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University of Kansas Cancer Center, Kansas City, Kansas (S.J.W., R.W., A.E.B., G.A.R., R.A.J., M.J.B., S.A., J.A.T.); Institute for Advancing Medical Innovation (S.J.W., R.W., A.E.B., M.J.B.) and Departments of Cancer Biology (S.J.W., P.R., S.A.), Pharmacology, Toxicology, and Therapeutics (S.J.W., G.A.R.) Pathology (R.A.J.), and Urology (J.A.T.), University of Kansas Medical Center, Kansas City, Kansas; Biotechnology Innovation and Optimization Center, University of Kansas, Lawrence, Kansas (K.S., K.H., L.R., M.T., M.J.B.); School of Pharmacy, Istanbul Kemerburgaz University, Istanbul, Turkey (M.T.); CicloMed LLC, Kansas City, Missouri (T.H.); Navigator LSA, Wilmington, North Carolina (M.J.M.); Alba BioPharm Advisors Inc., Durham, North Carolina (W.M.); and The Gnomon Group, Carrboro, North Carolina (M.D.).
Published: August 2019
AI Article Synopsis
Article Abstract
Pharmacokinetic studies in rats and dogs were performed to characterize the in vivo performance of a novel prodrug, fosciclopirox. Ciclopirox olamine (CPX-O) is a marketed topical antifungal agent with demonstrated in vitro and in vivo preclinical anticancer activity in several solid tumor and hematologic malignancies. The oral route of administration for CPX-O is not feasible due to low bioavailability and dose-limiting gastrointestinal toxicities. To enable parenteral administration, the phosphoryl-oxymethyl ester of ciclopirox (CPX), fosciclopirox (CPX-POM), was synthesized and formulated as an injectable drug product. In rats and dogs, intravenous CPX-POM is rapidly and completely metabolized to its active metabolite, CPX. The bioavailability of the active metabolite is complete following CPX-POM administration. CPX and its inactive metabolite, ciclopirox glucuronide (CPX-G), are excreted in urine, resulting in delivery of drug to the entire urinary tract. The absolute bioavailability of CPX following subcutaneous administration of CPX-POM is excellent in rats and dogs, demonstrating the feasibility of this route of administration. These studies confirmed the oral bioavailability of CPX-O is quite low in rats and dogs compared with intravenous CPX-POM. Given its broad-spectrum anticancer activity in several solid tumor and hematologic cancers and renal elimination, CPX-POM is being developed for the treatment of urothelial cancer. The safety, dose tolerance, pharmacokinetics, and pharmacodynamics of intravenous CPX-POM are currently being characterized in a United States multicenter first-in-human Phase 1 clinical trial in patients with advanced solid tumors (NCT03348514).
