Geldanamycin Analogue in Treating Patients With Advanced Solid Tumors or Non-Hodgkin's Lymphoma

A Phase I and Pharmacologic Study of 17-(Allylamino)-17-Demethoxygeldanamycin (AAG, NSC 330507) in Adult Patients With Solid Tumors

Phase I trial to study the effectiveness of geldanamycin analogue in treating patients who have advanced solid tumors or non-Hodgkin's lymphoma. Drugs used in chemotherapy work in different ways to stop tumor cells from dividing so they stop growing or die.

PRIMARY OBJECTIVES:

I. To determine the maximum tolerated dose of geldanamycin analogue (AAG) in patients with advanced solid tumors.

II. To determine the toxic effects of this drug in this patient population. III. To determine the biochemical and molecular effects of this drug in normal and accessible tumor tissue in these patients.

IV. To determine the pharmacokinetics of this drug in these patients. V. To assess any antitumor activity of this drug in these patients.

OUTLINE: This is a dose-escalation study.

Patients receive geldanamycin analogue (AAG) IV over 1-6 hours once daily on days 1, 4, 15, and 18. Courses repeat every 4 weeks in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of AAG until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 6 patients experience dose-limiting toxicity. Once the MTD is determined, an additional 10 patients are treated at the MTD.

Patients are followed every 6 weeks.

Criteria:

• Platelet count at least 100,000/mm^3
• No leukemia
• No active CNS involvement with tumor
• ECOG 0-2
• Life expectancy: at least 3 months
• Absolute neutrophil count at least 2,000/mm^3
• No New York Heart Association class III or IV heart failure
• No history of myocardial infarction within the past year
• Bilirubin =< upper limit of normal (ULN)
• AST no greater than 2 times ULN (no greater than 98 U/L)
• No uncontrolled dysrhythmias
• No poorly controlled angina
• No serious ventricular arrhythmia (i.e., ventricular tachycardia (VT) or ventricular fibrillation (VF) >= 3 beats in a row)
• QTc interval =< 450 msec for men or =< 470 msec for women
• LVEF >= 40% by MUGA
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception
• HIV negative
• No other serious medical condition that would preclude study participation
• No serious hypersensitivity to egg products
• No concurrent anticancer immunotherapy
• At least 4 weeks since prior chemotherapy and recovered
• No other concurrent anticancer chemotherapy (e.g., cyclophosphamide, doxorubicin, vincristine, and prednisone [CHOP] or mechlorethamine, vincristine, procarbazine, and prednisone [MOPP])
• No concurrent anticancer hormonal therapy
• Concurrent glucocorticoids as antiemetics for nonmalignant disease allowed
• At least 4 weeks since prior radiotherapy and recovered
• No concurrent radiotherapy
• No concurrent major surgery
• No concurrent anticancer glucocorticoids
• Creatinine =< ULN or Creatinine clearance at least 60 mL/min
• No concurrent medications that cause QTc prolongation
• Histologically confirmed advanced solid tumor for which no curative therapy exists
• Non-Hodgkin's lymphoma allowed
• No concurrent drugs that interfere with hepatic CYP3A4 metabolism (e.g., grapefruit juice, ketoconazole, fluconazole, itraconazole, cyclosporine, erythromycin, clarithromycin, cimetidine, terfenadine, astemizole, indinavir, or nelfinavir mesylate)