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| ID | Type | Description | Link |
|---|---|---|---|
| UNC-LCCC-2020 | |||
| CDR0000368767 | Other Identifier | PDQ number |
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| Name | Class |
|---|---|
| National Cancer Institute (NCI) | NIH |
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RATIONALE: Drugs used in chemotherapy, such as doxorubicin hydrochloride liposome, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Bortezomib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Giving doxorubicin hydrochloride liposome together with bortezomib may kill more cancer cells.
PURPOSE: This phase I/II trial is studying the side effects and best dose of bortezomib when given together with doxorubicin hydrochloride liposome and to see how well they work in treating patients with refractory hematologic cancer or malignant solid tumor or metastatic breast cancer.
OBJECTIVES:
Primary
Secondary
OUTLINE: This is a phase I (closed to accrual as of 10/15/2007), dose-escalation study of bortezomib followed by a phase II study.
After completion of study therapy, patients are followed at 1 week.
PROJECTED ACCRUAL: A total of 72 patients will be accrued for the phase I portion of the study and 40 for the phase II portion.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Part 1 | Experimental | Doxil + PS-341 |
|
| Part 2 | Experimental | Doxil + Velcade |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| PS-341 | Drug | PS-341 will be administered as an intravenous push into a side arm of either a peripheral or central intravenous line infusing normal saline at 100 ml/hr. Patients will be treated twice weekly for two weeks, followed by a one week rest period, such that the typical days of treatment will be days 1, 4, 8, 11 of each three-week cycle. The initial dose level for PS-341 will be 0.9 mg/m2/dose intravenously, while subsequent dose levels will be determined according to a modified Fibonacci schema |
| Measure | Description | Time Frame |
|---|---|---|
| Maximum tolerated dose (MTD) of PS-341 in combination with Doxil (Phase I) | When the current dose level exceeds the MTD, the preceding dose-level will be considered to be the MTD if there have been six patients treated at that dose level. Otherwise, 3 additional patients will be treated at the presumed MTD. No further dose escalation will occur. MTD, like dose limiting toxicity (DLT), will be defined based on toxicities seen within the first cycle. Among the additional 3 patients enrolled in a cohort, if one or more DLT is observed, the MTD will be considered to have been exceeded | 1 year |
| Response rate of the combination of Velcade and Doxil in patients with metastatic breast cancer | Radiographic response will be measured using RECIST criteria | every 42 days |
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DISEASE CHARACTERISTICS:
Phase I (closed to accrual as of 10/15/2007)
Histologically or cytologically confirmed solid tumor or hematologic malignancy, including, but not limited to, any of the following:
Measurable or evaluable disease
Must meet 1 of the following criteria:
No clinically or radiographically significant pleural or pericardial effusion
Previously treated central nervous system disease allowed provided it has been stable for > 3 months and it is not the only site of measurable disease
Not eligible for a higher priority protocol
Phase II
Diagnosis of breast cancer
Measurable disease by RECIST criteria
No symptomatic brain metastases
Hormone receptor status not specified
PATIENT CHARACTERISTICS:
Phase I (closed to accrual as of 10/15/2007)
Karnofsky performance status 60-100%
Life expectancy ≥ 2 months
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception
WBC ≥ 2,000/mm³
ANC ≥ 1,500/mm³ (≥ 1,000/mm³ for patients with marrow infiltration)
Platelet count ≥ 100,000/mm³ (≥ 50,000/mm³ for patients with marrow infiltration)
Hemoglobin ≥ 8 g/dL
Creatinine ≤ 2.5 mg/dL OR creatinine clearance ≥ 30 mL/min
AST and ALT < 2.5 times upper limit of normal (ULN)
Total bilirubin < 1.2 times ULN
Prothrombin time (PT) and activated partial thromboplastin time (aPTT) < 1.5 times ULN
Patients with a history of reactions to other liposomal drug formulations that are not due to the liposome itself may be eligible at the discretion of the investigator
No known HIV seropositivity
No known active hepatitis A, B, or C viral infection
No New York Heart Association class III or IV congestive heart failure
LVEF ≥ 45% by 2-D ECHO or MUGA
No acute ischemia or new conduction system abnormality by EKG
No conduction system abnormality (e.g., left bundle branch block) by EKG that would preclude the ability to detect new ischemic episodes
No myocardial infarction within the past 6 months
No significant comorbidity, such as poorly controlled hypertension, diabetes mellitus, or other serious medical or psychiatric illness that, in the opinion of the investigator, might compromise any aspect of the study
No uncontrolled infection
No prior hypersensitivity reaction to pegylated doxorubicin hydrochloride liposome or doxorubicin hydrochloride
Phase II
Female or male
Menopausal status not specified
Karnofsky performance status 70-100%
Life expectancy ≥ 3 months
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception during and for 3 months after completion of study therapy
ANC ≥ 1,500/mm³
Platelet count ≥ 100,000/mm³
Hemoglobin ≥ 9.0 g/dL
Creatinine ≤ 2.5 mg/dL (≤ 200 µmol/L)
AST and ALT ≤ 2 times ULN
Alkaline phosphatase ≤ 2 times ULN (unless attributed to tumor)
Bilirubin ≤ ULN
Cardiac ejection fraction > 50% by MUGA or 2-D ECHO
No clinical evidence of congestive heart failure
No New York Heart Association class II-IV cardiac disease
No myocardial infarction within the past 6 months
No uncontrolled angina
No severe uncontrolled ventricular arrhythmias
No evidence of acute ischemia or active conduction system abnormalities by EKG
No grade 2 peripheral neuropathy within the past 14 days
No significant comorbidity that would impair compliance with study therapy or interpretation of study results
No history of hypersensitivity reactions attributed to a conventional formulation of doxorubicin hydrochloride or the components of pegylated doxorubicin hydrochloride liposome
No hypersensitivity to bortezomib, boron, or mannitol
No serious medical or psychiatric illness likely to interfere with participation in this study
PRIOR CONCURRENT THERAPY:
Phase I (closed to accrual as of 10/15/2007)
Phase II
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| Name | Affiliation | Role |
|---|---|---|
| Elizabeth C. Dees, MD | UNC Lineberger Comprehensive Cancer Center | Principal Investigator |
| Robert Z. Orlowski, MD, PhD | UNC Lineberger Comprehensive Cancer Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Lineberger Comprehensive Cancer Center at University of North Carolina - Chapel Hill | Chapel Hill | North Carolina | 27599-7295 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 18327587 | Result | Dees EC, O'Neil BH, Lindley CM, Collichio F, Carey LA, Collins J, Riordan WJ, Ivanova A, Esseltine D, Orlowski RZ. A phase I and pharmacologic study of the combination of bortezomib and pegylated liposomal doxorubicin in patients with refractory solid tumors. Cancer Chemother Pharmacol. 2008 Dec;63(1):99-107. doi: 10.1007/s00280-008-0716-8. Epub 2008 Mar 8. |
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| Doxil | Drug | Doxil will be administered at a dose of 30 mg/m2 as a 1 hour infusion through either a peripheral or central intravenous line every 3 weeks (on day 4 of each 21 day cycle) |
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| Velcade | Drug | Velcade will be adminstered intravenously at 1.3 mg/m2 days 1, 4, 8, 11 every 3 weeks |
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| ID | Term |
|---|---|
| D001943 | Breast Neoplasms |
| D007938 | Leukemia |
| D008223 | Lymphoma |
| D009101 | Multiple Myeloma |
| D054219 | Neoplasms, Plasma Cell |
| D010051 | Ovarian Neoplasms |
| D018567 | Breast Neoplasms, Male |
| D000077216 | Carcinoma, Ovarian Epithelial |
| D054198 | Precursor Cell Lymphoblastic Leukemia-Lymphoma |
| D015470 | Leukemia, Myeloid, Acute |
| D000013 | Congenital Abnormalities |
| D007946 | Leukemia, Mast-Cell |
| D015451 | Leukemia, Lymphocytic, Chronic, B-Cell |
| D054066 | Leukemia, Large Granular Lymphocytic |
| D054438 | Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative |
| D015465 | Leukemia, Myeloid, Accelerated Phase |
| D001752 | Blast Crisis |
| D015466 | Leukemia, Myeloid, Chronic-Phase |
| D015477 | Leukemia, Myelomonocytic, Chronic |
| D007943 | Leukemia, Hairy Cell |
| D054218 | Precursor T-Cell Lymphoblastic Leukemia-Lymphoma |
| D006689 | Hodgkin Disease |
| D017728 | Lymphoma, Large-Cell, Anaplastic |
| D007119 | Immunoblastic Lymphadenopathy |
| D016410 | Lymphoma, T-Cell, Cutaneous |
| D009182 | Mycosis Fungoides |
| D012751 | Sezary Syndrome |
| D054391 | Lymphoma, Extranodal NK-T-Cell |
| D008258 | Waldenstrom Macroglobulinemia |
| D002051 | Burkitt Lymphoma |
| D016403 | Lymphoma, Large B-Cell, Diffuse |
| D008228 | Lymphoma, Non-Hodgkin |
| D016400 | Lymphoma, Large-Cell, Immunoblastic |
| D008224 | Lymphoma, Follicular |
| D020522 | Lymphoma, Mantle-Cell |
| D018442 | Lymphoma, B-Cell, Marginal Zone |
| D064090 | Intraocular Lymphoma |
| ID | Term |
|---|---|
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D001941 | Breast Diseases |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D009370 | Neoplasms by Histologic Type |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D008232 | Lymphoproliferative Disorders |
| D008206 | Lymphatic Diseases |
| D007160 | Immunoproliferative Disorders |
| D007154 | Immune System Diseases |
| D020141 | Hemostatic Disorders |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D010265 | Paraproteinemias |
| D001796 | Blood Protein Disorders |
| D006474 | Hemorrhagic Disorders |
| D004701 | Endocrine Gland Neoplasms |
| D010049 | Ovarian Diseases |
| D000291 | Adnexal Diseases |
| D005831 | Genital Diseases, Female |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D005833 | Genital Neoplasms, Female |
| D014565 | Urogenital Neoplasms |
| D000091662 | Genital Diseases |
| D004700 | Endocrine System Diseases |
| D006058 | Gonadal Disorders |
| D002277 | Carcinoma |
| D009375 | Neoplasms, Glandular and Epithelial |
| D007945 | Leukemia, Lymphoid |
| D007951 | Leukemia, Myeloid |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D034721 | Mastocytosis, Systemic |
| D008415 | Mastocytosis |
| D000090362 | Mast Cell Activation Disorders |
| D015448 | Leukemia, B-Cell |
| D002908 | Chronic Disease |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D015458 | Leukemia, T-Cell |
| D054437 | Myelodysplastic-Myeloproliferative Diseases |
| D001855 | Bone Marrow Diseases |
| D015464 | Leukemia, Myelogenous, Chronic, BCR-ABL Positive |
| D009196 | Myeloproliferative Disorders |
| D002471 | Cell Transformation, Neoplastic |
| D063646 | Carcinogenesis |
| D009385 | Neoplastic Processes |
| D016399 | Lymphoma, T-Cell |
| D000072281 | Lymphadenopathy |
| D020031 | Epstein-Barr Virus Infections |
| D006566 | Herpesviridae Infections |
| D004266 | DNA Virus Infections |
| D014777 | Virus Diseases |
| D007239 | Infections |
| D014412 | Tumor Virus Infections |
| D016393 | Lymphoma, B-Cell |
| D005134 | Eye Neoplasms |
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| ID | Term |
|---|---|
| D000069286 | Bortezomib |
| C506643 | liposomal doxorubicin |
| ID | Term |
|---|---|
| D001897 | Boronic Acids |
| D000148 | Acids, Noncarboxylic |
| D000143 | Acids |
| D007287 | Inorganic Chemicals |
| D001896 | Boron Compounds |
| D009930 | Organic Chemicals |
| D011719 | Pyrazines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
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