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Study to Determine the Maximum Tolerated Time of Infusion for High-Dose Methotrexate, Administered as a Continuous Intravenous Infusion at a Dose of 6g/m² Per 24 Hours of Infusion Time


Phase 1
N/A
21 Years
Not Enrolling
Both
Brain and Central Nervous System Tumors, Sarcoma, Unspecified Childhood Solid Tumor, Protocol Specific

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Trial Information

Study to Determine the Maximum Tolerated Time of Infusion for High-Dose Methotrexate, Administered as a Continuous Intravenous Infusion at a Dose of 6g/m² Per 24 Hours of Infusion Time


OBJECTIVES:

- To determine the maximum tolerated time to exposure to high-dose methotrexate when
administered as a continuous infusion at a dose of 6 g/m² per 24 hours.

- To relate the methotrexate schedules investigated to the magnitude and duration of
changes in plasma homocysteine and methionine.

- To relate evidence of the systemic effect of methotrexate through changes in plasma
homocysteine and methionine to any hepatic, neurological, or antiproliferative toxicity
observed in the study group.

OUTLINE: Patients receive a continuous infusion of high-dose methotrexate IV over 24, 30,
36, or 42 hours depending on time of study entry. Beginning at hour 42 or 48, patients
receive leucovorin calcium IV every 6 hours for 3 days or until plasma methotrexate
concentration is < 0.2 µM. Treatment repeats every 2 weeks in the absence of disease
progression or unacceptable toxicity.

Blood samples are collected at baseline and periodically during study and analyzed for
pharmacodynamic effects on plasma homocysteine and methionine by gas chromatography/mass
spectrometry techniques.

Inclusion Criteria


DISEASE CHARACTERISTICS:

- Histologically proven malignancy, including but not limited to, any of the following:

- Patients with MRI findings in keeping with a diffuse intrinsic pontine glioma
will be eligible without histological confirmation of tumor type

- Patients with a diagnosis of diffuse intrinsic pontine glioma who are not
eligible for the erlotinib hydrochloride phase I study (CCLG-NAG-2005-09)

- Patients with relapsed ependymoma following the CCLG phase II study of
intravenous etoposide (CCLG-CNS-2001-4) or prior to this are eligible at the
discretion of the physician

- Patients with relapsed osteogenic sarcoma, other soft tissue sarcomas, or other
solid tumors may be suitable for this study at the discretion of the physician

- Radiologically evaluable disease without bone marrow involvement

PATIENT CHARACTERISTICS:

Inclusion criteria:

- Lansky performance status (PS) 30-100% (for patients ≤ 12 years of age)

- ECOG PS ≤ 2 (for patients ≥ 13 years of age)

- Life expectancy ≥ 9 weeks

- ANC > 1,000/mm³

- Platelet count > 100,000/mm³

- Hemoglobin > 9 g/dL

- Serum creatinine ≤ 1.5 times upper limit of normal (ULN) for age

- Serum total bilirubin normal

- AST or ALT ≤ 2 times ULN

- Glomerular filtration rate ≥ 60 mL/min

- Negative pregnancy test

- Fertile patients must use effective contraception

Exclusion criteria:

- Poor medical risk because of nonmalignant systemic disease or uncontrolled infection

- Concurrent malignancies at other sites

PRIOR CONCURRENT THERAPY:

Inclusion criteria:

- Prophylactic trimethoprim-sulfamethoxazole must be stopped 1 week prior to
methotrexate administration

Exclusion criteria:

- Received chemotherapy or biologic therapy within the past 4 weeks

- Received radiotherapy within the past 6 weeks

Type of Study:

Interventional

Study Design:

Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Maximum tolerated infusion time for high-dose methotrexate

Safety Issue:

No

Principal Investigator

Eddy J. Estlin

Investigator Role:

Principal Investigator

Investigator Affiliation:

Royal Manchester Children's Hospital

Authority:

United States: Federal Government

Study ID:

CCLG-NAG-2005-13

NCT ID:

NCT00513981

Start Date:

March 2007

Completion Date:

August 2009

Related Keywords:

  • Brain and Central Nervous System Tumors
  • Sarcoma
  • Unspecified Childhood Solid Tumor, Protocol Specific
  • unspecified childhood solid tumor, protocol specific
  • recurrent osteosarcoma
  • recurrent childhood soft tissue sarcoma
  • recurrent childhood ependymoma
  • untreated childhood brain stem glioma
  • recurrent childhood brain stem glioma
  • Nervous System Neoplasms
  • Central Nervous System Neoplasms
  • Neoplasms
  • Sarcoma

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