Phase I trial of an oral immunomodulator and interferon inducer in cancer patients. Cancer Res 1993 Nov 01;53(21):5176-80
Date
11/01/1993Pubmed ID
8221654Scopus ID
2-s2.0-0027420347 (requires institutional sign-in at Scopus site) 78 CitationsAbstract
Imiquimod [1-(2-methylpropyl)-1H-imidazo[4,5c]quinolin-4-amine] is a compound of low molecular weight that, when administered p.o., induces interferon-alpha in several animal species and inhibits tumor growth in mice. To determine maximum tolerated dose, toxicity, and biological response in humans, a phase I clinical trial was conducted with 14 eligible cancer patients who received 100-500 mg imiquimod p.o. either once or twice weekly. Imiquimod induced interferon-alpha in serum in 10 of 19 doses of 200-300 mg. Interferon serum levels peaked 8-24 h after treatment and reached a maximum of 23,000 IU/ml in one patient. Significant mean increases (P < 0.01) in serum beta 2-microglobulin (1.5-fold), serum neopterin (3.5-fold), and 2-5A synthetase activity in peripheral blood mononuclear cells (7.9-fold) indicated that 200-300 mg imiquimod had biological and immunological activity in all evaluable patients. Increases in serum interferon, beta 2-microglobulin, and neopterin correlated significantly with dose (P < 0.001). No patient developed measurable antibody to interferon-alpha. Dose-limiting side effects included fatigue, malaise, fever, headache, and lymphocytopenia; no hepatic or renal toxicity or other hematological changes exceeded the normal range. Patients tolerated weekly doses of up to 500 mg, with the longest treatment lasting 4 weeks at 200 mg weekly. Twice-weekly doses up to to 300 mg were tolerated, with the longest twice-weekly treatments being 200 mg for 9 weeks and 100 mg for 25 weeks. No clinical responses were observed. Imiquimod, as an oral inducer of interferon, may have therapeutic usefulness in human cancers, viral infections, and other diseases. However, before initiation of phase II trials, additional work will be required to establish a tolerated dose and schedule for continued administration.
Author List
Witt PL, Ritch PS, Reding D, McAuliffe TL, Westrick L, Grossberg SE, Borden ECAuthor
Timothy L. McAuliffe PhD Professor in the Psychiatry and Behavioral Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
2',5'-Oligoadenylate SynthetaseAdministration, Oral
Aminoquinolines
Autoantibodies
Drug Administration Schedule
Drug Monitoring
Humans
Interferon Inducers
Interferon-alpha
Neoplasm Staging
Neoplasms
Neopterin
Tumor Necrosis Factor-alpha
beta 2-Microglobulin
