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Chemotherapy in Treating Patients With Refractory Advanced Solid Tumors or Hematologic Cancer

20 giugno 2013 aggiornato da: Memorial Sloan Kettering Cancer Center

A Phase I Trial of 17-N-Allylamino-17-Demethoxy Geldanamycin (17-AAG, NSC #330507) Daily X 5 in Patients With Advanced Cancer Therapeutic Protocol

RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die.

PURPOSE: This phase I trial is studying the side effects and best dose of 17-N-allylamino-17-demethoxygeldanamycin in treating patients with refractory advanced solid tumors or hematologic cancers.

Panoramica dello studio

Descrizione dettagliata

OBJECTIVES:

  • Determine the maximum tolerated dose of 17-N-allylamino-17-demethoxygeldanamycin (17-AAG) in patients with refractory or advanced solid tumors or hematologic malignancies.
  • Evaluate the effects of this drug on the expression of signaling proteins present on an individual patient's cancer at the start of treatment and, if possible, post treatment.

OUTLINE: This is a two-phase, dose-escalation, multicenter study. Patients are stratified according to disease (chronic myelogenous leukemia [CML] or Philadelphia chromosome [Ph]+ acute lymphoblastic leukemia [ALL] vs solid tumor).

Patients receive 17-N-allylamino-17-demethoxygeldanamycin (17-AAG) IV over 60-90 minutes twice weekly. Courses repeat every 12 weeks in the absence of disease progression (after at least 2 courses for CML or Ph+ ALL patients) or unacceptable toxicity.

  • Accelerated phase: Single patients receive escalating dose levels of 17-AAG until one patient experiences a first course grade 3 or greater toxicity or two different patients experience grade 2 toxicity during any course.
  • Standard phase: Cohorts of 3-6 patients in each stratum receive escalating doses of 17-AAG 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.

PROJECTED ACCRUAL: Approximately 51 patients will be accrued for this study.

Tipo di studio

Interventistico

Fase

  • Fase 1

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Luoghi di studio

    • California
      • Los Angeles, California, Stati Uniti, 90095
        • Jonsson Comprehensive Cancer Center, UCLA
    • New York
      • New York, New York, Stati Uniti, 10021
        • Memorial Sloan-Kettering Cancer Center

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

18 anni e precedenti (Adulto, Adulto più anziano)

Accetta volontari sani

No

Sessi ammissibili allo studio

Tutto

Descrizione

DISEASE CHARACTERISTICS:

  • Diagnosis of 1 of the following:

    • Histologically confirmed advanced primary or malignant solid tumor refractory to standard therapy or for which no curative standard therapy exists

      • Progressive disease evidenced by 1 of the following:

        • Non-prostate cancer (including, but not limited to, breast, ovary, head and neck, non-small cell lung, bladder, kidney, colon, stomach, or malignant melanoma)

          • Development of new lesions or an increase in existing lesions
          • No increase in a biochemical marker (e.g., carcinoembryonic antigen, CA-15-3, or an increase in symptoms) as sole measure of disease
    • Prostate cancer (androgen independent) meeting the following criteria:

      • Progressing metastatic disease on bone scan, CT scan, or MRI
      • Metastatic disease and rising prostate-specific antigen (PSA) values meeting 1 of the following criteria:

        • At least 3 rising PSA values obtained at least 1 week apart = 2 rising values more than 1 month apart with at least 25% increase over the range of values
      • Serum testosterone less than 30 ng/mL
      • Castrate status should be maintained by medical therapies if orchiectomy has not been performed
      • Progressive disease must be evident off antiandrogen therapy if received prior to study entry
      • Registered to protocol MSKCC-9040
    • Cytologically confirmed chronic, accelerated, or blastic phase chronic myelogenous leukemia (CML) or Philadelphia chromosome (Ph)-positive acute lymphoblastic leukemia (ALL) refractory to standard therapy or for which no curative therapy exists

      • Progressive disease evidenced by 1 of the following:

        • Accelerated or blastic phase disease that is not responsive to standard therapy or loss of hematologic response to imatinib mesylate while remaining in chronic phase for CML
        • Relapsed or refractory after treatment with standard chemotherapy and imatinib mesylate for Ph-positive ALL
  • No active CNS or epidural tumor
  • Hormone receptor status:

    • Not specified

PATIENT CHARACTERISTICS:

Age:

  • 18 and over

Sex:

  • Not specified

Menopausal status:

  • Not specified

Performance status:

  • Karnofsky 70-100%

Life expectancy:

  • At least 6 months

Hematopoietic:

  • WBC greater than 3,500/mm^3
  • Platelet count greater than 100,000/mm^3
  • No restrictions based on peripheral blood counts for CML and Ph-positive ALL

Hepatic:

  • Bilirubin no greater than 1.2 times upper limit of normal (ULN)
  • AST less than 1.5 times ULN
  • Prothrombin time normal

Renal:

  • Creatinine no greater than 1.5 times ULN OR
  • Creatinine clearance greater than 60 mL/min

Cardiovascular:

  • No myocardial infarction within the past 6 months
  • Ejection fraction greater than 45% by radionuclide cardiac angiography
  • No ventricular aneurysm or other abnormal wall motion
  • No reversible defect by thallium stress test if any of the following conditions are present:

    • Ejection fraction less than 45% on radionuclide angiocardiography
    • Worrisome but nonexclusive cardiovascular history
    • Abnormal echocardiogram
  • Patients with the following history or clinical findings require additional diagnostic testing:

    • Significant Q waves (greater than 3 mm or greater than one-third of the height of the QRS complex)
    • ST elevation or depressions of greater than 2 mm that are not attributable to hypertension strain
    • Absence of regular sinus rhythm
    • Bundle branch block
    • Requirement for diuretics for reasons other than hypertension or digoxin for reasons other than atrial fibrillation
    • Prior mild to moderate congestive heart failure
  • No New York Heart Association class III or IV heart disease
  • No angina pectoris
  • No uncontrolled hypertension or intermittent claudication
  • No severe debilitating valvular disease

Pulmonary:

  • No severe debilitating pulmonary disease

Other:

  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No active infection requiring IV antibiotics
  • No symptomatic peripheral neuropathy grade 2 or higher
  • No other severe medical conditions that would increase risk for toxicity
  • No allergy to eggs or egg products

PRIOR CONCURRENT THERAPY:

Biologic therapy:

  • At least 4 weeks since prior biologic therapy (including interferon for CML) and recovered

Chemotherapy:

  • At least 4 weeks since prior chemotherapy (3 days for hydroxyurea for CML or ALL) and recovered
  • No other concurrent chemotherapy

Endocrine therapy:

  • See Disease Characteristics
  • At least 4 weeks since prior endocrine therapy and recovered

Radiotherapy:

  • At least 4 weeks since prior radiotherapy and recovered
  • Concurrent radiotherapy to localized disease sites not being used to evaluate antitumor response allowed
  • No concurrent radiotherapy to only measurable lesion

Surgery:

  • See Disease Characteristics
  • Prior orchiectomy allowed
  • No concurrent surgery

Other:

  • At least 3 days since prior imatinib mesylate for CML or ALL
  • At least 4 weeks since prior investigational anticancer drugs and recovered
  • At least 4 weeks since prior palliative treatment for metastatic disease
  • No concurrent ketoconazole, warfarin, verapamil, miconazole, or erythromycin
  • No other concurrent investigational drugs

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio

1 luglio 1999

Completamento primario (Effettivo)

1 marzo 2005

Completamento dello studio (Effettivo)

1 marzo 2005

Date di iscrizione allo studio

Primo inviato

10 dicembre 1999

Primo inviato che soddisfa i criteri di controllo qualità

26 gennaio 2003

Primo Inserito (Stima)

27 gennaio 2003

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Stima)

24 giugno 2013

Ultimo aggiornamento inviato che soddisfa i criteri QC

20 giugno 2013

Ultimo verificato

1 giugno 2013

Maggiori informazioni

Termini relativi a questo studio

Parole chiave

Altri numeri di identificazione dello studio

  • 99-037
  • CDR0000067267 (Identificatore di registro: PDQ (Physician Data Query))
  • NCI-T99-0035
  • UCLA-0206019

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .

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