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| ID | Type | Description | Link |
|---|---|---|---|
| COG-ADVL0419 | Other Identifier | Children's Oncology Group | |
| NCI-05-C-0235 | |||
| NCI-P6631 | |||
| CDR0000417845 | Other Identifier | Clinical Trials.gov |
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| Name | Class |
|---|---|
| National Cancer Institute (NCI) | NIH |
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RATIONALE: Drugs used in chemotherapy, such as valproic acid, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Valproic acid may also stop the growth of solid tumors or CNS tumors by blocking blood flow to the tumor.
PURPOSE: This phase I trial is studying the side effects and best dose of valproic acid in treating patients with recurrent or refractory solid tumors or CNS tumors.
OBJECTIVES:
Primary
Secondary
OUTLINE: This is a dose-escalation, multicenter study.
For course 1, patients receive escalating doses of oral valproic acid (VPA) twice daily until a target serum trough VPA concentration range is maintained for 28 days. Patients who achieve the target serum trough VPA concentration range receive subsequent courses of oral VPA twice daily (at the dose found to maintain the target serum trough VPA concentration range) on days 1-28. Treatment repeats every 28 days for up to 12 courses in the absence of disease progression or unacceptable toxicity.
The first cohort of 6 patients receives VPA to achieve an initial target trough serum VPA concentration. If fewer than 2 of 6 patients in the first cohort experience dose-limiting toxicity (DLT), then a second cohort of 6 patients receives VPA to achieve the next higher target trough serum VPA concentration. If fewer than 2 patients from the second cohort experience DTL, then 6 additional patients are enrolled in this cohort to better define pharmacokinetics and DLT at this VPA concentration range.
After completion of study treatment, patients are followed annually.
PROJECTED ACCRUAL: A total of 12-18 patients will be accrued for this study.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Treatment 1 | Experimental | VPA Target Trough Concentration 75-100 mcg/mL, week 1 VPA dose: 15 mg/kg/day, divided tid |
|
| Treatment 10 | Experimental | VPA Target Trough Concentration 100-150 mcg/mL, week 1 VPA dose: 15 mg/kg/day, divided tid |
|
| Treatment 20 | Experimental | VPA Target Trough Concentration 150-200 mcg/mL |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| valproic acid | Drug |
|
| Measure | Description | Time Frame |
|---|---|---|
| Efficacy of oral etoposide at 50 mg/m2/day given concurrently with radiotherapy |
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DISEASE CHARACTERISTICS:
Histologically confirmed* malignant solid tumor, including CNS tumors, at original diagnosis or relapse
Measurable or evaluable disease, defined by 1 of the following criteria:
No known curative therapy exists
No documented tumor involvement in the bone marrow
PATIENT CHARACTERISTICS:
Age
Performance status*
Life expectancy
Hematopoietic
Hepatic
Renal
Creatinine clearance or radioisotope glomerular filtration rate ≥ 70 mL/min OR
Creatinine based on age as follows:
Other
PRIOR CONCURRENT THERAPY:
Biologic therapy
Recovered from prior immunotherapy
At least 7 days since prior hematopoietic growth factors that support platelet or WBC number or function
At least 7 days since prior antineoplastic biologic agents
At least 3 months since prior stem cell transplantation or rescue without total body irradiation
No other concurrent anticancer biologic therapy or immunotherapy
Chemotherapy
Endocrine therapy
Radiotherapy
Surgery
Other
No other concurrent investigational agents
No other concurrent anticancer agents
No other concurrent anticonvulsants
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| Name | Affiliation | Role |
|---|---|---|
| Jack M. Su, MD | Texas Children's Cancer Center | Study Chair |
| Heidi V. Russell, MD | Texas Children's Cancer Center | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Children's Hospital of Orange County | Orange | California | 92868 | United States | ||
| Stanford Comprehensive Cancer Center - Stanford |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 21115653 | Result | Su JM, Li XN, Thompson P, Ou CN, Ingle AM, Russell H, Lau CC, Adamson PC, Blaney SM. Phase 1 study of valproic acid in pediatric patients with refractory solid or CNS tumors: a children's oncology group report. Clin Cancer Res. 2011 Feb 1;17(3):589-97. doi: 10.1158/1078-0432.CCR-10-0738. Epub 2010 Nov 29. |
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| Stanford |
| California |
| 94305 |
| United States |
| Children's National Medical Center | Washington D.C. | District of Columbia | 20010-2970 | United States |
| Children's Memorial Hospital - Chicago | Chicago | Illinois | 60614 | United States |
| Indiana University Melvin and Bren Simon Cancer Center | Indianapolis | Indiana | 46202-5289 | United States |
| Dana-Farber/Harvard Cancer Center at Dana Farber Cancer Institute | Boston | Massachusetts | 02115 | United States |
| University of Minnesota Children's Hospital - Fairview | Minneapolis | Minnesota | 55455 | United States |
| Mayo Clinic Cancer Center | Rochester | Minnesota | 55905 | United States |
| Herbert Irving Comprehensive Cancer Center at Columbia University Medical Center | New York | New York | 10032 | United States |
| SUNY Upstate Medical University Hospital | Syracuse | New York | 13210 | United States |
| Cincinnati Children's Hospital Medical Center | Cincinnati | Ohio | 45229-3039 | United States |
| Oregon Health & Science University Cancer Institute | Portland | Oregon | 97239-3098 | United States |
| Children's Hospital of Philadelphia | Philadelphia | Pennsylvania | 19104-9786 | United States |
| Baylor University Medical Center - Houston | Houston | Texas | 77030-2399 | United States |
| Children's Hospital and Regional Medical Center - Seattle | Seattle | Washington | 98105 | United States |
| Hospital for Sick Children | Toronto | Ontario | M5G 1X8 | Canada |
| Hopital Sainte Justine | Montreal | Quebec | H3T 1C5 | Canada |
| ID | Term |
|---|---|
| D016543 | Central Nervous System Neoplasms |
| D001254 | Astrocytoma |
| C531673 | Familial ependymoma |
| D008527 | Medulloblastoma |
| D020339 | Optic Nerve Glioma |
| D013120 | Spinal Cord Neoplasms |
| ID | Term |
|---|---|
| D009423 | Nervous System Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D009422 | Nervous System Diseases |
| D005910 | Glioma |
| D018302 | Neoplasms, Neuroepithelial |
| D017599 | Neuroectodermal Tumors |
| D009373 | Neoplasms, Germ Cell and Embryonal |
| D009370 | Neoplasms by Histologic Type |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009380 | Neoplasms, Nerve Tissue |
| D018242 | Neuroectodermal Tumors, Primitive |
| D019574 | Optic Nerve Neoplasms |
| D003390 | Cranial Nerve Neoplasms |
| D010524 | Peripheral Nervous System Neoplasms |
| D003389 | Cranial Nerve Diseases |
| D009901 | Optic Nerve Diseases |
| D005128 | Eye Diseases |
| D013118 | Spinal Cord Diseases |
| D002493 | Central Nervous System Diseases |
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| ID | Term |
|---|---|
| D014635 | Valproic Acid |
| ID | Term |
|---|---|
| D010421 | Pentanoic Acids |
| D014631 | Valerates |
| D000144 | Acids, Acyclic |
| D002264 | Carboxylic Acids |
| D009930 | Organic Chemicals |
| D005232 | Fatty Acids, Volatile |
| D005227 | Fatty Acids |
| D008055 | Lipids |
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