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Phase I study of high-dose cytosine arabinoside and etoposide in patients with advanced malignancies
Authors:Bayard L Powell  Hyman B Muss  Robert L Capizzi  Mary E Caponera  Douglas R White  Patricia J Zekan  James N Atkins  Don V Jackson Jr  Frederick Richards II  John B Craig  Julia M Cruz  Charles L Spurr
Affiliation:(1) Oncology Research Center, Bowman Gray School of Medicine of Wake Forest University, 300 South Hawthorne Road, 27103 Winston-Salem, North Carolina, USA
Abstract:Summary Cytosine arabinsodie (ara-C) and etoposide (VP-16) display synergy in the laboratory. Twenty-six patients participated in a phase I study of high-dose ara-C in combination with VP-16. The dose of VP-16 was held constant at 50 mg/m2 as an intermittent infusion over 33 h; escalating doses of ara-C were given as infusions during hours 9–12 and 21–24. Myelosuppression was the dose-limiting toxicity and occurred with doses considerably less than those expected from studies of the two drugs as single agents. The suggested initial doses for phase II trials with this schedule are 750 mg/m2×2 doses of ara-C and 50 mg/m2 of VP-16. Nonhematologic toxicity was minimal; therefore, further dose escalation is feasible in patients in whom myelosuppression is acceptable.Supported in part by grants from the National Cancer Institute (CA-12197 and CA-09422) and the American Cancer Society CF-85-182
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