Intravenous vincristine infusion: phase I trial

Area of Science:

• Oncology
• Pharmacology

Background:

• Vincristine is a standard chemotherapy agent.
• Conventional intravenous bolus injection may limit its efficacy.
• Sustaining cytotoxic concentrations is a therapeutic goal.

Purpose of the Study:

• To evaluate the safety and efficacy of a five-day continuous infusion of vincristine.
• To determine optimal dosing for intravenous vincristine infusion therapy.
• To explore enhanced clinical utility of vincristine through infusion techniques.

Main Methods:

• 30 patients with refractory malignancies received a five-day continuous infusion of vincristine.
• Three dose levels were tested: 0.5, 0.75, and 1.0 mg/m2 daily.
• Neurologic and hematologic toxicity were assessed.

Main Results:

• Objective responses were observed in 11 patients (37%), including lymphomas, leukemias, and carcinomas.
• Responses occurred across all tested infusion dose levels.
• Nine responders had previously progressed on conventional vincristine bolus therapy.
• Mild to moderate toxicity was noted at 0.5 and 0.75 mg/m2; severe toxicity at 1.0 mg/m2.

Conclusions:

• Continuous intravenous infusion of vincristine can enhance its clinical effectiveness.
• A maximum daily dose of 0.5 mg/m2 for five days is recommended for future trials.
• Infusion delivery may overcome resistance to conventional vincristine administration.