Carbon nanoparticle-Fe (II) complex for ferroptosis therapy in refractory solid tumors: a phase I trial.

We developed a novel carbon nanoparticle-Fe (II) complex prepared via suspension injection (CNSI-Fe) to induce cancer cell ferroptosis through direct intratumoral delivery of ferrous iron. Preclinical studies have demonstrated that CNSI-Fe has promising antitumour effects, thereby prompting this first-in-human, single-arm, open-label, dose-escalation phase I trial in patients with refractory solid tumors. Primary objectives included assessments of safety and tolerability and the determination of dose-limiting toxicity (DLT) and the maximum tolerated dose (MTD). Secondary objectives included the determination of preliminary antitumour efficacy and pharmacokinetics. Applying a 3 + 3 design across five doses (30-150 mg), a total of 19 enrolled patients received CNSI-Fe treatment. The MTD was not reached, and only one patient (in the 90 mg cohort) experienced DLT events. For all treated patients (n = 19), the common adverse events included injection site pain (89.5%), hypertension (52.6%), elevated serum iron levels (47.4%), and anemia (47.4%). Pharmacokinetic analysis revealed rapid iron absorption (peak time: 0.15-0.41 h) and clearance (half-life: 1.96-5.06 h), with peak serum concentrations ranging from 3520.33 to 13961.67 ng/mL. Preliminary efficacy estimates revealed an overall response rate of 10.5% and a disease control rate (DCR) of 84.2%. Notably, the DCR reached 100% in patients with lymph node and sarcoma lesions. Overall, CNSI-Fe demonstrated a favorable safety profile and promising antitumour activity (ClinicalTrials.gov identifier: NCT06048367), supporting further investigations in a phase II trial.
Cancer
Care/Management

Authors

Shi Shi, Xie Xie, Li Li, Lai Lai, Dang Dang, Gou Gou, Liao Liao, He He, Guo Guo, Ding Ding, Wu Wu, Chen Chen, Lin Lin, Wen Wen, Huang Huang, Chen Chen, Xu Xu, Huang Huang, Wang Wang
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