A phase i trial of imexon, a pro-oxidant, in combination with docetaxel for the treatment of patients with advanced breast, non-small cell lung and prostate cancer

Stacy Moulder, Navneet Dhillon, Chaan Ng, David Hong, Jennifer Wheler, Aung Naing, Susan Tse, Amy La Paglia, Robert T Dorr, Evan M Hersh, Michelle Boytim, Razelle Kurzrock

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Summary: Purpose Imexon is an iminopyrrolidone that induces apoptosis and has synergistic activity with docetaxel in preclinical models. This trial was designed to establish the maximum tolerated dose (MTD) of imexon given with docetaxel in breast, prostate and non-small cell lung cancer (NSCLC). Patients and Methods 34 patients received protocol therapy. 26 patients received escalating doses of imexon given intravenously over 60 min on days 1-5 every 21 days. Docetaxel was administered intravenously at a fixed dose of 75 mg/m 2 immediately following imexon on day 1 every 21 days. A 3+3 design was used with eight additional patients treated at MTD. Response was measured using RECIST. Results Seven dose levels of imexon were evaluated (390 mg/m 2 to 1,700 mg/m2). The MTD was imexon 1,300 mg/m 2 IV on days 1-5 in combination with docetaxel. Dose limiting toxicities were grade 3 non-cardiac chest pain and grade 3 diarrhea. Activity was seen in 4 patients [2 partial responses (NSCLC (PR=1), prostate cancer (PR=1)), 2 minor responses (MR=breast, NSCLC)]. Eleven patients had stable disease by RECIST (including the patients with MR; prostate cancer=6, NSCLC=3). Six (one with breast cancer, two with prostate cancer and three with NSCLC) demonstrated stable disease (SD) for ≥ 3 months. Conclusion The MTD of combination therapy is imexon 1,300 mg/m2 IV on days 1-5 with docetaxel 75 mg/m2 IV on day 1 of a 21 day treatment cycle. Demonstrated responses warrant further investigation in phase II trials of which a phase II trial in NSCLC is planned.

Original languageEnglish (US)
Pages (from-to)634-640
Number of pages7
JournalInvestigational New Drugs
Volume28
Issue number5
DOIs
StatePublished - Oct 2010

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docetaxel
Non-Small Cell Lung Carcinoma
Reactive Oxygen Species
Prostatic Neoplasms
Breast
Maximum Tolerated Dose
Therapeutics
4-imino-1,3-diazabicyclo(3.1.0)hexan-2-one
Chest Pain
Prostate
Diarrhea

Keywords

  • Breast cancer
  • Docetaxel
  • Imexon
  • Lung cancer
  • Phase I
  • Prostate cancer

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Oncology
  • Medicine(all)

Cite this

A phase i trial of imexon, a pro-oxidant, in combination with docetaxel for the treatment of patients with advanced breast, non-small cell lung and prostate cancer. / Moulder, Stacy; Dhillon, Navneet; Ng, Chaan; Hong, David; Wheler, Jennifer; Naing, Aung; Tse, Susan; La Paglia, Amy; Dorr, Robert T; Hersh, Evan M; Boytim, Michelle; Kurzrock, Razelle.

In: Investigational New Drugs, Vol. 28, No. 5, 10.2010, p. 634-640.

Research output: Contribution to journalArticle

Moulder, Stacy ; Dhillon, Navneet ; Ng, Chaan ; Hong, David ; Wheler, Jennifer ; Naing, Aung ; Tse, Susan ; La Paglia, Amy ; Dorr, Robert T ; Hersh, Evan M ; Boytim, Michelle ; Kurzrock, Razelle. / A phase i trial of imexon, a pro-oxidant, in combination with docetaxel for the treatment of patients with advanced breast, non-small cell lung and prostate cancer. In: Investigational New Drugs. 2010 ; Vol. 28, No. 5. pp. 634-640.
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abstract = "Summary: Purpose Imexon is an iminopyrrolidone that induces apoptosis and has synergistic activity with docetaxel in preclinical models. This trial was designed to establish the maximum tolerated dose (MTD) of imexon given with docetaxel in breast, prostate and non-small cell lung cancer (NSCLC). Patients and Methods 34 patients received protocol therapy. 26 patients received escalating doses of imexon given intravenously over 60 min on days 1-5 every 21 days. Docetaxel was administered intravenously at a fixed dose of 75 mg/m 2 immediately following imexon on day 1 every 21 days. A 3+3 design was used with eight additional patients treated at MTD. Response was measured using RECIST. Results Seven dose levels of imexon were evaluated (390 mg/m 2 to 1,700 mg/m2). The MTD was imexon 1,300 mg/m 2 IV on days 1-5 in combination with docetaxel. Dose limiting toxicities were grade 3 non-cardiac chest pain and grade 3 diarrhea. Activity was seen in 4 patients [2 partial responses (NSCLC (PR=1), prostate cancer (PR=1)), 2 minor responses (MR=breast, NSCLC)]. Eleven patients had stable disease by RECIST (including the patients with MR; prostate cancer=6, NSCLC=3). Six (one with breast cancer, two with prostate cancer and three with NSCLC) demonstrated stable disease (SD) for ≥ 3 months. Conclusion The MTD of combination therapy is imexon 1,300 mg/m2 IV on days 1-5 with docetaxel 75 mg/m2 IV on day 1 of a 21 day treatment cycle. Demonstrated responses warrant further investigation in phase II trials of which a phase II trial in NSCLC is planned.",
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AU - Moulder, Stacy

AU - Dhillon, Navneet

AU - Ng, Chaan

AU - Hong, David

AU - Wheler, Jennifer

AU - Naing, Aung

AU - Tse, Susan

AU - La Paglia, Amy

AU - Dorr, Robert T

AU - Hersh, Evan M

AU - Boytim, Michelle

AU - Kurzrock, Razelle

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N2 - Summary: Purpose Imexon is an iminopyrrolidone that induces apoptosis and has synergistic activity with docetaxel in preclinical models. This trial was designed to establish the maximum tolerated dose (MTD) of imexon given with docetaxel in breast, prostate and non-small cell lung cancer (NSCLC). Patients and Methods 34 patients received protocol therapy. 26 patients received escalating doses of imexon given intravenously over 60 min on days 1-5 every 21 days. Docetaxel was administered intravenously at a fixed dose of 75 mg/m 2 immediately following imexon on day 1 every 21 days. A 3+3 design was used with eight additional patients treated at MTD. Response was measured using RECIST. Results Seven dose levels of imexon were evaluated (390 mg/m 2 to 1,700 mg/m2). The MTD was imexon 1,300 mg/m 2 IV on days 1-5 in combination with docetaxel. Dose limiting toxicities were grade 3 non-cardiac chest pain and grade 3 diarrhea. Activity was seen in 4 patients [2 partial responses (NSCLC (PR=1), prostate cancer (PR=1)), 2 minor responses (MR=breast, NSCLC)]. Eleven patients had stable disease by RECIST (including the patients with MR; prostate cancer=6, NSCLC=3). Six (one with breast cancer, two with prostate cancer and three with NSCLC) demonstrated stable disease (SD) for ≥ 3 months. Conclusion The MTD of combination therapy is imexon 1,300 mg/m2 IV on days 1-5 with docetaxel 75 mg/m2 IV on day 1 of a 21 day treatment cycle. Demonstrated responses warrant further investigation in phase II trials of which a phase II trial in NSCLC is planned.

AB - Summary: Purpose Imexon is an iminopyrrolidone that induces apoptosis and has synergistic activity with docetaxel in preclinical models. This trial was designed to establish the maximum tolerated dose (MTD) of imexon given with docetaxel in breast, prostate and non-small cell lung cancer (NSCLC). Patients and Methods 34 patients received protocol therapy. 26 patients received escalating doses of imexon given intravenously over 60 min on days 1-5 every 21 days. Docetaxel was administered intravenously at a fixed dose of 75 mg/m 2 immediately following imexon on day 1 every 21 days. A 3+3 design was used with eight additional patients treated at MTD. Response was measured using RECIST. Results Seven dose levels of imexon were evaluated (390 mg/m 2 to 1,700 mg/m2). The MTD was imexon 1,300 mg/m 2 IV on days 1-5 in combination with docetaxel. Dose limiting toxicities were grade 3 non-cardiac chest pain and grade 3 diarrhea. Activity was seen in 4 patients [2 partial responses (NSCLC (PR=1), prostate cancer (PR=1)), 2 minor responses (MR=breast, NSCLC)]. Eleven patients had stable disease by RECIST (including the patients with MR; prostate cancer=6, NSCLC=3). Six (one with breast cancer, two with prostate cancer and three with NSCLC) demonstrated stable disease (SD) for ≥ 3 months. Conclusion The MTD of combination therapy is imexon 1,300 mg/m2 IV on days 1-5 with docetaxel 75 mg/m2 IV on day 1 of a 21 day treatment cycle. Demonstrated responses warrant further investigation in phase II trials of which a phase II trial in NSCLC is planned.

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KW - Docetaxel

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KW - Lung cancer

KW - Phase I

KW - Prostate cancer

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