Purpose:To determine the maximum tolerated dose, dose-limiting toxicity, and pharmacokinetics of the dolastatin-15 analogue, tasidotin (ILX651), when administered i.v. daily for 5 days every 3 weeks. Experimental Design: Thirty-six patients with advanced solid tumors received a total of 114 courses through eight dose levels ranging from 2.3 to 36.3 mg/m 2 . Pharmacokinetic samples were collected in cycle 1. Tasidotin decayed from plasma in a biphasic fashion with a half-life of <45 minutes in most cases.
Conclusion:The maximum tolerated dose and recommended phase II dose for tasidotin when administered on this schedule was 27.3 mg/m 2 /d. The favorable toxicity profile of tasidotin compared with other antitubulin agents (particularly the lack of severe cumulative neuropathy, peripheral edema, and fatigue), the observed antitumor activity of tasidotin, and its novel mechanism of action support further disease-directed evaluations of this agent on this 5-day schedule every 3 weeks.prolyl-L-proline-tert -butylamide hydrochloride; Genzyme Corp., San Antonio, TX) is a third-generation dolastatin-15 analogue that is metabolically stable through its resistance to hydrolysis by prolyl oligopeptidases. The dolastatins are a group of peptides with unusual amino acids that were isolated from the Indian Ocean sea hare Dolabella auricularia (1 -4). The preclinical antitumor potential of the dolastatins initially garnered much enthusiasm (5 -8). Cemadotin, a dolastatin-15 pentapeptide, at concentrations as low as 10 to 100 nmol/L, suppressed the rate of tubulin growth more than shortening, a process that differentiated dolastatin-15 analogues from other tubulin-acting agents like Vinca alkaloids (which suppress the rate of growth and shortening simultaneously) and taxanes (which preferentially suppress the rate of tubulin growth; ref. 9). However, clinical trial results with cemadotin were disappointing due to rapid metabolic conversion and dose-limiting cardiovascular toxicity, including hypertension, angina, and myocardial infarction (10 -13).Tasidotin induces cell cycle arrest in the G 2 and M phases and inhibits tubulin polymerization in vitro similar to cemadotin and the Vinca alkaloids. Whereas tasidotin tubulin-binding studies have not been done, evaluation of other dolastatin analogues suggests a binding site distinct from the Vinca alkaloids, taxanes, and colchicine (14). The effects of tasidotin on microtubule assembly were examined in vitro and compared with those of podophyllotoxin and vinblastine. Tasidotin is unique because at low concentrations, 25 to 40 Amol/L, a prolonged lag phase in microtubule assembly is induced followed by assembly to normal levels (15). At concentrations z50 Amol/L, tasidotin inhibits the extent of microtubule assembly.