Document Detail

Phase I/II study of pegylated arginine deiminase (ADI-PEG 20) in patients with advanced melanoma.
MedLine Citation:
PMID:  22864522     Owner:  NLM     Status:  MEDLINE    
Background Arginine deiminase (ADI) is an enzyme that degrades arginine, an amino acid that is important for growth and development of normal and neoplastic cells. Melanoma cells are auxotrophic for arginine, because they lack argininosuccinatesynthetase (ASS), a key enzyme required for the synthesis of arginine. Patients and methods Patients with advanced melanoma were treated with 40, 80 or 160 IU/m(2) ADI-PEG 20 i.m. weekly. Primary endpoints were toxicity and tumor response, secondary endpoints included metabolic response by (18)FDG-PET, pharmacodynamic (PD) effects upon circulating arginine levels, and argininosuccinate synthetase tumor expression by immunohistochemistry. Results 31 previously treated patients were enrolled. The main toxicities were grade 1 and 2 adverse events including injection site pain, rash, and fatigue. No objective responses were seen. Nine patients achieved stable disease (SD), with 2 of these durable for >6 months. Four of the 9 patients with SD had uveal melanoma. PD analysis showed complete plasma arginine depletion in 30/31 patients by day 8. Mean plasma levels of ADI-PEG 20 correlated inversely with ADI-PEG 20 antibody levels. Immunohistochemical ASS expression analysis in tumor tissue was negative in 24 patients, whereas 5 patients had <5 % cells positive. Conclusions ADI-PEG 20 is well tolerated in advanced melanoma patients and leads to consistent, but transient, arginine depletion. Although no RECIST responses were observed, the encouraging rate of SD in uveal melanoma patients indicates that it may be worthwhile to evaluate ADI-PEG 20 in this melanoma subgroup.
Patrick A Ott; Richard D Carvajal; Neeta Pandit-Taskar; Achim A Jungbluth; Eric W Hoffman; Bor-Wen Wu; John S Bomalaski; Ralph Venhaus; Linda Pan; Lloyd J Old; Anna C Pavlick; Jedd D Wolchok
Publication Detail:
Type:  Clinical Trial, Phase I; Clinical Trial, Phase II; Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-08-05
Journal Detail:
Title:  Investigational new drugs     Volume:  31     ISSN:  1573-0646     ISO Abbreviation:  Invest New Drugs     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-03-06     Completed Date:  2013-09-24     Revised Date:  2014-10-15    
Medline Journal Info:
Nlm Unique ID:  8309330     Medline TA:  Invest New Drugs     Country:  United States    
Other Details:
Languages:  eng     Pagination:  425-34     Citation Subset:  IM    
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MeSH Terms
Aged, 80 and over
Cohort Studies
Dose-Response Relationship, Drug
Follow-Up Studies
Hydrolases / pharmacokinetics,  therapeutic use*
Immunoenzyme Techniques
Maximum Tolerated Dose
Melanoma / drug therapy*,  metabolism,  pathology
Middle Aged
Neoplasm Staging
Polyethylene Glycols / pharmacokinetics,  therapeutic use*
Skin Neoplasms / drug therapy*,  metabolism,  secondary
Survival Rate
Tissue Distribution
Uveal Neoplasms / drug therapy*,  metabolism,  secondary
Grant Support
Reg. No./Substance:
0/Polyethylene Glycols; EC 3.-/Hydrolases; EC PEG20

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