Effects of motexafin gadolinium in a phase II trial in refractory chronic lymphocytic leukemia

• Published in: Leukemia & lymphoma Vol. 50; no. 12; pp. 1977 - 1982
• Main Authors: Lin, Thomas S., Naumovski, Louie, Lecane, Philip S., Lucas, Margaret S., Moran, Mollie E., Cheney, Carolyn, Lucas, David M., Phan, See-Chun, Miller, Richard A., Byrd, John C.
• Format: Journal Article
• Language: English
• Published: United States Informa UK Ltd 01.12.2009; Taylor & Francis
• Subjects: Aged; Aged, 80 and over; Antineoplastic Agents - adverse effects; Antineoplastic Agents - pharmacokinetics; Antineoplastic Agents - therapeutic use; Chemotherapeutic approaches; Chromosome Deletion; Chromosomes, Human, Pair 11 - genetics; Chromosomes, Human, Pair 17 - genetics; Drug Administration Schedule; Drug Resistance, Neoplasm; Female; Flow Cytometry; Humans; Immunoblotting; In Situ Hybridization, Fluorescence; Leukemia, Lymphocytic, Chronic, B-Cell - drug therapy; Leukemia, Lymphocytic, Chronic, B-Cell - genetics; Leukemia, Lymphocytic, Chronic, B-Cell - metabolism; Lymphoid leukemia; Lymphoma; Male; Metalloporphyrins - adverse effects; Metalloporphyrins - pharmacokinetics; Metalloporphyrins - therapeutic use; Middle Aged; Phosphorylation - drug effects; Proto-Oncogene Proteins c-akt - metabolism; Treatment Outcome
• ISSN: 1042-8194; 1029-2403
• DOI: 10.3109/10428190903288464

Chronic lymphocytic leukemia (CLL) cells are susceptible to oxidative stress. The expanded porphyrin, motexafin gadolinium (MGd), reacts with intracellular reducing metabolites and protein thiols to generate reactive oxygen species (ROS). A phase II trial administered MGd 5 mg/kg/day IV for 5 days every 3 weeks until disease progression to patients with previously treated CLL and small lymphocytic lymphoma. Thirteen patients (median age 66 years) with a median of four prior therapies (range 2-9) were enrolled. Modest anti-tumor activity was seen in three patients, with improvement in lymphocytosis, lymphadenopathy and/or splenomegaly, but no patient achieved a partial or complete response by NCI 96 criteria. Flow cytometry confirmed tumor uptake of MGd. Serial increase in AKT phosphorylation in patient samples following MGd treatment was not observed, suggesting intracellular generation of ROS was not optimal. Therefore, this schedule of administration achieved MGd uptake into primary tumor cells in vivo, but clinical activity was modest.