First-in-man phase I study assessing the safety and pharmacokinetics of a 1-hour intravenous infusion of the doxorubicin prodrug DTS-201 every 3 weeks in patients with advanced or metastatic solid tumours

Publication date: November 2017
Source:European Journal of Cancer, Volume 86
Author(s): Patrick Schöffski, Jean-Pierre Delord, Etienne Brain, Jacques Robert, Herlinde Dumez, Jamal Gasmi, André Trouet
PurposeDTS-201 is a doxorubicin (Dox) prodrug that shows encouraging data in experimental models in terms of both efficacy and safety compared with conventional Dox. The purpose of this phase I study was to assess the safety profile, to establish the recommended dose (RD) for clinical phase II studies and to assess potential anticancer activity of the compound.Experimental designDTS-201 was administered as a 1-hour infusion every 3 weeks in eligible patients with advanced solid tumours according to common clinical phase I criteria. Dose escalation was performed according to a modified Fibonacci schema.ResultsTwenty-five patients with a median age of 58 years (range, 30–72) were enrolled in the study. The median number of treatment cycles was 2 (range, 1–8). DTS-201 was administered at four dose levels (DLs) ranging from 80 to 400 mg/m², which is equivalent to 45–225 mg/m² of conventional Dox. No dose-limiting toxicity (DLT) occurred at the first two DLs. Three DLTs were observed at DL3 and DL4 (diarrhoea for DL3, vomiting and neutropenia for DL4). DL4 (400 mg/m²) was considered the maximum tolerated dose. Myelosuppression was the main toxicity, and NCI-CTC grade III–IV neutropenia was common at RD. Non-haematological adverse reactions were mild to moderate and included nausea, anorexia, asthenia and alopecia. No treatment-related severe cardiac adverse events were observed.ConclusionsDTS-201 is well tolerated and safe in heavily pretreated solid tumour patients. A high equivalent dose of Dox could be delivered without severe drug-related cardiac events. DTS-201 showed evidence of clinical activity with a confirmed partial response in a patient with soft-tissue sarcoma. The recommended phase II dose is 400 mg/m².



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