Phase I Study of Intravenous Triapine® (IND #68338) in Combination With Pelvic Radiation Therapy With or Without Weekly Intravenous Cisplatin Chemotherapy for Locally Advanced Cervical, Vaginal, or Pelvic Gynecologic Malignancies.
PRIMARY OBJECTIVES:
I. To determine the maximum tolerated dose (MTD) of Triapine® when given in combination with
pelvic radiotherapy with or without weekly intravenous cisplatin chemotherapy.
II. To determine the dose limiting toxicity (DLT) of Triapine® when given in combination
with pelvic radiotherapy with or without weekly intravenous cisplatin chemotherapy.
III. To determine the safety and sequelae of intravenous Triapine® when given in combination
with pelvic radiotherapy with or without weekly intravenous cisplatin chemotherapy.
SECONDARY OBJECTIVES:
I. Evaluation of intravenous Triapine®'s targeted inhibition of ribonucleotide reductase
through tumor tissue biopsy at pretreatment evaluation and during external beam radiotherapy
(Day 10).
II. Serial monitoring of methemoglobin levels during therapy given Triapine®'s iron
chelating properties.
OUTLINE: This is a multicenter, dose-escalation study of 3-AP. Patients are assigned to 1 of
2 treatment groups based on eligibility* to receive cisplatin (yes vs no).
NOTE: *Patients who refuse or are not candidates for cisplatin chemotherapy due to prior
platinum adverse sensitivity, active neuropathy, or comobid illness, as determined by the
treating physician, are eligible to receive 3-AP alone with pelvic radiotherapy.
Group 1: Patients undergo external-beam pelvic radiotherapy once daily on days 1-5, 8-12,
15-19, 22-26, and 29-33. Patients also receive 3-AP IV over 2 hours on days 1, 3, 5, 8, 10,
12, 15, 17, 19, 22, 24, 26, 29, 31, and 33 and cisplatin IV over 1½ hours on day 2, 9, 16,
23, and 30.
Group 2: Patients undergo external-beam pelvic radiotherapy and receive 3-AP as in group 1.
In both groups, patients undergo intracavitary or interstitial brachytherapy at least once
weekly for 3-5 weeks during or after external-beam radiotherapy as per standard of care.
Cohorts of 3-6 patients in group 1 and 1-3 patients in group 2 receive escalating doses of
3-AP 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. At
least 6 patients are treated at the MTD.
Patients undergo blood draws on days 1 and 10 before treatment with 3-AP and at 2, 4, 6, and
24 hours after starting treatment to assess methemoglobin levels and 3-AP plasma levels.
Patients also undergo punch biopsy on days 1 and 10 to determine R2 protein levels by
Western blot analysis, ribonucleotide reductase R2 protein levels by flow cytometry, and
cytidine deoxyphosphate reductase assay.
After completion of study treatment, patients are followed periodically for up to 5 years.
PROJECTED ACCRUAL: A total of 24 patients will be accrued for this study.
Interventional
Endpoint Classification: Safety Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
Toxicity of radiotherapy and Triapine® combination therapy as documented by dose-limiting toxicities (DLTs) using Common Terminology Criteria for Adverse Events (CTCAE) criteria, version 3.0
Up to 12 weeks
Yes
Charles Kunos
Principal Investigator
Case Western Reserve University
United States: Food and Drug Administration
NCI-2012-03126
NCT00335998
March 2006
Name | Location |
---|---|
Case Western Reserve University | Cleveland, Ohio 44106 |