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Metformin and Temsirolimus in Treating Patients With Metastatic or Unresectable Solid Tumor or Lymphoma
This study is currently recruiting participants.
Verified by National Cancer Institute (NCI), April 2008
First Received: April 15, 2008   Last Updated: October 8, 2008   History of Changes
Sponsored by: London Regional Cancer Program at London Health Sciences Centre
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00659568
  Purpose

RATIONALE: Metformin and temsirolimus may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth.

PURPOSE: This phase I trial is studying the side effects and best dose of metformin when given together with temsirolimus in treating patients with metastatic or unresectable solid tumor or lymphoma.


Condition Intervention Phase
Breast Cancer
Endometrial Cancer
Kidney Cancer
Lung Cancer
Lymphoma
Unspecified Adult Solid Tumor, Protocol Specific
Drug: metformin hydrochloride
Drug: temsirolimus
Phase I

Genetics Home Reference related topics: breast cancer
MedlinePlus related topics: Breast Cancer Cancer Fungal Infections Hodgkin's Disease Kidney Cancer Leukemia, Adult Acute Leukemia, Adult Chronic Lung Cancer Lymphoma
Drug Information available for: CCI 779 Metformin Metformin hydrochloride
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Non-Randomized, Open Label
Official Title: A Phase I Study of Temsirolimus in Combination With Metformin in Advanced Solid Tumours

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

Primary Outcome Measures:
  • Maximum tolerated dose and recommended phase II dose of metformin hydrochloride when administered with temsirolimus [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Toxicity and safety, with particular reference to glucose and lipid deregulation [ Designated as safety issue: Yes ]
  • Antitumor activity, including tumor response rate and time to progression [ Designated as safety issue: No ]
  • Objective response [ Designated as safety issue: No ]
  • Survival [ Designated as safety issue: No ]
  • Frequency and severity of adverse events [ Designated as safety issue: Yes ]

Estimated Enrollment: 28
Study Start Date: March 2008
Estimated Primary Completion Date: March 2009 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • To establish the maximum tolerated dose and recommended phase II dose of metformin hydrochloride when administered with temsirolimus in patients with advanced solid cancers or lymphoma.

Secondary

  • To determine the toxicity and safety, with particular reference to glucose and lipid deregulation, of this regimen in these patients.
  • To assess antitumor activity, including tumor response rate and time to progression, in patients treated with this regimen.

OUTLINE: This is a dose-escalation study of metformin hydrochloride.

Patients receive oral metformin once, twice, or three times daily on days 1-28 and temsirolimus IV over 30-60 minutes on days 1, 8, 15, and 22. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed periodically.

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Histologically confirmed malignancy, including any of the following types:

    • Renal cell
    • Endometrial
    • Breast
    • Small cell lung carcinoma
    • Lymphoma
  • Metastatic or unresectable disease for which standard curative or palliative measures do not exist or are no longer effective
  • Measurable disease according to RECIST criteria
  • No unstable primary CNS tumors or metastases

PATIENT CHARACTERISTICS:

Inclusion criteria:

  • ECOG performance status (PS) 0-2 or Karnofsky PS 60-100%
  • Life expectancy > 12 weeks
  • Absolute neutrophil count ≥ 1.5 x 10^9/L
  • Platelets ≥ 100 x 10^9/L
  • AST ≤ 2.5 times upper limit of normal (ULN)
  • Serum creatinine ≤ ULN
  • Serum bilirubin ≤ 1.5 times ULN
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • Able to understand and willing to sign a written informed consent document

Exclusion criteria:

  • Allergies to or a history of allergic reactions attributed to any other compound of similar chemical or biologic composition to temsirolimus or metformin
  • Diabetes mellitus (type I or II)
  • Uncontrolled hypertriglyceridemia (triglyceride levels > 10 mmol/L)
  • History of lactic acidosis
  • Inability to swallow or digest oral medications
  • Uncontrolled intercurrent illness including, but not limited to, any of the following:

    • Uncontrolled hypertension
    • Ongoing or active infection
    • Symptomatic congestive heart failure
    • Unstable angina pectoris
    • Cardiac arrhythmia
    • Psychiatric illness/social situation that would limit compliance with study requirements
  • Significant traumatic injury within 21 days prior to treatment

PRIOR CONCURRENT THERAPY:

Inclusion criteria:

  • Recovered from all prior therapy
  • At least 4 weeks since prior chemotherapy or radiotherapy (6 weeks for carmustine or mitomycin C) except low-dose, non-myelosuppressive radiotherapy
  • No limitation on other prior therapy
  • Concurrent low-dose anticoagulant (i.e., warfarin) allowed provided INR ≤ 1.1 times ULN
  • Concurrent full-dose anticoagulant (i.e., warfarin) allowed provided INR is within institutional therapeutic range (usually 2.0-3.0)

Exclusion criteria:

  • Major surgery within the past 21 days
  • Prior temsirolimus (or other known inhibitors of mammalian target of rapamycin) or metformin
  • Concurrent combination antiretroviral therapy for HIV-positive patients
  • Concurrent enzyme-inducing anti-epileptic drugs (EIAEDs) (e.g., phenytoin, carbamazepine, or phenobarbital) or other CYP3A4 inducer (e.g., rifampin or Hypericum perforatum [St. John's wort])
  • Concurrent investigational or commercial agents or therapies to treat the patient's malignancy
  • Other concurrent investigational agents other than temsirolimus or metformin
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00659568

Locations
Canada, Ontario
London Regional Cancer Program at London Health Sciences Centre Recruiting
London, Ontario, Canada, N6A 4L6
Contact: Mary Mackenzie, MD     519-685-8615        
Sponsors and Collaborators
London Regional Cancer Program at London Health Sciences Centre
Investigators
Principal Investigator: Mary Mackenzie, MD London Regional Cancer Program at London Health Sciences Centre
  More Information

Additional Information:
No publications provided

Study ID Numbers: CDR0000593360, CAN-LRCC-UWOREB13877, WYETH-CAN-LRCC-UWOREB13877
Study First Received: April 15, 2008
Last Updated: October 8, 2008
ClinicalTrials.gov Identifier: NCT00659568     History of Changes
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
unspecified adult solid tumor, protocol specific
stage III renal cell cancer
stage IV renal cell cancer
recurrent renal cell cancer
recurrent endometrial carcinoma
stage III endometrial carcinoma
stage IV endometrial carcinoma
recurrent breast cancer
stage IIIA breast cancer
stage IIIB breast cancer
stage IIIC breast cancer
stage IV breast cancer
recurrent small cell lung cancer
extensive stage small cell lung cancer
stage III adult Burkitt lymphoma
stage III adult diffuse large cell lymphoma
stage III adult diffuse mixed cell lymphoma
stage III adult diffuse small cleaved cell lymphoma
stage III adult Hodgkin lymphoma
stage III adult immunoblastic large cell lymphoma
stage III adult lymphoblastic lymphoma
stage III adult T-cell leukemia/lymphoma
stage III cutaneous T-cell non-Hodgkin lymphoma
stage III grade 1 follicular lymphoma
stage III grade 2 follicular lymphoma
stage III grade 3 follicular lymphoma
stage III mantle cell lymphoma
stage III marginal zone lymphoma
stage III small lymphocytic lymphoma
stage IV adult Burkitt lymphoma

Study placed in the following topic categories:
Thoracic Neoplasms
Lymphoma, Mantle-Cell
Mantle Cell Lymphoma
Urogenital Neoplasms
Urologic Neoplasms
Follicular Lymphoma
Mycoses
Endometrial Neoplasms
Hypoglycemic Agents
Leukemia, Lymphocytic, Chronic, B-Cell
Lung Neoplasms
Lymphoma, Large-Cell, Anaplastic
Kidney Diseases
Hodgkin Disease
Breast Diseases
Lymphoma, Large B-Cell, Diffuse
Immunoproliferative Disorders
Genital Neoplasms, Female
Breast Neoplasms
Carcinoma
Carcinoma, Small Cell
Waldenstrom Macroglobulinemia
B-cell Lymphomas
Lung Diseases
Leukemia, T-Cell
Lymphoma, Non-Hodgkin
Lymphoma, T-Cell, Cutaneous
Neoplasms, Glandular and Epithelial
Urinary Tract Neoplasm
Lymphoma, Follicular

Additional relevant MeSH terms:
Thoracic Neoplasms
Physiological Effects of Drugs
Urogenital Neoplasms
Urologic Neoplasms
Genital Diseases, Female
Endometrial Neoplasms
Hypoglycemic Agents
Neoplasms by Site
Urologic Diseases
Respiratory Tract Diseases
Lung Neoplasms
Kidney Neoplasms
Uterine Neoplasms
Kidney Diseases
Lymphoma
Breast Diseases
Respiratory Tract Neoplasms
Immunoproliferative Disorders
Neoplasms by Histologic Type
Immune System Diseases
Skin Diseases
Metformin
Genital Neoplasms, Female
Uterine Diseases
Breast Neoplasms
Pharmacologic Actions
Carcinoma
Lymphatic Diseases
Neoplasms
Lung Diseases

ClinicalTrials.gov processed this record on May 07, 2009