Pharmacokinetic, biochemical and clinical effects of dimethyltriazenoimidazole-4-carboxamide-bischloroethylnitrosourea combination therapy in patients with advanced breast cancer
| Autor: | Anthony Howell, Mark Clemons, Audrey Griffiths, Hassan El Teraifi, Malcolm R Ranson, Geoffrey P. Margison, Charles Q Morris, Jane Kelly, Jennifer M Margison |
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| Rok vydání: | 2002 |
| Předmět: |
Adult
Cancer Research Combination therapy medicine.medical_treatment Dacarbazine Drug Resistance Breast Neoplasms Pharmacology Immunoenzyme Techniques O(6)-Methylguanine-DNA Methyltransferase Breast cancer Pharmacokinetics Antineoplastic Combined Chemotherapy Protocols Medicine Humans Carmustine Chemotherapy Dose-Response Relationship Drug business.industry Biopsy Needle Cancer Middle Aged medicine.disease Oncology Area Under Curve Toxicity Female business medicine.drug |
| Zdroj: | International journal of cancer. 103(5) |
| ISSN: | 0020-7136 |
| Popis: | We assessed whether split dosing with the methylating agent DTIC is an effective strategy for inactivating the DNA repair protein O6-alkylguanine DNA-ATase in order to decrease tumour resistance to BCNU. ATase levels in PBMCs were used as a surrogate for tumour ATase depletion to determine whether this correlated with either the pharmacokinetics of DTIC and its major metabolite AIC or other clinical sequelae. Two 1 hr infusions of DTIC (400 mg/m(2)) 4 hr apart followed another 4 hr later by BCNU (75 mg/m(2)) were administered every 6 weeks in 7 patients with heavily pretreated advanced breast cancer. The extent and kinetics of ATase depletion and recovery in PBMCs varied not only between patients but also between cycles in the same patient. Serial FNAs showed heterogeneity in tumour ATase expression but no clear pattern of change in ATase activity. DTIC and AIC exhibited biphasic clearance from the blood, consistent with a 2-compartment pharmacokinetic model. The AUC of AIC was strongly correlated with the percentage decrease in PBMC ATase levels. There were no clinical responses, and toxicity in neutrophils and platelets was marked. Split-dose DTIC therefore does not appear to be a clinically effective approach to overcome O(6)-alkylating agent resistance in advanced breast cancer. |
| Databáze: | OpenAIRE |
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