A Phase II trial of suramin monthly × 3 for hormone‐refractory prostate carcinoma

Abstract

BACKGROUND The goal of the current study was to determine the prostate‐specific antigen (PSA) and objective response rates and the pharmacokinetics associated with a monthly × 3 one‐hour infusion of suramin in 58 patients with hormone‐refractory prostate carcinoma. METHODS A PSA response was defined as a > 50% reduction in the PSA level from baseline for at least 3 consecutive evaluations over a minimum of 6 weeks. The suramin dose was 2400 mg/m2 taken intravenously on Day 1, 1620 mg/m2 on Day 29, and 1292 mg/m2 on Day 57. All patients received 0.5 mg dexamethasone twice daily. RESULTS Among 56 evaluable patients (median entry PSA level, 229.5 ng/mL), there were 21 PSA responders (37.5%). Among 27 patients with measurable disease, there were 5 responders (4 partial and 1 complete). The median overall survival time was 15.3 months. Grade III fatigue (14.1%) was the predominant toxicity observed. Suramin plasma levels remained high even 3 months after treatment was discontinued. Among the 12 evaluable patients who previously had received chemotherapy, the PSA response rate was 42%; one response was observed among 4 patients with measurable disease, and the median survival was 12 months. CONCLUSIONS Monthly bolus suramin was well tolerated, reduced PSA levels, and induced objective responses, even in patients who previously had received chemotherapy. Cancer 2004;100:65–71. © 2003 American Cancer Society.

Suramin Inhibits Renal Fibrosis in Chronic Kidney Disease

“…29,30 Suramin has been used to treat prostate and breast cancers in clinical settings. 31,32 Recent experimental studies showed that it is also effective in attenuating muscle and liver fibrosis. 33,34 However, it remains unclear whether suramin has an antifibrotic effect in the kidney.…”

Suramin augments the antitumor and antimetastatic activity of pentoxifylline in B16F10 melanoma

“…It is in clinical trials for some metastatic cancers such as renal, prostate carcinomas and lymphomas, but has not been considerably successful because of its broad spectrum of toxicity. 17,18 Therefore current studies use suramin in low concentrations as a sensitizer or to reverse b FGFinduced chemoresistance.…”

“…It is in clinical trials for some metastatic cancers such as renal, prostate carcinomas and lymphomas, but has not been considerably successful because of its broad spectrum of toxicity. 17,18 Therefore current studies use suramin in low concentrations as a sensitizer or to reverse b FGFinduced chemoresistance. 19 Many preclinical and clinical trials are also being carried out where suramin is being combined with other compounds to reduce its effective concentration and overall toxicity.…”

Suramin protects from cisplatin-induced acute kidney injury.

“…More importantly, suramin is currently being pursued for the treatment of many cancers as a single agent and in combination therapy with many anti-cancer chemotherapeutic agents including cisplatin (56)(57)(58)(59). Our data also indicate that suramin does not inhibit cisplatin's cytotoxic efficacy.…”