Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: EC:5.99.1.2 (topoisomerase)
 9,166 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The camptothecin derivative 7-ethyl-10-[4-(1-piperidino)-1-piperidino]-carbonyloxy camptothecin (CPT-11) has attracted the attention of clinicians because of its high antitumor activity against refractory solid cancers. We established two CPT-11-resistant cell lines, a non-small-cell lung-cancer cell line (PC-7/CPT-11) from the parental PC-7 line and an ovarian cancer cell line (HAC-2/CPT-11) from the parental HAC-2 line. The mechanisms of resistance to CPT-11 in PC-7/CPT-11 cells were reduced conversion of CPT-11 to its active metabolite SN-38 and point mutation topoisomerase I. Those in HAC-2/CPT-11 cells were reduction of topoisomerase I activity and decreased sensitivity of topoisomerase to topoisomerase I inhibitors. No point mutation of the topoisomerase was observed in HAC-2/CPT-11 cells. We conducted two phase I trials using CPT-11 in combination with other anticancer agents. One was a phase I trial of CPT-11 and cisplatin given with a fixed dose of vindesine to patients with advanced non-small-cell lung-cancer and the other was a phase I study on a topoisomerase-targeting combination of CPT-11 and etoposide (VP-16) in patients with various malignant solid tumors. The results of the first trial indicated that the recommended dose of CPT-11 for phase II studies was 80 mg/m2 combined with 3 mg/m2 vindesine on days 1 and 8 and 60 mg/m2 cisplatin on day 1. In the second trial, the recommended dose of CPT-11/VP-16 given with recombinant granulocyte colony-stimulating factor (on days 4-17) was found to be 60/60 mg/m2. In both trials, diarrhea and granulocytopenia were considered to be dose-limiting toxicities.
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PMID:7-Ethyl-10-[4-(1-piperidino)-1-piperidino] carbonyloxy camptothecin: mechanism of resistance and clinical trials. 807 19

The topoisomerase-1 inhibitor, topotecan, was tested in 48 eligible patients with advanced colorectal cancer. The patients had no prior chemotherapy and a Southwest Oncology Group performance status of 0-2. Topotecan was administered intravenously at 1.5 mg/m2/day for five days and repeated every 21 days. The major toxicity was hematologic with 19 out of 48 (40%) patients having grade IV granulocytopenia and 4 out of 48 (8%) patients demonstrating grade IV thrombocytopenia. Two patients (4%) demonstrated partial response. Thirty patients have died and the Kaplan-Meier estimate of median survival is 9 months (95% confidence interval; 7-16 months). Topotecan in this dose and schedule does not appear active in patients with advanced colorectal cancer.
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PMID:Phase II evaluation of topotecan in patients with advanced colorectal cancer. A Southwest Oncology Group trial (SWOG 9241). 954 79

Inhibitors of topoisomerase I and topoisomerase II have demonstrated synergy when administered sequentially in several tumor models while having a diminished antitumor effect when given concurrently. To explore the potential for clinical sequence-dependent synergy, we instituted a Phase I study of topotecan (a topoisomerase I inhibitor) followed by doxorubicin (a topoisomerase II inhibitor) in patients with advanced malignancies. Thirty-three patients with advanced malignancies or malignancies for whom no standard therapy exists were entered into the study. Topotecan was administered in escalating doses by 72-h continuous infusion on days 1, 2, and 3, followed by a bolus of doxorubicin given on day 5. To explore the hematological toxicity associated with this sequence, bone marrow aspirates were obtained both prior to the topotecan infusion and immediately prior to the doxorubicin in 10 patients to determine by fluorescence-activated cell sorting analysis whether CD34+ cell synchronization was occurring using this sequential schedule. Dose-limiting hematological toxicity occurred at the first dose-level in three of six patients. Therefore, we defined the maximum-tolerated dose (MTD) below our starting dose-level. Further dose-escalation and a new MTD were defined with the addition of granulocyte-colony stimulating factor (G-CSF). The MTD was, therefore, topotecan 0.35 mg/m2/day continuous i.v. infusion on days 1, 2, and 3, followed by doxorubicin 45 mg/m2 on day 5 without G-CSF, whereas the MTD with G-CSF was topotecan 0.75 mg/m2/day by 72-h continuous i.v. infusion, followed by doxorubicin 45 mg/m2 i.v. bolus on day 5. Ten patients with paired bone marrow aspirates obtained before topotecan and before doxorubicin administrations were available for evaluation. In 7 of 10 patients, there was an increase (16.6 +/- 2.9% to 25.0 +/- 3.5%; P < 0.02) in the proportion of CD34+ cells in S-phase 24 h after the topotecan infusion and prior to doxorubicin compared to the pretreatment values, whereas 1 patient had a decrease in the proportion of CD34+ cells in S phase and 2 patients had no change. Topotecan and doxorubicin with this sequence and schedule can be given safely; the dose-limiting toxicity is hematological toxicity. Alterations in the fraction of hematopoietic progenitor CD34+ cells in S-phase may account for the increased granulocytopenia and thrombocytopenia observed at relatively low dose levels of the combination with and without G-CSF.
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PMID:A phase I study of topotecan followed sequentially by doxorubicin in patients with advanced malignancies. 981 46

Tests for chromosomal damage are indispensable in the genotoxicity testing battery. Thus, positive results of clastogenicity or aneugenicity tests are of key relevance in safety assessment and product development. Schultz and Onfelt [N. Schultz, A. Onfelt, Sensitivity of cytokinesis to hydrophobic interactions. Chemical induction of bi- and multi-nucleated cells, Chem. Biol. Interact. 126 (2000) 97-123.] have studied the chemical induction of bi- and multi-nucleated cells in Chinese hamster V79 cells and compared non-specific agents with inducers acting through a known specific mechanism. They separated compounds with a specific action from those with a non-specific action based on lipophilicity, following a theory of hydrophobic interactions with processes of cytokinesis. It appeared possible to broaden the original database of this concept to include aneugenic as well as clastogenic compounds studied in the micronucleus (MN) test. The datasets used for this purpose were (A) the original dataset of Schultz and Onfelt [N. Schultz, A. Onfelt, Sensitivity of cytokinesis to hydrophobic interactions. Chemical induction of bi- and multi-nucleated cells, Chem. Biol. Interact. 126 (2000) 97-123.], and two sets (B, C) of our own data from studies in V79 cells in vitro. As the particular endpoints used were different (A: counts of bi- and multi-nucleated cells, B/C: micronucleus counts) the coherence of the experimental data sets was validated by including compounds belonging to both collections. Data set B included compounds with a specific effect on the mitotic spindle (nitrobenzene and benzonitrile) and data set C included the phytoestrogens genistein and daidzein, as well as a number of hormonal steroids with unknown mode of action. Taking all three data sets (A, B, C) together, the 33 compounds investigated covered a total lipophilicity range of logP between -0.51 (diamide) and 5.65 (17alpha-propylmesterolone). In order to separate statistical outliers (with a specific mode of action to be likely) from the large cluster of compounds with non-specific genotoxicity related to hydrophobic interactions, the method of robust regression was applied. It appeared that all compounds with a specific mode of action were in fact outliers of the lipophilicity rule. Genistein, a weak clastogen causing chromosomal aberrations and being discussed to induce topoisomerase-2 mediated DNA breaks, came close to the statistical borderline between compounds with specific and non-specific chromosomal genotoxicity. A general procedure is proposed, applicable in chemical product development, to screen specific and non-specific modes of action.
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PMID:Proposed criteria for specific and non-specific chromosomal genotoxicity based on hydrophobic interactions. 1729 61