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Human & Experimental Toxicology
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Acute and repeat-dose toxicity studies of the (6-maleimidocaproyl)hydrazone derivative of doxorubicin (DOXO-EMCH), an albumin-binding prodrug of the anticancer agent doxorubicin

F Kratz

Tumor Biology Center, Breisacher Straße 117, 79106 Freiburg, Germany, felix{at}tumorbio.uni-freiburg.de

G Ehling

Aventis Pharma Deutschland GmbH, 65795 Hattersheim, Germany

H-M Kauffmann

Aventis Pharma Deutschland GmbH, 65795 Hattersheim, Germany

C Unger

Tumor Biology Center, Breisacher Straße 117, 79106 Freiburg, Germany

The (6-maleimidocaproyl)hydrazone derivative of doxorubicin (DOXO-EMCH) is an albumin-binding prodrug of doxorubicin with acid-sensitive properties that demonstrates superior antitumor efficacy in murine tumor models, and has been evaluated in a phase I study. In order to establish the toxicity profile of this prodrug, acute and repeat-dose toxicity studies were performed with DOXO-EMCH in CD1-mice, Sprague-Dawley rats and Beagle dogs. Although the objective of the acute toxicity studies was not the determination of LD50 values, the LD50 of DOXO-EMCH was >60mg/kg doxorubicin equivalents in both male and female mice (the LD50 of doxorubicin in CD-1 mice is ~12 mg/kg). In Sprague-Dawley rats, the LD50 was 23.4 and 45.9 mg/kg doxorubicin equivalents for males and females, respectively. For comparison, the LD50 of doxorubicin in Sprague-Dawley rats is ~10.5 mg/kg. The major clinical sign noted following intravenous administration of DOXOEMCH in mice and rats was a dose-dependent peripheral neuropathy which, in general, developed as a delayed toxicity 1-3 weeks after application. The observed neurotoxicity has been well documented for Sprague-Dawley rats treated with doxorubicin at a dose of 5 and 10 mg/kg. In Beagle dogs, LD10 was not reached for DOXO-EMCH at 4.5 mg/kg doxorubicin equivalents. A four-cycle intravenous study with DOXO-EMCH at dose levels of 4x2.5, 5.0 or 7.5 mg/kg doxorubicin equivalents in rats revealed approximately three-fold less side effects on the hemolymphoreticular system when compared to 4x2.5 mg/kg doxorubicin dose, whereas effects on the testes/oligospermia seem to be comparable between both drugs at equitoxic dose. A No Observable Adverse Effect Level (NOAEL) for DOXO-EMCH of 4x2.5 mg/kg doxorubicin equivalents was established in this study. This dose is equivalent to the maximum tolerated dose (MTD) of doxorubicin in rats. In a two-cycle study over a period of 6 weeks in Beagle dogs (intravenous administration of DOXO-EMCH at dose levels of 1.5, 3.0 or 4.5 mg/kg doxorubicin equivalents), dose-related systemic histamine-like reactions within the first 3 hours after injection were noted in all treated groups. Only transient and temporary effects on hematology, urinary function, as well as on histopathology in mid- and/or high-dose animals, were observed. The low dose of 2x1.5 mg/kg was considered to be the NOAEL in this study, which is equivalent to twice the MTD of doxorubicin in Beagle dogs. In summary, the toxicity studies with DOXO-EMCH in mice, rats or dogs have not identified any other special toxicity when compared to the toxicity data for doxorubicin. Preclinical tolerance of DOXO-EMCH was higher in mice, rats and dogs compared to doxorubicin. A dose of 20 mg/m2 doxorubicin equivalents was recommended as the starting dose for a phase I study with DOXO-EMCH.

Key Words: doxorubicin • human serum albumin • (6-maleimidocaproyl)hydrazone derivative of doxorubicin • prodrug • toxicity

Human & Experimental Toxicology, Vol. 26, No. 1, 19-35 (2007)
DOI: 10.1177/0960327107073825


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Home page
Clin. Cancer Res.Home page
C. Unger, B. Haring, M. Medinger, J. Drevs, S. Steinbild, F. Kratz, and K. Mross
Phase I and Pharmacokinetic Study of the (6-Maleimidocaproyl)Hydrazone Derivative of Doxorubicin
Clin. Cancer Res., August 15, 2007; 13(16): 4858 - 4866.
[Abstract] [Full Text] [PDF]



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