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Combination Chemotherapy in Treating Patients With Advanced Solid Tumors
This study is ongoing, but not recruiting participants.
Sponsors and Collaborators: Mayo Clinic
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00047047
  Purpose

RATIONALE: Drugs used in chemotherapy, such as 17-N-allylamino-17-demethoxygeldanamycin (17-AAG), gemcitabine, and cisplatin, 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.

PURPOSE: This phase I trial is studying the side effects, best way to give, and the best dose of 17-AAG when given together with gemcitabine and/or cisplatin in treating patients with advanced solid tumors.


Condition Intervention Phase
Unspecified Adult Solid Tumor, Protocol Specific
Drug: cisplatin
Drug: gemcitabine hydrochloride
Drug: tanespimycin
Phase I

MedlinePlus related topics: Cancer
Drug Information available for: Cisplatin Gemcitabine hydrochloride Gemcitabine IPI-504 17-(Allylamino)-17-demethoxygeldanamycin
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment
Official Title: A Phase I Trial Of Gemcitabine, 17-Allyaminogeldanamycin (917-AAG) And Cisplatin In Advanced Solid Tumor Patients

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

Estimated Enrollment: 78
Study Start Date: August 2002
Detailed Description:

OBJECTIVES:

  • Determine the maximum tolerated dose (MTD)* of the combination of 17-N-allylamino-17-demethoxygeldanamycin (17-AAG), gemcitabine, and cisplatin in patients with advanced solid tumors.

NOTE: *The MTD of this 3-drug combination has been determined; cohort A closed to accrual as of 3/2/04

  • Determine the MTD of 17-AAG when administered with constant-dose gemcitabine AND constant-dose cisplatin (cohort B [closed to accrual as of 3/2/05]) OR constant-dose gemcitabine (cohort C) OR constant-dose cisplatin (cohort D) OR higher dose 17-AAG, constant-dose gemcitabine, and escalating doses of cisplatin (cohort E) in these patients.
  • Determine the dose-limiting toxicity of these regimens in these patients.
  • Assess the effect of these regimens on surrogate markers in these patients.
  • Determine any responses in patients treated with these regimens.

OUTLINE: This is a dose-escalation, cohort study of 17-N-allylamino-17-demethoxygeldanamycin (17-AAG). Patients are assigned to 1 of 3 treatment cohorts. (Cohort A closed to accrual as of 3/2/04; cohort B closed to accrual as of 3/2/05.)

  • Cohort A (closed to accrual as of 3/2/04)*: Patients receive escalating doses of gemcitabine IV over 30 minutes, 17-AAG IV over 1 hour, and cisplatin IV over 2 hours on days 1 and 8.

NOTE: *The maximum tolerated dose (MTD) of this 3-drug combination has been determined as of 3/2/04.

  • Cohort B (closed to accrual as of 3/2/05): Patients receive gemcitabine** IV over 30 minutes, 17-AAG IV over 1 hour, and cisplatin** IV over 2 hours on days 1 and 8.
  • Cohort C: Patients receive gemcitabine** IV over 30 minutes and 17-AAG IV over 1-2 hours on days 2 and 9.
  • Cohort D: Patients receive cisplatin** IV over 2 hours and 17-AAG IV over 1-2 hours on days 1 and 8.
  • Cohort E: Patients receive gemcitabine***, 17-AAG***, and cisplatin*** as in cohort B.

NOTE: **Gemcitabine and cisplatin dosage is constant, while 17-AAG is escalated in cohorts B, C, and D.

NOTE: ***Gemcitabine dosage is constant, 17-AAG is started at a higher dose level than all other cohorts, and cisplatin dosage is escalated in cohort E.

Cohorts of 3-6 patients receive escalating doses of 17-AAG until the MTD is determined. The MTD is defined as the dose preceding that at which at least 2 of 6 patients experience dose-limiting toxicity.

In all cohorts, courses repeat every 3 weeks in the absence of disease progression or unacceptable toxicity.

Patients are followed for 3 months.

PROJECTED ACCRUAL: A total of 12 patients have been accrued for part I (cohort A closed to accrual as of 3/2/04) of this study. An additional 33-66 patients will be accrued for part II (cohorts B [closed to accrual as of 3/2/05], C, D, and E) of this study within approximately 3 years.

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Histologically confirmed solid tumor that is clinically unresectable
  • No standard therapy available that is potentially curative or definitely capable of extending life expectancy
  • No CNS metastases

PATIENT CHARACTERISTICS:

Age

  • 18 and over

Performance status

  • ECOG 0-1

Life expectancy

  • At least 12 weeks

Hematopoietic

  • Absolute neutrophil count ≥ 1,500/mm^3
  • Platelet count ≥ 100,000/mm^3
  • Hemoglobin ≥ 9.0 g/dL

Hepatic

  • Bilirubin ≤ 2 times upper limit of normal (ULN)
  • AST ≤ 2.5 times ULN
  • Alkaline phosphatase ≤ 2 times ULN (5 times ULN if liver involvement present)

Renal

  • Creatinine ≤ 1.5 times ULN

Cardiovascular

  • QTc < 450 msec for men (470 msec for women)
  • LVEF > 40% by MUGA
  • No cardiac symptoms ≥ grade 2
  • Normal ejection fraction on MUGA if had prior anthracycline treatment
  • No history of serious ventricular arrhythmia (ventricular tachycardia or ventricular fibrillation ≥ 3 beats in a row)
  • No myocardial infarction or active ischemic heart disease within the past year
  • No New York Heart Association class III or IV heart failure
  • No uncontrolled dysrhythmias or dysrhythmias requiring antiarrhythmic drugs
  • No poorly controlled angina
  • No congenital long QT syndrome
  • No left bundle branch block
  • No history of cardiac toxicity after treatment with anthracyclines (e.g., doxorubicin hydrochloride, daunorubicin hydrochloride, mitoxantrone hydrochloride, bleomycin, or carmustine)
  • No other significant cardiac disease

Pulmonary

  • DLCO ≥ 80%
  • No pulmonary symptoms ≥ grade 2
  • No significant pulmonary disease requiring oxygen
  • No pulmonary fibrosis by chest x-ray
  • No symptomatic pulmonary disease requiring medication including the following:

    • Dyspnea on or off exertion
    • Paroxysmal nocturnal dyspnea
    • Chronic obstructive/restrictive pulmonary disease
  • No home oxygen that meets the Medicare criteria
  • No history of pulmonary toxicity after treatment with anthracyclines (e.g., doxorubicin hydrochloride, daunorubicin hydrochloride, mitoxantrone hydrochloride, bleomycin, or carmustine)

Other

  • Willing to provide biologic specimens
  • No uncontrolled infection
  • No seizure disorder
  • No prior serious allergic reactions to eggs
  • No peripheral neuropathy ≥ grade 2
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective barrier contraception

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • More than 4 weeks since prior immunotherapy or biologic therapy
  • No concurrent prophylactic use of any of the following colony-stimulating factors:

    • Filgrastim (G-CSF)
    • Pegfilgrastim
    • Sargramostim (GM-CSF)
  • No concurrent immunotherapy or biologic therapy
  • No concurrent gene therapy

Chemotherapy

  • Prior gemcitabine and/or cisplatin allowed
  • More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin C) and recovered
  • No other concurrent chemotherapy

Endocrine therapy

  • No concurrent oral contraceptives

Radiotherapy

  • More than 4 weeks since prior radiotherapy
  • No prior radiotherapy to more than 25% of bone marrow
  • No prior radiotherapy that included the heart in the field (e.g. mantle radiotherapy) or chest
  • No prior radiopharmaceuticals
  • No concurrent radiotherapy

Surgery

  • Not specified

Other

  • No other concurrent investigational therapy
  • No concurrent medications that prolong or may prolong QTc interval
  • No concurrent inhibitors of the 3A4 enzyme
  • No concurrent enrollment in any other study involving a pharmacologic agent
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00047047

Locations
United States, Minnesota
Mayo Clinic Cancer Center
Rochester, Minnesota, United States, 55905
Sponsors and Collaborators
Mayo Clinic
Investigators
Study Chair: Charles Erlichman, MD Mayo Clinic
Investigator: David O. Toft, PhD Mayo Clinic
Investigator: Joel M. Reid, PhD Mayo Clinic
Investigator: Matthew M. Ames, PhD Mayo Clinic
Investigator: Paul Haluska, MD, PhD Mayo Clinic
  More Information

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

Study ID Numbers: CDR0000257247, MAYO-MC0111, NCI-5291
Study First Received: October 3, 2002
Last Updated: July 23, 2008
ClinicalTrials.gov Identifier: NCT00047047  
Health Authority: United States: Federal Government

Keywords provided by National Cancer Institute (NCI):
unspecified adult solid tumor, protocol specific

Study placed in the following topic categories:
Cisplatin
Gemcitabine

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

ClinicalTrials.gov processed this record on January 15, 2009