Annals of Oncology Advance Access originally published online on March 8, 2006
Annals of Oncology 2006 17(5):860-865; doi:10.1093/annonc/mdl010
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© 2006 European Society for Medical Oncology
Phase I trial of phenoxodiol delivered by continuous intravenous infusion in patients with solid cancer
1 Taussig Cancer Center, The Cleveland Clinic Foundation, Cleveland, Ohio, USA; 2 Sammons Baylor Cancer Center, Dallas, Texas, USA; 3 Novogen Ltd., North Ryde, New South Wales, Australia
* Correspondence to: Dr T. K. Choueiri, Department of Hematology and Medical Oncology, Taussig Cancer Center, The Cleveland Clinic Foundation, 9500 Euclid Avenue, R-35, Cleveland, OH 44195, USA. Tel: +1 216–444–2200; Fax: +1 216–444–9464; E-mail: choueit{at}ccf.org
Background: Phenoxodiol is a multi-pathway initiator of apoptosis with broad anti-tumor activity and high specificity for tumor cells. Its biochemical effects are particularly suited to reversal of chemo-resistance, and the drug is being developed as a chemo-sensitizer of standard chemotherapeutics in solid cancers. This phase I, single-center trial was conducted to test a continuous intravenous dosing regimen of phenoxodiol in patients with late-stage, solid tumors to determine toxicity, pharmacokinetics, and preliminary efficacy.
Methods: Phenoxodiol given by intravenous infusion continuously for 7 days on 14-day cycles was dose-escalated on an inter-patient basis at dosages of 0.65,1.3, 3.3, 20.0, and 27.0 mg/kg/day (three to four patients per stratum). Treatment cycles continued until disease progression. Toxicity was based on standard criteria; efficacy was based on changes in tumor burden (WHO); pharmacokinetic analysis was conducted on plasma samples at specified time points during treatment cycles.
Results: Nineteen heavily-pre-treated patients with solid tumors received a median of three cycles of treatment (range 1–13); two patients received 
12 cycles. No dose-limiting toxicities were encountered, with emesis and fatigue (one patient) and rash (one patient) the only significant toxicities. Stabilized disease was the best efficacy outcome, with one patient showing stable disease at 24 weeks. Pharmacokinetics suggested a linear relationship between dosage and mean steady-state plasma concentrations of phenoxodiol.
Conclusion: A 7-day continuous infusion of phenoxodiol given every 2 weeks is well tolerated up to a dose of 27.0 mg/kg/day
Key words: phase I trial, phenoxodiol, refractory cancer, toxicity, pharmacokinetics
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