Chemotherapy in Treating Patients With Refractory Advanced Solid Tumors or Hematologic Cancer
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.
調査の概要
詳細な説明
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.
研究の種類
段階
- フェーズ 1
連絡先と場所
研究場所
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California
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Los Angeles、California、アメリカ、90095
- Jonsson Comprehensive Cancer Center, UCLA
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New York
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New York、New York、アメリカ、10021
- Memorial Sloan-Kettering Cancer Center
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
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
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
協力者と研究者
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (見積もり)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
キーワード
- IV期腎細胞がん
- 再発腎細胞がん
- ステージ IV 乳がん
- IIIA期乳がん
- 再発乳癌
- IIIB期乳がん
- 再発非小細胞肺がん
- III期膀胱がん
- 再発膀胱がん
- ステージ IV の膀胱がん
- III期前立腺がん
- IV期の前立腺がん
- 再発性前立腺がん
- ステージ IIIA 非小細胞肺がん
- ステージ IIIB 非小細胞肺がん
- IV期の非小細胞肺がん
- 詳細不明の成人固形腫瘍、プロトコル固有
- 原発不明の未治療の転移性頸部扁平上皮がん
- 原発不明の再発転移性扁平上皮頸部がん
- 唇および口腔のIII期扁平上皮癌
- III期の口唇基底細胞がん
- III期の口腔がん
- 口腔のIII期粘表皮癌
- III期の口腔腺様嚢胞癌
- 唇および口腔のステージ IV 扁平上皮癌
- 唇のIV期基底細胞がん
- 口腔のステージ IV 疣贅癌
- 口腔のIV期粘表皮癌
- IV期の口腔腺様嚢胞癌
- 唇および口腔の再発性扁平上皮癌
- 口唇の再発性基底細胞がん
- 再発性口腔がん
- 口腔粘膜表皮癌の再発
- 口腔の再発性腺様嚢胞癌
- III期中咽頭扁平上皮がん
- III期の中咽頭リンパ上皮腫
- IV期の中咽頭扁平上皮癌
- IV期の中咽頭リンパ上皮腫
- 中咽頭の再発性扁平上皮癌
- 中咽頭の再発性リンパ上皮腫
- 上咽頭のIII期扁平上皮癌
- III期の上咽頭リンパ上皮腫
- ステージ IV 上咽頭扁平上皮がん
- ステージ IV 上咽頭リンパ上皮腫
- 上咽頭の再発性扁平上皮癌
- 上咽頭の再発性リンパ上皮腫
- III期の下咽頭扁平上皮癌
- IV期の下咽頭扁平上皮癌
- 下咽頭の再発性扁平上皮癌
- 喉頭のIII期扁平上皮癌
- III期の喉頭疣贅癌
- 喉頭のステージ IV 扁平上皮癌
- ステージ IV の喉頭疣贅癌
- 喉頭の再発性扁平上皮癌
- 再発性喉頭疣贅癌
- 副鼻腔および鼻腔のIII期扁平上皮がん
- III期 副鼻腔および鼻腔の正中線致死性肉芽腫
- III期の副鼻腔および鼻腔の神経芽細胞腫
- 副鼻腔および鼻腔のIV期扁平上皮がん
- IV期 副鼻腔および鼻腔の正中線致死性肉芽腫
- ステージ IV 副鼻腔および鼻腔の esthesioneuroblastoma
- 副鼻腔および鼻腔の再発扁平上皮癌
- 副鼻腔および鼻腔の再発性正中線致死性肉芽腫
- 副鼻腔および鼻腔の再発性神経芽細胞腫
- 再発唾液腺がん
- III期唾液腺がん
- IV期唾液腺がん
- ステージ IV 結腸がん
- 再発大腸がん
- III期の卵巣上皮がん
- ステージ IV の卵巣上皮がん
- 再発性卵巣上皮がん
- III期の結腸がん
- IIIC期乳がん
- 再発性黒色腫
- ステージ IV 黒色腫
- 慢性期慢性骨髄性白血病
- 芽球期慢性骨髄性白血病
- 慢性骨髄性白血病の再発
- IV期胃がん
- 再発胃がん
- III期腎細胞がん
- III期黒色腫
- III期胃がん
- 再発性成人急性リンパ芽球性白血病
- 卵巣肉腫
- 加速期慢性骨髄性白血病
- 境界性卵巣表面上皮間質腫瘍
- 卵巣間質がん
- 再発性卵巣胚細胞腫瘍
- III期の卵巣胚細胞腫瘍
- IV期の卵巣胚細胞腫瘍
- 再発性副鼻腔および鼻腔の逆さ乳頭腫
- III期の副鼻腔および鼻腔の逆乳頭腫
- IV期の副鼻腔および鼻腔の逆乳頭腫
追加の関連 MeSH 用語
その他の研究ID番号
- 99-037
- CDR0000067267 (レジストリ識別子:PDQ (Physician Data Query))
- NCI-T99-0035
- UCLA-0206019
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