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| ID | Type | Description | Link |
|---|---|---|---|
| CDR0000550148 | 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 vinflunine, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Erlotinib and pemetrexed may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Giving vinflunine together with erlotinib or pemetrexed may kill more tumor cells.
PURPOSE: This phase I trial is studying the side effects and best dose of vinflunine when given together with erlotinib or pemetrexed in treating patients with unresectable or metastatic solid tumors.
OBJECTIVES:
Primary
Secondary
OUTLINE: This is a nonrandomized, open-label, dose-escalation study. Patients are assigned to 1 of 2 treatment groups.
Cohorts of 3-6 patients receive escalating doses of pemetrexed disodium and vinflunine 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. Additional patients may be treated at the MTD.
Cohorts of 3-6 patients receive escalating doses of erlotinib hydrochloride and vinflunine 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. Additional patients may be treated at the MTD.
In both groups, courses repeat every 21 days in the absence of unacceptable toxicity.
Blood samples are collected on day 1 of course 1 for pharmacodynamic studies.
After completion of study treatment, patients are followed for 30-40 days.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Arm A | Experimental | Pemetrexed, Vinflunine, Folate, B12, Dexamethasone, Ondansetron, Midazolam |
|
| Arm B | Experimental | Vinflunine, Erlotinib, Ondansetron, Midazolam |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| erlotinib hydrochloride | Drug | 75 mg to 150mg |
| |
| pemetrexed disodium |
| Measure | Description | Time Frame |
|---|---|---|
| Maximum tolerated dose (MTD) of vinflunine and pemetrexed disodium | The MTD is defined as the dose cohort where approximately 0.20 of patients experience DLT. Standard "groups of three" phase I dose escalation design will be used in each arm. Each dose cohort will accrue a minimum of three patients.The estimated MTD is the dose level below the dose that induced dose limiting toxicity (DLT) in one third or more of patients | 1 year |
| Maximum tolerated dose (MTD) of vinflunine and continuously dosed erlotinib | The MTD is defined as the dose cohort where approximately 0.20 of patients experience DLT. Standard "groups of three" phase I dose escalation design will be used in each arm. Each dose cohort will accrue a minimum of three patients.The estimated MTD is the dose level below the dose that induced dose limiting toxicity (DLT) in one third or more of patients | 1 year |
| Maximum tolerated dose (MTD) of vinflunine and intermittently dosed erlotinib | The MTD is defined as the dose cohort where approximately 0.20 of patients experience DLT. Standard "groups of three" phase I dose escalation design will be used in each arm. Each dose cohort will accrue a minimum of three patients.The estimated MTD is the dose level below the dose that induced dose limiting toxicity (DLT) in one third or more of patients | 1 year |
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DISEASE CHARACTERISTICS:
Histologically confirmed solid tumors
Refractory to standard therapy OR no standard therapy exists
No lymphoma
Measurable or evaluable disease
Measurable disease is defined as at least one target lesion measuring ≥ 20 mm by conventional techniques or ≥ 10 mm by spiral CT scan
Evaluable disease includes ascites, pleural effusion, bone metastases, pulmonary lymphangitic spread, and lesions not meeting above criteria as measurable
Brain metastases allowed if CNS-directed treatment has been given, patient has been off CNS-directed therapy for > 3 months, and CNS disease has been clinically and radiographically stable for at least 8 weeks
PATIENT CHARACTERISTICS:
Life expectancy > 3 months
ECOG performance status 0-2
Absolute neutrophil count ≥ 1,500/μL
Platelet count ≥ 100,000/μL
Creatinine clearance ≥ 60 mL/min
Total bilirubin ≤ 1.5 mg/dL
AST and ALT ≤ 3 times upper limit of normal (ULN) OR ≤ 5 times ULN if due to known liver metastases
No New York Heart Association class III or IV heart failure
No unstable angina
No myocardial infarction within the past 6 months
No poorly controlled hypertension
No prior allergic reaction to any vinca alkaloid
No uncontrolled active infection or severe illness
Able to receive vitamin B12 and folate supplementation and dexamethasone during chemotherapy
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception during and for 3 months after last dose of chemotherapy
PRIOR CONCURRENT THERAPY:
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| Name | Affiliation | Role |
|---|---|---|
| Elizabeth C. Dees, MD | 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 |
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| Drug |
Pemetrexed is administered intravenously over 10 minutes, every 21 days |
|
| vinflunine | Drug | Vinflunine is administered intravenously over 20 minutes and should be given after pemetrexed, every 21 days |
|
| ID | Term |
|---|---|
| D000069347 | Erlotinib Hydrochloride |
| D000068437 | Pemetrexed |
| C111217 | vinflunine |
| ID | Term |
|---|---|
| D011799 | Quinazolines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |
| D006147 | Guanine |
| D007042 | Hypoxanthines |
| D011688 | Purinones |
| D011687 | Purines |
| D005971 | Glutamates |
| D024342 | Amino Acids, Acidic |
| D000596 | Amino Acids |
| D000602 | Amino Acids, Peptides, and Proteins |
| D000600 | Amino Acids, Dicarboxylic |
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