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Concentrations of the DNA methyltransferase inhibitor 5-fluoro-2′-deoxycytidine (FdCyd) and its cytotoxic metabolites in plasma of patients treated with FdCyd and tetrahydrouridine (THU)

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Abstract

Purpose

Although the DNA methyltransferase inhibitor 5-fluoro-2′-deoxycytidine (FdCyd), is being evaluated clinically, it must be combined with the cytidine deaminase inhibitor tetrahydrouridine (THU) to prevent rapid metabolism of FdCyd to the pharmacologically active, yet unwanted, metabolites 5-fluoro-2′-deoxyuridine (FdUrd), 5-fluorouracil (FU), and 5-fluorouridine (FUrd). We assessed plasma concentrations of FdCyd and metabolites in patients receiving FdCyd and THU.

Methods

We validated an LC-MS/MS assay, developed for a preclinical study, to quantitate FdCyd and metabolites in human plasma. Patients were treated with five daily, 3-h infusions of FdCyd at doses of 5–80 mg/m2 with 350 mg/m2 THU. Plasma was obtained during, and before the end of infusions on days 1 and 5.

Results

The lower limits of quantitation for FU, FdUrd, FUrd, FC and FdCyd were 1, 1.5, 10, 3, and 10 ng/ml, respectively. Plasma FdCyd increased with dose, from 19–96 ng/ml at 5 mg/m2 to 1,600–1,728 ng/ml at 80 mg/m2. FdUrd was undetectable in patients treated with FdCyd doses <20 mg/m2, and increased from 2.3 ng/ml at 20 mg/m2 to 3.5–5.7 ng/ml at 80 mg/m2. FU increased from 1.2–5.5 ng/ml at 5 mg/m2 to 6.0–12 ng/ml at 80 mg/m2.

Conclusions

By co-administering FdCyd with THU, FdCyd plasma concentrations were achieved that are known to inhibit DNA methylation in vitro. The accompanying plasma FU and FdUrd concentrations are <10% those observed after therapeutic infusions of FU or FdUrd, while FdCyd levels are well above those required to inhibit methylation in vitro. Therefore, inhibition of DNA methylation with FdCyd and THU appears feasible.

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Acknowledgments

We thank the University of Pittsburgh Cancer Institute, Hematology/Oncology Writing Group for constructive suggestions regarding the manuscript.

Author information

Authors and Affiliations

  1. Molecular Therapeutics/Drug Discovery Program, University of Pittsburgh Cancer Institute, Pittsburgh, PA, 15213, USA

    Jan H. Beumer, Robert A. Parise & Merrill J. Egorin

  2. Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, 15213, USA

    Jan H. Beumer

  3. Division of Molecular Medicine, Beckman Research Institute of the City of Hope, 1500 E. Duarte Road, Duarte, CA, 91010, USA

    Edward M. Newman

  4. Division of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, 1500 E. Duarte Road, Duarte, CA, 91010, USA

    Edward M. Newman & Timothy W. Synold

  5. Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD, 20892, USA

    James H. Doroshow

  6. Norris Cancer Center, University of Southern California, Los Angeles, CA, 90033, USA

    Heinz-Josef Lenz

  7. Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15261, USA

    Merrill J. Egorin

  8. Department of Pharmacology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15261, USA

    Merrill J. Egorin

  9. University of Pittsburgh Cancer Institute, Room G.27d, Hillman Research Pavilion, 5117 Centre Avenue, Pittsburgh, PA, 15213-1863, USA

    Jan H. Beumer

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  1. Jan H. Beumer
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  2. Robert A. Parise
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  6. Heinz-Josef Lenz
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  7. Merrill J. Egorin
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Corresponding author

Correspondence to Jan H. Beumer.

Additional information

Grant support: in support of RAID project #266 (Dr. Edward Newman, City of Hope National Medical Center) by NO1-CM-52202, NCI, and by grants P30CA47904, U01 CA62505, and P30CA33572.

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Beumer, J.H., Parise, R.A., Newman, E.M. et al. Concentrations of the DNA methyltransferase inhibitor 5-fluoro-2′-deoxycytidine (FdCyd) and its cytotoxic metabolites in plasma of patients treated with FdCyd and tetrahydrouridine (THU). Cancer Chemother Pharmacol 62, 363–368 (2008). https://doi.org/10.1007/s00280-007-0603-8

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  • DOI: https://doi.org/10.1007/s00280-007-0603-8

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