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Continuous streptozotocin infusion: a phase I study.

K Seibert, G Golub, P Smiledge

    Cancer Treatment Reports
    |November 1, 1979
    PubMed
    Summary
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    This study explored continuous intravenous infusions of streptozotocin (STZ) for advanced cancers. Prolonged STZ infusions showed potential antitumor activity with manageable toxicity, though central nervous system effects require consideration.

    Area of Science:

    • Oncology
    • Pharmacology

    Background:

    • Streptozotocin (STZ) exhibits antitumor properties but is limited by renal and gastrointestinal toxicity.
    • Continuous infusion strategies may mitigate STZ's adverse effects.

    Purpose of the Study:

    • To evaluate the safety and efficacy of prolonged continuous intravenous infusions of streptozotocin in patients with advanced cancers.
    • To assess renal, gastrointestinal, and central nervous system toxicity associated with this administration method.

    Main Methods:

    • Nineteen patients with advanced cancers received streptozotocin (STZ) at 3.4 g/m2 via continuous IV infusion over 5-6 days monthly for 1-2 cycles.
    • Pre- and post-treatment serum and urine studies were conducted.
    • Adverse events, including renal function, proteinuria, myelosuppression, gastrointestinal symptoms, and neurological effects, were monitored.

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    Main Results:

    • No significant changes in BUN or creatinine were observed, indicating preserved renal function.
    • Proteinuria developed in four patients, but no renal failure or myelosuppression occurred.
    • Gastrointestinal toxicity (nausea/vomiting) was reported in 13 patients, with varying severity and control.
    • Five patients experienced central nervous system toxicity (confusion, lethargy, depression).
    • Two patients achieved complete remission of diffuse non-Hodgkin's lymphoma; others showed documented improvement.

    Conclusions:

    • Prolonged continuous intravenous streptozotocin infusions demonstrate potential clinical promise for advanced cancers.
    • While renal and gastrointestinal toxicities appear manageable, central nervous system toxicity may be a dose-limiting factor.
    • Further investigation into optimizing STZ infusion protocols is warranted.