Journal of Clinical Oncology, Vol 7, 499-508, Copyright © 1989 by American Society of Clinical Oncology
Suramin: an anticancer drug with a unique mechanism of action
CA Stein, RV LaRocca, R Thomas, N McAtee and CE Myers
Clinical Oncology Program, National Cancer Institute, Bethesda, MD 208292.
We administered suramin, an anti-parasitic drug and reverse transcriptase
inhibitor, to 15 patients with metastatic cancer. This compound is known to
inhibit the binding of growth factors (eg, epidermal growth factor [EGF],
platelet-derived growth factor [PDGF], tumor growth factor-beta [TGF-beta])
to their receptors and thus antagonize the ability of these factors to
stimulate growth of tumor cells in vitro. There were no complete responses
(CRs), four partial responses (PRs) (two of ten adrenal cortex, one of four
renal, one of one adult T-cell leukemia-lymphoma [HTLV-1]), and two minimal
responses (MRs) (two of ten adrenal cortex). Toxicity included proteinuria
(14 patients), reversible liver function test abnormalities (eight), vortex
keratopathy (five), adrenal insufficiency (three), coagulopathy secondary
to increased circulating levels of glycosaminoglycans (11), and one case of
a reversible acute demyelinating polyneuropathy resembling the
Guillain-Barre syndrome. We conclude that suramin is an active agent in the
treatment of metastatic cancer, and further work is necessary to define its
scope.
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