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A Cancer Research UK Phase I Trial to Evaluate the Safety, Tolerability and Pharmacokinetics of 17-Dimethylaminoethyl-Amino-17-Demethoxygeldanamycin (17-DMAG) Given as a Once Weekly Infusion in Patients With Advanced Solid Tumors


Phase 1
18 Years
N/A
Open (Enrolling)
Both
Unspecified Adult Solid Tumor, Protocol Specific

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Trial Information

A Cancer Research UK Phase I Trial to Evaluate the Safety, Tolerability and Pharmacokinetics of 17-Dimethylaminoethyl-Amino-17-Demethoxygeldanamycin (17-DMAG) Given as a Once Weekly Infusion in Patients With Advanced Solid Tumors


OBJECTIVES:

Primary

- Determine the maximum tolerated dose, dose-limiting toxicity, and recommended phase II
dose of 17-dimethylaminoethylamino-17-demethoxygeldanamycin (17-DMAG) in patients with
unresectable or metastatic solid tumors.

- Determine the feasibility, safety, and toxicity profile of this drug in these patients.

Secondary

- Determine the clinical pharmacokinetic profile of this drug in these patients.

- Determine tumor response in patients treated with this drug.

- Determine the biologically effective dose.

OUTLINE: This is an open-label, non-randomized, dose-escalation, multicenter study.

Patients receive 17-dimethylaminoethylamino-17-demethoxygeldanamycin (17-DMAG) IV over 1
hour on days 1, 8, 15, and 22. Courses repeat every 28 days in the absence of disease
progression or unacceptable toxicity.

Cohorts of 3-6 patients receive escalating doses of 17-DMAG until the maximum tolerated dose
(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. An additional 10 patients are treated at the
MTD.

After completion of study treatment, patients are followed for 28 days.

PROJECTED ACCRUAL: Approximately 25-35 patients will be accrued for this study within 12-18
months.

Inclusion Criteria


DISEASE CHARACTERISTICS:

- Histologically or cytologically confirmed solid tumor

- Unresectable or metastatic disease

- Standard curative or palliative measures do not exist OR are no longer effective OR
patient refused such measures

- No known brain metastases

PATIENT CHARACTERISTICS:

Age

- 18 and over

Performance status

- ECOG 0-1

Life expectancy

- More than 12 weeks

Hematopoietic

- Absolute neutrophil count > 1,500/mm^3

- Platelet count ≥ 100,000/mm^3

- Hemoglobin ≥ 9.0 g/dL

Hepatic

- Bilirubin normal

- ALT and AST ≤ 1.5 times upper limit of normal

- No chronic liver disease

- Hepatitis B or C negative

Renal

- Creatinine normal OR

- Creatinine clearance normal

Cardiovascular

- No symptomatic New York Heart Association class III-IV cardiac disease

- No myocardial infarction within the past year

- No active ischemic heart disease within the past year

- No poorly controlled angina

- No uncontrolled dysrhythmia or dysrhythmias requiring antiarrhythmic drugs

- No transient ischemic attack

- No stroke

- No peripheral vascular disease

- No congenital long QT syndrome

- No history of serious ventricular arrhythmia (ventricular tachycardia or ventricular
fibrillation ≥ 3 beats in a row)

- QTc < 450 msec (for men) and 470 msec (for woman)

- LVEF > 40% by MUGA

- No left bundle branch block

Pulmonary

- No symptomatic pulmonary disease requiring medication, including any of the
following:

- Dyspnea with or without exertion

- Paroxysmal nocturnal dyspnea

- Oxygen requirement

- Significant pulmonary disease (e.g., chronic obstructive/restrictive pulmonary
disease

Other

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception 4 weeks before, during, and for 6
months after completion of study treatment

- No known HIV positivity

- No other malignancy within the past 5 years except adequately treated cone biopsied
carcinoma in situ of the cervix or basal cell or squamous cell skin cancer

- No ongoing or active infection

- No diabetes mellitus (with evidence of severe peripheral vascular disease or ulcers)

- No psychiatric illness or social situation that would preclude study compliance

- No other uncontrolled illness

PRIOR CONCURRENT THERAPY:

Biologic therapy

- More than 4 weeks since prior immunotherapy

- Concurrent epoetin alfa allowed

Chemotherapy

- More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin)

- No prior 17-N-allylamino-17-demethoxygeldanamycin (17-AAG)

Endocrine therapy

- More than 4 weeks since prior endocrine therapy

- Concurrent luteinizing hormone-releasing hormone analogues for androgen-insensitive
prostate cancer and rising prostate-specific antigen allowed

Radiotherapy

- More than 4 weeks since prior radiotherapy (except for palliative treatment)

- No prior irradiation field that potentially included the heart (e.g., mantle)

Surgery

- Not specified

Other

- Recovered from all prior therapy

- Concurrent bisphosphonates allowed

- At least 5 half-lives since prior and no concurrent medication that prolong QTc

- No other concurrent anticancer or investigational agents

- No concurrent grapefruit juice

Type of Study:

Interventional

Study Design:

Allocation: Non-Randomized, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Recommended phase II dose of 17-dimethylaminoethylamino-17-demethoxygeldanamycin (17-DMAG) at 28 days after treatment

Safety Issue:

Yes

Principal Investigator

Ian R. Judson, MA, MD, FRCP

Investigator Role:

Study Chair

Investigator Affiliation:

Institute of Cancer Research, United Kingdom

Authority:

United States: Federal Government

Study ID:

CDR0000442402

NCT ID:

NCT00248521

Start Date:

October 2005

Completion Date:

Related Keywords:

  • Unspecified Adult Solid Tumor, Protocol Specific
  • unspecified adult solid tumor, protocol specific
  • Neoplasms

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