A Phase I Safety, Pharmacokinetic, and Pharmacodynamic Presurgical Trial of Vitamin E δ-tocotrienol in Patients with Pancreatic Ductal Neoplasia

EBioMedicine

卷:2

Dung-Tsa Chen¹  Barbara Centeno²  Saïd Sebti³  Gregory M. Springett⁴  Tai Z. Hutchinson⁴  Kazim Husain⁴  Mokenge P. Malafa⁴  Anthony Neuger⁵  Richard M. Lush⁵ 

[1] Biostatistics Core, Tampa, FL, USA;

[2] Department of Cytopathology, Tampa, FL, USA;

[3] Department of Drug Discovery, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA;

[4] Department of Gastrointestinal Oncology, Tampa, FL, USA;

[5] Translational Research Core, Tampa, FL, USA;

关键词: Vitamin E;    Tocotrienols;    Presurgical trial;    Pancreatic cancer;    Chemoprevention;   

DOI  :  10.1016/j.ebiom.2015.11.025

来源: DOAJ

【 摘 要 】

Background: Vitamin E δ-tocotrienol (VEDT), a natural vitamin E from plants, has shown anti-neoplastic and chemoprevention activity in preclinical models of pancreatic cancer. Here, we investigated VEDT in patients with pancreatic ductal neoplasia in a window-of-opportunity preoperative clinical trial to assess its safety, tolerability, pharmacokinetics, and apoptotic activity.Methods: Patients received oral VEDT at escalating doses (from 200 to 3200 mg) daily for 13 days before surgery and one dose on the day of surgery. Dose escalation followed a three-plus-three trial design. Our primary endpoints were safety, VEDT pharmacokinetics, and monitoring of VEDT-induced neoplastic cell apoptosis (ClinicalTrials.gov number NCT00985777).Findings: In 25 treated patients, no dose-limiting toxicity was encountered; thus no maximum-tolerated dose was reached. One patient had a drug-related adverse event (diarrhea) at a 3200-mg daily dose level. The effective half-life of VEDT was ~4 h. VEDT concentrations in plasma and exposure profiles were quite variable but reached levels that are bioactive in preclinical models. Biological activity, defined as significant induction of apoptosis in neoplastic cells as measured by increased cleaved caspase-3 levels, was seen in the majority of patients at the 400-mg to 1600-mg daily dose levels.Interpretation: VEDT from 200 to 1600 mg daily taken orally for 2 weeks before pancreatic surgery was well tolerated, reached bioactive levels in blood, and significantly induced apoptosis in the neoplastic cells of patients with pancreatic ductal neoplasia. These promising results warrant further clinical investigation of VEDT for chemoprevention and/or therapy of pancreatic cancer.

【 授权许可】

Unknown