A phase I and pharmacokinetic study of tallimustine [PNU 152241 (FCE 24517)] in patients with advanced cancer.

Tallimustine [PNU 152241 (FCE 24517)] is a synthetic derivative of the DNA minor groove binder distamycin A, in which the NH2-terminal formyl group is substituted by benzoyl mustard. In this Phase I clinical trial, patients with advanced solid tumors received i.v. bolus injections of tallimustine daily for 3 consecutive days. Patients were treated at six dosage levels of 33.3 micrograms/m2/day to 250 micrograms/m2/day for 3 consecutive days, with courses of therapy repeated every 28 days. Detailed pharmacokinetic blood sampling was performed during the first 3 days of the first course of tallimustine. The plasma samples were analyzed by high-performance liquid chromatography with UV detection. Forty-eight eligible patients were treated at all six dosage levels. The dominant dose-related toxicity of tallimustine was neutropenia, becoming dose limiting at 250 micrograms/m2/day. At this dosage level, one patient experienced febrile neutropenia, and a second patient died on study of indeterminate cause. Thrombocytopenia was not observed, and only 10 patients developed anemia < 8.0 gm/dl. Sporadic elevation of liver enzymes or bilirubin was observed but was not dose related. Pharmacokinetic analysis gave reliable results for 33 patients. For most patients, analysis of the data best fit a three-exponential model. Dose-related increases in areas under the concentration-time curve and end-of-infusion concentrations were observed. There was no significant plasma accumulation of tallimustine over the 3 days of administration. The terminal half-life of tallimustine in individual patients ranged from 6.83 to 39.02 h following the last dose. In summary, the recommended Phase II dosage for tallimustine is 200 micrograms/m2/day for 3 consecutive days every 28 days. Neutropenia is the principal toxicity of this agent at this dosage and schedule.

Interactions among the effects of normorphine, calcium and magnesium on transmitter release in the mouse vas deferens.

1 Excitatory junction potentials (e. j. ps) were recorded with intracellular electrodes from smooth muscle cells of the mouse vas deferens. 2 The dependence of the e.j.p. amplitude on the extracellular calcium ion concentration was determined in the absence or presence of normorphine (50 nM-1 microM) or magnesium (1.2-4.8 mM). 3 The interaction between normorphine and calcium was non-competitive beyond a dose-ratio of 1.5, whereas the interaction between magnesium and calcium was competitive up to the highest dose-ratio investigated (1.9). 4 It is suggested that inhibition by normorphine occurs at least partly by a mechanism different from that of magnesium.

The effect of chronic morphine treatment of excitatory junction potentials in the mouse vas deferens.

1 Intracellular recordings were made from smooth muscle cells of vasa deferentia in vitro. Vasa from two groups of mice were studied; the first were naive and the second had been chronically pretreated with morphine for 3 days. The vasa from morphine-pretreated mice were maintained in Krebs solution containing normorphine (300 nM). 2 The resting membrane potentials of the smooth muscle cells were the same in both groups of mice. 3 The excitatory junction potentials (e.j.ps) evoked by stimulation of the intramural nerves were depressed by normorphine in both groups of mice. The EC50 for this action of normorphine was 560 nM for the naive group and 6.6 microM for the morphine-pretreated group. 4 The EC50 for adenosine in depressing e.j.p. amplitude was the same in the two groups. 5 Naloxone did not change the resting membrane potential in cells from either group of mice. In morphine-pretreated mice, naloxone caused a marked increase in the amplitude of the evoked e.j.p. 6 The EC50 for noradrenaline in causing a contractile response of the isolated vas deferens was the same in both groups of mice. 7 The results indicate that changes in postsynaptic sensitivity to transmitter do not occur following morphine pretreatment.

A study of the role of cyclic adenosine 3',5'-monophosphate in the depression by opiates and opioid peptides of excitatory junction potentials in the mouse vas deferens.

1 Excitatory junction potentials (e.j.ps) were recorded with intracellular microelectrodes from smooth muscle cells of the mouse isolated vas deferens. The amplitude of the e.j.p. was used as a measure of transmitter release evoked by applying single pulse stimuli to the intramural nerves. 2 Cyclic adenosine 3',5'-monophosphate (cyclic AMP) and dibutyryl cyclic AMP (db cyclic AMP, up to 1 mM) depressed the amplitude of e.j.ps, probably by interacting with extracellular sites on the nerve terminals, similar to those responsive to adenosine. 3 The phosphodiesterase inhibitors, 1-methyl-3-isobutyl xanthine (IBMX) and 1-ethyl-4-hydrazino-1H-pyrazolo(3,4-b)pyridine-5-carboxylic acid, ethylester, hydrochloride (SQ20,006) increased e.j.p. amplitude; this increase was much greater when the phosphodiesterase inhibitor was applied together with db cyclic AMP. 4 Neither the cyclic nucleotides nor the phosphodiesterase inhibitors altered the resting membrane potential of smooth muscle cells. 5 The amplitude of the e.j.p. was depressed by normorphine, D-Ala2-Met5-enkephalinamide (DAEA) and D-Ala2-D-Leu5-enkephalin (DADL) with respective EC50s of 560 nM, 49 nM and 510 pM. 6 There was no change in the EC50 for normorphine in the presence of cyclic AMP (1 mM) or in the presence of a combination of IBMX (50 microM) and db cyclic AMP (500 microM). Similarly, the depression of the e.j.p. by DAEA or DADL was not affected by the combination IBMX (500 microM) and db cyclic AMP (250 microM). 7 These findings provide evidence against the hypothesis that a reduction in cyclic AMP levels in nerve terminals is an essential step in the inhibition by opiates and opioid peptides of transmitter release.