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Phase I trial of O6-benzylguanine for patients undergoing surgery for malignant glioma.

Publication ,  Journal Article
Friedman, HS; Kokkinakis, DM; Pluda, J; Friedman, AH; Cokgor, I; Haglund, MM; Ashley, DM; Rich, J; Dolan, ME; Pegg, AE; Moschel, RC; Kerby, T ...
Published in: J Clin Oncol
November 1998

PURPOSE: The major mechanism of resistance to alkylnitrosourea therapy is the DNA repair protein O6-alkylguanine-DNA alkyltransferase (AGT), which removes chlorethylation or methylation damage from the O6-position of guanine. O6-benzylguanine (O6-BG) is an AGT substrate that inhibits AGT by suicide inactivation. We conducted a phase I trial to define the presurgical dose required for depletion of tumor AGT activity in patients with malignant glioma. MATERIALS AND METHODS: Patients were to be treated 18 hours before craniotomy with intravenous doses that ranged between 40 and 100 mg/m2 given over 1 hour. Resected tumor was snap-frozen in liquid nitrogen and AGT activity analyzed by high-pressure liquid chromatography (HPLC). Up to 13 patients were treated at a specific dose of O6-BG, with a target end point of > or = 11 of 13 patients with undetectable tumor AGT levels (< 10 fmol/mg protein). RESULTS: Thirty patients with malignant gliomas were enrolled, with 11 of 11 patients treated at 100 mg/m2 O6-BG demonstrating tumor AGT levels less than 10 fmol/mg protein. No toxicity was noted in any patient treated. CONCLUSION: These results indicate that 100 mg/m2 of O6-BG can maintain tumor AGT levels less than 10 fmol/mg protein for at least 18 hours after treatment, a time interval in which bis(2-chloroethyl)nitrosourea (BCNU)-induced chloroethyl adducts are fully converted into interstrand cross-links. A 100-mg/m2 dose of O6-BG will be used in combination with BCNU in another phase I trial designed to determine the maximal-tolerated dose of BCNU.

Duke Scholars

Published In

J Clin Oncol

DOI

ISSN

0732-183X

Publication Date

November 1998

Volume

16

Issue

11

Start / End Page

3570 / 3575

Location

United States

Related Subject Headings

  • Preoperative Care
  • Oncology & Carcinogenesis
  • O(6)-Methylguanine-DNA Methyltransferase
  • Middle Aged
  • Humans
  • Guanine
  • Glioblastoma
  • Enzyme Inhibitors
  • Brain Neoplasms
  • Aged
 

Citation

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MLA
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Friedman, H. S., Kokkinakis, D. M., Pluda, J., Friedman, A. H., Cokgor, I., Haglund, M. M., … Schold, S. C. (1998). Phase I trial of O6-benzylguanine for patients undergoing surgery for malignant glioma. J Clin Oncol, 16(11), 3570–3575. https://doi.org/10.1200/JCO.1998.16.11.3570
Friedman, H. S., D. M. Kokkinakis, J. Pluda, A. H. Friedman, I. Cokgor, M. M. Haglund, D. M. Ashley, et al. “Phase I trial of O6-benzylguanine for patients undergoing surgery for malignant glioma.J Clin Oncol 16, no. 11 (November 1998): 3570–75. https://doi.org/10.1200/JCO.1998.16.11.3570.
Friedman HS, Kokkinakis DM, Pluda J, Friedman AH, Cokgor I, Haglund MM, et al. Phase I trial of O6-benzylguanine for patients undergoing surgery for malignant glioma. J Clin Oncol. 1998 Nov;16(11):3570–5.
Friedman, H. S., et al. “Phase I trial of O6-benzylguanine for patients undergoing surgery for malignant glioma.J Clin Oncol, vol. 16, no. 11, Nov. 1998, pp. 3570–75. Pubmed, doi:10.1200/JCO.1998.16.11.3570.
Friedman HS, Kokkinakis DM, Pluda J, Friedman AH, Cokgor I, Haglund MM, Ashley DM, Rich J, Dolan ME, Pegg AE, Moschel RC, McLendon RE, Kerby T, Herndon JE, Bigner DD, Schold SC. Phase I trial of O6-benzylguanine for patients undergoing surgery for malignant glioma. J Clin Oncol. 1998 Nov;16(11):3570–3575.

Published In

J Clin Oncol

DOI

ISSN

0732-183X

Publication Date

November 1998

Volume

16

Issue

11

Start / End Page

3570 / 3575

Location

United States

Related Subject Headings

  • Preoperative Care
  • Oncology & Carcinogenesis
  • O(6)-Methylguanine-DNA Methyltransferase
  • Middle Aged
  • Humans
  • Guanine
  • Glioblastoma
  • Enzyme Inhibitors
  • Brain Neoplasms
  • Aged