- ICH GCP
- Registre américain des essais cliniques
- Essai clinique NCT00873002
Panobinostat and Sorafenib in Treating Patients With Liver Cancer That is Metastatic and/or Cannot Be Removed by Surgery
Phase I Study of Combination of Sorafenib and LBH589 in Hepatocellular Carcinoma
RATIONALE: Panobinostat and sorafenib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Sorafenib may also stop the growth of liver cancer by blocking blood flow to the tumor.
PURPOSE: This phase I trial is studying the side effects and best dose of panobinostat when given together with sorafenib in treating patients with liver cancer that is metastatic and/or cannot be removed by surgery.
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
OBJECTIVES:
Primary
- Assess the safety and tolerability of panobinostat when combined with standard doses of sorafenib tosylate in patients with metastatic and/or unresectable hepatocellular carcinoma.
- Determine the maximum tolerated dose of panobinostat when combined with standard doses of sorafenib tosylate in these patients.
Secondary
- Determine the response rate.
- Determine the progression-free survival.
- Determine the overall survival rate.
OUTLINE: This is a dose escalation study of panobinostat.
Patients receive panobinostat IV on days 1 and 8 and oral sorafenib tosylate twice daily on days 1-21. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.
After completion of study therapy, patients are followed for 30 days.
Type d'étude
Inscription (Réel)
Phase
- La phase 1
Contacts et emplacements
Lieux d'étude
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Ohio
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Cleveland, Ohio, États-Unis, 44195
- Cleveland Clinic Taussig Cancer institute, Case Comprehensive Cancer Center
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
DISEASE CHARACTERISTICS:
Histologically or cytologically confirmed hepatocellular carcinoma
- Metastatic and/or unresectable disease
- Child-Pugh score A or B
PATIENT CHARACTERISTICS:
- ECOG performance status 0-2
- Neutrophil count > 1500/mm³
- Platelet count > 100,000/mm³
- Hemoglobin ≥ 9 g/dL
- AST and ALT ≤ 2.5 times upper limit of normal (ULN) (≤ 5.0 times ULN if elevation due to disease involvement)
- Serum bilirubin ≤ 1.5 times ULN
- Serum creatinine ≤ 1.5 times ULN or creatinine clearance ≥ 50 mL/min
- Total serum calcium (corrected for serum albumin) or ionized calcium ≥ lower limit of normal (LLN)
- Serum potassium ≥ LLN
- Serum sodium ≥ LLN
- Serum albumin ≥ LLN or 3 g/dL
- LVEF ≥ LLN as demonstrated by baseline MUGA or ECHO
- TSH and free T4 within normal limits (thyroid hormone replacement therapy allowed)
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective double-method contraception (one being a barrier method) during and for 3 months after completion of study treatment
- INR < 1.5 or PT/PTT within normal limits
No impaired cardiac function including any 1 of the following:
- QTc > 450 msec on screening ECG
- Congenital long QT syndrome
- History of sustained ventricular tachycardia
- History of ventricular fibrillation or torsades de pointes
Bradycardia, defined as heart rate < 50 beats per minute
- Patients with a pacemaker and heart rate ≥ 50 beats per minute are eligible
- Myocardial infarction or unstable angina within the past 6 months
- Congestive heart failure (NYHA class III-IV)
- Right bundle branch block and left anterior hemiblock (bifascicular block)
- No uncontrolled hypertension
- No thrombolic or embolic events (e.g., cerebrovascular accident and transient ischemic attacks) within the past 6 months
- No pulmonary hemorrhage/bleeding event > CTCAE Grade 2 within the past 4 weeks
- No other hemorrhage/bleeding event > CTCAE Grade 3 within the past 4 weeks
- No unresolved diarrhea > CTCAE grade 1
- No other concurrent severe and/or uncontrolled medical conditions
- No other primary malignancy within the past 5 years except curatively treated carcinoma in situ of the cervix or basal cell or squamous cell carcinoma of the skin
- No serious non-healing wound, ulcer, or bone fracture
- No evidence or history of bleeding diathesis or coagulopathy
- No significant traumatic injury within the past 4 weeks
- No known or suspected allergy to sorafenib tosylate or any other study drug
- No condition that would impair a patient's ability to swallow whole pills
- No malabsorption problem
- No known human immunodeficiency virus (HIV) or hepatitis C positivity (baseline testing for HIV and hepatitis C is not required)
- No significant history of non-compliance to medical regimens
PRIOR CONCURRENT THERAPY:
- No prior HDAC inhibitors, DAC inhibitors, HSP90 inhibitors, sorafenib tosylate, or valproic acid for the treatment of cancer
- More than 4 weeks since prior chemotherapy, investigational drugs, or major surgery and recovered
- More than 4 weeks since open biopsy
- More than 5 days since prior and no concurrent valproic acid for any medical condition
- No concurrent St. John's wort or rifampin
- No concurrent drugs with a risk of causing torsades de pointes
- No concurrent CYP3A4 inhibitors
- No concurrent radiotherapy
- No concurrent grapefruit, grapefruit juice, or Seville (sour) oranges
- No other concurrent investigational therapy
- No other concurrent anticancer agents
- Concurrent anticoagulation treatment with warfarin or heparin allowed
Plan d'étude
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 |
---|---|
Comparateur actif: LBH589
This study utilizes a sequential dose-escalation design to define the MTD of LBH589 when combined with standard doses of sorafenib.
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Dose escalation: 7.5 mg/m2 day 1 and day 8 of 21 days cycle 10 mg/m2 day 1 and day 8 of 21 days cycle 15 mg/m2 day 1 and day 8 of 21 days cycle 20 mg/m2 day 1 and day 8 of 21 days cycle 30 mg/m2 day 1 and day 8 of 21 days cycle
400 mg PO BID
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
---|---|---|
Assessment of Safety and Tolerability
Délai: 6months to 1 year
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•Primary objective of the phase I trial will be to assess the safety and tolerability and to determine the maximum tolerated dose (MTD) of LBH 589 when combined with standard doses of sorafenib in the treatment of hepatocellular carcinoma.
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6months to 1 year
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
---|---|---|
Progression-free survival
Délai: 6mo 1 year
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Evaluate time to progression vs progression free survival
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6mo 1 year
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Overall survival
Délai: until death
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Overall survival (OS) will be measured from study entry until death from any cause.
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until death
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Response as assessed by RECIST
Délai: every 42 days
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To ensure comparability, baseline methods and on-study methods for response assessment must be performed using identical techniques.
In addition, all subjects with evidence of objective tumor response (CR, PR or SD) should have the response confirmed with repeat assessments at least 21 days after the first documentation of response, resuming bimonthly (every 42 days) assessments thereafter.
Objective tumor response will be assessed using the RECIST method.
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every 42 days
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Adverse events and abnormal laboratory value severity as assessed by NCI CTCAE version 3.0
Délai: weekly during treatment to 30 days after treatment
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Events should be documented and recorded at each visit.
Subjects should be followed for adverse events for 30 days after the last protocol related assessment, or until drug-related toxicities have resolved, whichever is later.
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weekly during treatment to 30 days after treatment
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Collaborateurs et enquêteurs
Parrainer
Collaborateurs
Les enquêteurs
- Chercheur principal: Richard Kim, MD, Cleveland Clinic Taussig Cancer institute, Case Comprehensive Cancer Center
Publications et liens utiles
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude
Achèvement primaire (Réel)
Achèvement de l'étude (Réel)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Estimation)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Estimation)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
- Maladies du système digestif
- Tumeurs
- Tumeurs par site
- Tumeurs du système digestif
- Maladies du foie
- Tumeurs du foie
- Mécanismes moléculaires de l'action pharmacologique
- Inhibiteurs d'enzymes
- Agents antinéoplasiques
- Inhibiteurs de protéine kinase
- Inhibiteurs de l'histone désacétylase
- Sorafénib
- Panobinostat
Autres numéros d'identification d'étude
- CASE6208 (Autre identifiant: Case Comprehensive Cancer Center)
- P30CA043703 (Subvention/contrat des NIH des États-Unis)
- CLBH589BUS23T
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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