Phase II study of amonafide in advanced pancreatic adenocarcinoma

To determine the efficacy of amonafide in patients with advanced, measurable pancreatic adenocarcinoma, 15 patients previously untreated with chemotherapy were entered on a phase II trial. The starting dose was 400 mg/m2 administered daily over 1 hr for 5 consecutive days repeated every 3 weeks. Because of grade 4 myelosuppression observed in the initial 2 patients, the daily starting dose was decreased to 350 mg/m2. Of the 15 patients, 14 were evaluable. Amonafide failed to produce clinical responses in the doses and schedule employed. Grade 4 granulocytopenia was observed in 3 of 9 courses at 400 mg/m2, 3 of 12 courses at 350 mg/m2 and in 1 of 4 courses at 300 mg/m2. Grade 4 thrombocytopenia was observed in 3 courses at 400 mg/m2. Nonhematologic toxicities included mild nausea and vomiting and skin rashes.