A phase II clinical trial of echinomycin in metastatic soft tissue sarcoma: An Illinois cancer center study
Abstract
Echinomycin, a cyclic peptide in the family of quinoxaline antibiotics, was evaluated in patient with metastatic, soft tissue sarcoma not previously treated for metastatic disease. The starting dose of echinomycin was 1,200 mcg/m2 administered intravenously, once weekly x 4, followed by a two-week break. The protocol design called for dose escalation on subsequent cycles of therapy, but because of significant toxicity, dose escalation occurred in only 5 of 25 treatment cycles. Severe nausea and vomiting was the most common toxicity. No clinical responses were observed in the 12 evaluable patients. Echinomycin at this dose and schedule is inactive in metastatic soft tissue sarcoma.
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Clinical trials conducted in the 1990s across multiple tumor types revealed substantial toxicity, most commonly gastrointestinal, with minimal antitumor efficacy.
“clinical trials conducted in the 1990s across multiple tumor types revealed substantial toxicity, most commonly gastrointestinal, with minimal antitumor efficacy [[386], [387], [388]].”
From HIF inhibition: Current strategies and clinical challenges (2026) · cites this paper as [388]
CrEL-echinomycin caused severe nausea and vomiting, constituting its dose-limiting toxicity.
“CrEL-echinomycin also caused severe nausea and vomiting, constituting its dose-limiting toxicity11, 12, 15-21.”
From Liposomal Formulation of HIF-1α Inhibitor Echinomycin Eliminates Established Metastases of Triple-negative Breast Cancer (2020) · cites this paper as [11]
Clinical development of echinomycin was discontinued because it was not effective for patients with solid tumors refractory to all available treatments.
“However, clinical development was discontinued because echinomycin was not found to be effective for patients with solid tumors that were refractory to all available treatments.”
From Liposomal Formulation of HIF-1α Inhibitor Echinomycin Eliminates Established Metastases of Triple-negative Breast Cancer (2020) · cites this paper as [11]
Clinical studies have provided considerable safety data for echinomycin.
“Clinical studies have provided considerable safety data for echinomycin10-12, 14-18, 41-45”
From Liposomal Formulation of HIF-1α Inhibitor Echinomycin Eliminates Established Metastases of Triple-negative Breast Cancer (2020) · cites this paper as [11]
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- Authors
- Gradishar, W. J., Vogelzang, N. J., Kilton, L. J., Leibach, S. J., Rademaker, A. W., French, S., & Benson, A. B.
- Affiliations
- Northwestern University (US)
- University of Chicago (US)
- New York Oncology Hematology (US)
- Venue
- Investigational New Drugs
- Published
- 1995-06
- Volume
- 13
- Issue
- 2
- Pages
- 171-174
- ISSN
- 0167-6997 (ISSN-L)
- 1573-0646
- OpenAlex
- W2056606812
- Cited by
- 49
- References
- 16
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 3 · 2023: 2 · 2022: 3 · 2021: 6 · 2020: 3 · 2019: 2 · 2017: 3 · 2016: 1 · 2015: 5 · 2014: 2 · 2012: 1
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Investigational New Drugs (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Cancer Institute (2P30-CA-21741)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Sarcoma Diagnosis and Treatment
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Cancer therapeutics and mechanisms
- Physical Sciences › Chemistry › Organic Chemistry › Synthesis and Biological Evaluation
- Keywords
- echinomycin, quinoxaline antibiotics, metastatic soft tissue sarcoma, dose escalation, nausea and vomiting, drug toxicity, anticancer activity, intravenous chemotherapy
- MeSH terms
- Adult, Aged, Aged, 80 and over, Antibiotics, Antineoplastic, Dose-Response Relationship, Drug, Drug Evaluation, Echinomycin, Female, Follow-Up Studies, Humans, Infusions, Intravenous, Longitudinal Studies, Male, Middle Aged, Sarcoma, Soft Tissue Neoplasms, Drugs, Investigational
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