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Amonafide treatment of refractory esophageal cancer. A Southwest Oncology Group study
E Poplin1, T Fleming, J S MacDonald
1Wayne State University Medical Center, Detroit, MI.
Abstract:
Amonafide, a synthetic benzisoquinolinedione, was evaluated for treatment of squamous esophageal cancer. Eleven men and 5 women were eligible with a median performance status of 1 and median age of 63 years. Six had no prior treatment. All patients had measurable disease. Therapy consisted of amonafide 300 mg/m2d days 1-5 every 21 days. Thirty-five courses of therapy were delivered. The median number of courses received was two. Sixteen patients are evaluable for toxicity. Thirteen are evaluable for response. Toxicity was severe. Seven patients were hospitalized for toxicity. Six patients had grade IV granulocytopenia; two, grade IV thrombocytopenia. Angioedema developed in one patient; severe exfoliative dermatitis in another. A single partial response, with the decrease in size a supraclavicular node, was noted in a previously untreated patient. Amonafide, in this dose and schedule, is associated with occasionally severe toxicity precluding its likely use in squamous cell esophageal carcinoma.
Insights
Amonafide showed severe toxicity in patients with squamous esophageal cancer, including dangerous drops in white blood cells and platelets. Its severe side effects limit its potential use for this cancer.
Area of Science:
- Oncology
- Pharmacology
Background:
- Squamous cell esophageal carcinoma is a challenging cancer.
- Benzisoquinolinedione derivatives are investigated for anticancer properties.
Purpose of the Study:
- To evaluate the efficacy and toxicity of amonafide in patients with squamous esophageal cancer.
Main Methods:
- A phase II study administered amonafide (300 mg/m2) on days 1-5 every 21 days.
- Patients with measurable squamous esophageal cancer were enrolled.
Main Results:
- Severe toxicities were observed, including grade IV granulocytopenia and thrombocytopenia.
- Hospitalization was required for seven patients due to toxicity.
- A single partial response was noted in one patient.
Conclusions:
- Amonafide, at the tested dose and schedule, demonstrated severe toxicity in squamous esophageal cancer patients.
- The toxicity profile suggests limited potential for amonafide in treating this malignancy.