Phase I Study Of BMS-599626 In Patients With Advanced Solid Malignancies That Express Her2
Inclusion Criteria
DISEASE CHARACTERISTICS:
- Histologically or cytologically confirmed primary solid (i.e., non-hematologic) tumor
- Radiographic or tissue confirmation of metastatic disease
- Locally advanced disease allowed if no surgical or local therapeutic
treatment exists
- HER2/neu overexpression (1+, 2+, or 3 +) by immunohistochemistry
- Tumors with HER2 gene amplification by fluorescence in situ hybridization
analysis allowed
- Tumor paraffin tissue block OR 20-30 unstained slides from tumor tissue block must be
available for biomarker and predictive marker analyses
- Disease progression during or after standard therapy OR no standard therapy exists
- Measurable or non-measurable disease
- Measurable disease is required for the expanded cohort treated at the maximum
tolerated dose of the study drug
- No known brain metastasis
- Patients with controlled brain metastasis with no disease progression 60 days
after prior therapy and no neurologic signs or symptoms are allowed
- Patients with signs or symptoms suggestive of brain metastasis are eligible
provided that brain metastasis is ruled out by CT scan or MRI
PATIENT CHARACTERISTICS:
Age
- 18 and over
Performance status
- ECOG 0-1
Life expectancy
- At least 3 months
Hematopoietic
- Absolute neutrophil count ≥ 1,500/mm^3
- Platelet count ≥ 100,000/mm^3
- Hemoglobin ≥ 9.0 g/dL
Hepatic
- Bilirubin ≤ 1.5 times upper limit of normal (ULN)
- ALT and AST ≤ 2.5 times ULN
- PT/PTT ≤ 1.5 times ULN
- INR ≤ 1.5 times ULN
Renal
- Creatinine ≤ 1.5 times ULN
- Calcium normal
Cardiovascular
- LVEF ≥ 45%
- Heart rate ≥ 50 beats/min on electrocardiogram
- No uncontrolled cardiovascular disease
- No myocardial infarction within the past 12 months
- No uncontrolled angina within the past 6 months
- No congestive heart failure within the past 6 months
- No prolonged QTc (> 450 msec) on electrocardiogram
- No diagnosed or suspected congenital long QT syndrome
- No history of clinically significant ventricular arrhythmias (e.g., ventricular
tachycardia, ventricular fibrillation, or torsades de pointes)
- No history of second- or third-degree heart block
- Patients with pacemakers may be eligible
- No uncontrolled hypertension
Other
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception during and for at least 3 months
after study participation
- Potassium normal
- Magnesium normal
- No medical condition that has a risk of causing torsades de pointes
- No active infection
- No serious uncontrolled medical disorder that would preclude study participation
- No dementia or altered mental status that would preclude giving informed consent
- No known allergy to BMS-599626 or related compound
- No prisoners or patients involuntarily incarcerated for treatment of either a
psychiatric or physical (e.g., infectious disease) illness
PRIOR CONCURRENT THERAPY:
Biologic therapy
- At least 4 weeks since prior immunotherapy
- At least 2 weeks since prior targeted kinase inhibitor (e.g., trastuzumab
[Herceptin^®])
Chemotherapy
- At least 4 weeks since prior chemotherapy (6 weeks for nitrosoureas, mitomycin, or
doxorubicin HCl liposome)
Endocrine therapy
- At least 2 weeks since prior anticancer hormonal therapy
Radiotherapy
- At least 4 weeks since prior radiotherapy
Surgery
- Not specified
Other
- Recovered from prior therapy
- Prior adjuvant or neoadjuvant therapy allowed
- No short-acting antacids (e.g., Maalox^® or TUMS^®) 8 hours before or 4 hours after
study drug administration
- No recent anticancer therapy
- More than 4 weeks since prior investigational agents
- At least 5 days (or 5 half-lives) since prior drugs that cause torsades de pointes
- At least 48 hours since prior proton pump inhibitors (e.g., omeprazole or
lansoprazole) or histamine H_2 antagonists (e.g., ranitidine, famotidine, or
cimetidine)
- Concurrent low-dose coumadin allowed
- No other concurrent investigational agents
- No concurrent drugs that may cause torsades de pointes or QTc prolongation