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Pharmacokinetics, Metabolism, and Routes of Excretion of Intravenous Irofulven in Patients with Advanced Solid Tumors

Unité Propre de Recherche et de l'Enseignement Supérieur, Equipe d'Accueil 3535, Pharmacology and New Treatments of Cancer, l'Institut Fédératif de Recherches 54, Institute Gustave Roussy, Villejuif, France (A.P., M.R., G.V.); Pharmacology Laboratory, Centre René Huguenin, Saint-Cloud, France (K.R., S.W., F.L.); Mass Spectrometry Platform, l'Institut Fédératif de Recherches 54, Institute Gustave Roussy, Villejuif, France (A.D.); Chemotherapy Unit, Institut Jules Bordet, Brussels, Belgium (D.D.V.); Cvitkovic and Cvitkovic, Kremlin Bicètre, France (E.C., C.K.); and MGI Pharma, Bloomington, Minnesota (A.S., S.W., G.W.)

Irofulven is currently in Phase 2 clinical trials against a wide variety of solid tumors and has demonstrated activity in ovarian, prostate, gastrointestinal, and non–small cell lung cancer. The objectives of this study were to determine its pharmacokinetics and route of excretion and to characterize its metabolites in human plasma and urine samples after a 30-min i.v. infusion at a dose of 0.55 mg/kg in patients with advanced solid tumors. Three patients were administered i.v. 100 µCi of [¹⁴C]irofulven over a 30-min infusion on day 1 of cycle 1. Serial blood and plasma samples were drawn at 0 (before irofulven infusion) and up to 144 h after the start of infusion. Urine and fecal samples were collected for up to 144 h after the start of infusion. The mean urinary and fecal excretion of radioactivity up to 144 h were 71.2 and 2.9%, respectively, indicating renal excretion was the major route of elimination of [¹⁴C]irofulven. The C_max, AUC_0-, and terminal half-life values for total radioactivity were 1130 ng-Eq/ml, 24,400 ng-Eq · h/ml, and 116.5 h, respectively, and the corresponding values for irofulven were 82.7 ng/ml, 65.5 ng · h/ml, and 0.3 h, respectively, suggesting that the total radioactivity in human plasma was a result of the metabolites. Twelve metabolites of irofulven were detected in human urine and plasma by electrospray ionization/tandem mass spectrometry. Among these metabolites, the cyclopropane ring-opened metabolite (M₂) of irofulven was found, and seven others were proposed as glucuronide and glutathione conjugates.