A Non-Randomized Phase II Study of Sequential Irinotecan (CPT-11) And Flavopiridol In Patients With Advanced Hepatoma
Inclusion Criteria
DISEASE CHARACTERISTICS:
- Histologically or cytologically confirmed hepatocellular carcinoma
- Advanced disease
- Measurable disease
- At least 1 unidimensionally measurable lesion ≥ 20 mm by conventional techniques
OR ≥ 10 mm by spiral CT scan
- Prior local therapy (e.g., surgery, hepatic arterial embolization, radiofrequency
ablation, or cryoablation) allowed provided therapy was completed ≥ 8 weeks before
study entry AND ≥ 1 of the following conditions are met:
- Target lesion was not subjected to local therapy
- 25% increase in the size of target lesion within the field of prior local
therapy
- Lesions treated with external beam radiotherapy are not acceptable as
target lesions
- Child-Pugh class A or B status if liver cirrhosis is present
- Score 7 or 8 only
- No known brain metastases
PATIENT CHARACTERISTICS:
Age
- 18 and over
Performance status
- Karnofsky 70-100%
Life expectancy
- Not specified
Hematopoietic
- Absolute neutrophil count ≥ 1,500/mm^3
- Platelet count ≥ 75,000/mm^3
- WBC ≥ 3,000/mm^3
Hepatic
- See Disease Characteristics
- AST and ALT ≤ 2.5 times upper limit of normal
- Bilirubin ≤ 1.5 mg/dL
Renal
- Creatinine normal OR
- Creatinine clearance ≥ 60 mL/min
Cardiovascular
- No symptomatic congestive heart failure
- No unstable angina pectoris
- No deep vein thrombosis within the past 6 months
- Patients maintained on anticoagulation therapy for an event that occurred more
than 6 months ago are eligible
- No myocardial infarction within the past 6 months
- No cardiac arrhythmia within the past 6 months
- Rate-controlled atrial fibrillation allowed if stable for at least 6 months
Pulmonary
- No pulmonary embolus within the past 6 months
- Patients maintained on anticoagulation therapy for an event that occurred more
than 6 months ago are eligible
Other
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception during and for 3 months after study
participation
- No prior allergic reaction attributed to compounds of similar chemical or biological
composition to flavopiridol or irinotecan
- No clinically significant gastrointestinal bleeding requiring hospitalization within
the past month
- No active or ongoing infection
- No psychiatric illness or social situation that would preclude study compliance
- No other uncontrolled illness
- No other malignancy within the past 3 years except carcinoma in situ of the cervix,
adequately treated basal cell skin cancer, or superficial bladder tumors [Ta, Tis, or
T1]
PRIOR CONCURRENT THERAPY:
Biologic therapy
- No prior systemic biologic therapy
Chemotherapy
- No prior systemic chemotherapy for hepatocellular carcinoma
- No other concurrent chemotherapy
Endocrine therapy
- Not specified
Radiotherapy
- See Disease Characteristics
Surgery
- See Disease Characteristics
- No prior organ allograft
Other
- No concurrent combination antiretroviral therapy for HIV-positive patients
- No concurrent vitamins, antioxidants, or herbal preparations and supplements
- Single-tablet multivitamin allowed
- No other concurrent investigational agents
- No other concurrent anticancer agents or therapies