- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00937417
S0716 Vandetanib and Docetaxel in Treating Patients With Advanced Solid Tumors
Phase I Study of the Pharmacokinetics and Pharmacodynamics of ZD6474 in Combination With Docetaxel in Advanced Solid Tumors
RATIONALE: Vandetanib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth and by blocking blood flow to the tumor. Drugs used in chemotherapy, such as docetaxel, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving vandetanib together with docetaxel may kill more tumor cells.
PURPOSE: This phase I trial is studying the side effects and best dose of vandetanib given together with docetaxel in treating patients with advanced solid tumors.
Study Overview
Status
Conditions
Detailed Description
OBJECTIVES:
Primary
- To investigate the differential biological effects in tumor tissues through pharmacodynamic endpoints (percent inhibition of pERK, pKDR, and pEGFR) and their correlation with pharmacokinetics of vandetanib in combination with docetaxel in patients with advanced solid tumors.
- To correlate the pharmacodynamic endpoints with the pharmacokinetics of this combination regimen in these patients.
- To recommend an optimal biological dose of this combination regimen for further testing.
Secondary
- To correlate the pharmacokinetics with safety profiles of two dose levels of vandetanib when given in combination with docetaxel.
- To investigate scientific correlates, including serum proteomics and microvessel density (CD31) and cell death (TUNEL) using tumor tissue biopsy samples taken at baseline and during treatment.
- To determine the objective response in patients with measurable disease at baseline.
OUTLINE: This is a multicenter study.
Patients receive docetaxel IV over 1 hour on day 1 and oral vandetanib once daily on days 1-21. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. After 6 weeks of treatment, patients who experience clinical benefit but poor tolerance to docetaxel may continue treatment with vandetanib alone.
Plasma samples are collected periodically for pharmacokinetic analysis, measurement of vandetanib trough levels, serum biomarker analysis, and serum proteomics. Tumor tissue samples are collected at baseline and once between days 36-38 for pharmacodynamic analysis.
After completion of study treatment, patients are followed up for up to 28 days.
Study Type
Phase
- Phase 1
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
DISEASE CHARACTERISTICS:
Histologically or cytologically confirmed advanced solid tumor, including, but not limited to the following:
- Non-small cell lung cancer
- Metastatic breast cancer
- Hormone-refractory prostate cancer
- Locally recurrent or metastatic head and neck cancer (including thyroid origin)
- Disease for which no standard therapy exists
- Tumor amenable to biopsy
- Measurable or non-measurable disease
Brain metastases allowed provided patient has undergone brain irradiation (whole brain or gamma knife) AND the metastases have been clinically and radiologically stable for ≥ 6 weeks after completion of irradiation
- Patients requiring corticosteroids or anticonvulsants for brain metastases must be on a stable or decreasing dose of corticosteroids and seizure free for ≥ 28 days before study enrollment
PATIENT CHARACTERISTICS:
- Zubrod performance status 0-1
- ANC ≥ 1,500/mm^3
- Platelet count ≥ 100,000/mm^3
- SGOT or SGPT ≤ 2.5 times upper limit of normal (ULN)
- Bilirubin ≤ 1.5 times ULN
- PT/INR ≤ 1.1 times normal
- Serum creatinine ≤ 1.8 times ULN OR measured or estimated creatinine clearance > 50 mL/min
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception during and for ≥ 3 months after completion of study treatment
- Willing to undergo two tumor biopsies and blood and tissue sample submission for correlative laboratory studies
No clinically significant cardiovascular event, including any of the following:
- Myocardial infarction or cerebrovascular accident within the past 3 months
- Unstable angina pectoris
- NYHA class II-IV heart disease within the past 3 months
- Symptomatic congestive heart failure
- Serious cardiac arrhythmia
- No history of cardiac disease that, in the investigator's opinion, increases the risk of ventricular arrhythmia
No history of arrhythmia that is symptomatic or requires treatment (CTCAE grade 3), including any of the following:
- Multifocal premature ventricular contractions (PVCs)
- Bigeminy or trigeminy
- Ventricular tachycardia
Uncontrolled atrial fibrillation
- Medically controlled atrial fibrillation allowed
- No asymptomatic sustained ventricular tachycardia
No history of or evidence of any of the following on ECG:
- History of QTc prolongation as a result from other medication that required discontinuation of that medication
- Congenital long QT syndrome
- First degree relative with unexplained sudden death under 40 years of age
- Presence of left bundle branch block
- QTc with Bazett's correction that is unmeasurable or ≥ 480 msec on screening ECG
- No uncontrolled hypertension, defined as consistent systolic BP > 160 mm Hg or consistent diastolic BP > 100 mm Hg despite medical management
- No intractable nausea or vomiting
- No concurrent active diarrhea that may affect the ability to absorb or tolerate vandetanib
- No gastrointestinal (GI) tract disease resulting in malabsorption syndrome or a requirement for IV alimentation
- No uncontrolled inflammatory GI disease (e.g., Crohn's disease or ulcerative colitis)
- No history of allergic reactions attributed to docetaxel or compounds of similar chemical or biological composition to vandetanib, including other quinazoline compounds (e.g., gefitinib or erlotinib)
- No history of deep venous thrombosis or pulmonary embolism requiring therapeutic anticoagulation
- No known HIV positivity
No other concurrent uncontrolled illness, including, but not limited to the following:
- Ongoing or serious active infection
- Psychiatric illness or social situation that would limit compliance with study requirements
- Prior or concurrent malignancies of other histologies within the past 5 years allowed
PRIOR CONCURRENT THERAPY:
- See Disease Characteristics
- Recovered from prior therapy (i.e., ≤ grade 2 alopecia and ≤ grade 1 toxicity from all other adverse events)
- Prior docetaxel as monotherapy or in combination with other chemotherapeutic agents allowed provided there is potential clinical benefit present, in the investigator's opinion, from the combination of docetaxel and vandetanib
- No prior vandetanib
- No prior surgical procedures affecting absorption
- More than 14 days since prior drugs with a short half-life (e.g., sorafenib or sunitinib) (approval by study coordinator required)
- More than 28 days since prior major surgery, chemotherapy, or radiotherapy
- More than 28 days since prior investigational agents
- More than 2 weeks since prior and no concurrent medications associated with a risk of causing Torsades de Pointes
No concurrent therapeutic anticoagulation (coumadin, warfarin, or low-molecular weight heparin)
- Low-dose anticoagulation for indwelling catheter maintenance allowed
- No concurrent medication that may cause QTc prolongation
No other concurrent chemotherapy, hormonal therapy, radiotherapy, immunotherapy, or any other type of therapy for the treatment of cancer, except for the following:
- Luteinizing hormone-releasing hormone agonists
- Bisphosphonates
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Arm 1
vandetanib and docetaxel
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Pharmacodynamic parameters (percent inhibition of pERK, pKDR, and pEGFR)
Time Frame: 6 months
|
6 months
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Correlation of pharmacokinetic profile with pharmacodynamic data and treatment-related toxicities
Time Frame: 6 months
|
6 months
|
Association between scientific correlates (microvessel density, cell death, circulating endothelial cells, ERK and pERK, and serum proteomics) and treatment outcomes and other patient characteristics
Time Frame: 6 months
|
6 months
|
Objective tumor response and clinically stable disease in patients with measurable disease at baseline
Time Frame: 6 months
|
6 months
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Study Chair: Monica Mita, MD, Cancer Therapy and Research Center, Texas
Study record dates
Study Major Dates
Study Start
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
- stage IV breast cancer
- recurrent breast cancer
- recurrent non-small cell lung cancer
- stage IV prostate cancer
- recurrent prostate cancer
- stage IV non-small cell lung cancer
- unspecified adult solid tumor, protocol specific
- recurrent metastatic squamous neck cancer with occult primary
- stage IV squamous cell carcinoma of the lip and oral cavity
- stage IV basal cell carcinoma of the lip
- stage IV verrucous carcinoma of the oral cavity
- stage IV mucoepidermoid carcinoma of the oral cavity
- stage IV adenoid cystic carcinoma of the oral cavity
- recurrent squamous cell carcinoma of the lip and oral cavity
- recurrent basal cell carcinoma of the lip
- recurrent verrucous carcinoma of the oral cavity
- recurrent mucoepidermoid carcinoma of the oral cavity
- recurrent adenoid cystic carcinoma of the oral cavity
- stage IV squamous cell carcinoma of the oropharynx
- stage IV lymphoepithelioma of the oropharynx
- recurrent squamous cell carcinoma of the oropharynx
- recurrent lymphoepithelioma of the oropharynx
- stage IV squamous cell carcinoma of the nasopharynx
- stage IV lymphoepithelioma of the nasopharynx
- recurrent squamous cell carcinoma of the nasopharynx
- recurrent lymphoepithelioma of the nasopharynx
- stage IV squamous cell carcinoma of the hypopharynx
- recurrent squamous cell carcinoma of the hypopharynx
- stage IV squamous cell carcinoma of the larynx
- stage IV verrucous carcinoma of the larynx
- recurrent squamous cell carcinoma of the larynx
- recurrent verrucous carcinoma of the larynx
- stage IV squamous cell carcinoma of the paranasal sinus and nasal cavity
- stage IV midline lethal granuloma of the paranasal sinus and nasal cavity
- stage IV esthesioneuroblastoma of the paranasal sinus and nasal cavity
- recurrent squamous cell carcinoma of the paranasal sinus and nasal cavity
- recurrent midline lethal granuloma of the paranasal sinus and nasal cavity
- recurrent esthesioneuroblastoma of the paranasal sinus and nasal cavity
- recurrent salivary gland cancer
- stage IV salivary gland cancer
- male breast cancer
- anaplastic thyroid cancer
- recurrent inverted papilloma of the paranasal sinus and nasal cavity
- stage IV inverted papilloma of the paranasal sinus and nasal cavity
- stage IV papillary thyroid cancer
- stage IV follicular thyroid cancer
- thyroid gland medullary carcinoma
- recurrent thyroid cancer
- hormone-resistant prostate cancer
- insular thyroid cancer
Additional Relevant MeSH Terms
- Skin Diseases
- Respiratory Tract Diseases
- Neoplasms
- Lung Diseases
- Urogenital Neoplasms
- Neoplasms by Site
- Genital Neoplasms, Male
- Breast Diseases
- Prostatic Diseases
- Respiratory Tract Neoplasms
- Thoracic Neoplasms
- Breast Neoplasms
- Head and Neck Neoplasms
- Prostatic Neoplasms
- Lung Neoplasms
- Molecular Mechanisms of Pharmacological Action
- Antineoplastic Agents
- Tubulin Modulators
- Antimitotic Agents
- Mitosis Modulators
- Docetaxel
Other Study ID Numbers
- S0716
- SWOG-S0716
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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