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Tirapazamine Plus Cyclophosphamide in Treating Children With Refractory Solid Tumors

4. februar 2013 oppdatert av: National Cancer Institute (NCI)

A Trial of Tirapazamine and Cyclophosphamide in Children With Refractory Solid Tumors

Phase I trial to study the effectiveness of tirapazamine plus cyclophosphamide in treating children who have refractory solid tumors. Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Combining more than one drug may kill more tumor cells.

Studieoversikt

Detaljert beskrivelse

OBJECTIVES:

I. Determine the maximum tolerated dose and the dose limiting toxicity of tirapazamine when administered with cyclophosphamide as intravenous infusions to children with refractory solid tumors.

II. Determine the incidence and severity of other toxicities of tirapazamine and cyclophosphamide in these patients.

III. Determine a safe and tolerable dose of tirapazamine administered with cyclophosphamide for a phase II study for the same indications.

IV. Determine the pharmacokinetics of tirapazamine in children and adolescents receiving the combination of tirapazamine and cyclophosphamide.

V. Determine the preliminary evidence of antitumor activity of tirapazamine and cyclophosphamide.

OUTLINE: This is a dose escalation study.

Patients receive tirapazamine by 2 hour intravenous infusion (hours 0-2) followed 2 hours later by a 30 minute intravenous infusion of cyclophosphamide. This course is repeated every 3 weeks in patients with partial/complete response or stable disease for a maximum of 1 year. Cohorts of 3-6 patients each are treated at each dose level of tirapazamine. Dose escalation of tirapazamine occurs when 0 of 3 patients or 1 of 6 patients has experienced dose limiting toxicity (DLT). If DLT is experienced in 1 of 3 patients at a given dose level, up to 3 additional patients are treated at that same dose level. If none of the 3 additional patients at that dose level experiences DLT, the dose is escalated. If DLT is experienced in 1 or more of the additional 3 patients, the maximum tolerated dose (MTD) has been exceeded and 3 patients are treated at the next lower dose level (defined as the MTD). A total of six patients are treated at the MTD. If DLT is proved to be neutropenia, patients must then also meet the additional eligibility criteria listed for stratum 2. If neutropenia continues to be the DLT in stratum 2, then additional patients receive subcutaneous filgrastim (granulocyte colony-stimulating factor; G-CSF) beginning 24 hours after cyclophosphamide. A second MTD may be determined for chemotherapy with G-CSF. Patients are followed every 6 months for 4 years, and then annually thereafter.

Studietype

Intervensjonell

Registrering (Faktiske)

12

Fase

  • Fase 1

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

    • Ontario
      • Toronto, Ontario, Canada, M5G 1X8
        • Hospital for Sick Children
    • Quebec
      • Montreal, Quebec, Canada, H3H 1P3
        • Montreal Children's Hospital
      • Montreal, Quebec, Canada, H3T 1C5
        • Hôpital Sainte Justine
    • Alabama
      • Birmingham, Alabama, Forente stater, 35294
        • University of Alabama Comprehensive Cancer Center
    • Arkansas
      • Little Rock, Arkansas, Forente stater, 72205
        • University of Arkansas for Medical Sciences
    • California
      • La Jolla, California, Forente stater, 92093-0658
        • University of California San Diego Cancer Center
      • Palo Alto, California, Forente stater, 94304
        • Lucile Packard Children's Hospital at Stanford
    • Florida
      • Miami, Florida, Forente stater, 33136
        • Sylvester Cancer Center, University of Miami
    • Georgia
      • Atlanta, Georgia, Forente stater, 30322
        • Emory University Hospital - Atlanta
    • Illinois
      • Chicago, Illinois, Forente stater, 60614
        • Children's Memorial Hospital, Chicago
    • Kansas
      • Kansas City, Kansas, Forente stater, 66160-7357
        • University of Kansas Medical Center
    • Maryland
      • Baltimore, Maryland, Forente stater, 21287
        • Johns Hopkins Oncology Center
    • Massachusetts
      • Boston, Massachusetts, Forente stater, 02115
        • Dana-Farber Cancer Institute
      • Boston, Massachusetts, Forente stater, 02111
        • Floating Hospital for Children
    • Michigan
      • Detroit, Michigan, Forente stater, 48201
        • Children's Hospital of Michigan
    • Mississippi
      • Jackson, Mississippi, Forente stater, 39216-4505
        • University of Mississippi Medical Center
    • Missouri
      • Saint Louis, Missouri, Forente stater, 63110
        • Washington University School of Medicine
      • Saint Louis, Missouri, Forente stater, 63104
        • Cardinal Glennon Children's Hospital
    • New Jersey
      • Hackensack, New Jersey, Forente stater, 07601
        • Hackensack University Medical Center
    • New York
      • Buffalo, New York, Forente stater, 14263-0001
        • Roswell Park Cancer Institute
      • Syracuse, New York, Forente stater, 13210
        • State University of New York - Upstate Medical University
    • North Carolina
      • Durham, North Carolina, Forente stater, 27710
        • Duke Comprehensive Cancer Center
    • Tennessee
      • Memphis, Tennessee, Forente stater, 38105-2794
        • Saint Jude Children's Research Hospital
    • Texas
      • Dallas, Texas, Forente stater, 75235-9154
        • Simmons Cancer Center - Dallas
      • Fort Worth, Texas, Forente stater, 76104
        • Cook Children's Medical Center - Fort Worth
      • Houston, Texas, Forente stater, 77030
        • Baylor College of Medicine
      • San Antonio, Texas, Forente stater, 78284
        • University of Texas Health Science Center at San Antonio
    • Wisconsin
      • Milwaukee, Wisconsin, Forente stater, 53226
        • Midwest Children's Cancer Center

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

Ikke eldre enn 21 år (Barn, Voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

DISEASE CHARACTERISTICS:

  • Histologically confirmed solid tumor that is refractory to conventional therapy or for which no effective therapy is known
  • Brain tumors eligible Brainstem gliomas may waive histological verification requirement
  • Neurologic deficits associated with CNS malignancies must be stable for a minimum of 4 weeks prior to study
  • No leukemia Stratum 2
  • No marrow involvement

PATIENT CHARACTERISTICS:

  • Age: 21 and under
  • Performance status: Karnofsky or Lansky 50-100%
  • Life expectancy: At least 8 weeks
  • Absolute neutrophil count at least 1,000/mm3
  • Platelet count at least 75,000/mm3
  • Hemoglobin at least 9 g/dL
  • Bilirubin less than 1.5 mg/dL
  • SGPT less than 5 times normal
  • Creatinine normal for age OR creatinine clearance at least 70 mL/min
  • Shortening fraction at least 27% of normal OR ejection fraction greater than 50% of normal
  • Not pregnant or nursing
  • Negative pregnancy test required

PRIOR CONCURRENT THERAPY:

  • No concurrent anticancer therapy
  • At least 6 months since bone marrow transplant and no evidence of graft versus host disease
  • At least 1 week since growth factors
  • No concurrent granulocyte colony-stimulating factor
  • Recovered from prior immunotherapy
  • Stratum 2: No prior bone marrow transplantation (with or without total body irradiation)
  • At least 6 weeks since prior nitrosourea
  • At least 2 weeks since other prior myelosuppressive chemotherapy
  • Dexamethasone must be a stable or decreasing dose for 2 weeks prior to study
  • Recovered from prior chemotherapy
  • Stratum 2: No more than 2 prior chemotherapy regimens
  • At least 2 weeks since local palliative radiotherapy (small port)
  • At least 6 months since prior substantial bone marrow radiation (e.g., cross- sectional radiotherapy [greater than 24 Gy], total body irradiation, hemi- pelvic radiotherapy)
  • Recovered from prior radiotherapy
  • Stratum 2: No prior central axis radiation

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: N/A
  • Intervensjonsmodell: Enkeltgruppeoppdrag
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Arm I
See arm description.

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Etterforskere

  • Studiestol: Victor Aquino, MD, Simmons Cancer Center

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart

1. august 1998

Primær fullføring (Faktiske)

1. juni 2003

Datoer for studieregistrering

Først innsendt

1. november 1999

Først innsendt som oppfylte QC-kriteriene

10. september 2004

Først lagt ut (Anslag)

13. september 2004

Oppdateringer av studieposter

Sist oppdatering lagt ut (Anslag)

5. februar 2013

Siste oppdatering sendt inn som oppfylte QC-kriteriene

4. februar 2013

Sist bekreftet

1. april 2000

Mer informasjon

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .

Abonnere