Phase II trial of pyrazine diazohydroxide in androgen-independent prostate cancer.

Phase II trial of pyrazine diazohydroxide in androgen-independent prostate cancer.
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吡嗪重氮氢氧化物治疗雄激素非依赖性前列腺癌的 II 期试验。

DOI:
10.1023/a:1006097109088
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发表时间:
1998
影响因子:
3.4
通讯作者:
Doroshow,J
Doroshow,J
中科院分区:
医学3区
文献类型:
--
作者:
Edelman,MJ;Meyers,FJ;Grennan,T;Lauder,J;Doroshow,J

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目前尚无针对激素难治性前列腺癌 (HRPC) 的有效疗法。重氮吡嗪 (PZDH) 是一种新型抗肿瘤药物,在临床前研究中具有广泛的活性,在 I 期试验中具有中等毒性。我们利用 PSA 下降作为主要终点,对 HRPC 中的 PZDH 进行了 II 期研究。纳入 15 名患者,中位年龄 70 岁 (55-86),治疗前中位 PSA 206 ng/ml(范围 42-10,000)。四名患者是非裔美国人。疾病部位:仅骨骼 7 个,仅软组织 2 个,两者均为 6 个。所有部位均可评估毒性和反应。每三周以 250 mg/m2 静脉注射 PZDH。给药周期的中位数为两个(范围 1-6)。毒性轻微,只有一名患者表现出严重(3-4 级)毒性。不幸的是,活动很少,只有一名患者的 PSA 下降超过 75%。由于该患者的 PSA 几乎立即开始上升,因此该反应被认为是短暂的,并且没有理由进行第二阶段的试验。支持这一结论的是令人失望的中位生存期 220 天。总之,我们得出结论,PZDH 虽然在此剂量和时间表下具有良好的耐受性,但在 HRPC 中仅具有最小的活性。
No effective therapy has been demonstrated for hormone refractory prostate cancer (HRPC). Pyrazine diazohydroxide (PZDH) is a novel antineoplastic agent with a broad range of activity in preclinical studies and a moderate toxicity profile in Phase I trials. We undertook a Phase II study of PZDH in HRPC utilizing decline in PSA as the primary end point. Fifteen patients were enrolled, median age of 70 (55–86), median pretherapy PSA 206 ng/ml (range 42–10,000). Four patients were African American. Sites of disease: bone only 7, soft tissue only 2, both 6. All were evaluable for toxicity and response. PZDH was administered at 250 mg/m2 IV every three weeks. The median number of cycles administered was two (range 1–6). Toxicity was mild, with only one patient manifesting serious (grade 3–4) toxicity. Unfortunately, activity was minimal with only a single patient demonstrating a >75% decline in PSA. As this patient's PSA began to rise almost immediately the response was considered transient and not felt to justify pursuing a second stage of the trial. Supporting this conclusion was the disappointing median survival of 220 days. In summary, we conclude that PZDH, while well tolerated at this dose and schedule has only minimal activity in HRPC.
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