Anticancer activity of stabilized palifosfamide in vivo: schedule effects, oral bioavailability, and enhanced activity with docetaxel and doxorubicin

Anticancer Drugs. 2012 Feb;23(2):173-84. doi: 10.1097/CAD.0b013e32834d73a6.

Abstract

Palifosfamide, the DNA-alkylating metabolite of ifosfamide (IFOS), has been synthesized as a stabilized tris or lysine salt and found to have preclinical and clinical antitumor activity. Stabilized palifosfamide overcomes limitations of IFOS because of patient-to-patient variability in response resulting from variable prodrug activation, resistance and toxicities of metabolic byproducts, acrolein and chloroacetaldehyde. Palifosfamide represents an effective alternative to IFOS and other DNA-alkylating prodrugs. The antitumor activities of stabilized palifosfamide were investigated in vivo. Dose response, route and schedule of administration, and interaction with docetaxel or doxorubicin were investigated in NCr-nu/nu mice bearing established orthotopic mammary MX-1 tumor xenografts. Oral activity was investigated in P388-1 leukemia in CD2F1 mice. Oral and intraperitoneal bioavailabilities were compared in Sprague-Dawley rats. Stabilized palifosfamide administered by optimized regimens suppressed MX-1 tumor growth (P<0.05) by greater than 80% with 17% complete antitumor responses and up to three-fold increase in time to three tumor doublings over controls. Median survival in the P388-1 (P<0.001) model was increased by 9 days over controls. Oral bioavailability in rats was 48-73% of parenteral administration, and antitumor activity in mice was equivalent by both routes. Treatment with palifosfamide-tris combined with docetaxel or doxorubicin at optimal regimens resulted in complete tumor regression in 62-75% of mice. These studies support investigation of stabilized palifosfamide in human cancers by parenteral or oral administration as a single agent and in combination with other approved drugs. The potential for clinical translation of the cooperative interaction of palifosfamide-tris with doxorubicin by intravenous administration is supported by results from a recent randomized Phase-II study in unresectable or metastatic soft-tissue sarcoma.

MeSH terms

  • Administration, Oral
  • Animals
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / pharmacokinetics
  • Antineoplastic Agents / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / pharmacokinetics
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biological Availability
  • Disease-Free Survival
  • Docetaxel
  • Dose-Response Relationship, Drug
  • Doxorubicin / administration & dosage
  • Doxorubicin / therapeutic use*
  • Drug Administration Schedule
  • Female
  • Ifosfamide / administration & dosage
  • Ifosfamide / analogs & derivatives*
  • Ifosfamide / pharmacokinetics
  • Ifosfamide / therapeutic use
  • Injections, Intravenous
  • Leukemia, Experimental / drug therapy*
  • Lysine / administration & dosage
  • Lysine / analogs & derivatives*
  • Lysine / pharmacokinetics
  • Lysine / therapeutic use
  • Male
  • Mammary Neoplasms, Experimental / drug therapy*
  • Mice
  • Mice, Nude
  • Phosphoramide Mustards / administration & dosage
  • Phosphoramide Mustards / pharmacokinetics
  • Phosphoramide Mustards / therapeutic use*
  • Rats
  • Rats, Sprague-Dawley
  • Taxoids / administration & dosage
  • Taxoids / therapeutic use*
  • Xenograft Model Antitumor Assays

Substances

  • Antineoplastic Agents
  • Phosphoramide Mustards
  • Taxoids
  • palifosfamide lysine
  • Docetaxel
  • isophosphamide mustard
  • Doxorubicin
  • Lysine
  • Ifosfamide