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Sorafenib and Bortezomib in Treating Patients With Advanced Cancer
This study is currently recruiting participants.
Verified by National Cancer Institute (NCI), December 2008
First Received: March 15, 2006   Last Updated: January 28, 2009   History of Changes
Sponsors and Collaborators: Mayo Clinic
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00303797
  Purpose

RATIONALE: Sorafenib and bortezomib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Sorafenib may also stop the growth of cancer cells by blocking blood flow to the cancer.

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


Condition Intervention Phase
Leukemia
Multiple Myeloma and Plasma Cell Neoplasm
Unspecified Adult Solid Tumor, Protocol Specific
Drug: bortezomib
Drug: sorafenib tosylate
Phase I

Genetics Home Reference related topics: aceruloplasminemia hemophilia
MedlinePlus related topics: Cancer Leukemia, Adult Acute Leukemia, Adult Chronic Multiple Myeloma
Drug Information available for: Bortezomib Sorafenib Sorafenib tosylate
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment
Official Title: A Phase I Study of the Raf Kinase/VEGFR Inhibitor BAY 43-9006 in Combination With the Proteasome Inhibitor PS-341 in Patients With Advanced Malignancies

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

Estimated Enrollment: 50
Study Start Date: December 2005
Estimated Primary Completion Date: December 2006 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

  • Determine the maximum tolerated dose of sorafenib and bortezomib in patients with advanced malignancies.
  • Describe the toxicities associated with the combination of sorafenib and bortezomib.
  • Evaluate the therapeutic antitumor activity of the combination of sorafenib and bortezomib.
  • Evaluate the effects of sorafenib on the disposition of bortezomib.
  • Assess the correlation between clinical effects (toxicity and/or tumor response or activity) and the pharmacologic parameters (pharmacokinetic/pharmacodynamic) and/or biologic results (correlative laboratory).

OUTLINE: This is a dose-escalation study. Patients are assigned to 1 of 2 groups according to disease type.

  • Group I (solid tumors-dose-escalation group): Patients receive oral sorafenib twice daily on days 1-21 and 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 receive escalating doses of sorafenib and bortezomib until the MTD is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity.

  • Group II (multiple myeloma or chronic lymphocytic leukemia-maximum tolerated dose [MTD] group): Patients receive oral sorafenib at the MTD twice daily on days 3-21 of course 1 and on days 1-21 of each subsequent course. Patients also receive bortezomib IV over 3-5 seconds at the MTD on days 1, 4, 8, and 11. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.

Patients in group II also undergo blood collection periodically during study for mandatory pharmacologic and biomarker correlative studies.

After completion of study treatment, patients are followed for 3 months.

PROJECTED ACCRUAL: A total of 50 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:

  • Diagnosis of 1 of the following:

    • Cytologically or histologically proven unresectable solid tumor for which no curative treatment options exist (group I - dose-escalation phase)
    • Multiple myeloma or chronic lymphocytic leukemia requiring treatment (group II - maximum tolerated dose phase)

      • Failed ≥ 1 prior regimen
      • Non-secretory myeloma allowed
  • No known standard therapy that is potentially curative or definitely capable of extending life expectancy exists
  • Tumor amenable to serial sampling (group II)

PATIENT CHARACTERISTICS:

  • ECOG performance status 0-2
  • Absolute neutrophil count ≥ 1,500/mm^3
  • Hemoglobin ≥ 9 g/dL
  • Platelet count ≥ 100,000/mm^3 (75,000/mm^3 for patients with multiple myeloma [group II])
  • Bilirubin ≤ 1.5 times upper limit of normal (ULN)
  • AST ≤ 3 times ULN (5 times ULN if liver involvement)
  • Creatinine ≤ 1.5 times ULN (2.5 times ULN for patients with multiple myeloma [group II])
  • Life expectancy ≥ 12 weeks
  • No uncontrolled infection
  • No New York Heart Association class III or IV heart disease
  • No uncontrolled hypertension, labile hypertension, or history of poor compliance with antihypertensive medication
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No sensory peripheral neuropathy of any etiology > grade 1 or neuropathic pain of any etiology
  • No active HIV infection requiring therapy
  • No inability to swallow that would preclude use of oral medications
  • No evidence of bleeding diathesis
  • Medically capable and willing to provide biologic specimens as required (mandatory for patients in group II)

PRIOR CONCURRENT THERAPY:

  • Prior bortezomib allowed
  • More than 3 weeks since prior chemotherapy (6 weeks for mitomycin C or nitrosoureas) and recovered
  • More than 4 weeks since prior immunotherapy or biologic therapy
  • More than 2 weeks since prior steroid therapy (group II only)
  • No prior anti-vascular endothelial growth factor therapy
  • More than 4 weeks since prior full-field radiotherapy (2 weeks for limited-field radiotherapy)
  • No prior radiation to > 25% of bone marrow
  • More than 4 weeks since major surgery (e.g., laparotomy) (2 weeks for minor surgery)

    • Insertion of a vascular access device is not considered major or minor surgery
  • No concurrent chemotherapy, immunotherapy, radiotherapy, or any ancillary other therapy considered investigational
  • No concurrent prophylactic colony-stimulating factors
  • No concurrent therapeutic anticoagulation

    • Concurrent prophylactic anticoagulation (i.e., low-dose warfarin) of venous or arterial access devices allowed provided requirements for PT, INR, or PTT are met
  • No concurrent cytochrome P450 enzyme-inducing antiepileptic drugs (e.g., phenytoin, carbamazepine, and phenobarbital), rifampin, or Hypericum perforatum (St. John's Wort)
  • No concurrent participation in any other study involving a pharmacologic agent (e.g., drugs, biologics, immunotherapy, or gene therapy), either for symptom control, or therapeutic intent
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00303797

Locations
United States, Minnesota
Mayo Clinic Cancer Center Recruiting
Rochester, Minnesota, United States, 55905
Contact: Clinical Trials Office - All Mayo Clinic Locations     507-538-7623        
Sponsors and Collaborators
Mayo Clinic
Investigators
Study Chair: Shaji K. Kumar, MD Mayo Clinic
Investigator: Neil E. Kay, MD Mayo Clinic
  More Information

Additional Information:
No publications provided

Study ID Numbers: CDR0000458075, MAYO-MC0511, NCI-7082
Study First Received: March 15, 2006
Last Updated: January 28, 2009
ClinicalTrials.gov Identifier: NCT00303797     History of Changes
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
unspecified adult solid tumor, protocol specific
stage IV chronic lymphocytic leukemia
stage III multiple myeloma
refractory multiple myeloma
refractory chronic lymphocytic leukemia

Study placed in the following topic categories:
Leukemia, Lymphoid
Immunoproliferative Disorders
Blood Protein Disorders
Hematologic Diseases
Blood Coagulation Disorders
Bortezomib
Vascular Diseases
Paraproteinemias
Hemostatic Disorders
Protein Kinase Inhibitors
Protease Inhibitors
Multiple Myeloma
Leukemia
Chronic Lymphocytic Leukemia
Hemorrhagic Disorders
Leukemia, Lymphocytic, Chronic, B-Cell
Leukemia, B-cell, Chronic
Lymphoproliferative Disorders
Sorafenib
Neoplasms, Plasma Cell

Additional relevant MeSH terms:
Immunoproliferative Disorders
Neoplasms by Histologic Type
Molecular Mechanisms of Pharmacological Action
Immune System Diseases
Antineoplastic Agents
Blood Protein Disorders
Hematologic Diseases
Bortezomib
Vascular Diseases
Enzyme Inhibitors
Paraproteinemias
Hemostatic Disorders
Protein Kinase Inhibitors
Pharmacologic Actions
Protease Inhibitors
Multiple Myeloma
Leukemia
Neoplasms
Hemorrhagic Disorders
Therapeutic Uses
Cardiovascular Diseases
Lymphoproliferative Disorders
Sorafenib
Neoplasms, Plasma Cell

ClinicalTrials.gov processed this record on May 07, 2009