A Phase I and Pharmacokinetic Study Evaluating the Safety, Tolerability, and Maximally Tolerated Dose of Combination Therapy With Paclitaxel and L-778,123 in Patients With Recurrent or Refractory Solid Malignancies
Inclusion Criteria
DISEASE CHARACTERISTICS: Histologically proven solid tumor or lymphoma that is recurrent
or refractory to standard first line therapy Measurable or evaluable disease No active or
inactive primary CNS malignancy No untreated active metastatic CNS malignancy No leukemia
or plasma cell dyscrasias
PATIENT CHARACTERISTICS: Age: 18 and over Performance status: ECOG 0-2 Life expectancy:
Greater than 3 months Hematopoietic: Absolute neutrophil count at least 1,500/mm3 Platelet
count at least 100,000/mm3 Hemoglobin at least 9 g/dL Hepatic: Bilirubin no greater than
1.5 times normal ALT or AST no greater than 2.5 times normal Alkaline phosphatase no
greater than 4 times normal (no greater than 2 times normal if an increase of greater than
25% over past 2 weeks) PT, INR, or aPTT no greater than 1.2 times normal Renal: Creatinine
no greater than 1.5 times normal Electrolytes within 10% of normal range Cardiovascular:
No prior grade 3 or 4 cardiac arrhythmias except atrial fibrillation No QTc interval of
440 milliseconds or greater on electrocardiogram No other QTc abnormalities No myocardial
infarction, unstable angina, or congestive heart failure within the past 12 months
Psychiatric: No mental or legal incapacitation No concurrent significant emotional
problems No prior psychiatric disorder Neurologic: No grade 2 or higher peripheral
neuropathy No prior seizure disorder Other: Not pregnant or nursing Negative pregnancy
test Fertile patients must use effective double barrier contraception or practice
abstinence for at least 14 days before, during, and for at least 14 days after therapy No
allergy to latex, Cremophor (found in formulations of cyclosporine or vitamin K), or
paclitaxel HIV negative No HIV related malignancy No active infection No prior significant
retinal disorder or disease At least 5 years since prior drug or alcohol abuse
PRIOR CONCURRENT THERAPY: Biologic therapy: At least 4 weeks since prior immunotherapy No
concurrent immunotherapy No concurrent colony stimulating factors or epoetin alfa
Chemotherapy: At least 4 weeks since prior chemotherapy (6 weeks for mitomycin and
nitrosoureas) At least 4 weeks since prior paclitaxel and recovered No prior high dose
chemotherapy with stem cell rescue No other concurrent chemotherapy Endocrine therapy: At
least 4 weeks since prior endocrine therapy (except chronic LHRH agonist replacement
therapy administered for at least 3 months) No concurrent endocrine therapy except
prophylactic steroids during first course of chemotherapy Radiotherapy: At least 4 weeks
since prior radiotherapy No concurrent radiotherapy Surgery: At least 4 weeks since prior
surgery No concurrent surgery Permanent indwelling central venous catheter required Other:
At least 4 weeks since prior investigational agents (including FDA approved drugs for
non-FDA approved indication) No concurrent medications that prolong QTc interval (e.g.,
terfenadine, astemizole, cisapride, quinidine, procainamide, disopyramide, sotalol,
probucol, bepridil, tricyclic antidepressants, haloperidol, risperidone, indapamide, and
dolasetron mesylate) No concurrent potent inducers of CYP3A (e.g., rifampin,
phenobarbital, phenytoin, carbamazepine, troglitazone, and rifabutin) No concurrent
benzodiazepines that are metabolized by CYP3A (e.g., triazolam, alprazolam, and midazolam)
No concurrent HMG-CoA reductase inhibitors that are metabolized by CYP3A No other
prophylactic medications during first course of chemotherapy except antihistamines and H2
antagonists (for paclitaxel) No more than 6 cups of coffee or the equivalent for other
caffeinated beverages per day At least 24 hours since prior alcohol consumption No alcohol
consumption while confined to the clinical research unit No more than 24 ounces of beer, 8
ounces of wine, or 3 ounces of whiskey or other equivalent hard liquor per day while not
confined to the clinical research unit No concurrent illicit drugs No concurrent
prochlorperazine