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| ID | Type | Description | Link |
|---|---|---|---|
| P30CA093373 | U.S. NIH Grant/Contract | View source | |
| UCDCC-157 | Other Identifier | University of California, Davis - Cancer Center | |
| 200412738 | Other Identifier | University of California, Davis - IRB | |
| GSK-8531 | Other Grant/Funding Number | GlaxoSmithKline | |
| MILLENNIUM-X05131 | Other Grant/Funding Number | Millennium Pharmaceuticals |
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| Name | Class |
|---|---|
| National Cancer Institute (NCI) | NIH |
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RATIONALE: Bortezomib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as topotecan, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving bortezomib together with topotecan may kill more tumor cells.
PURPOSE: This phase I trial is studying the side effects and best dose of bortezomib and topotecan in treating patients with advanced solid tumors.
OBJECTIVES:
Primary
Secondary
OUTLINE: This is a dose-escalation study.
Patients receive topotecan hydrochloride IV over 30 minutes followed by bortezomib IV on days 1, 8, and 15. Treatment repeats every 28 days for up to 6 courses in the absence of disease progression or unacceptable toxicity. Patients with stable or responding disease may continue to receive bortezomib alone in the absence of disease progression or unacceptable toxicity.
Cohorts of 3-6 patients receive escalating doses of topotecan hydrochloride and bortezomib 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.
Ten additional patients with small cell lung cancer are treated at the MTD. These patients undergo tumor biopsy at baseline and before the second course of therapy.
Tumor tissue is collected at baseline in all patients. Blood samples are collected at baseline, at the beginning of courses 2 and 3, and after completion of study treatment. Samples are examined for topoisomerase-1 levels by western blotting; BCL-2, BCL-xL, BAX, and p27 by immunohistochemistry; hypoxia-inducible factor-1, plasminogen-activator inhibitor 1, vascular endothelial growth factor, and osteopontin by immunoenzyme techniques; and NF-kB and p27 nuclear expression by flow cytometry.
After completion of study treatment, patients are followed for 30 days.
PROJECTED ACCRUAL: A total of 34 patients will be accrued for this study.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| bortezomib | Drug | Dose level A: 1 mg/m2; Dose level B: 1.3 mg/m2; Dose level C: 1.6 mg/m2; Dose level D: 1.6 mg/m2 |
| |
| topotecan hydrochloride | Drug | Dose level A: 3 mg/m2; Dose level B: 3 mg/m2; Dose level C: 3 mg/m2; Dose level D: 4 mg/m2 |
| |
| flow cytometry | Other | No description | ||
| immunoenzyme technique | Other | No description | ||
| immunohistochemistry staining method | Other | No description | ||
| laboratory biomarker analysis |
| Measure | Description | Time Frame |
|---|---|---|
| Safety | If cumulative toxicities are seen in subsequent treatment cycles, a decision regarding modification or discontinuation of the study drug and/or patient enrollment will be made by the sponsor in conjunction with the investigator. | Monitored on an ongoing basis during the study |
| Measure | Description | Time Frame |
|---|---|---|
| Toxicity | Toxicity will be evaluated based on the standard NCI CTC grading criteria version 3.0. | On Day 8 and at beginning of subsequent cycles |
| Response rate | As assessed by RECIST criteria |
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DISEASE CHARACTERISTICS:
Histologically or cytologically confirmed advanced solid tumor, meeting 1 of the following criteria:
Patients with small cell lung cancer are enrolled after the maximum tolerated dose has been determined
Measurable disease by RECIST criteria or evaluable disease (e.g., pleural effusion, ascites, or bone metastasis)
Asymptomatic brain metastasis treated by prior surgical resection or radiotherapy allowed if both of the following criteria are met:
PATIENT CHARACTERISTICS:
PRIOR CONCURRENT THERAPY:
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| Name | Affiliation | Role |
|---|---|---|
| Angela Davies, MD | University of California, Davis | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of California Davis Cancer Center | Sacramento | California | 95817 | United States |
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| Other |
No description |
| At baseline and every 2 courses during treatment |
| Best response | Best response is determined from the sequence of objective status. | From start of treatment until disease progression/recurrence |
| Survival | Patients will be followed for 30 days after removal from study treatment or until all treatment-related toxicities resolve to < grade 1. | From registration to time of death due to any cause |
| Progression-free survival | If a patient has not progressed or died, progression-free survival is censored at the time of last follow-up. | From registration to the first observation of disease progression or death due to any cause |
| Topoisomerase levels as assessed by western blot and tumor tissue biopsy | The aim of these molecular correlates is to examine the relationship between these studies and the clinical response to treatment. | From pre-treatment to post-treatment |
| NF-kB and BCL-2 family activity as assessed by immunohistochemistry | The aim of these molecular correlates is to examine the relationship between these studies and the clinical response to treatment. | From pre-treatment to post-treatment |
| Loss of p27 as assessed by immunohistochemistry | The aim of these molecular correlates is to examine the relationship between these studies and the clinical response to treatment. | From pre-treatment to post-treatment |
| Hypoxia-induced plasma proteins as measured by enzyme-linked immunosorbent assay (ELISA) | The aim of these molecular correlates is to examine the relationship between these studies and the clinical response to treatment. | From pre-treatment to post-treatment |
| Shed tumor DNA in plasma | The aim of these molecular correlates is to examine the relationship between these studies and the clinical response to treatment. | From pre-treatment to post-treatment |
| Biological activity of bortezomib as measured by flow cytometry | The aim of these molecular correlates is to examine the relationship between these studies and the clinical response to treatment. | From pre-treatment to post-treatment |
| ID | Term |
|---|---|
| D008175 | Lung Neoplasms |
| D055752 | Small Cell Lung Carcinoma |
| ID | Term |
|---|---|
| D012142 | Respiratory Tract Neoplasms |
| D013899 | Thoracic Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D002283 | Carcinoma, Bronchogenic |
| D001984 | Bronchial Neoplasms |
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| ID | Term |
|---|---|
| D000069286 | Bortezomib |
| D019772 | Topotecan |
| D005434 | Flow Cytometry |
| D007124 | Immunoenzyme Techniques |
| D007150 | Immunohistochemistry |
| 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 |
| D002166 | Camptothecin |
| D000470 | Alkaloids |
| D002469 | Cell Separation |
| D003584 | Cytological Techniques |
| D019411 | Clinical Laboratory Techniques |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
| D003592 | Cytophotometry |
| D005470 | Fluorometry |
| D008163 | Luminescent Measurements |
| D010783 | Photometry |
| D002623 | Chemistry Techniques, Analytical |
| D008919 | Investigative Techniques |
| D007118 | Immunoassay |
| D007158 | Immunologic Techniques |
| D015336 | Molecular Probe Techniques |
| D006651 | Histocytochemistry |
| D006652 | Histological Techniques |
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