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A phase I study of nolatrexed dihydrochloride in children with advanced cancer. A United Kingdom Children's Cancer Study Group Investigation

Lookup NU author(s): Professor Herbie Newell, Professor Alan Boddy, Geoffrey Taylor, Andrew Johnston, Professor Andrew Pearson

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Abstract

A phase I study of nolatrexed, administered as a continuous 5 day intravenous infusion every 28 days, has been undertaken for children with advanced malignancy. 16 patients were treated at 3 dose levels; 420, 640 and 768 mg/m(2) 24 h(-1), 8 patients were evaluable for toxicity. In the 6 patients treated at 768 mg/m(2) 24 h(-1), dose-limiting oral mucositis and myelosuppression were observed. Plasma nolatrexed concentrations and systemic exposure, measured in 14 patients, were dose related. with mean AUC values of 36 mg(-1) ml(-1) min(-1), 50 mg ml(-1) min(-1) and 80 mg ml(-1) min(-1) at the 3 dose levels studied. Whereas no toxicity was encountered ii the nolatrexed AUC was <45 mg ml(-1) min(-1), Grade 3 or 4 toxicity was observed with AUC values of >60 mg ml(-1) min(-1). Elevated plasma deoxyuridine levels, measured as a surrogate marker of thymidylate synthase inhibition, were seen at all of the dose levels studied. One patient with a spinal primitive neuroectodermal tumour had stable disease for 11 cycles of therapy. and in two patients with acute lymphoblastic leukaemia a short-lived 50% reduction in peripheral lymphoblast counts was observed. Nolatrexed can be safely administered to children with cancer, and there is evidence of therapeutic activity as well as antiproliferative toxicity. Phase II studies of nolatrexed in children at the maximum tolerated dose of 640 mg/m2 24 h(-1) are warranted. (C) 2001 Cancer Research Campaign http://www.bjcancer.com.

Publication metadata

Author(s): Estlin, E. J., Pinkerton, C. R., Lewis, I. J., Lashford, L., McDowell, H., Morland, B., Kohler, J., Newell, D. R., Boddy, A. V., Taylor, G. A., Price, L., Ablett, S., Hobson, R., Pitsiladis, M., Brampton, M., Clendeninn, N., Johnston, A., Pearson, A. D. J.

Publication type: Article

Publication status: Published

Journal: British Journal of Cancer

Year: 2001

Volume: 84

Issue: 1

Pages: 11-18

ISSN (print): 0007-0920

ISSN (electronic): 1532-1827

URL: http://dx.doi.org/10.1054/bjoc.2000.1569

DOI: 10.1054/bjoc.2000.1569

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