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Sunitinib and Gemcitabine in Treating Patients With Pancreatic Cancer or Other Solid Tumors
This study is currently recruiting participants.
Verified by National Cancer Institute (NCI), December 2008
Sponsors and Collaborators: Case Comprehensive Cancer Center
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00462553
  Purpose

RATIONALE: Sunitinib may stop the growth of tumor cells 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 sunitinib together with gemcitabine may kill more tumor cells.

PURPOSE: This phase I trial is studying the side effects and best dose of sunitinib and gemcitabine in treating patients with pancreatic cancer or other solid tumors.


Condition Intervention Phase
Pancreatic Cancer
Unspecified Adult Solid Tumor, Protocol Specific
Drug: gemcitabine hydrochloride
Drug: sunitinib malate
Phase I

MedlinePlus related topics: Cancer Pancreatic Cancer
Drug Information available for: Gemcitabine hydrochloride Gemcitabine Sunitinib Sunitinib malate Pancrelipase Ultrase Malic acid
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment
Official Title: A Phase I Study of Sunitinib Malate and Standard Infusion Gemcitabine in Solid Tumors

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

Primary Outcome Measures:
  • Maximum tolerated dose [ Designated as safety issue: Yes ]
  • Toxicity [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Response rate [ Designated as safety issue: No ]
  • Overall survival [ Designated as safety issue: No ]

Estimated Enrollment: 37
Study Start Date: March 2007
Estimated Primary Completion Date: March 2008 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • Determine the maximum tolerated dose (MTD) of sunitinib malate and gemcitabine hydrochloride in patients with adenocarcinoma of the pancreas or other solid tumors.
  • Determine the toxicity of this regimen in these patients.

OUTLINE: This is a dose-escalation study.

Patients receive gemcitabine hydrochloride IV over 30 minutes on days 1 and 8 OR on days 1, 8, and 15. Patients also receive oral sunitinib malate once daily on days 1-21 OR days 1-28. Treatment repeats every 21 days OR every 28 days in the absence of disease progression or unacceptable toxicity.

Cohorts of 3-6 patients receive escalating doses of gemcitabine hydrochloride and sunitinib malate 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. Up to 10 patients may be treated at the recommended phase II dose (RPTD), which is generally the dose level below the maximally administered dose.

After completion of study treatment, patients are followed for 30 days and then periodically thereafter.

PROJECTED ACCRUAL: A total of 37 patients will be accrued for this study.

  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 pancreatic adenocarcinoma OR other solid tumor

    • Not amenable to curative therapy
    • Previously untreated metastatic pancreatic adenocarcinoma allowed
  • Measurable or evaluable disease
  • No history of or known brain metastases, spinal cord compression, carcinomatous meningitis, or new evidence of brain or leptomeningeal disease on screening CT scan or MRI scan

PATIENT CHARACTERISTICS:

  • ECOG performance status (PS) 0-2 OR Karnofsky PS 60-100%
  • Life expectancy ≥ 12 weeks
  • Absolute neutrophil count ≥ 1,500/mm^3
  • Platelet count ≥ 100,000/mm^3
  • Hemoglobin ≥ 8.5 g/dL
  • Bilirubin ≤ 1.5 mg/dL
  • Creatinine normal OR creatinine clearance ≥ 60 mL/min
  • AST and ALT ≤ 2.5 times upper limit of normal (ULN) (≤ 5 times ULN if due to underlying disease)
  • Calcium ≤ 12.0 mg/dL
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for at least 6 months after completion of study therapy
  • LVEF normal by MUGA scan or ECHO at baseline
  • QTc < 500 msec
  • Deep venous thrombosis or pulmonary embolism allowed provided they are clinically stable and adequately treated
  • No preexisting thyroid abnormality that results in the inability to maintain thyroid function in the normal range while using medication
  • No history of allergic reactions attributed to compounds of similar chemical or biological composition to sunitinib malate
  • No history of any of the following within the past 6 months:

    • Myocardial infarction
    • Ventricular arrhythmia (i.e., ventricular tachycardia or ventricular fibrillation ≥ 3 beats in a row)
    • Severe/unstable angina
    • Severe peripheral vascular disease (i.e., claudication)
    • Procedure on peripheral vasculature
    • Coronary/peripheral artery bypass graft
    • Cerebrovascular accident
    • Transient ischemic attack
    • Clinically significant bleeding requiring red blood cell transfusion
  • No NYHA class III or IV heart disease

    • Patients with NYHA class II disease who are stable and on medication are eligible
  • No ongoing cardiac dysrhythmias ≥ grade 2, atrial fibrillation of any grade, or any significant EKG abnormalities
  • No hypertension that cannot be controlled by medications to a systolic blood pressure (BP) of < 140 mm Hg and diastolic BP of < 90 mm Hg
  • No condition that impairs the ability to swallow and retain sunitinib malate tablets, including any of the following:

    • Gastrointestinal tract disease resulting in an inability to take oral medication
    • Requirement for IV alimentation
    • Prior surgical procedures affecting absorption
    • Active peptic ulcer disease
  • No gastrointestinal perforation or intra-abdominal abscess within the past 28 days
  • No serious nonhealing infection or bone fracture
  • No other severe acute or chronic medical condition, psychiatric condition, or laboratory abnormality that would preclude study therapy

PRIOR CONCURRENT THERAPY:

  • May have received any number of prior systemic therapies
  • More than 4 weeks since prior radiotherapy or surgery and recovered
  • More than 4 weeks since other prior therapies and recovered
  • Prior gemcitabine hydrochloride allowed
  • No prior sunitinib malate or other therapy directed against VEGF, including any of the following:

    • Sorafenib
    • Bevacizumab
    • Vatalanib
    • AZD2171
    • VEGF Trap
    • Investigational antiangiogenic therapy
  • More than 7 days since prior and no concurrent CYP3A4 inhibitors, including any of the following:

    • Ketoconazole
    • Itraconazole
    • Clarithromycin
    • Erythromycin
    • Diltiazem
    • Verapamil
    • Indinavir
    • Ritonavir
    • Nelfinavir
    • Saquinavir
    • Atazanavir
    • Delavirdine
  • More than 12 days since prior and no concurrent CYP3A4 inducers, including any of the following:

    • Rifampin
    • Rifabutin
    • Carbamazepine
    • Phenobarbital
    • Phenytoin
    • Hypericum perforatum (St. John's wort)
    • Efavirenz
    • Tipranavir
  • No concurrent agents with proarrhythmic potential, including any of the following:

    • Terfenadine
    • Quinidine
    • Procainamide
    • Disopyramide
    • Sotalol
    • Probucol
    • Bepridil
    • Haloperidol
    • Risperidone
    • Indapamide
    • Flecainide
  • No concurrent combination antiretroviral therapy for HIV-positive patients
  • No concurrent treatment on another clinical trial

    • Participation in non-therapeutic clinical trials allowed
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00462553

Locations
United States, Ohio
Case Comprehensive Cancer Center Recruiting
Cleveland, Ohio, United States, 44106-5065
Contact: Clinical Trials Office - Case Comprehensive Cancer Center     800-641-2422        
Geauga Regional Hospital Recruiting
Cleveland, Ohio, United States, 44024
Contact: Joanna M Brell     216-844-1676        
Lake/University Ireland Cancer Center Recruiting
Cleveland, Ohio, United States, 44060
Contact: Joanna M Brell     216-844-1676        
Mercy Cancer Center at Mercy Medical Center Recruiting
Cleveland, Ohio, United States, 44708
Contact: Joanna M Brell     216-844-1676        
University Suburban Health Center Recruiting
Cleveland, Ohio, United States, 44121
Contact: Joanna M Brell     216-844-1676        
UHHS Chagrin Highlands Medical Center Recruiting
Cleveland, Ohio, United States, 44122
Contact: Joanna M Brell     216-844-1676        
UHHS Westlake Medical Center Recruiting
Cleveland, Ohio, United States, 44145
Contact: Joanna M Brell     216-844-1676        
Southwest General Health Center Recruiting
Cleveland, Ohio, United States, 44130
Contact: Joanna M Brell     216-844-1676        
Sponsors and Collaborators
Case Comprehensive Cancer Center
Investigators
Study Chair: Joanna M. Brell, MD Case Comprehensive Cancer Center
  More Information

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

Study ID Numbers: CDR0000539459, CASE-3206
Study First Received: April 18, 2007
Last Updated: December 16, 2008
ClinicalTrials.gov Identifier: NCT00462553  
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
recurrent pancreatic cancer
stage III pancreatic cancer
stage IV pancreatic cancer
adenocarcinoma of the pancreas
unspecified adult solid tumor, protocol specific

Study placed in the following topic categories:
Digestive System Neoplasms
Pancreatic Neoplasms
Endocrine System Diseases
Pancrelipase
Recurrence
Digestive System Diseases
Sunitinib
Gastrointestinal Neoplasms
Pancreatic Diseases
Endocrinopathy
Adenocarcinoma
Gemcitabine
Endocrine Gland Neoplasms

Additional relevant MeSH terms:
Antimetabolites
Anti-Infective Agents
Antimetabolites, Antineoplastic
Molecular Mechanisms of Pharmacological Action
Immunologic Factors
Antineoplastic Agents
Growth Substances
Physiological Effects of Drugs
Enzyme Inhibitors
Angiogenesis Inhibitors
Antiviral Agents
Immunosuppressive Agents
Pharmacologic Actions
Neoplasms
Neoplasms by Site
Radiation-Sensitizing Agents
Therapeutic Uses
Growth Inhibitors
Angiogenesis Modulating Agents

ClinicalTrials.gov processed this record on January 16, 2009