Phase I dose-escalation study of vinflunine hard capsules administered twice a day for 2 consecutive days every week in patients with advanced/metastatic solid tumors |
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Authors: | E. Calvo J. B. Vermorken S. Hiret J. Rodon J. Cortes H. Senellart J. Van den Brande J. Dyck A. Pétain P. Ferre J. Bennouna |
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Affiliation: | Hospital Universitario Vall d'Hebron, Barcelona, Spain. |
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Abstract: | Background Vinflunine is a new microtubule inhibitor of the vinca-alkaloid family. It is marketed in transitional cell carcinoma of urothelial tract as a 20?min infusion given every 3?weeks in Europe. Methods In this phase I study, vinflunine was administered to patients with advanced malignancies as hard capsules given twice a day on days 1–2 every week, with 3?weeks cycles. Serial blood samples were collected during the first cycle for pharmacokinetic investigations. Results Thirty-six patients (pts) were treated at 6 dose levels 150 (3 pts), 190 (3 pts), 230 (8 pts), 300?mg/day (6 pts) and then 250 (3 pts) and 270?mg/day (13 pts). The Maximal Tolerated Dose (MTD) was reached at 300?mg/day where 2 patients out of 6 experienced a dose limiting toxicity (febrile neutropenia with diarrhea). The lower dose level of 270 mg/day was the recommended dose (RD), the toxicity profile being mainly anaemia, neutropenia, fatigue and constipation. The pharmacokinetic analysis demonstrated the adequacy of the flat-fixed dosing regimen, as no correlation between clearance of vinflunine and body surface area was evidenced. Blood concentrations and exposure increased with dose, and a pharmacokinetic accumulation was observed, which is consistent with the terminal half-life of the compounds. The inter-individual exposure variability at the RD was 35%. Conclusion Repeated weekly administration of oral vinflunine is feasible and exhibits a moderate inter-individual PK variability. The MTD was achieved at 300?mg/day given for 2 consecutive days. According to the protocol rules, the RD was established at 270?mg/day. |
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