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Irinotecan and ABT-888 in Treating Patients With Metastatic or Unresectable Cancer
This study is not yet open for participant recruitment.
Verified by National Cancer Institute (NCI), July 2008
Sponsors and Collaborators: Barbara Ann Karmanos Cancer Institute
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00576654
  Purpose

RATIONALE: Drugs used in chemotherapy, such as irinotecan, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. ABT-888 may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Giving irinotecan together with ABT-888 may kill more cancer cells.

PURPOSE: This phase I trial is studying the side effects and best dose of irinotecan given together with ABT-888 in treating patients with metastatic or unresectable cancer.


Condition Intervention Phase
Lymphoma
Unspecified Adult Solid Tumor, Protocol Specific
Drug: ABT-888
Drug: irinotecan hydrochloride
Procedure: biopsy
Procedure: high performance liquid chromatography
Procedure: immunoenzyme technique
Procedure: laboratory biomarker analysis
Procedure: pharmacological study
Procedure: polymorphism analysis
Phase I

MedlinePlus related topics: Cancer Fungal Infections Hodgkin's Disease Leukemia, Adult Acute Leukemia, Adult Chronic Lymphoma
Drug Information available for: Irinotecan Irinotecan hydrochloride
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Open Label
Official Title: A Phase I Dose-Escalation Study of Oral ABT-888 (NSC #737664) Plus Intravenous Irinotecan (CPT-11, NSC#616348) Administered in Patients With Advanced Solid Tumors

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

Primary Outcome Measures:
  • Optimal biological dose of study drugs [ Designated as safety issue: No ]
  • Maximum administered dose of study drugs [ Designated as safety issue: No ]
  • Maximum tolerated dose of study drugs [ Designated as safety issue: Yes ]
  • Recommend phase II dose of study drugs [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Toxicity [ Designated as safety issue: Yes ]
  • PAR levels [ Designated as safety issue: No ]
  • Pharmacological studies [ Designated as safety issue: No ]
  • PAR activity inhibition [ Designated as safety issue: No ]
  • Polymorphisms in UGT1A1, CYP2C9, CYP2C19, and ABCG2 [ Designated as safety issue: No ]

Estimated Enrollment: 25
Study Start Date: December 2007
Estimated Primary Completion Date: October 2008 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • To determine the optimal biologic dose for poly (ADP-ribose) polymerase (PARP) inhibition using irinotecan hydrochloride in combination with ABT-888 in patients with metastatic or unresectable malignancies.
  • To determine the recommended phase II dose for irinotecan hydrochloride in combination with ABT-888, by evaluating the feasibility, safety, dose-limiting toxicities and the maximum tolerated dose.
  • To determine the safety profile of this regimen (incidence of adverse events and clinically significant changes in laboratory tests, ECGs, and vital signs).
  • To determine the safety profile of this regimen at the recommended phase II dose (incidence of adverse events and clinically significant changes in laboratory tests, ECGs, and vital signs).

Secondary

  • To determine the pharmacokinetic (PK) profile of ABT-888.
  • To determine the PK profile of irinotecan hydrochloride both as a single agent and in combination with ABT-888.
  • To determine the tumor response as assessed by RECIST.

Tertiary

  • To determine the pharmacodynamic biomarker response (PARP inhibition in tumor cells and peripheral blood mononuclear cells) by measurement of PAR levels.
  • To determine the DNA damaging effects of irinotecan hydrochloride and the combination of irinotecan hydrochloride with ABT-888 (levels of γ-H2AX and Rad51 formation in tumor tissue).
  • To determine the relevance of CYP2C9 and 2C19 polymorphisms, UGT1A1 polymorphism, and ABCG2 polymorphism to the pharmacokinetics of irinotecan hydrochloride and/or ABT-888.

OUTLINE: This is a multicenter, dose-escalation of ABT-888 study.

Patients receive irinotecan hydrochloride IV over 90 minutes on days 1 and 8 and oral ABT-888 twice daily on days 0-14 (days 3-14 of course 1 only). Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.

Patients undergo blood sample collection for pharmacokinetic and pharmacodynamic sampling periodically during courses 1 and 2. Samples are analyzed for topoisomerase I expression, polymorphism of ERCC1, PAR concentration by immunoassay, plasma concentrations of irinotecan hydrochloride and its metabolites by high performance liquid chromatography, and pharmacogenomics assessing polymorphisms in UGT1A1, CYP2C9, CYP2C19, and ABCG2. Patients also undergo tumor tissue biopsies periodically and samples are also analyzed for research studies.

After completion of study treatment, patients are followed periodically for 30 days.

  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 metastatic or unresectable malignancy meeting 1 of the following criteria:

    • Standard curative or palliative measures do not exist or are no longer effective
    • Irinotecan hydrochloride is considered to be a viable therapy regimen
  • Patients with solid hematologic malignancies (Hodgkin or non-Hodgkin lymphoma) are eligible provided a bone marrow has been performed within 6 weeks of treatment
  • Measurable disease per RECIST guidelines
  • Patients must have tumors determined to be easily accessible for biopsy (e.g. pleural-based lesions, peripheral lymph nodes, soft tissue metastases, or large liver metastases)
  • Patients must be negative for carrying the UGT1A1*28 allele (also called (TA)7)
  • Archival tissue block or paraffin sample from archival tissue block (approximately 10 sections) for use in pharmacodynamic correlative studies must be available
  • No known active brain metastases

    • Patients with previously treated brain metastases are eligible, provided they are not accompanied by seizures and a baseline brain MRI scan demonstrates no current evidence of brain metastases

PATIENT CHARACTERISTICS:

  • ECOG performance status (PS) 0-2 OR Karnofsky PS 60-100%
  • Life expectancy > 12 weeks
  • Absolute neutrophil count ≥ 1,500/mm³
  • Platelet count ≥ 100,000/mm³
  • AST and ALT ≤ 2.5 times upper limit of normal (ULN) (≤ 5 times ULN if liver metastases are present)
  • Alkaline phosphatase ≤ 2.0 times ULN (≤ 5 times ULN if bone or liver metastases are present)
  • Bilirubin ≤ 1.5 times ULN
  • Creatinine ≤ 1.5 times ULN OR creatinine clearance ≥ 60 mL/min
  • Ability to understand and the willingness to sign a written informed consent document
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception prior to, during, and for 3 months after completion of study treatment
  • Must be able to reliably tolerate and/or receive oral medications
  • No history of allergic reactions attributed to the following:

    • Camptothecin derivatives (e.g., topotecan hydrochloride, irinotecan hydrochloride, or exatecan mesylate)
    • Any ingredients contained within the liquid irinotecan hydrochloride solution (e.g., sorbitol)
    • Any antiemetics or antidiarrheals appropriate for administration with study therapy (e.g., loperamide or dexamethasone)
    • No prior history of seizures
  • No uncontrolled intercurrent illness including, but not limited to:

    • Ongoing or active infection
    • Symptomatic congestive heart failure
    • Unstable angina pectoris
    • Cardiac arrhythmia
    • Psychiatric illness or social situations that would limit compliance with study requirements

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin C) and recovered
  • More than 3 weeks since prior minimal radiotherapy (i.e., ≤ 5% of total marrow volume)
  • More than 4 weeks since prior radiotherapy (i.e., > 5% of total marrow volume)
  • No prior radiotherapy to ≥ 50% of total marrow volume
  • More than 4 weeks since prior experimental (i.e., non-FDA approved) therapy or immunotherapy and recovered
  • Males receiving treatment for prostate cancer must be maintained at castrate levels of testosterone by continuation of luteinizing-releasing hormone agonists
  • No cytochrome P450 CYP3A4 isoform-inducing drugs (e.g. phenytoin, phenobarbital, carbamazepine, rifampin, rifabutin, ketoconazole, St. John's Wort)
  • No other investigational agents within 4 weeks of study entry
  • No chronic growth factor support (e.g., filgrastim [G-CSF], pegfilgrastim) for maintenance of white blood cell counts or granulocyte counts
  • No other concurrent anticancer therapy (cytotoxic, biologic, radiation, or hormonal other than for replacement) except medications for supportive care that may potentially have an anticancer effect (i.e., megestrol acetate, bisphosphonates) started 1 month prior to study
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00576654

Sponsors and Collaborators
Barbara Ann Karmanos Cancer Institute
Investigators
Study Chair: Patricia M. LoRusso, DO Barbara Ann Karmanos Cancer Institute
  More Information

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

Study ID Numbers: CDR0000579642, WSU-2007-014
Study First Received: December 18, 2007
Last Updated: September 22, 2008
ClinicalTrials.gov Identifier: NCT00576654  
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
unspecified adult solid tumor, protocol specific
recurrent adult Hodgkin lymphoma
recurrent adult non-Hodgkin lymphoma
stage III adult Hodgkin lymphoma
stage III adult non-Hodgkin lymphoma
stage IV adult Hodgkin lymphoma
stage IV adult non-Hodgkin lymphoma
recurrent adult T-cell leukemia/lymphoma
stage III adult T-cell leukemia/lymphoma
stage IV adult T-cell leukemia/lymphoma
angioimmunoblastic T-cell lymphoma
stage III mycosis fungoides/Sezary syndrome
stage IV mycosis fungoides/Sezary syndrome
recurrent mycosis fungoides/Sezary syndrome
recurrent cutaneous T-cell non-Hodgkin lymphoma
stage III cutaneous T-cell non-Hodgkin lymphoma
stage IV cutaneous T-cell non-Hodgkin lymphoma
recurrent adult grade III lymphomatoid granulomatosis
adult nasal type extranodal NK/T-cell lymphoma
Waldenstrom macroglobulinemia
recurrent adult Burkitt lymphoma
stage III adult Burkitt lymphoma
stage IV adult Burkitt lymphoma
recurrent adult diffuse large cell lymphoma
recurrent adult diffuse mixed cell lymphoma
recurrent adult diffuse small cleaved cell lymphoma
stage III adult diffuse large cell lymphoma
stage III adult diffuse mixed cell lymphoma
stage III adult diffuse small cleaved cell lymphoma
stage IV adult diffuse large cell lymphoma

Study placed in the following topic categories:
Sezary syndrome
Hodgkin's disease
Hodgkin lymphoma, adult
Cutaneous T-cell lymphoma
Lymphoma, Mantle-Cell
Irinotecan
Lymphoma, small cleaved-cell, diffuse
Lymphoma, Follicular
Sezary Syndrome
Lymphoma, B-Cell, Marginal Zone
Mycosis Fungoides
Lymphoma, large-cell, immunoblastic
Lymphoma, large-cell
Lymphoma, B-Cell
Lymphomatoid granulomatosis
Burkitt's lymphoma
Leukemia
Mycoses
Leukemia, Lymphocytic, Chronic, B-Cell
Lymphoma, T-Cell
Lymphoma, Large-Cell, Immunoblastic
Waldenstrom macroglobulinemia
Hodgkin Disease
Lymphoma
Chronic lymphocytic leukemia
Lymphoma, Large B-Cell, Diffuse
Lymphomatoid Granulomatosis
Immunoproliferative Disorders
Leukemia, B-cell, chronic
Leukemia-Lymphoma, Adult T-Cell

Additional relevant MeSH terms:
Neoplasms
Neoplasms by Histologic Type
Molecular Mechanisms of Pharmacological Action
Immune System Diseases
Antineoplastic Agents
Therapeutic Uses
Enzyme Inhibitors
Antineoplastic Agents, Phytogenic
Pharmacologic Actions

ClinicalTrials.gov processed this record on January 16, 2009