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Phase I and Pharmacokinetic Trial of Phenylbutyrate Given as a Continuous Infusion in Pediatric Patients With Refractory Malignancy
This study has been completed.
Sponsored by: National Cancer Institute (NCI)
Information provided by: National Institutes of Health Clinical Center (CC)
ClinicalTrials.gov Identifier: NCT00001565
  Purpose

This is a pharmacokinetic trial. Patients receive phenylbutyrate through a central venous catheter for each 28 day cycle. The first several days of drug administration should be inpatient. Cycles may be repeated if there is no tumor progression or dose limiting toxicities (DLT). There are no breaks between cycles.

Once a minimum of 3 patients have completed at least 4 weeks of therapy without DLT, new patients will be entered at the next dose level.


Condition Intervention Phase
Brain Neoplasms
Neuroblastoma
Drug: phenylbutyrate
Phase I

MedlinePlus related topics: Brain Cancer Cancer Childhood Brain Tumors Neuroblastoma
Drug Information available for: Sodium phenylbutyrate Sodium phenylacetate Phenyl acetate Phenylacetic acid
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Safety Study
Official Title: Phase I and Pharmacokinetic Trial of Phenylbutyrate Given as a Continuous Infusion in Pediatric Patients With Refractory Malignancy

Further study details as provided by National Institutes of Health Clinical Center (CC):

Estimated Enrollment: 35
Study Start Date: December 1996
Estimated Study Completion Date: October 2000
Detailed Description:

Phenylbutyrate is an aromatic fatty acid that is converted to phenylacetate in vivo by mitochondrial beta-oxidation to phenylacetate. Preclinical studies have shown that continuous exposure to phenylacetate or phenylbutyrate can induce tumor cytostasis and differentiation in a wide variety of cell lines including malignant gliomas and neuroblastomas. However, phenylbutyrate has been shown to be a more potent differentiating agent than phenylacetate in a variety of tumor cell lines. In addition, phenylbutyrate appears to have molecular activities that are distinct from phenylacetate. The objective of this trial is to determine the maximum tolerated dose and the toxicities of phenylbutyrate administered as a continuous intravenous infusion for 28 days. In addition, the pharmacokinetics of phenylbutyrate and its metabolite, phenylacetate, will be studied using both model-dependent and model-independent parameters.

  Eligibility

Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Disease Characteristics:

Histologically proven cancer that is refractory to standard therapy.

Patients with neurofibromatosis having progressive inoperable plexiform neurofibromas with potential to cause significant morbidity are eligible.

Patients with brainstem gliomas histology may have histology requirements waived.

Patients without prior therapy are eligible if they have diseases with no available standard therapy.

Patients with evidence of bone marrow involvement by tumor, or a history of either bone marrow transplantation or extensive radiotherapy will be eligible, but inevaluable for hematologic toxicities.

Patients with greater than grade 2 neurocortical toxicity will be excluded.

PRIOR/CONCURRENT THERAPY:

Biologic Therapy: No concurrent hematopoietic growth factor.

Chemotherapy: No chemotherapy within 3 weeks of study.

No nitrosoursea within 6 weeks of study.

No concurrent chemotherapy allowed.

Must be on stable or decreasing dose of dexamethasone within 2 weeks of study.

Endocrine Therapy: Not specified.

Radiotherapy: No radiotherapy within 6 weeks of study.

Surgery: Not specified.

Other:

Patient must be recovered from toxic effects of all prior therapy.

Concurrent antibiotic therapy when appropriate.

Patient Characteristics:

Age: 2 to 21.

Performance Status: ECOG 0-2.

Life Expectancy: At least 8 weeks.

Hematopoietic (hematologic requirements below do not apply to patients with histologically confirmed bone marrow involvement or history of either bone marrow transplantation or extensive radiotherapy; these patients are inevaluable for hematologic toxicity):

Absolute granulocyte count (AGC) at least 1500/mm3.

Platelet count at least 100,000/mm3.

Hemoglobin at least 8 g/dL.

Hepatic:

Bilirubin no greater than 2 mg/Dl.

SGPT less than 2 times normal.

Renal:

Creatinine no greater than 1.5 mg/Dl OR

Creatinine clearance at least 60 Ml/min/square meter.

Other:

No systemic illness.

Not pregnant or nursing.

No amino acidurias or organic acidemias.

  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00001565

Locations
United States, Maryland
National Cancer Institute (NCI)
Bethesda, Maryland, United States, 20892
Sponsors and Collaborators
  More Information

Publications:
Study ID Numbers: 970051, 97-C-0051
Study First Received: November 3, 1999
Last Updated: March 3, 2008
ClinicalTrials.gov Identifier: NCT00001565  
Health Authority: United States: Federal Government

Keywords provided by National Institutes of Health Clinical Center (CC):
Brain Tumors
Differentiation
Maximally Tolerated Dose
Neuroblastoma
Phenylacetate

Study placed in the following topic categories:
Neuroectodermal Tumors, Primitive
4-phenylbutyric acid
Phenylacetic acid
Central Nervous System Diseases
Central Nervous System Neoplasms
Brain Diseases
Neuroblastoma
Brain Neoplasms
Neuroectodermal Tumors
Neoplasms, Germ Cell and Embryonal
Neuroepithelioma
Nervous System Neoplasms
Neuroectodermal Tumors, Primitive, Peripheral
Neoplasms, Glandular and Epithelial

Additional relevant MeSH terms:
Neoplasms
Neoplasms by Histologic Type
Neoplasms by Site
Antineoplastic Agents
Therapeutic Uses
Neoplasms, Nerve Tissue
Nervous System Diseases
Neoplasms, Neuroepithelial
Pharmacologic Actions

ClinicalTrials.gov processed this record on January 15, 2009