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Bortezomib and Gemcitabine in Treating Older Patients With Advanced Solid Tumors

27 november 2017 uppdaterad av: Masonic Cancer Center, University of Minnesota

Phase I Study of Bortezomib and Gemcitabine in Elderly Patients With Solid Tumors (X05227)

RATIONALE: Bortezomib may stop the growth of solid tumors by blocking some of the enzymes needed for cell growth and by blocking blood flow to the tumor. Drugs used in chemotherapy, such as gemcitabine, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving bortezomib together with gemcitabine may kill more tumor cells.

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

Studieöversikt

Detaljerad beskrivning

OBJECTIVES:

Primary

  • To determine the maximum tolerated dose of weekly bortezomib and gemcitabine in treating elderly patients with advanced solid tumors.

Secondary

  • To characterize the quantitative and qualitative toxicities of bortezomib and gemcitabine in these patients.
  • To obtain preliminary information about the anti-tumor activity of bortezomib and gemcitabine.
  • To characterize gemcitabine and metabolite pharmacokinetics in patients receiving concurrent bortezomib therapy.

OUTLINE: This is a phase I dose escalation study of bortezomib and gemcitabine.

Patients receive gemcitabine intravenously (IV) over 30 minutes followed 1 hour later by bortezomib IV over 3-5 seconds on days 1 and 8. Treatment repeats every 21 days for up to 6 courses in the absence of disease progression or unacceptable toxicity.

Cohorts of 3-6 patients receive escalating doses of gemcitabine and bortezomib until the maximum tolerated dose of the combination is determined.

Blood is collected periodically for pharmacokinetic and pharmacogenetic studies.

After completion of study treatment, patients are followed every 3 months for up to 1 year.

Studietyp

Interventionell

Inskrivning (Faktisk)

17

Fas

  • Fas 1

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

    • Minnesota
      • Minneapolis, Minnesota, Förenta staterna, 55455
        • Masonic Cancer Center at University of Minnesota

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

70 år och äldre (Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

Inclusion Criteria:

  • Histologically or cytologically confirmed diagnosis of advanced non-hematologic malignancy, including any of the following:

    • Breast cancer
    • Lung cancer
    • Colon cancer
    • Pancreatic cancer
    • Head and neck cancer
    • Sarcoma
  • Must have failed or become intolerant to prior standard therapy and is no longer likely to respond to such therapy (for all diseases except pancreatic cancer)

    • Pancreatic cancer patients may be enrolled with no prior therapy requirements since gemcitabine is the current standard of care 1st line therapy
  • Measurable or nonmeasurable disease
  • Concurrent enrollment in the University of Minnesota study "Population Pharmacokinetics and Pharmacogenetics of Gemcitabine in Adult Patients with Solid Tumors" (Human Subjects Code 0508M72989) required
  • ECOG performance status of 0-1
  • Absolute neutrophil count ≥ 1,500/mm³
  • Platelet count ≥ 100,000/mm³
  • Hemoglobin ≥ 10 g/dL
  • Bilirubin ≤ 1.5 times upper limit of normal (ULN)
  • Alkaline phosphatase ≤ 3.0 times ULN (5 times ULN if liver has tumor involvement)
  • Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 3.0 times ULN (5 times ULN if liver has tumor involvement)
  • Calculated or measured creatinine clearance > 30 mL/minute
  • Fertile patients must use effective contraception during and for 3 months after study participation
  • Recovered from all prior therapy
  • Prior systemic chemotherapy, immunotherapy, or biological therapy allowed
  • At least 3 months since prior bortezomib and/or gemcitabine
  • At least 2 weeks since prior systemic therapy
  • At least 3 weeks since prior investigational agents (for reasons other than the treatment of cancer)
  • At least 2 weeks since prior radiotherapy

Exclusion Criteria:

  • Symptomatic brain metastases
  • Serious concomitant medical or psychiatric disorders (e.g., active infection or uncontrolled diabetes) that, in the opinion of the investigator, would compromise the safety of the patient or compromise the patient's ability to complete the study
  • Myocardial infarction within the past 6 months
  • New York Heart Association (NYHA) Class III or IV heart failure
  • Uncontrolled angina
  • Severe uncontrolled ventricular arrhythmias
  • Electrocardiographic evidence of acute ischemia or active conduction system abnormalities
  • Peripheral neuropathy ≥ grade 2
  • Known hypersensitivity to bortezomib, boron or mannitol
  • Prior radiotherapy to ≥ 25% of the bone marrow
  • Prior radiotherapy to the whole pelvis
  • Concurrent filgrastim (G-CSF) or other hematologic support during course 1 of study treatment

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: N/A
  • Interventionsmodell: Enskild gruppuppgift
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: Gemcitabine / Bortezomib

Gemcitabine will be administered as a 30 minute intravenous infusion at the patient's assigned dose on day 1 and day 8 of a 21 day cycle.

Bortezomib will be given 1 hour after gemcitabine by IVP over 3 to 5 seconds followed by a standard saline on days 1 and 8 of a 21 day treatment cycle until disease progression or for a maximum of 6 cycles.

Bortezomib will be given 1 hour after gemcitabine by intravenous pyelogram (IVP) over 3 to 5 seconds followed by a standard saline flush or through a running intravenous (IV) line at the patient's assigned dose (1.0 up to 1.8 mg/m^2) on days 1 and 8 of a 21 day treatment cycle until disease progression or for a maximum of 6 cycles.
Andra namn:
  • Velcade
Gemcitabine will be administered as a 30 minute intravenous infusion at the patient's assigned dose (800 up to 1000 mg/m^2) on day 1 and day 8 of a 21 day cycle.
Andra namn:
  • Gemzar

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Maximum tolerated dose of bortezomib and gemcitabine
Tidsram: Day 21 (Week 3 - Cycle 1)
A minimum of a 3 week period (1 cycle) must be completed by all patients within a dose level before dose escalation to the next level may occur. A cycle is defined as treatment day 1 and 8 with follow-up through day 21.
Day 21 (Week 3 - Cycle 1)

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Toxicity
Tidsram: 30 Days after Last Treatment
Toxicity will be graded using the NCI's Common Terminology Criteria for Adverse Events (CTCAE 3.0)
30 Days after Last Treatment
Disease response as measured by RECIST criteria
Tidsram: Week 4
The best overall response is the best response recorded from the start of treatment until disease progression/recurrence, taking as reference for progressive disease the smallest measurements recorded since the treatment began.
Week 4
Characterization of gemcitabine and metabolite pharmacokinetics (as part of co-enrollment in Population Pharmacokinetics and Pharmacogenetics of Gemcitabine in Adult Patients with Solid Tumors")
Tidsram: Pre-Dose
Pharmacokinetics will be done in conjunction with the dosing day 1 of cycle 1 whenever possible.
Pre-Dose

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart

1 mars 2007

Primärt slutförande (Faktisk)

1 februari 2009

Avslutad studie (Faktisk)

1 oktober 2009

Studieregistreringsdatum

Först inskickad

20 februari 2008

Först inskickad som uppfyllde QC-kriterierna

20 februari 2008

Första postat (Uppskatta)

21 februari 2008

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

29 november 2017

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

27 november 2017

Senast verifierad

1 november 2017

Mer information

Termer relaterade till denna studie

Andra studie-ID-nummer

  • CDR0000586510
  • UMN-2006LS040 (Annan identifierare: CPRC, University of Minnesota)
  • UMN-X05227 (Annan identifierare: Millennium Pharm., Inc.)
  • x464 (Annan identifierare: Eli Lilly & Co.)

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Kliniska prövningar på bortezomib

3
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