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Alvocidib in Treating Patients With Locally Advanced or Metastatic Solid Tumors

21 de febrero de 2014 actualizado por: National Cancer Institute (NCI)

A Pilot Study of Flavopiridol in Patients With Advanced Solid Tumors

This phase I trial is studying the side effects and best dose of alvocidib in treating patients with locally advanced or metastatic solid tumors. Drugs used in chemotherapy, such as alvocidib, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Alvocidib may also stimulate the immune system in different ways and stop tumor cells from growing. It may also stop the growth of solid tumors by blocking blood flow to the tumor.

Descripción general del estudio

Descripción detallada

PRIMARY OBJECTIVES:

I. Determine the toxicity profile and dose-limiting toxicity of flavopiridol (alvocidib) in patients with locally advanced or metastatic solid tumors.

II. Determine the maximum tolerated dose of this drug in these patients.

SECONDARY OBJECTIVES:

I. Determine the pharmacokinetics and pharmacodynamics of this drug in these patients.

II. Determine the immunomodulatory effects of this drug in these patients. III. Determine pharmacogenomics of this drug, using peripheral blood mononuclear cells, in patients who experience clinical response.

OUTLINE: This is a pilot, dose-escalation study.

Patients receive alvocidib intravenously (IV) over 4½ hours once weekly in weeks 1-4. Treatment repeats every 6 weeks for up to 6 courses in the absence of disease progression or unacceptable toxicity. Patients achieving stable disease after 4 courses of therapy discontinue study treatment. Patients who achieve complete remission (CR) receive 1 additional course of therapy beyond documentation of CR. Cohorts of 3-6 patients receive escalating doses of alvocidib 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. A total of 10 patients are treated at the MTD.

After completion of study treatment, patients are followed within 4 weeks.

Tipo de estudio

Intervencionista

Inscripción (Actual)

25

Fase

  • Fase 1

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Ubicaciones de estudio

    • Ohio
      • Columbus, Ohio, Estados Unidos, 43210
        • Ohio State University Medical Center

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

18 años y mayores (Adulto, Adulto Mayor)

Acepta Voluntarios Saludables

No

Géneros elegibles para el estudio

Todos

Descripción

Inclusion Criteria:

  • Histologically or cytologically confirmed solid tumor

    • Locally advanced or metastatic disease for which curative treatment does not exist or is no longer effective
  • Measurable disease, defined as ≥ 1 unidimensionally measurable lesion ≥ 20 mm by conventional techniques OR ≥ 10 mm by spiral CT scan

    • No previously irradiated* measurable lesion unless lesion demonstrates progressive disease OR there are other measurable lesions outside the irradiated* field
    • The following are not considered measurable disease:

      • Bone lesions
      • Leptomeningeal disease
      • Ascites
      • Pleural or pericardial effusion
      • Lymphangitis cutis/pulmonis
      • Abdominal masses that are not confirmed and followed by imaging techniques
      • Cystic lesions
  • No uncontrolled brain metastases
  • Performance status - ECOG 0-1
  • At least 6 months
  • Absolute neutrophil count ≥ 1,500/mm^3
  • Platelet count ≥ 100,000/mm^3
  • AST and ALT ≤ 2.5 times upper limit of normal (ULN)
  • Bilirubin ≤ 1.5 times ULN
  • Creatinine ≤ 1.5 times ULN
  • No symptomatic congestive heart failure
  • No unstable angina pectoris
  • No uncontrolled cardiac arrhythmia
  • No uncontrolled hypertension
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No history of allergic reaction attributed to compounds of similar chemical or biological composition to flavopiridol
  • No ongoing or active infection
  • No uncontrolled illness
  • No psychiatric illness or social situation that would preclude study compliance
  • More than 12 weeks since prior hepatic arterial chemoembolization
  • More than 4 weeks since prior systemic chemotherapy
  • No prior flavopiridol
  • See Disease Characteristics
  • More than 12 weeks since prior radioactive metaiodobenzylguanidine (MIBG)
  • More than 4 weeks since prior external beam radiotherapy
  • Recovered from all prior tumor-specific therapy
  • More than 4 weeks since prior investigational tumor-specific therapy
  • Concurrent octreotide for control of carcinoid syndrome allowed
  • No concurrent combination anti-retroviral therapy for HIV-positive patients
  • No other concurrent tumor-specific therapy
  • No other concurrent investigational therapy
  • No other concurrent anticancer therapy

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Tratamiento
  • Asignación: N / A
  • Modelo Intervencionista: Asignación de un solo grupo
  • Enmascaramiento: Ninguno (etiqueta abierta)

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Experimental: Treatment (chemotherapy, biological therapy)
Patients receive alvocidib IV over 4½ hours once weekly in weeks 1-4. Treatment repeats every 6 weeks for up to 6 courses in the absence of disease progression or unacceptable toxicity.
Estudios correlativos
Dado IV
Otros nombres:
  • FLAVO
  • flavopiridol
  • HMR 1275
  • L-868275
Estudios correlativos
Otros nombres:
  • estudios farmacológicos

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Adverse events of dose escalated alvocidib administered in patients with advanced solid tumors
Periodo de tiempo: At weeks 1-4, 7-10, 11 or 12, and within 4 weeks after the completion of study treatment
Graded using the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 3.0.
At weeks 1-4, 7-10, 11 or 12, and within 4 weeks after the completion of study treatment

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Pharmacokinetics of alvocidib administered in this schedule
Periodo de tiempo: After the first dose of treatment drug
The pharmacokinetic parameters include Cmax, Css, Clearance, t1/2 α, t1/2 β, central volume of distribution and steady state volume of distribution.
After the first dose of treatment drug
Immunomodulatory effects of alvocidib
Periodo de tiempo: Baseline, days 1 and 15 of courses 1 and 2, and within 4 weeks after the completion of study treatment
Gene expression quantified using Real Time PCR; type 1 and type 2 cytokines, co-stimulatory molecules, and adhesion molecules in PBMCs. Activation of lymphocyte subsets and presence of co-stimulatory and adhesion molecules assessed using multicolor flow cytometry. IL-6 levels in plasma will be measured by ELISA. T-cells will be enriched from PBMCs using mAb-coated immunomagnetic beads and activated with anti-CD3/anti-CD28 mAbs, inomycin or PMA. Cytokine production will be measured using cytometric bead array.
Baseline, days 1 and 15 of courses 1 and 2, and within 4 weeks after the completion of study treatment
Pharmacogenomics studies on procured PBMCs if clinical responses are observed
Periodo de tiempo: Baseline, and within 4 weeks after the completion of study treatment
Performed if clinical responses are observed. Examine for selected polymorphisms of genes influencing alvocidib metabolism and/or resistance genes that may predict response or toxicity. These changes will be correlated with AUC, toxicity and clinical response to therapy.
Baseline, and within 4 weeks after the completion of study treatment
Measurement of serum tumor markers depending on the tumor type
Periodo de tiempo: Baseline, week 11 or 12, and within 4 weeks after the completion of study treatment
Markers include CEA, CA 19-9, CA 15-3, PSA, LDH, AFP, b-HCG, pancreastatin, gastrin, pancreatic polypeptide, glucagon, substance-P, neurotensin, calcitonin, somatostatin, vasoactive intestinal peptide, gastrin releasing polypeptide, ACTH, and chromogranin-A.
Baseline, week 11 or 12, and within 4 weeks after the completion of study treatment

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Investigadores

  • Investigador principal: Manisha Shah, Ohio State University

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio

1 de febrero de 2006

Finalización primaria (Actual)

1 de julio de 2012

Fechas de registro del estudio

Enviado por primera vez

2 de junio de 2005

Primero enviado que cumplió con los criterios de control de calidad

2 de junio de 2005

Publicado por primera vez (Estimar)

3 de junio de 2005

Actualizaciones de registros de estudio

Última actualización publicada (Estimar)

24 de febrero de 2014

Última actualización enviada que cumplió con los criterios de control de calidad

21 de febrero de 2014

Última verificación

1 de noviembre de 2011

Más información

Términos relacionados con este estudio

Otros números de identificación del estudio

  • NCI-2009-00135 (Identificador de registro: CTRP (Clinical Trial Reporting Program))
  • P30CA016058 (Subvención/contrato del NIH de EE. UU.)
  • U01CA076576 (Subvención/contrato del NIH de EE. UU.)
  • OSU-2005C0009
  • CDR0000429582
  • NCI-7204
  • OSU-04111
  • OSU 04111 (Otro identificador: Ohio State University Medical Center)
  • 7204 (CTEP)

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

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