Phase I, pharmacokinetic and pharmacodynamic evaluation of CYT997, an orally-bioavailable cytotoxic and vascular-disrupting agent

Invest New Drugs. 2013 Feb;31(1):126-35. doi: 10.1007/s10637-012-9813-y. Epub 2012 Mar 27.

Abstract

Purpose: CYT997 is a novel microtubule inhibitor and vascular disrupting agent. This phase I trial examined the safety, tolerability, pharmacokinetics and vascular-disrupting effects of orally-administered CYT997.

Experimental design: We performed a phase I accelerated dose-escalation study of CYT997 given orally once every 2 to 3 weeks in patients with advanced solid tumours. Vascular disruption was assessed by measurement of plasma von Willebrand factor (vWF) levels and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI).

Results: A total of 56 doses were administered to 21 patients over 8 dose levels (15-164 mg/m(2)). Grade 3 fatigue and grade 3 hypoxia were dose limiting. Oral bioavailability was observed with approximate linear pharmacokinetics over the 11-fold dose range. At doses of 84 mg/m(2) and above, plasma vWF levels increased above baseline and DCE-MRI scans showed reductions in tumour K(trans) in some patients.

Conclusions: CYT997 is orally bioavailable. The 118 mg/m(2) dose level should be used to guide dosing in future studies.

Publication types

  • Clinical Trial, Phase I
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Aged
  • Antineoplastic Agents / administration & dosage*
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / pharmacokinetics
  • Biological Availability
  • Cytotoxins / administration & dosage*
  • Cytotoxins / adverse effects
  • Cytotoxins / pharmacokinetics
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / blood
  • Neoplasms / drug therapy*
  • Pyridines / administration & dosage*
  • Pyridines / adverse effects
  • Pyridines / pharmacokinetics
  • Pyrimidines / administration & dosage*
  • Pyrimidines / adverse effects
  • Pyrimidines / pharmacokinetics
  • Tubulin Modulators / administration & dosage*
  • Tubulin Modulators / adverse effects
  • Tubulin Modulators / pharmacokinetics

Substances

  • Antineoplastic Agents
  • CYT997
  • Cytotoxins
  • Pyridines
  • Pyrimidines
  • Tubulin Modulators