Purpose: The study aimed to assess the pharmacokinetic behavior of satraplatin under fasted and fed conditions, and its safety and preliminary antitumor activity in adults with advanced solid tumors. Experimental Design: Satraplatin was administered orally at 80 mg/m 2 once daily with prophylactic antiemetics for 5 consecutive days every 5 weeks. Patients were randomized to receive day 1 and day 5 doses of satraplatin in either the fed or fasted state, the order being reversed for cycle 2. Pharmacokinetic sampling was done during the first two cycles. For all subsequent cycles, patients received satraplatin in the fasted state. Results: Seventeen patients were treated with 60 total cycles of satraplatin. There was no dose-limiting toxicity during cycle 1. Severe hematologic toxicity was rare and the hematologic nadir occurred during week 4. Nausea, vomiting, and diarrhea were grade 1/2. No significant cardiac, renal, hepatic, or neurologic toxicity was observed. The hypothesis that food decreased ultrafiltrate platinum bioavailability could not be rejected, as the lower limit of the 90% confidence intervals for peak plasma concentration and area under the concentration-time curve from time 0 to 24 hours were 56.14% and 73.53%, respectively, both below the 80% bioequivalence acceptance criterion. One partial response (hormone refractory prostate cancer) and four durable stable diseases (breast, ovarian, parotid, and hormone refractory prostate cancer) were confirmed. Conclusions: There is an effect of food on the pharmacokinetics of satraplatin, the clinical significance of which is unclear. It is recommended that satraplatin be administered in the fasting state. This 5-week interval schedule of satraplatin was well tolerated in heavily pretreated patients.Platinum analogs form the mainstay of treatment for a number of cancers, including bladder, head and neck, lung, ovarian, and testicular cancer, and a usual first option against colorectal and esophagogastric cancer. All approved platinum anticancer drugs are administered i.v., with aggressive hydration to avoid acute nephrotoxicity in the case of cisplatin (1, 2). In addition, their efficacy is often limited by cumulative toxicity, particularly neurotoxicity and ototoxicity (1,3,4). Satraplatin [bisacetatoammine-dichloro-cyclohexylamine-platinum(IV)] is a novel, orally bioavailable, platinum agent (5). It was selected from a series of oral platinum compounds because of promising preclinical features including in vitro antitumor activity, in vivo antitumor activity at least comparable with cisplatin and carboplatin in a diversity of murine and human tumor models, and finally its ability to partially circumvent intrinsic and acquired resistance to cisplatin (5-12).When satraplatin was administered every three to four weeks, nonlinear pharmacokinetics, probably due to saturable absorption, were observed (13,14). Subsequently, a daily schedule for five consecutive days was developed, with the dose utilized for phase II and III studies varying between 100 ...