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Erlotinib and Irinotecan in Treating Patients With Advanced Solid Tumors
This study is currently recruiting participants.
Verified by National Cancer Institute (NCI), December 2008
Sponsors and Collaborators: Mayo Clinic
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00045201
  Purpose

RATIONALE: Erlotinib may stop the growth of tumor cells by blocking the enzymes necessary for tumor cell growth. Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Combining erlotinib and chemotherapy may kill more tumor cells.

PURPOSE: Phase I trial to study the effectiveness of combining erlotinib with irinotecan in treating patients who have advanced solid tumors.


Condition Intervention Phase
Unspecified Adult Solid Tumor, Protocol Specific
Drug: erlotinib hydrochloride
Drug: irinotecan hydrochloride
Phase I

MedlinePlus related topics: Cancer
Drug Information available for: Irinotecan Irinotecan hydrochloride Erlotinib Erlotinib hydrochloride
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment
Official Title: Phase I Trial of OSI-774 and CPT-11 in Patients With Advanced Solid Tumors

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

Estimated Enrollment: 92
Study Start Date: August 2002
Estimated Primary Completion Date: October 2006 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

  • Determine the maximum tolerated dose (MTD) of erlotinib and irinotecan, in relation to presence or absence of UGT1A1*28 polymorphism, in patients with advanced solid tumors that overexpress epidermal growth factor receptor.
  • Determine the dose-limiting toxicity of these regimens in these patients.
  • Determine whether erlotinib alters the disposition of irrinotecan using a previously described limited sampling model.
  • Determine factors that influence the disposition of these drugs, including genetic variation in UGT1A1 and BCRP, in patients treated with these regimens.
  • Detemine factors that influence the disposition of these drugs, in terms of tumor BCRP-expression, in tumor samples from patients treated with these drugs at the MTD.
  • Evaluate the effect of this regimen on epidermal growth factor receptor phosphorylation in these patients.
  • Assess, preliminarily, any antitumor activity in patients treated with these regimens.
  • Correlate, preliminarily, EGFR phosphorylation and/or BCRP -expression with response in tumor samples from these patients.

OUTLINE: This is a dose-escalation study. Patients are stratified according to UGTA1A genotype (all patients regardless of genotype [closed to accrual as of 9/15/04] vs UGT1A1 6/6 genotype vs UGTA1A 6/7 or 7/7 genotype).

Patients receive oral erlotinib daily on days -6 to -1. Patients then receive irinotecan IV over 90 minutes on day 1 and oral erlotinib once daily on days 1-21. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.

Cohorts of 3-6 patients per stratum receive escalating doses of erlotinib and irinotecan until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which at least 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. Additional patients are treated at the MTD.

Patients are followed for 3 months.

PROJECTED ACCRUAL: A total of 92 patients (20 in stratum 1 [closed to accrual as of 9/15/04], 42 in stratum 2, and 30 in stratum 3) will be accrued for this study within 3.25-5 years.

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Histologically confirmed malignancy that overexpresses epidermal growth factor receptor (EGFR)
  • Unresectable disease for which there is no known standard therapy that is potentially curative or definitely capable of extending life expectancy
  • UGT1A1 genotype 6/6, 6/7, or 7/7
  • Willing to provide biologic specimens
  • Lesions amenable for 2 biopsies from the same tumor site (only patients receiving MTD in groups 2 and 3)
  • No known brain metastases

PATIENT CHARACTERISTICS:

Age

  • 18 and over

Performance status

  • ECOG 0-2

Life expectancy

  • At least 12 weeks

Hematopoietic

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

Hepatic

  • Bilirubin no greater than 1.5 times upper limit of normal (ULN)
  • AST ≤ 2.5 times ULN (5 times ULN if liver metastases present)

Renal

  • Creatinine no greater than 1.5 times ULN

Cardiovascular

  • No symptomatic congestive heart failure
  • No unstable angina pectoris
  • No cardiac arrhythmia
  • No New York Heart Association class III or IV heart disease

Gastrointestinal

  • No gastrointestinal tract disease resulting in an inability to take oral or nasogastric medication
  • No requirement for IV alimentation
  • No active peptic ulcer disease

Ophthalmic

  • No abnormalities of the cornea (e.g., dry eye syndrome or Sjögren's syndrome)
  • No congenital abnormality (e.g., Fuch's dystrophy)
  • No abnormal slit-lamp examination using a vital dye (e.g., fluorescein or Bengal-Rose)
  • No abnormal corneal sensitivity test (e.g., Schirmer test or similar tear production test)

Other

  • No other uncontrolled concurrent illness
  • No ongoing or active infection
  • No significant traumatic injury within the past 21 days
  • No seizure disorder
  • No psychiatric illness or social situation that would preclude study compliance
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • More than 4 weeks since prior immunotherapy or biologic therapy
  • No concurrent immunotherapy

Chemotherapy

  • More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin) and recovered
  • No other concurrent chemotherapy

Endocrine therapy

  • Not specified

Radiotherapy

  • More than 4 weeks since prior radiotherapy
  • No prior radiotherapy to more than 25% of bone marrow
  • No concurrent radiotherapy

Surgery

  • More than 3 weeks since prior major surgery
  • No prior surgical procedures affecting absorption

Other

  • No prior EGFR-targeting therapy (e.g., gefitinib or EKB-569)
  • No other concurrent investigational therapy
  • No concurrent enzyme-inducing anticonvulsants (e.g., phenytoin, phenobarbital, carbamazepine, or valproic acid)
  • No concurrent combination antiretroviral therapy for HIV-positive patients
  • No concurrent enrollment on another study involving pharmacological agents for symptom control or therapeutic intent
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00045201

Locations
United States, Minnesota
Mayo Clinic Cancer Center Recruiting
Rochester, Minnesota, United States, 55905
Contact: Clinical Trials Office - All Mayo Clinic Locations     507-538-7623        
Sponsors and Collaborators
Mayo Clinic
Investigators
Study Chair: Henry C. Pitot, MD Mayo Clinic
  More Information

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

Publications of Results:
Pitot H, Reid J, Goetz M, et al.: UGT1A1*28 genotype determines the maximally tolerated dose (MTD) of OSI-774 and CPT-11 in patients with advanced solid tumors. [Abstract] American Association for Cancer Research: Molecular Targets and Cancer Therapeutics, October 22-26, 2007, San Francisco, CA A-B86, 2007.

Study ID Numbers: CDR0000256910, MAYO-MC0112, NCI-5351
Study First Received: September 6, 2002
Last Updated: December 31, 2008
ClinicalTrials.gov Identifier: NCT00045201  
Health Authority: Unspecified

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

Study placed in the following topic categories:
Erlotinib
Irinotecan
Camptothecin

Additional relevant MeSH terms:
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Therapeutic Uses
Enzyme Inhibitors
Protein Kinase Inhibitors
Antineoplastic Agents, Phytogenic
Pharmacologic Actions

ClinicalTrials.gov processed this record on January 16, 2009