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Abstract
In animal models, methionine (MET) restriction in association with chloroethylnitrosoureas led to a substantial improvement. On this basis, we initiated a Phase I clinical trial of dietary MET restriction in association with chloroethylnitrosourea (cystemustine) treatment for patients with recurrent glioma or metastatic melanoma. Our purpose was 1) to determine the optimal MET-free diet duration for a maximum depletion of plasma MET and 2) to evaluate the feasibility of this association. A total of 10 patients received 4 cycles of 2 wk of an association of a MET-free diet of 1, 2, 3, or 4 consecutive days and cystemustine (60 mg/m2). For each cycle, plasma MET concentrations, nutritional status (weight, albumin, prealbumin) and toxicity were measured. Conversely, fed-state concentrations of plasma MET (12 AM) were reduced by dietary MET restriction, with an optimal depletion of 41% at the 1st day of MET-free diet without effect of the extending MET-free diet period. Indeed, we demonstrated the feasibility, that is, good diet acceptability and good tolerance (nutritional status and toxicity), of the association of a MET-free diet and cystemustine treatment. Based on these results, a Phase II clinical trial has been initiated to test the activity of the association of a 1-day MET-free diet with cystemustine treatment.
ACKNOWLEDGMENTS
This work was supported by funds from the French League Against Cancer (committee of Puy de Dôme and committee of Haute Loire) and a regional PHRC (Hospital Program for Clinical Research).
The authors thank Fabrice Kwiatkowski of the Centre Jean Perrin for statistical assistance and helpful discussion, Anne Leger of the Laboratoire de Biochimie Pharmacologie of the Centre Jean Perrin for technical assistance, and Sylvie Jouvency of the Centre Jean Perrin for dietetic assistance.
Notes
a Abbreviations are as follows: WHO, World Health Organization, m, male; f, female; M, melanoma; CM, choroid melanoma; G, glioma.