Phase II and pharmacokinetic study of lobaplatin in patients with relapsed ovarian cancer

Br J Cancer. 1995 Jun;71(6):1302-7. doi: 10.1038/bjc.1995.252.

Abstract

In phase I studies, lobaplatin showed activity in ovarian cancer patients pretreated with platinum. A phase II trial with lobaplatin was performed in patients with refractory or relapsed ovarian cancer to define activity and pharmacokinetics. Twenty-two patients were treated with lobaplatin administered as an intravenous bolus every 4 weeks. Dependent on creatinine clearance (CRCL) patients received 30 or 50 mg m-2 lobaplatin as the starting dose. Twenty-two patients received 78 courses (median 3, range 1-6). In eight patients total platinum (TPt) in plasma and urine, free platinum (FPt) in plasma ultrafiltrate (both measured by atomic absorption spectrometry) and lobaplatin in plasma ultrafiltrate measured (by high-performance liquid chromatography) were measured. Toxicity was confined to mild nausea and vomiting, mild leucocytopenia (WHO grade 3 in 18% of the courses), and renal function-related thrombocytopenia (WHO grade 3/4 in 53% of the courses). A correlation was found between CRCL and reduction in platelet count (r = -0.77; P < 0.01). No renal toxicity was encountered. Five of 21 evaluable patients (24%) achieved a response (four complete remissions and one partial remission). Remissions occurred mainly in patients who relapsed more than 6 months after primary treatment. The median survival from start of lobaplatin treatment was 8 months. The mean areas under the curve (AUCs) were 4.2 +/- 0.5, 3.0 +/- 0.6, and 3.2 +/- 1.1 h mgl-1 for TPt, FPt and lobaplatin respectively. The free platinum fraction (FPt/TPt) was initially very high, indicating low protein binding. FPt was essentially present as intact lobaplatin. Four hours after infusion 54 +/- 5% and 24 h after infusion 74 +/- 3% of the lobaplatin dose was excreted in the urine. In conclusion, lobaplatin is a platinum compound with anti-tumour activity in patients with relapsed ovarian cancer, especially in those who have platinum-sensitive tumours. The main toxicity of lobaplatin is thrombocytopenia and its dose should be corrected according to renal function.

Publication types

  • Clinical Trial
  • Clinical Trial, Phase II

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antineoplastic Agents / pharmacokinetics*
  • Antineoplastic Agents / therapeutic use*
  • Antineoplastic Agents / toxicity
  • Creatinine / metabolism
  • Cyclobutanes / pharmacokinetics*
  • Cyclobutanes / therapeutic use*
  • Cyclobutanes / toxicity
  • Female
  • Humans
  • Metabolic Clearance Rate
  • Middle Aged
  • Neoplasm Staging
  • Organoplatinum Compounds / pharmacokinetics*
  • Organoplatinum Compounds / therapeutic use*
  • Organoplatinum Compounds / toxicity
  • Ovarian Neoplasms / drug therapy*
  • Ovarian Neoplasms / pathology
  • Pelvic Neoplasms / drug therapy
  • Pelvic Neoplasms / secondary
  • Recurrence
  • Vaginal Neoplasms / drug therapy
  • Vaginal Neoplasms / secondary

Substances

  • Antineoplastic Agents
  • Cyclobutanes
  • Organoplatinum Compounds
  • Creatinine
  • lobaplatin