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- Title
A phase 1 trial of 8‐chloro‐adenosine in relapsed/refractory acute myeloid leukemia: An evaluation of safety and pharmacokinetics.
- Authors
Pullarkat, Vinod; Chen, Lisa S.; Palmer, Joycelynne; Zhang, Jianying; Synold, Timothy W.; Buettner, Ralf; Truong Nguyen, Le Xuan; Marcucci, Guido; Tsai, Ni‐Chun; Wang, Yan; O'Hearn, James; Gandhi, Varsha; Rosen, Steven T.
- Abstract
Background: This study evaluated the safety, pharmacokinetics (PK), and pharmacodynamics (PD) of 8‐chloro‐adenosine (8‐Cl‐Ado) in patients with relapsed/refractory acute myeloid leukemia (AML). Methods: 8‐Cl‐Ado was administered daily for 5 days; the starting dose was 100 mg/m2, the highest dose tested was 800 mg/m2. The end points were toxicity, disease response, and PK/PD measurements. Results: The predominant nonhematologic toxicity was cardiac with grade ≥3 toxicity. Plasma PK in all patients suggested heterogeneity among patients, yet, some dose‐dependency for the accumulation of 8‐Cl‐Ado. Two 8‐Cl‐Ado metabolites accumulated at similar levels to 8‐Cl‐Ado. Cellular PK in eight patients indicated accumulation of 8‐Cl‐ATP, which was associated with AML blast cytoreduction in peripheral blood. The authors determined the RP2D of 8‐Cl‐Ado to be 400 mg/m2. Conclusions: Given the cardiac adverse events observed, patients require monitoring for arrhythmias and QT interval during infusion. Although peripheral blood cytoreduction was observed, responses were transient, suggesting combination strategies will be required. This study evaluated the safety and pharmacokinetics/pharmacodynamics of 8‐chloro‐adenosine (8‐Cl‐Ado) in patients with relapsed/refractory acute myeloid leukemia. The predominant nonhematologic toxicity was cardiac with grade ≥3 toxicity. We determined the recommended phase 2 dose of 8‐Cl‐Ado to be 400 mg/m2. Responses were transient, suggesting combination strategies will be required.
- Subjects
ACUTE myeloid leukemia; PHARMACOKINETICS; CARDIOTOXICITY
- Publication
Cancer (0008543X), 2024, Vol 130, Issue 5, p727
- ISSN
0008-543X
- Publication type
Article
- DOI
10.1002/cncr.35077