Phase I study of oral irinotecan as a single-agent and given sequentially with capecitabine

Laura W. Goff*, Al B. Benson, Patricia M. LoRusso, Antoinette R. Tan, Jordan D. Berlin, Louis J. Denis, Rebecca J. Benner, Donghua Yin, Mace L. Rothenberg

*Corresponding author for this work

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Purpose To assess the maximum tolerated dose (MTD) and dose-limiting toxicities (DLT) of orally administered irinotecan in the semi-solid matrix (SSM) formulation, both as a single agent and in sequential combination with capecitabine, in patients with advanced solid tumors. Patients and Methods Forty-three patients were treated with irinotecan given as a single oral daily dose on days 1-5 every three weeks. An additional forty patients were treated with sequential oral irinotecan given daily on days 1-5 followed by capecitabine given orally as a divided dose twice daily on days 6-14 of each three week cycle. Results The MTD of single-agent oral irinotecan was estimated to be 60 mg/m 2/day, and DLT included diarrhea, nausea, and neutropenia. In an initial group of patients with Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0 to 2, the MTD of sequential oral irinotecan/ capecitabine was estimated to be 40/1600 mg/m 2/day with DLT of delayed diarrhea. In a subsequent group of patients with ECOG PS of 0 or 1, the MTD for the sequential combination was 50/2000 mg/m 2/day. The most common adverse events were fatigue, diarrhea, nausea/vomiting and dehydration. Pharmacokinetic (PK) evaluation showed that oral irinotecan was rapidly absorbed and effectively converted to the active metabolite, SN-38, achieving approximately 50% of the SN-38 systemic exposure resulting from an equivalent IV dose. Conclusions Oral irinotecan can be safely administered as a single agent or in sequential combination with capecitabine. The efficacy of oral irinotecan should be explored further as a potentially convenient alternative to IV chemotherapy.

Original languageEnglish (US)
Pages (from-to)290-298
Number of pages9
JournalInvestigational New Drugs
Volume30
Issue number1
DOIs
StatePublished - Feb 1 2012

Keywords

  • Capecitabine
  • Irinotecan

ASJC Scopus subject areas

  • Oncology
  • Pharmacology
  • Pharmacology (medical)

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    Goff, L. W., Benson, A. B., LoRusso, P. M., Tan, A. R., Berlin, J. D., Denis, L. J., Benner, R. J., Yin, D., & Rothenberg, M. L. (2012). Phase I study of oral irinotecan as a single-agent and given sequentially with capecitabine. Investigational New Drugs, 30(1), 290-298. https://doi.org/10.1007/s10637-010-9528-x