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Topical Halofuginone Hydrobromide in Treating Patients With HIV-Related Kaposi's Sarcoma
This study has been completed.
Sponsors and Collaborators: AIDS Associated Malignancies Clinical Trials Consortium
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00064142
  Purpose

RATIONALE: Topical halofuginone hydrobromide ointment may stop the growth of Kaposi's sarcoma by stopping blood flow to the tumor.

PURPOSE: This randomized phase II trial is studying how well topical halofuginone hydrobromide works in treating patients with HIV-related Kaposi's sarcoma.


Condition Intervention Phase
Sarcoma
Drug: halofuginone hydrobromide
Phase II

MedlinePlus related topics: AIDS Cancer Kaposi's Sarcoma Soft Tissue Sarcoma
Drug Information available for: Halofuginone Halofuginone hydrobromide
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Randomized, Open Label, Active Control
Official Title: A Phase II Trial of Topical Halofuginone in Patients With HIV Related Kaposi's Sarcoma

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

Primary Outcome Measures:
  • Response rate by tumor evaluation every 4 weeks [ Designated as safety issue: No ]
  • Safety and tolerability every 4 weeks [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Expression of MMP-2 and collagen type I in tumor biopsies as measured by in situ hybridization at baseline, day 29, and day 85 [ Designated as safety issue: No ]
  • Pharmacokinetics at week 8 [ Designated as safety issue: No ]

Estimated Enrollment: 30
Study Start Date: May 2003
Primary Completion Date: March 2008 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

  • Compare the tumor response rate in patients with HIV-related Kaposi's sarcoma treated with topical halofuginone hydrobromide vs placebo.
  • Compare the safety and tolerability of these treatments in these patients.
  • Determine the ability of halofuginone hydrobromide to inhibit expression of MMP-2 and collagen type I in these patients.
  • Correlate CD4 and CD8 counts, HIV viral load, and HHV-8 viral load with response in patients treated with this drug.
  • Determine the pharmacokinetics of this drug in these patients.

OUTLINE: This is a randomized, double-blind, multicenter study, with subsequent open-label treatment in stable or responding patients. Twelve treatable Kaposi's sarcoma lesions are selected on each patient, and these 12 lesions are randomized equally to 1 of 2 treatment arms (6 lesions receive study treatment and 6 lesions receive placebo); each patient serves as his/her own control.

  • Arm I: Patients apply topical halofuginone hydrobromide ointment to each of 6 lesions twice a day for 12 weeks.
  • Arm II: Patients apply topical placebo ointment to each of 6 lesions twice a day for 12 weeks.

Patients with stable or responding disease in either or both groups of treated lesions (halofuginone hydrobromide ointment or placebo ointment) may receive open-label treatment with topical halofuginone hydrobromide ointment to all 12 lesions for an additional 12 weeks as above in the absence of disease progression or unacceptable toxicity.

Patients are followed for at least 1 month.

PROJECTED ACCRUAL: A total of 30 patients will be accrued for this study within 1 year.

  Eligibility

Ages Eligible for Study:   16 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Histologically proven Kaposi's sarcoma (KS)

    • At least 14 cutaneous lesions, 12 of which are bidimensionally measurable and can serve as marker lesions

      • Each lesion must measure at least 0.5 cm in diameter
  • Serologically confirmed HIV infection
  • No known active visceral KS
  • No symptomatic KS-related edema that interferes with function or requires cytotoxic therapy

PATIENT CHARACTERISTICS:

Age

  • 16 and over

Performance status

  • Karnofsky 60-100%

Life expectancy

  • At least 3 months

Hematopoietic

  • Absolute neutrophil count at least 750/mm^3
  • Platelet count at least 75,000/mm^3
  • Hemoglobin at least 8 g/dL

Hepatic

  • Bilirubin no greater than 1.5 times upper limit of normal (ULN)

    • Elevated bilirubin secondary to indinavir therapy allowed provided total bilirubin is no greater than 3.5 mg/dL and direct bilirubin is normal
  • AST and ALT no greater than 3 times ULN

Renal

  • Creatinine less than 1.5 times ULN OR
  • Creatinine clearance at least 60 mL/min

Other

  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective barrier contraception during and for 3 months after study participation
  • No acute, active, untreated opportunistic infection within the past 14 days

    • Oral thrush or genital herpes allowed
  • No other serious medical illness within the past 14 days
  • No concurrent neoplasm requiring cytotoxic therapy

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • More than 4 weeks since prior biological therapy for KS

Chemotherapy

  • More than 4 weeks since prior chemotherapy for KS
  • No concurrent anticancer systemic cytotoxic chemotherapy

Endocrine therapy

  • No concurrent corticosteroids

    • Replacement doses allowed

Radiotherapy

  • More than 4 weeks since prior radiotherapy for KS

Surgery

  • Not specified

Other

  • More than 60 days since prior local therapy for any KS-indicator lesion unless the lesion has clearly progressed since treatment
  • More than 14 days since prior acute treatment for an infection (other than oral thrush or genital herpes)
  • More than 4 weeks since prior local therapy for KS
  • More than 4 weeks since prior investigational therapy for KS
  • More than 4 weeks since other prior anticancer treatment for KS
  • No other concurrent investigational agents other than IND-approved antiretroviral agents available under expanded access or compassionate use protocols
  • No other concurrent KS-specific treatment
  • Concurrent antiretroviral therapy allowed provided patient is on a stable regimen for at least 12 weeks prior to study entry and shows no evidence of ongoing KS regression (i.e., less than 25% decrease in the size, number, or nodularity of lesions, in the investigator's opinion)
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00064142

Locations
United States, California
UCSF Comprehensive Cancer Center
San Francisco, California, United States, 94115
USC/Norris Comprehensive Cancer Center and Hospital
Los Angeles, California, United States, 90089-9181
United States, Hawaii
Leahi Hospital
Honolulu, Hawaii, United States, 96816
United States, Louisiana
Tulane Cancer Center at Tulane University Hospital and Clinic
New Orleans, Louisiana, United States, 70112-2699
United States, Massachusetts
Beth Israel Deaconess Medical Center
Boston, Massachusetts, United States, 02215
United States, New York
Herbert Irving Comprehensive Cancer Center at Columbia University
New York, New York, United States, 10032
Memorial Sloan-Kettering Cancer Center
New York, New York, United States, 10021
United States, Ohio
Arthur G. James Cancer Hospital and Solove Research Institute at Ohio State University
Columbus, Ohio, United States, 43210-1240
Case Comprehensive Cancer Center
Cleveland, Ohio, United States, 44106-5065
United States, Washington
Floyd & Delores Jones Cancer Institute at Virginia Mason Medical Center
Seattle, Washington, United States, 98111
Sponsors and Collaborators
AIDS Associated Malignancies Clinical Trials Consortium
Investigators
Study Chair: Susan E. Krown, MD Memorial Sloan-Kettering Cancer Center
Investigator: Henry Koon, MD Beth Israel Deaconess Medical Center
Investigator: Merrill J. Egorin, MD UPMC Cancer Centers
  More Information

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

Study ID Numbers: CDR0000309055, AMC-036, CWRU-040332
Study First Received: July 8, 2003
Last Updated: August 6, 2008
ClinicalTrials.gov Identifier: NCT00064142  
Health Authority: United States: Federal Government

Keywords provided by National Cancer Institute (NCI):
AIDS-related Kaposi sarcoma
recurrent Kaposi sarcoma

Study placed in the following topic categories:
Malignant mesenchymal tumor
Acquired Immunodeficiency Syndrome
Sarcoma, Kaposi
Recurrence
Soft tissue sarcomas
Herpesviridae Infections
Virus Diseases
Neoplasms, Connective and Soft Tissue
Kaposi sarcoma
HIV Infections
Sarcoma
DNA Virus Infections
Halofuginone

Additional relevant MeSH terms:
Anti-Infective Agents
Antiprotozoal Agents
Neoplasms by Histologic Type
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Growth Substances
Physiological Effects of Drugs
Enzyme Inhibitors
Angiogenesis Inhibitors
Pharmacologic Actions
Protein Synthesis Inhibitors
Neoplasms
Antiparasitic Agents
Therapeutic Uses
Neoplasms, Vascular Tissue
Growth Inhibitors
Angiogenesis Modulating Agents
Coccidiostats

ClinicalTrials.gov processed this record on January 16, 2009