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Alvocidib in Treating Patients With Locally Advanced or Metastatic Solid Tumors

21 février 2014 mis à jour par: 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.

Aperçu de l'étude

Description détaillée

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.

Type d'étude

Interventionnel

Inscription (Réel)

25

Phase

  • La phase 1

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

    • Ohio
      • Columbus, Ohio, États-Unis, 43210
        • Ohio State University Medical Center

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

18 ans et plus (Adulte, Adulte plus âgé)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

La description

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 d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Traitement
  • Répartition: N / A
  • Modèle interventionnel: Affectation à un seul groupe
  • Masquage: Aucun (étiquette ouverte)

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Expérimental: 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.
Études corrélatives
Étant donné IV
Autres noms:
  • SAVEUR
  • flavopiridol
  • HMR 1275
  • L-868275
Études corrélatives
Autres noms:
  • études pharmacologiques

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Adverse events of dose escalated alvocidib administered in patients with advanced solid tumors
Délai: 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

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Pharmacokinetics of alvocidib administered in this schedule
Délai: 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
Délai: 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
Délai: 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
Délai: 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

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Les enquêteurs

  • Chercheur principal: Manisha Shah, Ohio State University

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude

1 février 2006

Achèvement primaire (Réel)

1 juillet 2012

Dates d'inscription aux études

Première soumission

2 juin 2005

Première soumission répondant aux critères de contrôle qualité

2 juin 2005

Première publication (Estimation)

3 juin 2005

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Estimation)

24 février 2014

Dernière mise à jour soumise répondant aux critères de contrôle qualité

21 février 2014

Dernière vérification

1 novembre 2011

Plus d'information

Termes liés à cette étude

Autres numéros d'identification d'étude

  • NCI-2009-00135 (Identificateur de registre: CTRP (Clinical Trial Reporting Program))
  • P30CA016058 (Subvention/contrat des NIH des États-Unis)
  • U01CA076576 (Subvention/contrat des NIH des États-Unis)
  • OSU-2005C0009
  • CDR0000429582
  • NCI-7204
  • OSU-04111
  • OSU 04111 (Autre identifiant: Ohio State University Medical Center)
  • 7204 (CTEP)

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

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