Randomized, dose-escalation study of SD/01 compared with daily filgrastim in patients receiving chemotherapy

Purpose: To explore the use of SD/01 (a polyethylene glycol-conjugated filgrastim shown in preclinical studies to have a prolonged half-life) in patients with chemotherapy-induced neutropenia. Patients and Methods: Thirteen patients with nonsmall-cell lung cancer were randomized to receive daily filgrastim (5 mu g/kg/d) or a single injection of SD/01 (30, 100, or 300 mu g/kg) 2 weeks before chemotherapy and again 24 hours after administration of carboplatin and paclitaxel. Pharmacodynamic, pharmacokinetic, and safety analyses were performed. Results: Peak serum concentrations of SD/01 and the duration of increased serum concentrations were dependent on the SD/01 dose. SD/01 concentrations remained increased longer in patients with chemotherapy-induced neutropenia. Prechemotherapy median absolute neutrophil counts (ANCs) in patients receiving SD/01 were increased in a dose-dependent fashion, with the duration of this effect also being dose dependent. After chemotherapy, median ANC nadirs were similar in the filgrastim cohort and the cohort receiving SD/01 30 mu g/kg, with higher nadirs seen in the cohorts receiving SD/01 100 or 300 mu g/kg. Dose-limiting toxicities were not noted. CD34(+) cells were mobilized in all cohorts. Conclusion: A single dose of SD/01 increases the serum concentration of SD/01 for several days in a dose-dependent fashion and is not associated with significant toxicity. The effects of SD/01 on ANC and CD34(+) cell mobilization are comparable or greater than those achieved with daily filgrastim. The self-regulation of this molecule provides a potential therapeutic advantage in a variety of clinical settings associated with neutropenia. J Clin Oncol 18:2522-2528. (C) 2000 by American Society of Clinical Oncology.