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| ID | Type | Description | Link |
|---|---|---|---|
| NCI-2009-00019 | Registry Identifier | CTRP (Clinical Trial Reporting Program) | |
| NCI-5582 | |||
| WUSM-SCC-0102 | |||
| CDR0000069215 | |||
| UVACC-SCC-0102 | |||
| SCC 01-02 | Other Identifier | University of Virginia | |
| 5582 | Other Identifier | CTEP | |
| P30CA044579 | U.S. NIH Grant/Contract | View source |
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| Name | Class |
|---|---|
| Washington University Siteman Cancer Center | OTHER |
This phase I trial is studying the side effects and best dose of giving 7-hydroxystaurosporine together with irinotecan hydrochloride in treating patients with metastatic or unresectable solid tumors, including triple-negative breast cancer (currently enrolling only patients with triple-negative breast cancer since 6/8/2007). Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Giving 7-hydroxystaurosporine together with irinotecan hydrochloride may help kill more cancer cells by making tumor cells more sensitive to the drug.
PRIMARY OBJECTIVES:
I. Determine the maximum tolerated dose of UCN-01 (7-hydroxystaurosporine) and irinotecan (irinotecan hydrochloride) in patients with resistant solid tumors. (Part I [closed to accrual as of 6/8/2007]) II. Determine the dose-limiting toxicity of this regimen in these patients. (Part I [closed to accrual as of 6/8/2007]) III. Determine the types of toxic effects of this regimen in these patients. (Part I [closed to accrual as of 6/8/2007]) IV. Determine the anti-tumor activity in terms of overall response rate (partial response [PR] and complete response [CR]), clinical benefit rate (PR, CR, and stable disease), and time to disease progression in patients with estrogen receptor-negative, progesterone receptor-negative, and HER-2 not amplified (triple negative) locally recurrent or metastatic breast cancer treated with this regimen. (Part II) V. Determine the side effect profile of this regimen in patients with triple negative recurrent breast cancer. (Part II)
SECONDARY OBJECTIVES:
I. Determine any anti-tumor activity of this regimen in these patients. (Part I [closed to accrual as of 6/8/2007]) II. Determine the pharmacokinetics of this regimen in these patients. (Part I [closed to accrual as of 6/8/2007]) III. Determine the activity of the serum α-acid glycoprotein and correlate this level with free UCN-01 concentrations. (Part I [closed to accrual as of 6/8/2007]) IV. Determine the in vivo mechanisms of UCN-01 activity in these patients.
OUTLINE: This is a dose-escalation study.
PART I: Patients receive irinotecan hydrochloride intravenously (IV) over 90 minutes on days 1, 8, 15, and 22 and 7-hydroxystaurosporine IV over 3 hours on days 2 and 23. Courses repeat every 42 days in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of irinotecan hydrochloride and 7-hydroxystaurosporine until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. Blood samples are collected periodically during study treatment.
PART II: (treatment of triple negative recurrent breast cancer): Patients receive irinotecan hydrochloride IV and 7-hydroxystaurosporine IV as in part I at the MTD and undergo blood sample collection.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Treatment (combination chemotherapy) | Experimental | PART I: Patients receive irinotecan hydrochloride IV over 90 minutes on days 1, 8, 15, and 22 and 7-hydroxystaurosporine IV over 3 hours on days 2 and 23. Courses repeat every 42 days in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of irinotecan hydrochloride and 7-hydroxystaurosporine until the MTD is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. Blood samples are collected periodically during study treatment. PART II: (treatment of triple negative recurrent breast cancer): Patients receive irinotecan hydrochloride IV and 7-hydroxystaurosporine IV as in part I at the MTD and undergo blood sample collection. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| 7-hydroxystaurosporine | Drug | Given IV |
|
| Measure | Description | Time Frame |
|---|---|---|
| MTD of irinotecan hydrochloride in combination with 7-hydroxystaurosporine in patients with resistant solid tumor malignancies (Part I) | Defined as the highest dose given to at least 6 patients in which =< 1 out of 6 experience dose limiting toxicity (DLT). | Part I |
| DLT of irinotecan hydrochloride in combination with 7-hydroxystaurosporine in patients with resistant solid tumor malignancies (Part I) | Part I | |
| Toxicities associated with irinotecan hydrochloride in combination with 7-hydroxystaurosporine in patients with resistant solid tumor malignancies (Part I) | Graded using the Cancer Therapy Evaluation Program (CTEP) Active Version of the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE). | Continuously over study treatment |
| Anti-tumor activity of 7-hydroxystaurosporine in combination with irinotecan hydrochloride in ER-negative, PgR-negative, HER-2 not-amplified (triple negative) recurrent breast cancer (Part II) | Including overall response rate (partial response [PR] +complete response [CR]), clinical benefit rate (PR+CR+stable disease [SD]), and time to disease progression. 95% confidence interval will be calculated. Evaluated by the Response Evaluation Criteria in Solid Tumors (RECIST) criteria. | Every 6 weeks |
| Side effect profile of 7-hydroxystaurosporine in combination with irinotecan hydrochloride in triple negative recurrent breast cancer (Part II) | 95 % confidence interval will be calculated. | Continuously over study treatment |
| Measure | Description | Time Frame |
|---|---|---|
| Anti-tumor activity of the combination of irinotecan hydrochloride and 7-hydroxystaurosporine in treatment of patients with resistant solid tumor malignancies | Evaluated by the RECIST criteria. | Every 6 weeks |
| Pharmacokinetics of irinotecan hydrochloride and 7-hydroxystaurosporine when administered in combination |
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Inclusion Criteria:
Part I (closed to accrual as of 6/8/2007)
Histologically confirmed solid tumor that is metastatic or unresectable for which standard curative measures do not exist or are no longer effective, including the following:
Patients with or without measurable or evaluable disease allowed
Measurable disease, defined as ≥ 1 unidimensionally measurable lesion > 20 mm by conventional techniques or ≥ 10 mm with spiral CT scan
No known brain metastases
Part II
Histologically confirmed (either primary or the recurrent site) locally recurrent or metastatic breast cancer not amendable to surgery
Measurable disease
Must have undergone prior therapy with an anthracycline and a taxane either in the adjuvant or metastatic setting
CNS metastasis allowed provided stable disease (i.e., no evidence of local progression) ≥ 3 months after local therapy
Hormone receptor status:
Performance status - ECOG 0-2
Performance status - Karnofsky 60-100%
More than 12 weeks
WBC at least 3,000/mm^3
Absolute neutrophil count at least 1,500/mm^3
Platelet count at least 100,000/mm^3
Hemoglobin ≥ 10 g/dL
Bilirubin normal
AST/ALT no greater than 3 times upper limit of normal (ULN)
No Gilbert's disease
No chronic unconjugated hyperbilirubinemia
Creatinine no greater than 1.5 times ULN
Creatinine clearance at least 60 mL/min
No symptomatic cardiac dysfunction
No symptomatic pulmonary dysfunction
Oxygen saturation at least 90% by pulse oximetry on room air at rest and after walking 6 minutes
No insulin-dependent diabetes mellitus
No other uncontrolled concurrent illness
No active or ongoing infection
No psychiatric illness or social situation that would preclude study entry
No prior allergic reactions attributed to compounds of similar chemical or biological composition to UCN-01 or irinotecan
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception
No concurrent granulocyte colony-stimulating factors (filgrastim [G-CSF] or sargramostim [GM-CSF]) during the first course of study
See Disease Characteristics (Part II)
More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin) and recovered
Prior irinotecan allowed
Less than 4 prior chemotherapy regimens in the adjuvant and/or metastatic setting (Part II)
More than 4 weeks since prior radiotherapy and recovered
Concurrent warfarin allowed
Concurrent subcutaneous heparin allowed
No other concurrent investigational agents
No concurrent anticonvulsants (e.g., carbamazepine, phenobarbital, or phenytoin)
No concurrent combination antiretroviral therapy for HIV-positive patients
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| Name | Affiliation | Role |
|---|---|---|
| Paula Fracasso | University of Virginia | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Virginia | Charlottesville | Virginia | 22908 | United States |
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| irinotecan hydrochloride | Drug | Given IV |
|
|
| diagnostic laboratory biomarker analysis | Other | Correlative studies |
|
Using the high-performance liquid chromatography (HPLC) assays. |
| Weekly during the first 4 weeks of course 1 |
| Serum alpha-acid glycoprotein and correlate this level with free 7-hydroxystaurosporine concentrations | Weekly during the first 4 weeks of course 1 |
| In vivo mechanistic basis for 7-hydroxystaurosporine activity | Explored by subgroup analysis (responders versus non-responders) on pharmacodynamic measures. | Weekly during the first 4 weeks of course 1 |
| ID | Term |
|---|---|
| D001063 | Appendiceal Neoplasms |
| D046152 | Gastrointestinal Stromal Tumors |
| D006528 | Carcinoma, Hepatocellular |
| D001005 | Anus Neoplasms |
| D001943 | Breast Neoplasms |
| D002583 | Uterine Cervical Neoplasms |
| D003110 | Colonic Neoplasms |
| D016889 | Endometrial Neoplasms |
| D004938 | Esophageal Neoplasms |
| D018304 | Esthesioneuroblastoma, Olfactory |
| D001650 | Bile Duct Neoplasms |
| D005706 | Gallbladder Neoplasms |
| D013274 | Stomach Neoplasms |
| D002289 | Carcinoma, Non-Small-Cell Lung |
| D000077216 | Carcinoma, Ovarian Epithelial |
| D010190 | Pancreatic Neoplasms |
| D011471 | Prostatic Neoplasms |
| D012004 | Rectal Neoplasms |
| D012468 | Salivary Gland Neoplasms |
| D055752 | Small Cell Lung Carcinoma |
| D000077195 | Squamous Cell Carcinoma of Head and Neck |
| D064726 | Triple Negative Breast Neoplasms |
| ID | Term |
|---|---|
| D002430 | Cecal Neoplasms |
| D007414 | Intestinal Neoplasms |
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D004066 | Digestive System Diseases |
| D005767 | Gastrointestinal Diseases |
| D002429 | Cecal Diseases |
| D007410 | Intestinal Diseases |
| D009372 | Neoplasms, Connective Tissue |
| D018204 | Neoplasms, Connective and Soft Tissue |
| D009370 | Neoplasms by Histologic Type |
| D000230 | Adenocarcinoma |
| D002277 | Carcinoma |
| D009375 | Neoplasms, Glandular and Epithelial |
| D008113 | Liver Neoplasms |
| D008107 | Liver Diseases |
| D015179 | Colorectal Neoplasms |
| D001004 | Anus Diseases |
| D012002 | Rectal Diseases |
| D001941 | Breast Diseases |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D014594 | Uterine Neoplasms |
| D005833 | Genital Neoplasms, Female |
| D014565 | Urogenital Neoplasms |
| D002577 | Uterine Cervical Diseases |
| D014591 | Uterine Diseases |
| D005831 | Genital Diseases, Female |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D000091662 | Genital Diseases |
| D003108 | Colonic Diseases |
| D006258 | Head and Neck Neoplasms |
| D004935 | Esophageal Diseases |
| D009447 | Neuroblastoma |
| D018241 | Neuroectodermal Tumors, Primitive, Peripheral |
| D018242 | Neuroectodermal Tumors, Primitive |
| D018302 | Neoplasms, Neuroepithelial |
| D017599 | Neuroectodermal Tumors |
| D009373 | Neoplasms, Germ Cell and Embryonal |
| D009380 | Neoplasms, Nerve Tissue |
| D020431 | Olfactory Nerve Diseases |
| D003389 | Cranial Nerve Diseases |
| D009422 | Nervous System Diseases |
| D001661 | Biliary Tract Neoplasms |
| D001649 | Bile Duct Diseases |
| D001660 | Biliary Tract Diseases |
| D005705 | Gallbladder Diseases |
| D013272 | Stomach Diseases |
| D002283 | Carcinoma, Bronchogenic |
| D001984 | Bronchial Neoplasms |
| D008175 | Lung Neoplasms |
| D012142 | Respiratory Tract Neoplasms |
| D013899 | Thoracic Neoplasms |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D010051 | Ovarian Neoplasms |
| D004701 | Endocrine Gland Neoplasms |
| D010049 | Ovarian Diseases |
| D000291 | Adnexal Diseases |
| D004700 | Endocrine System Diseases |
| D006058 | Gonadal Disorders |
| D010182 | Pancreatic Diseases |
| D005834 | Genital Neoplasms, Male |
| D005832 | Genital Diseases, Male |
| D011469 | Prostatic Diseases |
| D052801 | Male Urogenital Diseases |
| D009062 | Mouth Neoplasms |
| D009059 | Mouth Diseases |
| D009057 | Stomatognathic Diseases |
| D012466 | Salivary Gland Diseases |
| D002294 | Carcinoma, Squamous Cell |
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| ID | Term |
|---|---|
| C054852 | 7-hydroxystaurosporine |
| D000077146 | Irinotecan |
| ID | Term |
|---|---|
| D002166 | Camptothecin |
| D000470 | Alkaloids |
| D006571 | Heterocyclic Compounds |
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