NCI Comparative Oncology Program Testing of Non-Camptothecin Indenoisoquinoline Topoisomerase I Inhibitors in Naturally Occurring Canine Lymphoma.

Abstract

PURPOSE:

Only one chemical class of topoisomerase I (TOP1) inhibitors is FDA approved, the camptothecins with irinotecan and topotecan widely used. Because of their limitations (chemical instability, drug efflux-mediated resistance, and diarrhea), novel TOP1 inhibitors are warranted. Indenoisoquinoline non-camptothecin topoisomerase I (TOP1) inhibitors overcome chemical instability and drug resistance that limit camptothecin use. Three indenoisoquinolines, LMP400 (indotecan), LMP776 (indimitecan), and LMP744, were examined in a phase I study for lymphoma-bearing dogs to evaluate differential efficacy, pharmacodynamics, toxicology, and pharmacokinetics.

EXPERIMENTAL DESIGN:

Eighty-four client-owned dogs with lymphomas were enrolled in dose-escalation cohorts for each indenoisoquinoline, with an expansion phase for LMP744. Efficacy, tolerability, pharmacokinetics, and target engagement were determined.

RESULTS:

The MTDs were 17.5 mg/m2 for LMP 776 and 100 mg/m2 for LMP744; bone marrow toxicity was dose-limiting; up to 65 mg/m2 LMP400 was well-tolerated and MTD was not reached. None of the drugs induced notable diarrhea. Sustained tumor accumulation was observed for LMP744; γH2AX induction was demonstrated in tumors 2 and 6 hours after treatment; a decrease in TOP1 protein was observed in most lymphoma samples across all compounds and dose levels, which is consistent with the fact that tumor response was also observed at low doses LMP744. Objective responses were documented for all indenoisoquinolines; efficacy (13/19 dogs) was greatest for LMP744.

CONCLUSIONS:

These results demonstrate proof-of-mechanism for indenoisoquinoline TOP1 inhibitors supporting their further clinical development. They also highlight the value of the NCI Comparative Oncology Program (https://ccr.cancer.gov/Comparative-Oncology-Program) for evaluating novel therapies in immunocompetent pets with cancers.

• Authors: Jenna H Burton, Christina Mazcko, Amy LeBlanc, Joseph M Covey, Jiuping Ji, Robert J Kinders, Ralph E Parchment, Chand Khanna, Melissa Paoloni, Sue Lana, Kristen Weishaar, Cheryl London, William Kisseberth, Erika Krick, David Vail, Michael Childress, Jeffrey N Bryan, Lisa Barber, E J Ehrhart, Michael Kent, Timothy Fan, Kelvin Kow, Nicole Northup, Heather Wilson-Robles, Joseph Tomaszewski, Julianne L Holleran, Miguel Muzzio, Julie Eiseman, Jan H Beumer, James H Doroshow, Yves Pommier
• Journal: Clinical cancer research : an official journal of the American Association for Cancer Research (Clin Cancer Res) Vol. 24 Issue 23 Pg. 5830-5840 (12 01 2018) ISSN: 1557-3265 [Electronic] United States
• PMID: 30061364 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: ©2018 American Association for Cancer Research.

Chemical References

• Antineoplastic Agents
• Topoisomerase I Inhibitors
• DNA Topoisomerases, Type I

Topics

• Animals
• Antineoplastic Agents (chemistry, pharmacology)
• Bone Marrow (drug effects)
• Clinical Trials as Topic
• DNA Topoisomerases, Type I (metabolism)
• Disease Models, Animal
• Dogs
• Drug Monitoring
• Lymphoma (drug therapy, metabolism, pathology)
• Maximum Tolerated Dose
• Molecular Targeted Therapy
• Topoisomerase I Inhibitors (chemistry, pharmacology)