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Blood, 1 April 2007, Vol. 109, No. 7, pp. 2781-2790.
Prepublished online as a Blood First Edition Paper on December 19, 2006; DOI 10.1182/blood-2006-05-021873.
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Submitted May 9, 2006
Accepted November 1, 2006
Phase 1 and pharmacological study of MS-275, a histone deacetylase inhibitor, in adults with refractory and relapsed acute leukemias
Ivana Gojo*, Anchalee Jiemjit, Jane B Trepel, Alex Sparreboom, William D Figg, Sandra Rollins, Michael L Tidwell, Jacqueline Greer, Eun Joo Chung, Min-Jung Lee, Steven D Gore, Edward A Sausville, James Zwiebel, and Judith E Karp
University of Maryland Marlene and Stewart Greenebaum Cancer Center, Baltimore, MD
The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD
National Cancer Institute, Bethesda, MD
* Corresponding author; email: igojo{at}umm.edu.
MS-275 is a benzamide derivative with potent histone deacetylase (HDAC) inhibitory and antitumor activity in preclinical models. We conducted a phase 1 trial of orally administered MS-275 in 39 adults with advanced acute leukemias. Cohorts of patients were treated with MS-275 initially once weekly x 2, repeated every 4 weeks from 4 to 8 mg/m2, and after 13 patients were treated, once weekly x 4, repeated every 6 weeks from 8 to 10 mg/m2. The maximum tolerated dose was 8 mg/m2 at weekly x 4 every 6 weeks schedule. Dose-limiting toxicities (DLTs) included infections and neurologic toxicity manifesting as unsteady gait and somnolence. Other frequent non-DLTs were fatigue, anorexia, nausea, vomiting, hypoalbuminemia, and hypocalcemia. Treatment with MS-275 induced increase in protein and histone H3/H4 acetylation, p21 expression, and caspase-3 activation in bone marrow mononuclear cells. No responses by classical criteria were seen. Our results show that MS-275 effectively inhibits HDAC in vivo in patients with advanced myeloid leukemias and should be further tested preferably in patients with less advanced disease.

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