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Bortezomib in Treating Patients With Advanced Cancer and Liver Dysfunction
This study is currently recruiting participants.
Verified by National Cancer Institute (NCI), January 2008
First Received: September 7, 2004   Last Updated: January 28, 2009   History of Changes
Sponsors and Collaborators: Barbara Ann Karmanos Cancer Institute
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00091117
  Purpose

RATIONALE: Bortezomib may stop the growth of cancer cells by blocking the enzymes necessary for their growth.

PURPOSE: This phase I trial is studying the side effects and best dose of bortezomib in treating patients with advanced cancer and liver dysfunction.


Condition Intervention Phase
Liver Cancer
Lymphoma
Unspecified Adult Solid Tumor, Protocol Specific
Drug: bortezomib
Phase I

MedlinePlus related topics: Cancer Liver Cancer Lymphoma
Drug Information available for: Bortezomib
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment
Official Title: A Phase I Pharmacokinetic Study of PS-341 in Patients With Advanced Malignancies and Varying Degrees of Liver Dysfunction for the CTEP-Sponsored Organ Dysfunction Working Group

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

Estimated Enrollment: 80
Study Start Date: July 2004
Estimated Primary Completion Date: June 2006 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

  • Determine the maximum tolerated dose of bortezomib in patients with advanced malignancies and varying degrees of liver dysfunction.
  • Determine the safety and tolerability of this drug in these patients.
  • Determine the pharmacokinetics and pharmacodynamics of this drug in these patients with mild, moderate, or severe liver insufficiency.
  • Examine the dietary influences on bortezomib disposition and efficacy.
  • Examine the influences of proteasome inhibition on CYP 450 activity.

OUTLINE: This is a multicenter, dose-escalation study. Patients are stratified according to hepatic function (normal vs mild dysfunction vs moderate dysfunction vs severe dysfunction).

Patients receive bortezomib IV over 3-5 seconds on days 1, 4, 8, and 11. 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 bortezomib until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 6 patients experience dose-limiting toxicity.

NOTE: * Patients with normal hepatic function do not receive escalating doses of bortezomib.

PROJECTED ACCRUAL: A total of 80 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 confirmed malignancy for which no known standard therapy that is potentially curative or definitely capable of extending life expectancy exists
  • Tumor types may include any of the following:

    • Solid tumors
    • Non-Hodgkin's lymphoma
    • Hepatocellular carcinoma, as evidenced by liver mass, elevated alpha-fetoprotein level (≥ 500 ng/mL), and positive serology for hepatitis

      • Pathological confirmation is not required
      • Confirmatory evidence for a prior Hepatitis B infection (HBsAg, HBcAb and/or HBsAb) required
  • No symptomatic CNS metastases

    • Brain metastasis allowed if the following criteria are met:

      • Received prior definitive treatment (radiation and/or surgery)
      • Stable disease for ≥ 4 weeks
      • Not currently on enzyme-inducing anticonvulsants and steroids

PATIENT CHARACTERISTICS:

Age

  • 18 and over

Performance status

  • ECOG 0-2

Life expectancy

  • At least 12 weeks

Hematopoietic

  • Absolute neutrophil count ≥ 1,000/mm^3
  • Platelet count ≥ 100,000/mm^3

Hepatic

  • See Disease Characteristics
  • Biliary obstruction for which a shunt has been placed allowed provided the shunt has been in place for ≥ 10 days AND liver function is stable, defined as 2 measurements taken ≥ 2 days apart that qualify the patient for the same hepatic dysfunction stratum
  • No biliary sepsis

Renal

  • Creatinine ≤ 1.5 mg/dL

Cardiovascular

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

Other

  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for 30 days after study participation
  • No preexisting neuropathy ≥ grade 2
  • No ongoing or active infection
  • No other concurrent uncontrolled illness that would preclude study participation
  • No psychiatric illness or social situation that would preclude study compliance

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • More than 4 weeks since prior immunotherapy
  • More than 4 weeks since prior biologic therapy
  • No concurrent prophylactic colony-stimulating factors
  • No concurrent immunotherapy
  • No concurrent thalidomide
  • Concurrent epoetin alfa or darbepoetin alfa for management of cancer-associated anemia allowed

Chemotherapy

  • Recovered from prior chemotherapy (not including liver function)
  • More than 3 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin)
  • No concurrent chemotherapy

Endocrine therapy

  • See Disease Characteristics

Radiotherapy

  • See Disease Characteristics
  • More than 2 weeks since prior radiotherapy
  • No prior radiotherapy to > 50% of the bone marrow
  • No concurrent radiotherapy

Surgery

  • See Disease Characteristics
  • More than 3 weeks since prior surgery

Other

  • No prior bortezomib
  • No concurrent antiretroviral therapy for HIV-positive patients
  • No other concurrent investigational agents
  • Concurrent cytochrome P450 interacting agents are allowed provided they are used with caution
  • Concurrent bisphosphonate therapy allowed (e.g., pamidronate or zolendronate), except during course 1 of bortezomib administration
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00091117

Locations
United States, California
City of Hope Comprehensive Cancer Center Recruiting
Duarte, California, United States, 91010-3000
Contact: Clinical Trials Office - City of Hope Comprehensive Cancer Cen     800-826-4673     becomingapatient@coh.org    
United States, Michigan
Barbara Ann Karmanos Cancer Institute Recruiting
Detroit, Michigan, United States, 48201-1379
Contact: Clinical Trials Office - Barbara Ann Karmanos Cancer Institute     313-576-9363        
United States, New York
Albert Einstein Cancer Center at Albert Einstein College of Medicine Recruiting
Bronx, New York, United States, 10461
Contact: Clinical Trials Office - Albert Einstein Cancer Center at Albe     718-904-2730     aecc@aecom.yu.edu    
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        
United States, Pennsylvania
UPMC Cancer Centers Recruiting
Pittsburgh, Pennsylvania, United States, 15232
Contact: Clinical Trials Office - UPMC Cancer Centers     412-647-8073        
United States, Texas
University of Texas Health Science Center at San Antonio Recruiting
San Antonio, Texas, United States, 78229
Contact: Contact Person     210-567-4777        
United States, Wisconsin
University of Wisconsin Paul P. Carbone Comprehensive Cancer Center Recruiting
Madison, Wisconsin, United States, 53792-6164
Contact: Clinical Trials Office - University of Wisconsin Paul P. Carbo     608-262-5223        
Australia
Sydney Cancer Centre at Royal Prince Alfred Hospital Recruiting
Sydney, Australia
Contact: Contact Person     61-2-9515-6018        
Sponsors and Collaborators
Barbara Ann Karmanos Cancer Institute
Investigators
Study Chair: Patricia M. LoRusso, DO Barbara Ann Karmanos Cancer Institute
Investigator: Manuel Valdivieso, MD, MS, CPE Barbara Ann Karmanos Cancer Institute
  More Information

Additional Information:
No publications provided

Study ID Numbers: CDR0000383782, WSU-C-2802, NCI-6432
Study First Received: September 7, 2004
Last Updated: January 28, 2009
ClinicalTrials.gov Identifier: NCT00091117     History of Changes
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
unspecified adult solid tumor, protocol specific
adult primary hepatocellular carcinoma
advanced adult primary liver cancer
recurrent adult primary liver cancer
recurrent adult diffuse large cell lymphoma
stage IV adult diffuse large cell lymphoma
recurrent adult diffuse mixed cell lymphoma
stage IV adult diffuse mixed cell lymphoma
recurrent adult diffuse small cleaved cell lymphoma
stage IV adult diffuse small cleaved cell lymphoma
recurrent adult Burkitt lymphoma
stage IV adult lymphoblastic lymphoma
stage IV adult Burkitt lymphoma
recurrent adult immunoblastic large cell lymphoma
stage IV adult immunoblastic large cell lymphoma
recurrent adult lymphoblastic lymphoma
recurrent marginal zone lymphoma
stage IV marginal zone lymphoma
recurrent small lymphocytic lymphoma
stage IV small lymphocytic lymphoma
recurrent grade 1 follicular lymphoma
recurrent grade 2 follicular lymphoma
recurrent grade 3 follicular lymphoma
stage IV grade 1 follicular lymphoma
stage IV grade 2 follicular lymphoma
stage IV grade 3 follicular lymphoma
recurrent mantle cell lymphoma
stage IV mantle cell lymphoma
adult grade III lymphomatoid granulomatosis
Waldenstrom macroglobulinemia

Study placed in the following topic categories:
Liver Diseases
Carcinoma, Hepatocellular
Lymphoma, Mantle-Cell
Lymphoma, Follicular
Mantle Cell Lymphoma
Lymphoma, B-Cell, Marginal Zone
Lymphoblastic Lymphoma
Follicular Lymphoma
Lymphoma, Large-cell, Immunoblastic
Lymphoma, B-Cell
Liver Neoplasms
Lymphoma, Small Cleaved-cell, Diffuse
Leukemia, Lymphocytic, Chronic, B-Cell
Lymphoma, Large-Cell, Immunoblastic
Lymphoma, Large-cell
Leukemia, B-cell, Chronic
Hepatocellular Carcinoma
Lymphoma
Lymphoma, Large B-Cell, Diffuse
Lymphomatoid Granulomatosis
Digestive System Neoplasms
Immunoproliferative Disorders
Bortezomib
Recurrence
Protease Inhibitors
Carcinoma
Burkitt's Lymphoma
Lymphatic Diseases
Chronic Lymphocytic Leukemia
Waldenstrom Macroglobulinemia

Additional relevant MeSH terms:
Liver Diseases
Digestive System Neoplasms
Neoplasms by Histologic Type
Immunoproliferative Disorders
Molecular Mechanisms of Pharmacological Action
Immune System Diseases
Antineoplastic Agents
Bortezomib
Enzyme Inhibitors
Pharmacologic Actions
Protease Inhibitors
Liver Neoplasms
Lymphatic Diseases
Neoplasms
Neoplasms by Site
Digestive System Diseases
Therapeutic Uses
Lymphoproliferative Disorders
Lymphoma

ClinicalTrials.gov processed this record on May 06, 2009