Summary
Combination chemotherapy regimens have produced a pathological complete response rate of only 1%–25% in patients with advanced ovarian cancer. Patients with small-volume residual disease after treatment are refractory to further systemic therapy, and most eventually die of their disease. Intraperitoneal (i.p.) chemotherapy, particularly with adriamycin or cisplatin has shown promise in these patients. However, the dose-limiting painful peritonitis associated with i.p. adriamycin makes this regimen potentially too toxic for many patients. Aclacinomycin A, another anthracycline antibiotic, has been found to have activity against a wide variety of murine tumors and human xenografts. It has also demonstrated clinical efficacy in phase I and II trials against refractory ovarian cancer and has less pronounced vesicant properties than adriamycin, making it an ideal candidate for i.p. use in ovarian cancer patients. In vitro clonogenic assays utilizing a battery of adriamycin-sensitive and-resistant human ovarian carcinoma cell lines have shown that aclacinomycin a is more cytotoxic than adriamycin in all cell lines tested. In addition, aclacinomycin A was found to prolong survival in a nude mouse xenograft of i.p. human ovarian cancer. These results have provided the experimental rationale for an ongoing clinical trial of i.p. aclacinomycin in refractory ovarian cancer patients at the Medicine Branch, NCI.
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Brukner HW, Cohen CJ, Wallach RC, Kabokow B, Deppe G, Greenspan E, Gusberg SB, Holland JF (1980) Prospective controlled randomized trial comparing combination chemotherapy of advanced ovarian carcinoma with adriamycin and cis-platinum ± cyclophosphamide and hexamethylmelamine. Proc Am Assoc Cancer Res 20: 414
Day TG, Smith JP (1975) Diagnosis and staging of ovarian cancer. Semin Oncol 2: 217
DePaulo GM, DeLena M, Dire F, Luciani L, Valgussa P, Bonadonna G (1975) Melphalan versus adriamycin in advanced ovarian carcinoma. Surg Gynecol Obstet 141: 899
Ehrlich CE, Einhorn L, Williams SD, Morgan J (1979) Chemotherapy for Stage III–IV epithelial ovarian cancer with cis-dichlorodiammineplatinum (II), adriamycin, and cyclophosphamide. Cancer Treat Rep 63: 281
Eva A, Robbins KC, Anderson PR, Srinivasan A, Tronick SR, Reddy EP, Ellmore NW, Galen AT, Lautenberger JA, Papas TS, Westin EH, Wong-Staal F, Gallo RC, Aaronson SA (1982) Cellular genes analagous to retroviral onc genes are transcribed in human tumour cells. Nature 295: 116
Hamilton TC, Young RC, Louie KG, Behrens BC, McKoy WM, Grotzinger KR, Ozols RF (1984a) Characterization of a xenograft model of human ovarian carcinoma which produces ascites and intraabdominal carcinomatosis. Cancer Res 44: 5286
Hamilton TC, Young RC, Ozols RF (1984b) Experimental model systems of ovarian cancer: applications to the design and evaluation of new treatment approaches. Semin Oncol 11: 285
Hori S, Shirai M, Hirano S, Oki T, Invi T, Tsukagoshi S, Ishizuka M, Takeuchi T, Umezawa H (1977) Antitumor activity of new anthracycline antibiotics, aclacinomycin A and its analogs, and their toxicity. Gann 68: 685
Howell SB, Pfeifle L, Wung WE, Olshen RA, Lucas WE, Yon JL, Green M (1982) Intraperitoneal cisplatin with systemic thiosulfate protection. Ann Intern Med 97: 845
Jones RB, Collins JM, Myers CE, Brooks AE, Hubbard SM, Ballow JW, Brennan MF, Dedrick RL, DeVita VT (1981) High volume intraperitoneal chemotherapy with methotrexate in patients with cancer. Cancer Res 41: 55
Luie KG, Behrens BC, Kinsella TJ, Hamilton TC, Grotzinger KR, McKoy WM, Winker MA, Ozols RF (1985) Radiation survival parameters of antineoplastic drug-sensitive and-resistant human ovarian cancer cell lines and their modification by buthionine sulfoximine. Cancer Res 45: 2110
McVie JG, ten Bokkel Huinink WW, Aartson E, Simonetti G, Dubbelman R, Franklin H (1985) Intraperitoneal chemotherapy in minimal residual ovarian cancer with cisplatin and IV sodium thiosulfate protection. Proc Am Soc Clin Oncol 4: 125
Myers CE (1984) The use of intraperitoneal chemotherapy in the treatment of ovarian cancer. Semin Oncol 11: 275
Oki T, Matsuzawa Y, Yoshimoto A, Numata K, Kitamura I, Hori S, Takamatsu A, Umezawa H, Ishizuka M, Naganawa H, Suda H, Hamada M, Takeuchi T (1975) New antitumor antibiotics, aclacinomycin A and B. J Antiobiot (Tokyo) 280: 830
Oki T, Takeuchi T, Oka S, Umezawa H (1980) Current status of Japanese Studies with the new anthracycline antibiotic aclacinomycin A A. Recent Results Cancer Res 74: 207
Oki T, Takeuchi T, Oka S, Umezawa H (1981) New anthracycline antibiotic aclacinomycin A: Experimental studies and correlations with clinical trials. Recent Results Cancer Res 76: 21
Ozols RF, Grotzinger KR, Fisher RI, Myers CE, Young RC (1979a) Kinetic characterization and response to chemotherapy in a transplantable murine ovarian cancer. Res 39: 3202
Ozols RF, Locker GY, Doroshaw JH, Grotzinger KR, Myers CE, Young RC (1979b) Pharmacokinetics of adriamycin and tissue penetration in murine ovarian cancer. Cancer Res 39: 3209
Ozols RF, Willson JKV, Grotzinger KR, Young RC (1980a) Cloning of human ovarian cancer cells in soft agar from malignant effusions and peritoneal washings. Cancer Res 40: 2743
Ozols RF, Willson JKV, Weltz MD, Grotzinger KR, Myers CE, Young RC (1980b) Inhibition of human ovarian cancer colony formation by adriamycin and its major metabolites. Cancer Res 40: 4109
Ozols RF, Young RC, Speyer JL, Sugarbaker PH, Greene R, Jenkins J, Myers CE (1982) Phase I and pharmacological studies of adriamycin administered intraperitoneally to patients with ovarian cancer. Cancer Res 42: 4265
Speyer JL, Collins JM, Dedrick RL, Brennan MF, Louder H, DeVita VT, Myers CE (1980) Phase I and pharmacologic studies of 5-fluorouracil administered intraperitoneally. Cancer Res 40: 567
Vogl SE, Berenweig M, Kaplan BH, Moukhtar M, Bulkin W (1979) The CHAD and HAD regimens in advanced ovarian cancer: Combination chemotherapy including cyclophosphamide, hexamethylmelamine, adriamycin, and cis-dichlorodiammineplatinum (II). Cancer Treat Rep 63: 311
Yamada K, Nakamura T, Tsuruo T, Kitahara T, Maekawa T, Uzaka Y, Kurita S, Masaoka T, Takaku F, Hirota Y, Amaki S, Osamura S, Ito M, Nakano N, Oguro M, Inagaki J, Onozawa K (1980) A phase II study of aclacinomycin A in acute leukemia in adults. Cancer Treat Rev 7: 177
Young RC, Chabner BA, Hubbard SP, Fisher RI, Bender RA, Anderson T, Simon RM, Canellos GP, DeVita VT (1978) Advanced ovarian adenocarcinoma. A prospective trial of melphalan (L-PAM) versus combination chemotherapy. N Engl J Med 299: 1261
Young RC, Howser DM, Myers RC, Ozols RF, Fisher RI, Wesley M, Chabner BA (1981a) Combination chemotherapy (Chex-UP) with intraperitoneal maintenance in advanced ovarian cancer. Proc Am Assoc Cancer Res 22: 465
Young RC, Ozols RF, Myers CE (1981b) The anthracycline antineoplastic drugs. N Engl J Med 305: 139
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Louie, K.G., Hamilton, T.C., Behrens, B.C. et al. Preclinical evaluation of aclacinomycin A for the intraperitoneal treatment of human ovarian carcinoma. Cancer Chemother. Pharmacol. 18, 153–156 (1986). https://doi.org/10.1007/BF00262286
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DOI: https://doi.org/10.1007/BF00262286