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Cetuximab in Treating Patients With Advanced Solid Tumors

25 maart 2010 bijgewerkt door: University of California, Davis

A Phase I Study of the Safety and Tolerability of Four Doses of Cetuximab (C225) in Patients With Advanced Solid Tumors

RATIONALE: Monoclonal antibodies, such as cetuximab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them.

PURPOSE: This phase I trial is studying the side effects and best dose of cetuximab in treating patients with advanced solid tumors.

Studie Overzicht

Gedetailleerde beschrijving

OBJECTIVES:

Primary

  • Determine the maximum tolerated dose of cetuximab in patients with advanced solid tumors.

Secondary

  • Evaluate the safety and tolerability of this drug in these patients.
  • Develop a detailed scale for assessment of rash in these patients.
  • Investigate potential predictors of response using correlative studies on patient tissue, buccal mucosa, and blood samples.
  • Obtain preliminary efficacy data and evaluate the relationship of efficacy to grade of rash.
  • Correlate downstream markers (e.g., pMAPK, pAKT, and Ki-67) and the presence of epidermal growth factor receptor (EGFR) polymorphisms with clinical response and/or survival.
  • Examine the levels of downstream marker proteins in buccal cells obtained pre- and post-treatment.
  • Correlate basal p27 expression levels with response and/or survival.
  • Determine if the presence of a K-RAS mutation influences response or survival outcome.
  • Correlate the presence or absence of mutant K-RAS tumor DNA shed into patient plasma with response and/or outcome.
  • Correlate levels of cytokines and chemokines with rash and clinical response.

OUTLINE: This is an open-label, dose-escalation study.

Patients receive cetuximab IV over 90 minutes once weekly for 4 weeks. Treatment repeats every 4 weeks for up to 12 courses in the absence of disease progression or unacceptable toxicity.

Cohorts of 3-6 patients receive escalating doses of cetuximab 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. At least 6 patients are treated at the MTD.

Patients undergo blood and buccal mucosa collection at baseline and prior to courses 2 and 3 of treatment for molecular correlative studies. Archival tumor tissue specimens are also used for molecular correlative studies. Immunologic correlative studies are performed using patient blood samples.

After completion of study treatment, patients are followed periodically for survival.

PROJECTED ACCRUAL: A total of 20 patients will be accrued for this study.

Studietype

Ingrijpend

Inschrijving (Werkelijk)

27

Fase

  • Fase 1

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studie Locaties

    • California
      • Sacramento, California, Verenigde Staten, 95817
        • University of California Davis Cancer Center

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

18 jaar en ouder (Volwassen, Oudere volwassene)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

Beschrijving

Inclusion Criteria:

  • Signed written informed consent
  • Histologically or cytologically proven advanced solid tumors not curable by surgery, radiation therapy or standard chemo-, immuno-, or hormonal therapy. A specific primary cancer need not have been identified (i.e., unknown primary is eligible).
  • Patients must have received at least one prior regimen (chemotherapy and/or radiation) for metastatic disease. There is no limit to the number of prior therapies.
  • Any prior chemotherapy must have been completed at least 4 weeks prior to start of study therapy. Previous radiation therapy must have been completed at least 2 weeks prior to start of study therapy. All side effects of prior therapy must be resolved prior to the start of study therapy.
  • Patients with ZUBROD performance status 0-2 (see Appendix 1).
  • Patients must have measurable disease or evaluable disease.
  • Patients must have an estimated survival of at least 3 months.
  • Patients with asymptomatic treated brain metastasis (surgical resection or radiotherapy) may be included if they are neurologically stable and have been off steroids for at least 4 weeks.
  • Patients >/= 18 years of age.
  • Patients of reproductive potential must agree to use an effective contraceptive method while on treatment and for 3 months afterward as the effects of cetuximab on the unborn fetus are unknown.
  • Patients must have adequate hematologic function defined as: ANC >/= 1,500/mm3, platelets >/= 100,000/mm3.
  • Patients must have adequate hepatic function defined as SGOT </= 3 x institutional UNL and serum bilirubin </= 2.0 mg/dL.
  • Patients must have adequate renal function defined as a serum creatinine level </= 1.6 mg/dL or a calculated creatinine clearance of >/= 40 ml/min.

Exclusion Criteria:

  • Female patients cannot be pregnant or breastfeeding as the effects of cetuximab on the unborn fetus are unknown. Documentation of a negative pregnancy test prior to treatment is required for all women of reproductive potential.
  • Uncontrolled intercurrent illness including but not limited to ongoing infection or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situation that would limit compliance with study requirements.
  • Patients with symptomatic brain metastasis or still requiring steroids.
  • Patients who have received prior cetuximab therapy, prior therapy with any other drug that targets the EGF receptor (including, but not limited to, Iressa, Tarceva, Herceptin, CI1033, etc.), or prior therapy with a monoclonal antibody.
  • Patients who have received prior chemotherapy within 4 weeks or radiation therapy within 2 weeks prior to the start of study therapy.
  • Prior hypersensitivity reaction to chimerized or murine monoclonal antibody therapy.
  • Patients may not receive any other chemotherapy, radiation therapy, or biologic therapy while on study.

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Behandeling
  • Toewijzing: Niet-gerandomiseerd
  • Interventioneel model: Opdracht voor een enkele groep
  • Masker: Geen (open label)

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: Phase I dose escalation study
Dose level 0: cetuximab 400 mg/m2 week 1, 250 mg/m2 weekly; Dose level 1: cetuximab 400 mg/m2 week 1, 300 mg/m2 weekly; Dose level 2: cetuximab 400 mg/m2 week 1, 350 mg/m2 weekly; Dose level 3: cetuximab 400 mg/m2 week 1, 400 mg/m2 weekly
Andere namen:
  • Erbitux
  • IMC-C225
Tissue and Blood Specimens; IHC Methodology; IHC Scoring; K-RAS Mutation Analysis
Peripheral Blood Mononuclear Cells (PBMC)
Cetuximab Pharmacodynamics

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Tijdsspanne
Maximum tolerated dose of cetuximab
Tijdsspanne: December 2007
December 2007

Secundaire uitkomstmaten

Uitkomstmaat
Tijdsspanne
Safety and tolerability of cetuximab
Tijdsspanne: December 2007
December 2007
Potential predictors of response using correlative studies
Tijdsspanne: December 2007
December 2007
Correlation of efficacy of cetuximab with grade of skin rash
Tijdsspanne: December 2007
December 2007
Development of a detailed scale for assessing skin rash
Tijdsspanne: December 2007
December 2007

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Onderzoekers

  • Studie stoel: Angela Davies, MD, University of California, Davis

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start

1 december 2004

Primaire voltooiing (Werkelijk)

1 november 2007

Studie voltooiing (Werkelijk)

1 december 2007

Studieregistratiedata

Eerst ingediend

13 september 2006

Eerst ingediend dat voldeed aan de QC-criteria

13 september 2006

Eerst geplaatst (Schatting)

15 september 2006

Updates van studierecords

Laatste update geplaatst (Schatting)

29 maart 2010

Laatste update ingediend die voldeed aan QC-criteria

25 maart 2010

Laatst geverifieerd

1 maart 2010

Meer informatie

Termen gerelateerd aan deze studie

Andere studie-ID-nummers

  • CDR0000506089
  • P30CA093373 (Subsidie/contract van de Amerikaanse NIH)
  • UCDCC-165 (Andere identificatie: University of California, Davis - Cancer Center)
  • BMS-CA225027 (Ander subsidie-/financieringsnummer: Bristol-Myers Squibb)
  • 200412499 (Andere identificatie: University of California, Davis - IRB)
  • IMCL-8420 (Ander subsidie-/financieringsnummer: Imclone Systems, Inc.)

Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .

Klinische onderzoeken op cetuximab

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