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Obatoclax Mesylate, Vincristine Sulfate, Doxorubicin Hydrochloride, and Dexrazoxane Hydrochloride in Treating Young Patients With Relapsed or Refractory Solid Tumors, Lymphoma, or Leukemia
This study is currently recruiting participants.
Verified by National Cancer Institute (NCI), September 2009
First Received: July 7, 2009   Last Updated: September 3, 2009   History of Changes
Sponsors and Collaborators: Children's Oncology Group
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00933985
  Purpose

RATIONALE: Obatoclax mesylate may stop the growth of cancer cells by blocking some of the proteins needed for cell growth and causing the cells to self-destruct. Drugs used in chemotherapy, such as vincristine sulfate, doxorubicin hydrochloride, and dexrazoxane hydrochloride, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Giving obatoclax mesylate together with combination chemotherapy may kill more cancer cells.

PURPOSE: This phase I trial is studying the side effects and best dose of obatoclax mesylate when given together with vincristine sulfate, doxorubicin hydrochloride, and dexrazoxane hydrochloride in treating young patients with relapsed or refractory solid tumors, lymphoma, or leukemia.


Condition Intervention Phase
Leukemia
Lymphoma
Unspecified Childhood Solid Tumor, Protocol Specific
Drug: dexrazoxane hydrochloride
Drug: doxorubicin hydrochloride
Drug: obatoclax mesylate
Drug: vincristine sulfate
Phase I

Study Type: Interventional
Study Design: Treatment, Open Label
Official Title: A Phase I Study of Obatoclax (Pan Anti-Apoptotic BCL-2 Family Small Molecule Inhibitor), in Combination With Vincristine/Doxorubicin/Dexrazoxane, in Children With Relapsed/Refractory Solid Tumors or Leukemia

Resource links provided by NLM:


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

Primary Outcome Measures:
  • Maximum-tolerated dose and/or recommended phase II dose of obatoclax mesylate [ Designated as safety issue: Yes ]
  • Adverse events as assessed by NCI CTCAE v. 3.0 [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Antitumor activity of obatoclax mesylate [ Designated as safety issue: No ]

Estimated Enrollment: 52
Study Start Date: June 2009
Estimated Primary Completion Date: March 2011 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • Estimate the maximum-tolerated dose and/or recommended phase II dose of obatoclax mesylate in combination with vincristine sulfate, doxorubicin hydrochloride, and dexrazoxane hydrochloride in pediatric patients with refractory solid tumors.
  • Define and describe the toxicities of obatoclax mesylate in these patients.

Secondary

  • Preliminarily define the antitumor activity of obatoclax hydrochloride in patients with refractory or relapsed solid tumors or leukemias within the confines of a phase I study.

OUTLINE: This is a multicenter, dose-escalation study of obatoclax mesylate. Patients are stratified according to disease type (solid tumor or lymphoma [stratum 1] vs multilineage leukemia (MLL) [stratum 2] vs non-MLL leukemia [stratum 3]) and treated according to stratum.

  • Stratum 1 (dose-escalation): Patients receive obatoclax mesylate IV over 3 hours on days 1 and 8 and vincristine sulfate IV, doxorubicin hydrochloride IV, and dexrazoxane hydrochloride IV on day 8 of course 1 (28 days). Drugs are administered on day 1 of subsequent courses and repeat every 21 days for up to 1 year in the absence of disease progression or unacceptable toxicity.
  • Stratum 2: Patients receive obatoclax mesylate (at starting dose in stratum 1), vincristine sulfate, doxorubicin hydrochloride, and dexrazoxane hydrochloride as in stratum 1.
  • Stratum 3: Patients receive obatoclax mesylate (at the MTD determined in stratum 1), vincristine sulfate, doxorubicin hydrochloride, and dexrazoxane hydrochloride as in stratum 1. After completion of study therapy, patients are followed up for 30 days.
  Eligibility

Ages Eligible for Study:   up to 21 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Diagnosis of 1 of the following:

    • Histologically confirmed refractory or relapsed solid tumor or lymphoma (stratum 1)

      • Measurable or evaluable disease
      • No primary CNS tumors
      • No known CNS metastases
    • Recurrent or refractory mixed-lineage leukemia (MLL) leukemia (stratum 2)

      • More than 25% blasts on bone marrow aspirate
      • No symptomatic CNS leukemia, CNS chloromas, or leptomeningeal leukemic involvement
    • Recurrent or refractory non-MLL leukemia (stratum 3)

      • Acute lymphoblastic leukemia, acute myeloid leukemia, or chronic myeloid leukemia in blast crisis
      • More than 25% blasts on bone marrow aspirate
      • No symptomatic CNS leukemia, CNS chloromas, or leptomeningeal leukemic involvement
  • No known curative therapy or therapy proven to prolong survival with an acceptable quality of life

PATIENT CHARACTERISTICS:

  • Karnofsky performance status 50-100% (> 16 years of age)
  • Lansky performance status 50-100% (≤ 16 years of age)
  • ANC ≥ 1,000/mm^3 (stratum 1)
  • Platelet count ≥ 100,000/mm^3 (transfusion independent defined as ≥ 7 days since prior transfusion)(stratum
  • Platelet count ≥ 20,000/mm^3 (may receive platelet transfusion) (stratum 2 and 3)
  • Hemoglobin ≥ 8.0 g/dL (may receive RBC transfusion)
  • Creatinine clearance OR radioisotope GFR ≥ 70 mL/min OR serum creatinine based on age/gender as follows:

    • 0.5 mg/dL (6 months to < 1 year of age)
    • 0.6 mg/dL (1 to < 2 years of age)
    • 0.8 mg/dL (2 to < 6 years of age)
    • 1 mg/dL (6 to < 10 years of age)
    • 1.2 mg/dL (10 to < 13 years of age)
    • 1.5 mg/dL (male) or 1.4 mg/dL (female) (13 to < 16 years of age)
    • 1.7 mg/dL (male) or 1.4 mg/dL (female) (≥ 16 years of age)
  • Bilirubin (sum of conjugated and unconjugated) ≤ 1.5 times upper limit of normal
  • ALT ≤ 110 U/L
  • Serum albumin ≥ 2 g/dL
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • Adequate cardiac function defined as 1 of the following:

    • Shortening fraction ≥ 27% by echocardiogram
    • Ejection fraction ≥ 50% by gated radionuclide study
  • Central nervous system function defined as:

    • Stable neurological examination ≥ 2 weeks prior to study
    • No known unresolved neurological toxicities > grade 2
  • No uncontrolled infection
  • Must be able to comply with the safety-monitoring requirements of the study according to the primary investigator's opinion

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • Recovered from all prior chemotherapy, immunotherapy, or radiotherapy
  • At least 3 weeks since prior myelosuppressive chemotherapy (6 weeks for nitrosourea)

    • At least 24 hours since prior hydroxyurea
  • At least 7 days since prior hematopoietic growth factor
  • At least 7 days since prior biologic therapy

    • At least 3 half-lives since prior monoclonal antibody therapy
    • Time must be extended for other biological agents known to have adverse events beyond 7 days, at the discretion of the primary investigator
  • Prior radiotherapy allowed according to the following criteria:

    • At least 2 weeks since prior palliative radiotherapy (small port)
    • At least 6 months since prior total-body irradiation (TBI), craniospinal radiotherapy, or ≥ 50% radiation of the pelvis
    • At least 6 weeks since other prior substantial bone marrow radiation
  • At least 3 months since prior stem cell transplantation or rescue without TBI and no evidence of active graft-vs-host disease
  • More than 7 days since prior growth factor that supports platelet or white cell number or function
  • Stable or decreasing dose of corticosteroid in the past 7 days
  • No concurrent investigational drugs
  • No other concurrent anticancer agents (including chemotherapy, radiotherapy, immunotherapy, or biologic therapy) except for hydroxyurea

    • Patients with leukemia may receive concurrent anticancer agents (methotrexate, hydrocortisone, cytarabine) intrathecally, if necessary
  • No concurrent anticonvulsants
  • No prior total lifetime cumulative anthracycline dose > 750 mg/m^2 of doxorubicin hydrochloride or equivalent (e.g., daunorubicin hydrochloride, idarubicin, or mitoxantrone hydrochloride)
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00933985

Locations
United States, Alabama
UAB Comprehensive Cancer Center Recruiting
Birmingham, Alabama, United States, 35294
Contact: Clinical Trials Office - UAB Comprehensive Cancer Center     205-934-0309        
United States, California
Children's Hospital of Orange County Recruiting
Orange, California, United States, 92868
Contact: Violet Shen     714-532-8636        
United States, Illinois
Children's Memorial Hospital - Chicago Recruiting
Chicago, Illinois, United States, 60614
Contact: Stewart Goldman     773-880-4598x3270        
United States, Indiana
Indiana University Melvin and Bren Simon Cancer Center Recruiting
Indianapolis, Indiana, United States, 46202-5289
Contact: Clinical Trials Office - Indiana University Cancer Center     317-274-2552        
United States, Missouri
Siteman Cancer Center at Barnes-Jewish Hospital - Saint Louis Recruiting
St. Louis, Missouri, United States, 63110
Contact: Robert J. Hayashi     314-454-4118        
United States, Ohio
Cincinnati Children's Hospital Medical Center Recruiting
Cincinnati, Ohio, United States, 45229-3039
Contact: Clinical Trials Office - Cincinnati Children's Hospital Medica     513-636-2799        
Sponsors and Collaborators
Children's Oncology Group
Investigators
Study Chair: Richard Aplenc, MD, MSCE Children's Hospital of Philadelphia
  More Information

Additional Information:
No publications provided

Responsible Party: Dan L. Duncan Cancer Center at Baylor College of Medicine ( Susan M. Blaney )
Study ID Numbers: CDR0000647160, COG-ADVL0816
Study First Received: July 7, 2009
Last Updated: September 3, 2009
ClinicalTrials.gov Identifier: NCT00933985     History of Changes
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
unspecified childhood solid tumor, protocol specific
recurrent childhood acute lymphoblastic leukemia
recurrent childhood acute myeloid leukemia
secondary acute myeloid leukemia
acute undifferentiated leukemia
relapsing chronic myelogenous leukemia
childhood chronic myelogenous leukemia
blastic phase chronic myelogenous leukemia
recurrent childhood anaplastic large cell lymphoma
recurrent childhood grade III lymphomatoid granulomatosis
recurrent childhood large cell lymphoma
recurrent childhood lymphoblastic lymphoma
recurrent childhood small noncleaved cell lymphoma
recurrent/refractory childhood Hodgkin lymphoma
Burkitt lymphoma
recurrent mycosis fungoides/Sezary syndrome
recurrent cutaneous T-cell non-Hodgkin lymphoma
cutaneous B-cell non-Hodgkin lymphoma

Study placed in the following topic categories:
Blast Crisis
Razoxane
Mycoses
Acute Myelocytic Leukemia
Lymphoma, Large-Cell, Anaplastic
Neoplasm Metastasis
Hodgkin Disease
Lymphoma, Large B-Cell, Diffuse
Immunoproliferative Disorders
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Vincristine
Leukemia, Myeloid
Doxorubicin
B-cell Lymphomas
Chronic Myelogenous Leukemia
Chelating Agents
Lymphoma, Non-Hodgkin
Antineoplastic Agents, Phytogenic
Lymphoma, T-Cell, Cutaneous
Acute Lymphoblastic Leukemia, Childhood
Leukemia, Lymphoid
Hodgkin Lymphoma, Childhood
Sezary Syndrome
Mycosis Fungoides
Leukemia, Myeloid, Acute
Lymphoblastic Lymphoma
Lymphoma, B-Cell
Lymphoma, Small Cleaved-cell, Diffuse
Leukemia
Anti-Bacterial Agents

Additional relevant MeSH terms:
Neoplasms by Histologic Type
Immunoproliferative Disorders
Molecular Mechanisms of Pharmacological Action
Immune System Diseases
Antineoplastic Agents
Mitosis Modulators
Vincristine
Antimitotic Agents
Cardiovascular Agents
Antibiotics, Antineoplastic
Pharmacologic Actions
Doxorubicin
Razoxane
Leukemia
Lymphatic Diseases
Neoplasms
Therapeutic Uses
Tubulin Modulators
Chelating Agents
Lymphoproliferative Disorders
Antineoplastic Agents, Phytogenic
Lymphoma

ClinicalTrials.gov processed this record on September 10, 2009