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Vorinostat in Treating Patients With Metastatic or Unresectable Solid Tumors or Lymphoma and Liver Dysfunction

This study is currently recruiting participants.
Verified by National Cancer Institute (NCI), May 2008

Sponsors and Collaborators: UPMC Cancer Centers
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00499811
  Purpose

RATIONALE: Vorinostat may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Vorinostat may have different effects in patients who have changes in their liver function.

PURPOSE: This phase I trial is studying the side effects and best dose of vorinostat in treating patients with metastatic or unresectable solid tumors or lymphoma and liver dysfunction.


Condition Intervention Phase
Lymphoma
Small Intestine Cancer
Unspecified Adult Solid Tumor, Protocol Specific
Drug: vorinostat
Procedure: pharmacological study
Phase I

MedlinePlus related topics:   Cancer    Fungal Infections    Hodgkin's Disease    Intestinal Cancer    Leukemia, Adult Acute    Leukemia, Adult Chronic    Lymphoma   

ChemIDplus related topics:   Suberoylanilide hydroxamic acid    Salicylsalicylic acid    Sodium salicylate   

U.S. FDA Resources

Study Type:   Interventional
Study Design:   Treatment
Official Title:   Phase I and Pharmacokinetic Study of Vorinostat for Solid Tumors and Lymphomas in Patients With Varying Degrees of Hepatic Dysfunction

Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Pharmacokinetic variables corresponding to the disposition of vorinostat (SAHA) [ Designated as safety issue: No ]
  • Maximum tolerated dose and dose-limiting toxicity of vorinostat in groups of patients with varying degrees of hepatic dysfunction (mild, moderate, or severe) [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Toxicity profile of vorinostat [ Designated as safety issue: Yes ]
  • Clinical response rate [ Designated as safety issue: No ]
  • Child-Pugh classification and liver function test results [ Designated as safety issue: No ]

Estimated Enrollment:   112
Study Start Date:   June 2007
Estimated Primary Completion Date:   January 2012 (Final data collection date for primary outcome measure)

Detailed Description:

OBJECTIVES:

Primary

  • Determine the pharmacokinetic disposition of vorinostat (SAHA) in patients with metastatic or unresectable solid tumors or lymphoma and varying degrees of hepatic dysfunction.
  • Establish the maximum tolerated dose (MTD) and dose-limiting toxicity (DLT) of vorinostat in groups of patients with varying degrees of hepatic dysfunction (mild, moderate, or severe).

Secondary

  • Document the non-DLTs associated with administration of vorinostat in patients with hepatic dysfunction.
  • Determine the association of the Child-Pugh classification of hepatic dysfunction with the observed toxicities, plasma pharmacokinetics, and pharmacodynamics of vorinostat administration.
  • Document any antitumor activity associated with vorinostat treatment in patients enrolled on this study.

OUTLINE: This is a parallel-group, dose-escalation study. Patients are stratified according to level of hepatic dysfunction (normal vs mild vs moderate vs severe).

  • Part I: Vorinostat (SAHA) will be administered as a single oral dose on day -6 for all patients.

Blood samples are obtained periodically on day -6 for pharmacokinetic studies.

  • Part II: One week later (day 1), the first cycle of oral vorinostat will be initiated on a continuous daily oral regimen. Each treatment cycle will consist of 21 days of therapy. Treatment continues in the absence of disease progression or unacceptable toxicity.

Dose escalation will proceed within each hepatic dysfunction group (except in the normal group). Only dose-limiting toxicities (DLTs) that occur during the first cycle of treatment will be used to guide dose escalation. The maximum tolerated dose (MTD) is the highest dose at which no more than one instance of DLT is observed (among 6 patients treated). Once the MTD has been determined for a given hepatic dysfunction group, a maximum of 12 patients will be accrued to this dose level.

After completion of study treatment, patients are followed for 4 weeks.

  Eligibility
Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Criteria

DISEASE CHARACTERISTICS:

  • Histologically or cytologically confirmed solid malignancy or lymphoma that is metastatic or unresectable

    • Patients with a liver mass, elevated α-fetoprotein level (≥ 500 ng/mL), and positive serology for hepatitis consistent with a diagnosis of hepatocellular carcinoma will be eligible without the need for pathologic confirmation of the diagnosis
  • Standard curative or palliative measures do not exist or are no longer effective

    • Patients who have not received any prior therapy for malignancy are also eligible if they are ineligible for standard therapy due to hepatic dysfunction
  • Patients with abnormal liver function will be eligible

    • No distinction will be made between liver dysfunction due to metastases and liver dysfunction due to other causes
    • Patients with biliary obstruction for which a shunt has been placed are eligible, provided the shunt has been in place for at least 10 days prior to the first dose of vorinostat (SAHA) and liver function has stabilized

      • Two measurements at least 2 days apart that put the patient in the same hepatic dysfunction stratum will be accepted as evidence of stable hepatic function
    • No evidence of biliary sepsis
  • Patients with gliomas or brain metastases who require corticosteroids or anticonvulsants must be on a stable dose of corticosteroids and seizure free for 1 month prior to study enrollment

    • Patients with known brain metastases should have had brain irradiation (whole brain or gamma knife) more than 4 weeks before starting protocol treatment
    • Patients with unstable or untreated (non-irradiated) brain metastases should be excluded

PATIENT CHARACTERISTICS:

  • ECOG performance status ≤ 2 (Karnofsky ≥ 60%)
  • Life expectancy > 3 months
  • Absolute neutrophil count > 1,500/mm^3
  • Platelets ≥ 100,000/mm^3
  • Creatinine within normal institutional limits OR creatinine clearance ≥ 60 mL/min
  • Not pregnant or nursing
  • Fertile patients must use effective contraception
  • HIV-positive patients without an AIDS-defining diagnosis who are not receiving agents with the potential for pharmacokinetic interactions with vorinostat may be eligible
  • Able to take oral medications on a continuous basis
  • No uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
  • No active hemolysis

PRIOR CONCURRENT THERAPY:

  • More than 3 weeks since prior chemotherapy or radiotherapy (6 weeks for nitrosoureas or mitomycin C) and recovered

    • Patients who have been treated with agents that persist in the body for longer than 4 to 6 weeks (such as suramin) are ineligible during the elimination period for those agents
  • More than 14 days since prior major surgery
  • No prior vorinostat
  • At least 2 weeks since prior valproic acid or other histone deacetylase inhibitors
  • More than 4 weeks since other prior investigational agents
  • No concurrent combination antiretroviral therapy for HIV-positive patients
  • No concurrent therapy with enzyme-inducing anticonvulsants
  • No concurrent prophylactic granulocyte growth factors during the first cycle of therapy
  • No other concurrent investigational or commercial agents or therapies
  Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00499811

Locations
United States, California
City of Hope Medical Group     Recruiting
      Pasadena, California, United States, 91105
      Contact: Mark V. McNamara, MD     626-396-2900     mmcnamara@ccsmg.com    
United States, Maryland
Warren Grant Magnuson Clinical Center - NCI Clinical Trials Referral Office     Recruiting
      Bethesda, Maryland, United States, 20892-1182
      Contact: Clinical Trials Office - Warren Grant Magnusen Clinical Center     888-NCI-1937        
United States, Michigan
Barbara Ann Karmanos Cancer Institute     Recruiting
      Detroit, Michigan, United States, 48201-1379
      Contact: Clinical Trials Office - Barbara Ann Karmanos Cancer Institute     313-576-9363        
United States, Pennsylvania
Penn State Cancer Institute at Milton S. Hershey Medical Center     Recruiting
      Hershey, Pennsylvania, United States, 17033-0850
      Contact: Clinical Trials Office - Penn State Cancer Institute at Milton     717-531-3779     CTO@hmc.psu.edu    
UPMC Cancer Centers     Recruiting
      Pittsburgh, Pennsylvania, United States, 15232
      Contact: Clinical Trials Office - UPMC Cancer Centers     412-647-8073        

Sponsors and Collaborators
UPMC Cancer Centers
National Cancer Institute (NCI)

Investigators
Study Chair:     Suresh Ramalingam, MD     UPMC Cancer Centers    
Principal Investigator:     Shivaani Kummar, MD     NCI - Medical Oncology Branch    
  More Information


Clinical trial summary from the National Cancer Institute's PDQ® database  This link exits the ClinicalTrials.gov site
 

Study ID Numbers:   CDR0000555102, PCI-07013, PCI-UPCI 07-013, NCI-07-C-0228
First Received:   July 10, 2007
Last Updated:   July 23, 2008
ClinicalTrials.gov Identifier:   NCT00499811
Health Authority:   Unspecified

Keywords provided by National Cancer Institute (NCI):
unspecified adult solid tumor, protocol specific  
recurrent adult Hodgkin lymphoma  
stage IV adult Hodgkin lymphoma  
stage III adult Hodgkin lymphoma  
recurrent adult T-cell leukemia/lymphoma  
stage IV adult T-cell leukemia/lymphoma  
stage III adult T-cell leukemia/lymphoma  
anaplastic large cell lymphoma  
angioimmunoblastic T-cell lymphoma  
cutaneous B-cell non-Hodgkin lymphoma  
recurrent mycosis fungoides/Sezary syndrome  
stage IV mycosis fungoides/Sezary syndrome  
stage III mycosis fungoides/Sezary syndrome  
recurrent cutaneous T-cell non-Hodgkin lymphoma  
stage IV cutaneous T-cell non-Hodgkin lymphoma  
stage III cutaneous T-cell non-Hodgkin lymphoma
stage IV adult Burkitt lymphoma
stage III adult Burkitt lymphoma
stage IV adult diffuse large cell lymphoma
stage III adult diffuse large cell lymphoma
stage IV adult diffuse mixed cell lymphoma
stage III adult diffuse mixed cell lymphoma
stage IV adult diffuse small cleaved cell lymphoma
stage III adult diffuse small cleaved cell lymphoma
stage IV adult immunoblastic large cell lymphoma
stage III adult immunoblastic large cell lymphoma
stage IV adult lymphoblastic lymphoma
stage III adult lymphoblastic lymphoma
stage IV grade 1 follicular lymphoma
stage III grade 1 follicular lymphoma

Study placed in the following topic categories:
Sezary syndrome
Lymphoma, Mantle-Cell
Hodgkin lymphoma, adult
Lymphoma, small cleaved-cell, diffuse
Lymphoma, large-cell, immunoblastic
Central nervous system lymphoma, primary
Duodenal Neoplasms
Lymphomatoid granulomatosis
Mycoses
Lymphoma, Large-Cell, Anaplastic
Hodgkin Disease
Lymphoma, Large B-Cell, Diffuse
Immunoproliferative Disorders
Digestive System Neoplasms
Leukemia, B-cell, chronic
Waldenstrom Macroglobulinemia
B-cell lymphomas
Leukemia, T-Cell
Gastrointestinal Neoplasms
Anaplastic large cell lymphoma
Lymphoma, Non-Hodgkin
Lymphoma, T-Cell, Cutaneous
Hodgkin's disease
Gastrointestinal Diseases
Cutaneous T-cell lymphoma
Sodium Salicylate
Lymphoma, Follicular
Lymphoma, B-Cell, Marginal Zone
Sezary Syndrome
Mycosis Fungoides

Additional relevant MeSH terms:
Anti-Inflammatory Agents
Anticarcinogenic Agents
Neoplasms by Histologic Type
Immune System Diseases
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Physiological Effects of Drugs
Enzyme Inhibitors
Ileal Diseases
Protective Agents
Pharmacologic Actions
Neoplasms
Neoplasms by Site
Sensory System Agents
Analgesics, Non-Narcotic
Jejunal Diseases
Therapeutic Uses
Anti-Inflammatory Agents, Non-Steroidal
Peripheral Nervous System Agents
Analgesics
Antirheumatic Agents
Central Nervous System Agents

ClinicalTrials.gov processed this record on October 06, 2008




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