Phase I Study of the Pharmacokinetics and Pharmacodynamics of ZD6474 in Combination With Docetaxel in Advanced Solid Tumors
Inclusion Criteria
DISEASE CHARACTERISTICS:
- Histologically or cytologically confirmed advanced solid tumor, including, but not
limited to the following:
- Non-small cell lung cancer
- Metastatic breast cancer
- Hormone-refractory prostate cancer
- Locally recurrent or metastatic head and neck cancer (including thyroid origin)
- Disease for which no standard therapy exists
- Tumor amenable to biopsy
- Measurable or non-measurable disease
- Brain metastases allowed provided patient has undergone brain irradiation (whole
brain or gamma knife) AND the metastases have been clinically and radiologically
stable for ≥ 6 weeks after completion of irradiation
- Patients requiring corticosteroids or anticonvulsants for brain metastases must
be on a stable or decreasing dose of corticosteroids and seizure free for ≥ 28
days before study enrollment
PATIENT CHARACTERISTICS:
- Zubrod performance status 0-1
- ANC ≥ 1,500/mm^3
- Platelet count ≥ 100,000/mm^3
- SGOT or SGPT ≤ 2.5 times upper limit of normal (ULN)
- Bilirubin ≤ 1.5 times ULN
- PT/INR ≤ 1.1 times normal
- Serum creatinine ≤ 1.8 times ULN OR measured or estimated creatinine clearance > 50
mL/min
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception during and for ≥ 3 months after
completion of study treatment
- Willing to undergo two tumor biopsies and blood and tissue sample submission for
correlative laboratory studies
- No clinically significant cardiovascular event, including any of the following:
- Myocardial infarction or cerebrovascular accident within the past 3 months
- Unstable angina pectoris
- NYHA class II-IV heart disease within the past 3 months
- Symptomatic congestive heart failure
- Serious cardiac arrhythmia
- No history of cardiac disease that, in the investigator's opinion, increases the risk
of ventricular arrhythmia
- No history of arrhythmia that is symptomatic or requires treatment (CTCAE grade 3),
including any of the following:
- Multifocal premature ventricular contractions (PVCs)
- Bigeminy or trigeminy
- Ventricular tachycardia
- Uncontrolled atrial fibrillation
- Medically controlled atrial fibrillation allowed
- No asymptomatic sustained ventricular tachycardia
- No history of or evidence of any of the following on ECG:
- History of QTc prolongation as a result from other medication that required
discontinuation of that medication
- Congenital long QT syndrome
- First degree relative with unexplained sudden death under 40 years of age
- Presence of left bundle branch block
- QTc with Bazett's correction that is unmeasurable or ≥ 480 msec on screening ECG
- No uncontrolled hypertension, defined as consistent systolic BP > 160 mm Hg or
consistent diastolic BP > 100 mm Hg despite medical management
- No intractable nausea or vomiting
- No concurrent active diarrhea that may affect the ability to absorb or tolerate
vandetanib
- No gastrointestinal (GI) tract disease resulting in malabsorption syndrome or a
requirement for IV alimentation
- No uncontrolled inflammatory GI disease (e.g., Crohn's disease or ulcerative colitis)
- No history of allergic reactions attributed to docetaxel or compounds of similar
chemical or biological composition to vandetanib, including other quinazoline
compounds (e.g., gefitinib or erlotinib)
- No history of deep venous thrombosis or pulmonary embolism requiring therapeutic
anticoagulation
- No known HIV positivity
- No other concurrent uncontrolled illness, including, but not limited to the
following:
- Ongoing or serious active infection
- Psychiatric illness or social situation that would limit compliance with study
requirements
- Prior or concurrent malignancies of other histologies within the past 5 years allowed
PRIOR CONCURRENT THERAPY:
- See Disease Characteristics
- Recovered from prior therapy (i.e., ≤ grade 2 alopecia and ≤ grade 1 toxicity from
all other adverse events)
- Prior docetaxel as monotherapy or in combination with other chemotherapeutic agents
allowed provided there is potential clinical benefit present, in the investigator's
opinion, from the combination of docetaxel and vandetanib
- No prior vandetanib
- No prior surgical procedures affecting absorption
- More than 14 days since prior drugs with a short half-life (e.g., sorafenib or
sunitinib) (approval by study coordinator required)
- More than 28 days since prior major surgery, chemotherapy, or radiotherapy
- More than 28 days since prior investigational agents
- More than 2 weeks since prior and no concurrent medications associated with a risk of
causing Torsades de Pointes
- No concurrent therapeutic anticoagulation (coumadin, warfarin, or low-molecular
weight heparin)
- Low-dose anticoagulation for indwelling catheter maintenance allowed
- No concurrent medication that may cause QTc prolongation
- No other concurrent chemotherapy, hormonal therapy, radiotherapy, immunotherapy, or
any other type of therapy for the treatment of cancer, except for the following:
- Luteinizing hormone-releasing hormone agonists
- Bisphosphonates