Phase 1 trial of levonantradol in chemotherapy-induced emesis Journal Article


Authors: Tyson, L. B.; Gralla, R. J.; Clark, R. A.; Kris, M. G.; Bordin, L. A.; Bosl, G. J.
Article Title: Phase 1 trial of levonantradol in chemotherapy-induced emesis
Abstract: Levonantradol is a synthetic cannabinoid with demonstrated preclinical antiemetic activity. The current phase I trial was undertaken to determine: 1) the maximally tolerated dose; 2) the side effects at the different dosage levels; and 3) to evaluate the antiemetic efficacy of levonantradol in patients receiving emesis-producing chemotherapy. Thirty-four patients received 52 courses of levonantradol. Concurrent chemotherapy most frequently consisted of high dose cisplatin (120 mg/m2), either alone or in combination with other agents. Levonantradol dosage was escalated through seven treatment levels (0.5-4.0 mg per dose) and was given intramuscularly every 4 hours. Toxicity was similar to that observed with other cannabinoids and primarily consisted of dizziness (65%), burning and erythema at the injection site (48%), mild sedation (44%), orthostatic hypotension (37%), dysphoria (29%), and urinary retention (10%). Marked urinary retention occurred in three of seven patients at the 4.0 mg per dose level, and two of 24 patients at either the 2.5 mg and 3.0 mg levels. Major or minor antiemetic responses (0-2 or 3-5 emetic episodes, respectively) occurred in 23% of patients receiving cisplatin and in 53% of patients receiving non-cisplatin containing chemotherapy. Intramuscular levonantradol can be given safely at doses up to 3.0 mg/kg, with toxicity and antiemetic efficacy similar to that observed with other cannabinoids.
Keywords: cancer chemotherapy; clinical article; cisplatin; doxorubicin; drug efficacy; methotrexate; neurotoxicity; vomiting; orthostatic hypotension; sedation; cyclophosphamide; central nervous system; psychological aspect; cardiovascular system; dactinomycin; erythema; drug dose; phase 1 clinical trial; drug therapy; toxicity; urine retention; adverse drug reaction; therapy; urinary tract; bladder; nervous system; intramuscular drug administration; prevention; vertigo; intoxication; dysphoria; injection pain; human; priority journal; levonantradol
Journal Title: American Journal of Clinical Oncology
Volume: 8
Issue: 6
ISSN: 0277-3732
Publisher: Lippincott Williams & Wilkins  
Date Published: 1985-12-01
Start Page: 528
End Page: 532
Language: English
DOI: 10.1097/00000421-198512000-00014
PROVIDER: scopus
PUBMED: 4083271
DOI/URL:
Notes: Article -- Export Date: 26 October 2021 -- Source: Scopus
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MSK Authors
  1. Mark Kris
    869 Kris
  2. George Bosl
    430 Bosl
  3. Leslie Tyson
    70 Tyson
  4. Richard J. Gralla
    69 Gralla
  5. Rebecca Clark
    21 Clark