A Phase I Study of Sunitinib Malate and Standard Infusion Gemcitabine in Solid Tumors
Inclusion Criteria
Criteria:
- Histologically or cytologically confirmed pancreatic adenocarcinoma OR other solid
tumor:
- Not amenable to curative therapy
- Previously untreated metastatic pancreatic adenocarcinoma allowed
- Measurable or evaluable disease
- No history of or known brain metastases, spinal cord compression, carcinomatous
meningitis, or new evidence of brain or leptomeningeal disease on screening CT scan
or MRI scan
- 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
- Hemoglobin >= 8.5 g/dL
- Bilirubin =< 1.5 mg/dL
- Creatinine normal OR creatinine clearance >= 60 mL/min
- AST and ALT =< 2.5 times upper limit of normal (ULN) (=< 5 times ULN if due to
underlying disease)
- Calcium =< 12.0 mg/dL
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception during and for at least 6 months
after completion of study therapy
- LVEF normal by MUGA scan or ECHO at baseline
- Deep venous thrombosis or pulmonary embolism allowed provided they are clinically
stable and adequately treated
- No preexisting thyroid abnormality that results in the inability to maintain thyroid
function in the normal range while using medication
- No history of allergic reactions attributed to compounds of similar chemical or
biological composition to sunitinib malate
- No history of any of the following within the past 6 months:
- Myocardial infarction
- Ventricular arrhythmia (i.e., ventricular tachycardia or ventricular
fibrillation >= 3 beats in a row)
- Severe/unstable angina
- Severe peripheral vascular disease (i.e., claudication)
- Procedure on peripheral vasculature
- Coronary/peripheral artery bypass graft
- Cerebrovascular accident
- No history of any of the following within the past 6 months:
- Transient ischemic attack;
- Clinically significant bleeding requiring red blood cell transfusion
- No NYHA class III or IV heart disease:
- Patients with NYHA class II disease who are stable and on medication are
eligible
- No ongoing cardiac dysrhythmias >= grade 2, atrial fibrillation of any grade, or any
significant EKG abnormalities
- No hypertension that cannot be controlled by medications to a systolic blood pressure
(BP) of < 140 mm Hg and diastolic BP of < 90 mm Hg
- No condition that impairs the ability to swallow and retain sunitinib malate tablets,
including any of the following:
- Gastrointestinal tract disease resulting in an inability to take oral medication
- Requirement for IV alimentation
- Prior surgical procedures affecting absorption
- Active peptic ulcer disease
- No gastrointestinal perforation or intra-abdominal abscess within the past 28 days
- No serious nonhealing infection or bone fracture
- No other severe acute or chronic medical condition, psychiatric condition, or
laboratory abnormality that would preclude study therapy
- May have received any number of prior systemic therapies
- More than 4 weeks since prior radiotherapy or surgery and recovered
- More than 4 weeks since other prior therapies and recovered
- Prior gemcitabine hydrochloride allowed
- No prior sunitinib malate or other therapy directed against VEGF, including any of
the following:
Sorafenib; Bevacizumab; Vatalanib; AZD2171; VEGF Trap; Investigational antiangiogenic
therapy
- More than 7 days since prior and no concurrent CYP3A4 inhibitors, including any of
the following:
- Ketoconazole
- Itraconazole
- Clarithromycin
- Erythromycin
- Diltiazem
- Verapamil
- Indinavir
- Ritonavir
- Nelfinavir
- Saquinavir
- Atazanavir
- Delavirdine
- More than 12 days since prior and no concurrent CYP3A4 inducers, including any of the
following:
- Rifampin
- Rifabutin
- Carbamazepine
- Phenobarbital
- Phenytoin
- Hypericum perforatum (St. John's wort)
- Efavirenz
- Tipranavir
- No concurrent agents with proarrhythmic potential, including any of the following:
- Terfenadine
- Quinidine
- Procainamide
- Disopyramide
- Sotalol
- Probucol
- Bepridil
- Haloperidol
- Risperidone
- Indapamide
- Flecainide
- No concurrent combination antiretroviral therapy for HIV-positive patients
- No concurrent treatment on another clinical trial:
Participation in non-therapeutic clinical trials allowed
- QTc < 500 msec