A phase I and pharmacokinetic study of oral 3-aminopyridine-2- carboxaldehyde thiosemicarbazone (3-AP, NSC #663249) in the treatment of advanced-stage solid cancers: A California Cancer Consortium Study

Joseph Chao, Timothy W. Synold, Robert J. Morgan, Charles Kunos, Jeff Longmate, Heinz Josef Lenz, Dean Lim, Stephen Shibata, Vincent Chung, Ronald G. Stoller, Chandra P. Belani, David R Gandara, Mark McNamara, Barbara J. Gitlitz, Derick H Lau, Suresh S. Ramalingam, Angela Davies, Igor Espinoza-Delgado, Edward M. Newman, Yun Yen

Research output: Contribution to journalArticle

23 Scopus citations

Abstract

Background: 3-Aminopyridine-2-carboxaldehyde thiosemicarbazone (3-AP) is a novel small-molecule ribonucleotide reductase inhibitor. This study was designed to estimate the maximum tolerated dose (MTD) and oral bioavailability of 3-AP in patients with advanced-stage solid tumors. Methods: Twenty patients received one dose of intravenous and subsequent cycles of oral 3-AP following a 3 + 3 patient dose escalation. Intravenous 3-AP was administered to every patient at a fixed dose of 100 mg over a 2-h infusion 1 week prior to the first oral cycle. Oral 3-AP was administered every 12 h for 5 consecutive doses on days 1-3, days 8-10, and days 15-17 of every 28-day cycle. 3-AP was started at 50 mg with a planned dose escalation to 100, 150, and 200 mg. Dose-limiting toxicities (DLT) and bioavailability were evaluated. Results: Twenty patients were enrolled. For dose level 1 (50 mg), the second of three treated patients had a DLT of grade 3 hypertension. In the dose level 1 expansion cohort, three patients had no DLTs. No further DLTs were encountered during escalation until the 200-mg dose was reached. At the 200 mg 3-AP dose level, two treated patients had DLTs of grade 3 hypoxia. One additional DLT of grade 4 febrile neutropenia was subsequently observed at the de-escalated 150 mg dose. One DLT in 6 evaluable patients established the MTD as 150 mg per dose on this dosing schedule. Responses in the form of stable disease occurred in 5 (25%) of 20 patients. The oral bioavailability of 3-AP was 67 ± 29% and was consistent with the finding that the MTD by the oral route was 33% higher than by the intravenous route. Conclusions: Oral 3-AP is well tolerated and has an MTD similar to its intravenous form after accounting for the oral bioavailability. Oral 3-AP is associated with a modest clinical benefit rate of 25% in our treated patient population with advanced solid tumors.

Original languageEnglish (US)
Pages (from-to)835-843
Number of pages9
JournalCancer Chemotherapy and Pharmacology
Volume69
Issue number3
DOIs
StatePublished - Mar 2012

Keywords

  • 3-AP
  • Oral triapine
  • Phase I trial
  • Ribonucleotide reductase

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Pharmacology
  • Pharmacology (medical)
  • Toxicology

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    Chao, J., Synold, T. W., Morgan, R. J., Kunos, C., Longmate, J., Lenz, H. J., Lim, D., Shibata, S., Chung, V., Stoller, R. G., Belani, C. P., Gandara, D. R., McNamara, M., Gitlitz, B. J., Lau, D. H., Ramalingam, S. S., Davies, A., Espinoza-Delgado, I., Newman, E. M., & Yen, Y. (2012). A phase I and pharmacokinetic study of oral 3-aminopyridine-2- carboxaldehyde thiosemicarbazone (3-AP, NSC #663249) in the treatment of advanced-stage solid cancers: A California Cancer Consortium Study. Cancer Chemotherapy and Pharmacology, 69(3), 835-843. https://doi.org/10.1007/s00280-011-1779-5