Phase I pharmacokinetic and pharmacodynamic study of recombinant human endostatin in patients with advanced solid tumors

James P. Thomas, Rhoda Z. Arzoomanian, Dona Alberti, Rebecca Marnocha, Fred Lee, Andreas Friedl, Kendra Tutsch, Amy Dresen, Peter Geiger, James Pluda, William Fogler, Joan H. Schiller, George Wilding

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213 Scopus citations

Abstract

Purpose: Endostatin is the first endogenous angiogenesis inhibitor to enter clinical trials. Laboratory investigations with endostatin have indicated broad antitumor activity coupled with remarkably low toxicity. A phase I trial of recombinant human endostatin was designed to evaluate toxicity and explore biologic effectiveness in patients with refractory solid tumors. Patients and Methods: Endostatin was administered as a 1-hour intravenous infusion given daily for a 28-day cycle. A starting dose of 30 mg/m2 was explored with subsequent dose escalations of 60, 100, 150, 225, and 300 mg/m2. Assessment of serum pharmacokinetics was performed on all 21 patients. Western blot assay and mass spectroscopy were employed to evaluate endostatin metabolism. Circulating levels of endogenous proangiogenic growth factors were examined. Tumor and tumor blood supply were imaged by dynamic computed tomography (CT), magnetic resonance imaging, ultrasound, and positron emission tomography. Results: Endostatin given on this schedule was essentially free of significant drug-related toxicity. Two transient episodes of grade 1 rash were observed. No clinical responses were observed. Endostatin pharmacokinetics were linear with dose, and serum concentrations were achieved that are associated with antitumor activity in preclinical models. No aggregate effect on circulating proangiogenic growth factors were seen, although several patients exhibited persistent declines in vascular endothelial growth factor levels while enrolled in the study. A few patients demonstrated changes in their dynamic CT scans suggestive of a decline in microvessel density, although overall, no consistent effect of endostatin on tumor vasculature was seen. Conclusion: Endostatin given daily as a 1-hour intravenous infusion was well tolerated without dose-limiting toxicity at doses up to 300 mg/m2.

Original languageEnglish (US)
Pages (from-to)223-231
Number of pages9
JournalJournal of Clinical Oncology
Volume21
Issue number2
DOIs
StatePublished - Jan 15 2003

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ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Thomas, J. P., Arzoomanian, R. Z., Alberti, D., Marnocha, R., Lee, F., Friedl, A., Tutsch, K., Dresen, A., Geiger, P., Pluda, J., Fogler, W., Schiller, J. H., & Wilding, G. (2003). Phase I pharmacokinetic and pharmacodynamic study of recombinant human endostatin in patients with advanced solid tumors. Journal of Clinical Oncology, 21(2), 223-231. https://doi.org/10.1200/JCO.2003.12.120