- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT00280176
Bortezomib, Fluorouracil, and External-Beam Radiation Therapy in Treating Patients With Stage II, Stage III, or Stage IV Rectal Cancer
Phase I Study of PS-341 in Combination With 5-Fluorouracil and External Beam Radiotherapy For The Treatment Of Locally Advanced And Metastatic Rectal Cancer
RATIONALE: Bortezomib 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 fluorouracil, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Radiation therapy uses high-energy x-rays to kill tumor cells. Giving bortezomib and fluorouracil together with radiation therapy may kill more tumor cells.
PURPOSE: This phase I trial is studying the side effects and best dose of bortezomib when given together with fluorouracil and external-beam radiation therapy in treating patients with stage II, stage III, or stage IV rectal cancer.
Studieoversigt
Status
Betingelser
Intervention / Behandling
Detaljeret beskrivelse
OBJECTIVES:
Primary
- Determine the maximum tolerated dose of bortezomib when administered in combination with fluorouracil and external beam radiotherapy as preoperative or palliative treatment in patients with stage II-IV rectal adenocarcinoma.
- Determine the dose-limiting toxicities of this regimen in these patients.
Secondary
- Determine the dose-effect relationship of bortezomib on NF-kappa B activation induced by chemoradiotherapy.
- Determine downstream events induced by NF-kappa B activation.
- Determine downstream events related to activation of p53 in response to treatment with chemoradiotherapy and bortezomib.
- Determine the rate of complete pathologic remission in patients who undergo surgical resection of their primary tumor.
- Determine the gene expression pattern of tumors by cDNA microarray analysis before and during treatment with this regimen.
OUTLINE: This is a multicenter, dose-escalation study of bortezomib.
Patients receive bortezomib IV on days 1, 4, 8, 11, 22, 25, 29, and 32 and fluorouracil IV continuously on days 2-38. Patients also undergo external beam radiotherapy 5 days a week for 5½ weeks. Treatment continues in the absence of disease progression or unacceptable toxicity.
Cohorts of 3-6 patients receive escalating doses of bortezomib until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity.
Patients undergo tissue biopsy at baseline and on days 1 and 2. Samples are collected and evaluated by tissue microarray analysis for NF-kappa B pathway activation; cDNA analysis, RNase protection assay, and immunohistochemistry for analysis of downstream events induced by NF-kappa B activation; and modified TdT-mediated dUTP nick-end label for analysis of apoptosis by DNA fragmentation. NF-kappa B subunits are quantified by enzyme-linked immunosorbent assay. Serum samples are collected at baseline and stored for future studies.
After completion of study treatment, patients are followed every 3 months for up to 2 years.
Undersøgelsestype
Tilmelding (Faktiske)
Fase
- Fase 1
Kontakter og lokationer
Studiesteder
-
-
North Carolina
-
Chapel Hill, North Carolina, Forenede Stater, 27599-7295
- Lineberger Comprehensive Cancer Center at University of North Carolina - Chapel Hill
-
-
Tennessee
-
Nashville, Tennessee, Forenede Stater, 37232-6838
- Vanderbilt-Ingram Cancer Center
-
-
Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
DISEASE CHARACTERISTICS:
Biopsy confirmed diagnosis of adenocarcinoma of the rectum meeting 1 of the following clinical staging criteria:
T3-T4, N0, M0 (stage II disease)
- T4 disease defined as tumor fixed on examination or involving adjacent pelvic structures, such as the sidewall, bladder, uterus, prostate, or small bowel by ultrasound or CT scan
- Any T, N1-2, M0 (stage III disease)
- Any T, any N, M1 (stage IV disease)
- Recurrent disease (any prior stage)
- Candidate for local palliative therapy or curative resection of metastatic disease
- Previously treated CNS disease allowed provided it is stable for > 3 months
PATIENT CHARACTERISTICS:
- ECOG performance status 0-2
- Life expectancy > 3 months
- Adequate nutrition
- WBC ≥ 4,000/mm³
- ANC > 2,000/mm³
- Platelet count ≥ 100,000/mm³
- Creatinine ≤ 1.5 mg/dL OR creatinine clearance ≥ 30 mL/min
- Bilirubin ≤ 1.5 mg/dL
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
- No serious medical or psychiatric illness that would limit study compliance or limit survival to < 2 years
- No history of refractory congestive heart failure or cardiomyopathy
- No active coronary artery disease, myocardial infarction within the past 3 months, or cerebrovascular accident within the past 3 months
- No peripheral neuropathy ≥ grade 2
- No hypersensitivity to bortezomib, boron, or mannitol
PRIOR CONCURRENT THERAPY:
- More than 1 week since prior major surgery
- More than 28 days since prior investigational agents
- Prior chemotherapy allowed
- No prior pelvic radiotherapy (for treatment of any pelvic malignancy)
- No concurrent herbal medication (excluding vitamin and mineral supplements)
- No concurrent filgrastim (G-CSF) or sargramostim (GM-CSF)
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: N/A
- Interventionel model: Enkelt gruppeopgave
- Maskning: Ingen (Åben etiket)
Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Tidsramme |
---|---|
Dosisbegrænsende toksicitet
Tidsramme: 8 uger
|
8 uger
|
Maximum tolerated dose
Tidsramme: 6 weeks
|
6 weeks
|
Sekundære resultatmål
Resultatmål |
Tidsramme |
---|---|
Dose-effect relationship of bortezomib on NF-kappa B activation induced by chemoradiotherapy
Tidsramme: 6 weeks
|
6 weeks
|
Downstream events induced by NF-kappa B activation
Tidsramme: 8 weeks
|
8 weeks
|
Downstream events related to activation of p53 in response to treatment with chemoradiotherapy and bortezomib
Tidsramme: 8 weeks
|
8 weeks
|
Rate of complete pathologic remission
Tidsramme: 2 years
|
2 years
|
Gene expression pattern of tumors as assessed by cDNA microarray analysis pre- and post-treatment
Tidsramme: 8 weeks
|
8 weeks
|
Samarbejdspartnere og efterforskere
Samarbejdspartnere
Efterforskere
- Ledende efterforsker: Bert H. O'Neil, MD, UNC Lineberger Comprehensive Cancer Center
Datoer for undersøgelser
Studer store datoer
Studiestart
Primær færdiggørelse (Faktiske)
Studieafslutning (Faktiske)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Skøn)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Skøn)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
- Sygdomme i fordøjelsessystemet
- Neoplasmer
- Neoplasmer efter sted
- Gastrointestinale neoplasmer
- Neoplasmer i fordøjelsessystemet
- Gastrointestinale sygdomme
- Tarmsygdomme
- Intestinale neoplasmer
- Endetarmssygdomme
- Kolorektale neoplasmer
- Rektale neoplasmer
- Lægemidlers fysiologiske virkninger
- Molekylære mekanismer for farmakologisk virkning
- Antimetabolitter, Antineoplastisk
- Antimetabolitter
- Antineoplastiske midler
- Immunsuppressive midler
- Immunologiske faktorer
- Fluorouracil
- Bortezomib
Andre undersøgelses-id-numre
- LCCC 0209
- CDR0000549844 (Anden identifikator: PDQ number)
Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .
Kliniske forsøg med Kolorektal cancer
-
University of ArkansasAktiv, ikke rekrutterendeColorectal cancer og inflammatorisk tarmsygdomForenede Stater
-
University Health Network, TorontoAstraZenecaAktiv, ikke rekrutterendeAdenocarcinom i bugspytkirtlen | Leiomyosarkom | Mismatch Reparation Proficient Colorectal CancerCanada
-
Tianjin Medical University Cancer Institute and...RekrutteringMSI-H Advanced Colorectal CancerKina
-
Bristol-Myers SquibbAktiv, ikke rekrutterendeMikrosatellit stabil kolorektal cancer | Mismatch Reparation Proficient Colorectal Cancer | Mikrosatellit ustabil kolorektal cancer | Mismatch Reparation Manglende tyktarmskræftForenede Stater, Australien, Belgien, Canada, Irland, Italien, Spanien, Frankrig
-
Syndax PharmaceuticalsMerck Sharp & Dohme LLCAfsluttetMelanom | Ikke-småcellet lungekræft | Mismatch Reparation-Proficient Colorectal CancerForenede Stater
Kliniske forsøg med bortezomib
-
The First Affiliated Hospital of Soochow UniversityUkendtMyelom påvist ved laboratorietestKina
-
Baylor College of MedicineMillennium Pharmaceuticals, Inc.AfsluttetProstata neoplasmerForenede Stater
-
NCIC Clinical Trials GroupAfsluttet
-
University Hospital, Clermont-FerrandLaboratoires TakedaUkendtMyelomatose | Voksen | Bortezomib-regimenFrankrig
-
National Cancer Institute (NCI)AfsluttetGastrointestinal kræft | Avanceret primær leverkræft hos voksne | Lokaliseret ikke-operabel primær leverkræft hos voksne | Tilbagevendende primær leverkræft hos voksne | Tilbagevendende ekstrahepatisk galdevejskræft | Tilbagevendende galdeblærekræft | Ikke-operabel ekstrahepatisk galdevejskræft | Ikke-operabel... og andre forholdForenede Stater
-
Janssen-Cilag International NVAfsluttetMyelomatoseKalkun, Grækenland, Tjekkiet, Østrig, Tyskland, Sverige, Det Forenede Kongerige, Danmark
-
University Health Network, TorontoNational Cancer Institute (NCI)AfsluttetBlærekræft | Overgangscellekræft i nyrebækkenet og urinlederenForenede Stater, Canada
-
Janssen Korea, Ltd., KoreaAfsluttet
-
Southwest Oncology GroupNational Cancer Institute (NCI)Afsluttet
-
Memorial Sloan Kettering Cancer CenterNational Cancer Institute (NCI)AfsluttetLymfom | Myelodysplastiske syndromer | Leukæmi | Myelom og plasmacelle-neoplasmaForenede Stater