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Gossypol, Paclitaxel, and Carboplatin in Treating Patients With Solid Tumors That Are Metastatic or Cannot Be Removed by Surgery
This study is not yet open for participant recruitment.
Verified by National Cancer Institute (NCI), May 2009
First Received: April 29, 2009   Last Updated: May 5, 2009   History of Changes
Sponsors and Collaborators: Cancer Institute of New Jersey
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00891072
  Purpose

RATIONALE: Drugs used in chemotherapy, such as gossypol, paclitaxel, and carboplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving gossypol together with paclitaxel and carboplatin may kill more tumor cells.

PURPOSE: This phase I trial is studying the side effects and best dose of gossypol when given together with paclitaxel and carboplatin in treating patients with solid tumors that are metastatic or cannot be removed by surgery.


Condition Intervention Phase
Lymphoma
Unspecified Adult Solid Tumor, Protocol Specific
Drug: R-(-)-gossypol acetic acid
Drug: carboplatin
Drug: paclitaxel
Other: laboratory biomarker analysis
Other: liquid chromatography
Other: mass spectrometry
Other: pharmacological study
Phase I

MedlinePlus related topics: Cancer Lymphoma Surgery
Drug Information available for: Acetic acid Paclitaxel Carboplatin
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Open Label
Official Title: A Phase 1 Study of R-(-)-Gossypol (Ascenta's AT-101) in Combination With Paclitaxel and Carboplatin in Solid Tumors

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

Primary Outcome Measures:
  • Maximum-tolerated dose of R-(-)-gossypol acetic acid [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Toxicity as assessed by NCI CTCAE v3.0 [ Designated as safety issue: Yes ]
  • Pharmacokinetics of R-(-)-gossypol acetic acid [ Designated as safety issue: No ]

Estimated Enrollment: 36
Study Start Date: April 2009
Estimated Primary Completion Date: May 2012 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • To determine the maximum-tolerated dose of R-(-)-gossypol acetic acid in combination with paclitaxel and carboplatin in patients with metastatic or unresectable solid tumors.

Secondary

  • To describe the toxicities associated with the combination of paclitaxel, carboplatin, and R-(-)-gossypol acetic acid in these patients.
  • To evaluate the human pharmacokinetic disposition of R-(-)-gossypol acetic acid in the context of escalating doses.
  • To describe the pharmacokinetics of paclitaxel when given concurrently with R-(-)-gossypol acetic acid.
  • To evaluate for evidence of activity for the combination of paclitaxel, carboplatin, and R-(-)-gossypol acetic acid.

OUTLINE: This is a dose-escalation study of R-(-)-gossypol acetic acid.

Patients receive oral R-(-)-gossypol acetic acid twice daily on days 1-3. Patients also receive paclitaxel IV over 3 hours and carboplatin IV over 30 minutes on day 1. Treatment repeats every 21 days for up to 8 courses in the absence of disease progression or unacceptable toxicity.

Blood samples are collected periodically for pharmacokinetic and pharmacodynamic studies by liquid chromatography/mass spectrometry.

After completion of study therapy, patients are followed for 4 weeks.

  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 malignancy

    • Metastatic and unresectable disease for which standard curative or palliative measures do not exist or are no longer effective
    • Previously treated or untreated disease allowed
  • Non-Hodgkin lymphoma amenable to hematopoietic stem cell transplantation with curative intent are allowed only if stem cell transplant is refused or is not indicated
  • Measurable or evaluable disease per RECIST criteria
  • Previously treated brain metastases clinically and radiographically stable or improved ≥ 4 weeks after completion of radiation therapy and off steroids are allowed

    • An MRI of the brain or CT scan of the head with contrast must be performed at baseline for patients with history and/or symptoms suspicious of brain metastases

PATIENT CHARACTERISTICS:

  • ECOG performance status (PS) 0-2 OR Karnofsky PS 60-100%
  • Life expectancy > 3 months
  • Absolute neutrophil count ≥ 1,500/μL
  • Platelet count ≥ 100,000/μL
  • Total bilirubin normal
  • AST and ALT ≤ 2.5 times upper limit of normal
  • Creatinine normal OR creatinine clearance ≥ 60 mL/min
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for ≥ 1 month after completion of study therapy
  • Baseline peripheral neuropathy < grade 2
  • No history of allergic reactions attributed to compounds of similar chemical or biological composition to R-(-)-gossypol acetic acid or other study agents
  • No requirement for routine hematopoietic growth factors (including granulocyte colony-stimulating factor, granulocyte-macrophage colony-stimulating factor, or interleukin-11) or platelet transfusions to maintain absolute neutrophil counts or platelet counts above the required thresholds for study entry
  • No condition (e.g., gastrointestinal tract disease resulting in an inability to take oral medication or a requirement for IV alimentation, prior surgical procedures affecting absorption, or active peptic ulcer disease) that impairs ability to swallow and retain R-(-)-gossypol acetic acid tablets
  • No malabsorption syndrome, disease significantly affecting gastrointestinal function, or resection of the stomach or small bowel
  • No ulcerative colitis, inflammatory bowel disease, or a partial or complete small bowel obstruction
  • No uncontrolled intercurrent illness including, but not limited to, any of the following:

    • Ongoing or active infection
    • Symptomatic congestive heart failure
    • Unstable angina pectoris
    • Cardiac arrhythmia
    • Psychiatric illness or social situations that would affect safety or limit compliance with study requirements
  • No myocardial infarction or cardiac surgery within the past 3 months
  • No symptomatic hypercalcemia > grade 2

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • Recovered from prior surgical procedures and adverse events from prior therapy as judged by the investigator
  • No more than 9 months of prior marrow-damaging cytotoxic chemotherapy including, but not limited to, platinum agents, cyclophosphamide, ifosfamide, carmustine, and mitomycin C

    • Non-alkylator chemotherapy agents (e.g., fluorouracil or taxanes) are not considered marrow-damaging chemotherapy
  • At least 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin C) or molecular therapy
  • At least 6 weeks since prior chemotherapy regimen containing carmustine
  • At least 2 weeks since prior and no concurrent radiation therapy and < 30% of the bone marrow receiving radiation dose ≥ 3,000 cGy
  • More than 4 weeks since prior hormonal agents used for anticancer activity or biologic-response modifiers
  • More than 4 weeks since prior and no concurrent other treatment with an investigational agent or device
  • No prior high-dose therapy requiring hematopoietic stem cell transplantation
  • No prior anticancer treatments involving radioactive pharmaceuticals
  • No prior use of racemic gossypol or R-(-)-gossypol acetic acid
  • No concurrent combination antiretroviral therapy for HIV-positive patients
  • No other concurrent anticancer agents or therapies
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00891072

Sponsors and Collaborators
Cancer Institute of New Jersey
Investigators
Principal Investigator: Mark Stein, MD Cancer Institute of New Jersey
  More Information

Additional Information:
No publications provided

Responsible Party: Cancer Institute of New Jersey at UMDNJ - Robert Wood Johnson Medical School ( Mark Stein )
Study ID Numbers: CDR0000640622, CINJ-050905, 0220090064
Study First Received: April 29, 2009
Last Updated: May 5, 2009
ClinicalTrials.gov Identifier: NCT00891072     History of Changes
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
unspecified adult solid tumor, protocol specific
recurrent adult grade III lymphomatoid granulomatosis
adult grade III lymphomatoid granulomatosis
adult nasal type extranodal NK/T-cell lymphoma
Waldenstrom macroglobulinemia
contiguous stage II adult Burkitt lymphoma
noncontiguous stage II adult Burkitt lymphoma
recurrent adult Burkitt lymphoma
stage I adult Burkitt lymphoma
stage III adult Burkitt lymphoma
stage IV adult Burkitt lymphoma
contiguous stage II adult diffuse large cell lymphoma
noncontiguous stage II adult diffuse large cell lymphoma
recurrent adult diffuse large cell lymphoma
stage I adult diffuse large cell lymphoma
stage III adult diffuse large cell lymphoma
stage IV adult diffuse large cell lymphoma
contiguous stage II adult diffuse mixed cell lymphoma
noncontiguous stage II adult diffuse mixed cell lymphoma
recurrent adult diffuse mixed cell lymphoma
stage I adult diffuse mixed cell lymphoma
stage III adult diffuse mixed cell lymphoma
stage IV adult diffuse mixed cell lymphoma
contiguous stage II adult diffuse small cleaved cell lymphoma
noncontiguous stage II adult diffuse small cleaved cell lymphoma
recurrent adult diffuse small cleaved cell lymphoma
stage I adult diffuse small cleaved cell lymphoma
stage III adult diffuse small cleaved cell lymphoma
stage IV adult diffuse small cleaved cell lymphoma
contiguous stage II adult immunoblastic large cell lymphoma

Study placed in the following topic categories:
Contraceptive Agents
Lymphoma, Mantle-Cell
Contraceptive Agents, Female
Lymphoma, Follicular
Lymphoma, B-Cell, Marginal Zone
Mantle Cell Lymphoma
Contraceptive Agents, Male
Lymphoblastic Lymphoma
Lymphoma, T-Cell, Peripheral
Follicular Lymphoma
Gossypol
Lymphoma, Large-cell, Immunoblastic
Lymphoma, B-Cell
Lymphoma, Small Cleaved-cell, Diffuse
Leukemia, Lymphocytic, Chronic, B-Cell
Lymphoma, T-Cell
Retinol acetate
Lymphoma, Large-Cell, Immunoblastic
Leukemia, B-cell, Chronic
Lymphoma, Large-cell
Lymphoma
Peripheral T-cell Lymphoma
Lymphoma, Large B-Cell, Diffuse
Lymphomatoid Granulomatosis
Immunoproliferative Disorders
Antimitotic Agents
Carboplatin
Gossypol acetic acid
Recurrence
Burkitt's Lymphoma

Additional relevant MeSH terms:
Molecular Mechanisms of Pharmacological Action
Contraceptive Agents
Antineoplastic Agents
Physiological Effects of Drugs
Contraceptive Agents, Female
Reproductive Control Agents
Contraceptive Agents, Male
Gossypol
Therapeutic Uses
Lymphoma, Large-Cell, Immunoblastic
Antispermatogenic Agents
Lymphoma
Immunoproliferative Disorders
Neoplasms by Histologic Type
Immune System Diseases
Mitosis Modulators
Antimitotic Agents
Carboplatin
Gossypol acetic acid
Pharmacologic Actions
Lymphatic Diseases
Neoplasms
Paclitaxel
Tubulin Modulators
Lymphoproliferative Disorders
Lymphoma, Non-Hodgkin
Antineoplastic Agents, Phytogenic
Spermatocidal Agents

ClinicalTrials.gov processed this record on May 07, 2009