
Vol. 164
Issue 2
Pg. 359-369
(Jul 2017)
ISSN: 1573-7217 [Electronic] Netherlands |
PMID | 28439738
(Publication Type: Clinical Trial, Phase I, Journal Article)
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Chemical References |
- Antineoplastic Agents, Hormonal
- Artemisinins
- Artesunate
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Topics |
- Adult
- Aged
- Antineoplastic Agents, Hormonal
(administration & dosage, adverse effects)
- Antineoplastic Combined Chemotherapy Protocols
(administration & dosage, adverse effects)
- Artemisinins
(administration & dosage, adverse effects)
- Artesunate
- Breast Neoplasms
(drug therapy)
- Drug Administration Schedule
- Female
- Humans
- Maximum Tolerated Dose
- Middle Aged
- Neoplasm Metastasis
- Prospective Studies
- Treatment Outcome
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