Oral gossypol in the treatment of patients with refractory metastatic breast cancer: A phase I/II clinical trial Journal Article


Authors: Van Poznak, C.; Seidman, A. D.; Reidenberg, M. M.; Moasser, M. M.; Sklarin, N.; Van Zee, K.; Borgen, P.; Gollub, M.; Bacotti, D.; Yao, T. J.; Bloch, R.; Ligueros, M.; Sonenberg, M.; Norton, L.; Hudis, C.
Article Title: Oral gossypol in the treatment of patients with refractory metastatic breast cancer: A phase I/II clinical trial
Abstract: Gossypol has demonstrated in vitro effects on cell cycle regulation and anti-tumor activity against mammary carcinoma cell lines. This Phase I/II study assesses both the effect of gossypol on cell cycle regulatory proteins in vivo and the clinical effect. Twenty women with refractory metastatic breast cancer received oral gossypol at daily doses between 30 and 50 mg per day. Gossypol plasma levels were measured (n = 8) and the modulation of the retinoblastoma (Rb) gene protein and Cyclin D1 was assessed by serial biopsies (n = 4). Grade I-II toxicities with gossypol treatment included nausea in 30% of patients, fatigue 15%, emesis 15%, altered taste sensation 15% and diarrhea in 10% of patients. Two of the three patients receiving 50 mg/day experienced dose limiting dermatologic toxicity (grade III). One patient had a minor response and two patients had stable disease with > 50% decline in serial assessments of the serum tumor markers. Immunohistochemical analysis of cyclin D1 and Rb expression in serial biopsies of four patients revealed both a concurrent decrease in cyclin D1 expression and an increase in nuclear Rb expression in three patients. The maximal tolerated dose (MTD) of gossypol was 40 mg/day. Gossypol appears to affect the expression of Rb protein and cyclin D1 in breast cancer metastases at doses achievable, yet had negligible antitumor activity against anthracycline and taxane refractory metastatic breast cancer. The cell cycle regulatory effects of gossypol suggest a potential role for gossypol as a modulating agent in conjunction with other cell cycle specific compounds.
Keywords: immunohistochemistry; adult; clinical article; treatment outcome; aged; middle aged; clinical trial; drug activity; fatigue; skin toxicity; cancer grading; cell cycle; metastasis; breast cancer; nausea; antineoplastic activity; drug effect; dose-response relationship, drug; drug resistance, neoplasm; breast neoplasms; breast carcinoma; drug blood level; taxane derivative; anthracycline; cyclin d1; administration, oral; retinoblastoma protein; carcinoma cell; gossypol; taste disorders; humans; human; female; priority journal; article; novel chemotherapeutics; retinoblastoma gene product
Journal Title: Breast Cancer Research and Treatment
Volume: 66
Issue: 3
ISSN: 0167-6806
Publisher: Springer  
Date Published: 2001-04-01
Start Page: 239
End Page: 248
Language: English
DOI: 10.1023/a:1010686204736
PUBMED: 11510695
PROVIDER: scopus
DOI/URL:
Notes: Export Date: 21 May 2015 -- Source: Scopus
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. Mark M Moasser
    56 Moasser
  2. Andrew D Seidman
    318 Seidman
  3. Clifford Hudis
    905 Hudis
  4. Larry Norton
    759 Norton
  5. Nancy T Sklarin
    54 Sklarin
  6. Marc J Gollub
    209 Gollub
  7. Kimberly J Van Zee
    293 Van Zee
  8. Tzy-Jyun Yao
    59 Yao
  9. Patrick I Borgen
    253 Borgen
  10. Renny J Bloch
    2 Bloch