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This is a study of the drug perifosine for patients who have no standard treatment options. This study is designed to identify which cancer types respond to perifosine, and determine which regimen of perifosine is most effective in each one. Patients with either solid tumors or with lymphomas for whom this protocol represents reasonable or optimal treatment will be randomized to receive either perifosine 100 mg daily or 900 mg weekly until disease progression. Based on currently available data it is anticipated that these doses should be easily tolerated by most patients.
This is an exploratory phase IIA trial with unique elements of design and patient selection with an aim to:
It is not anticipated that this study will provide "proof of principle" regarding the use of perifosine or serve as a pivotal trial for regulatory purposes. Information obtained from this study will be used to design additional trials that will be more definitive in nature.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Perifosine Daily Dose | Experimental | Daily dose perifosine 50 mg. |
|
| Perifosine Twice Daily Dose | Experimental | Twice daily dose perifosine 50 mg. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Perifosine | Drug | Perifosine 50 mg tablets |
|
| Measure | Description | Time Frame |
|---|---|---|
| Overall Response Rate (PR + CR) | To determine for each disease category the proportion of patients treated with perifosine who experience a favorable outcome, defined as a complete or partial response; a 50% increase in progression-free survival compared to patient's latest treatment regimen for metastatic disease, or stabilization of disease. | Evaluated every 12 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| To Show that doses will be each sufficiently and tolerated | To show that daily 50 mg daily and 50 mg twice-daily doses are each sufficiently well tolerated to ensure good compliance in future studies of these two regimens | From date of randomization |
| To obtain plasma levels |
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Inclusion Criteria:
Patients must have a histologically or cytologically confirmed diagnosis of either a lymphoma or solid tumor for which there is no established therapy that, in the opinion of the treating physician, will prolong the patient's survival or have a larger net effect on the patient's quality of life.
The physician must believe that the patient's course and the growth rate of the tumor are such that the patient would feel comfortable continuing treatment for at least 12 weeks even if there were a transient period of modest tumor growth (defined as less than 30%) during the first weeks following the initiation of perifosine treatment.
Patients must have a life expectancy of more than 6 months.
Patients must not be eligible for any other available perifosine study.
In general, patients should have received no more than two prior cytotoxic chemotherapy regimens for metastatic disease.
Patients may have measurable or non-measurable disease. If the outcome for a patient is to be based on response using Response Evaluation Criteria in Solid Tumors (RECIST) criteria, the patient must have at least one measurable lesion that can be accurately measured in at least one dimension and fit one of the following criteria: longest diameter >= 20 mm using conventional techniques or >= 10 mm with spiral computed tomography (CT) scan. The dimensions of all target lesions that will be used to determine objective response along with the date of last measurement and the method of measurement (e.g. physical examination, spiral CT, conventional CT) must be recorded on the enrollment form prior to the patient's first treatment.
If the outcome for a patient is to be based on an increase in time to progression, the following will apply:
Patients should have a performance status of 0 to 1 according to the ECOG criteria.
Patients must have adequate organ and marrow function. Adequate organ and marrow function are described below.
Patients must have recovered from acute toxicity related to prior therapy including surgery or radiotherapy, excluding alopecia.
Patients with breast cancer or prostate cancer who discontinue endocrine therapy prior to entry into this study must wait for a minimum of 1 month and then be reassessed for a withdrawal response prior to starting perifosine. However, it is not a requirement that endocrine therapies be discontinued.
Patients must be able to ingest oral medications or to obtain them through a gastrostomy tube.
Patients must be at least 18 years of age
Patients must have ability to understand and the willingness to sign a written informed consent document.
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Timothy Goggins, MD | Fox Valley Hematology and Oncology SC, Appleton | Study Chair |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| Result | 1) Journal of Clinical Oncology, 2009 ASCO Annual Meeting Proceedings (Post-Meeting Edition). Vol 27, No 15S (May 20 Supplement), 2009: e15505 / For HCC ( hepatic / sub-population) 2) Journal of Clinical Oncology, 2007 ASCO Annual Meeting Proceedings (Post-Meeting Edition). Vol 25, No 18S (June 20 Supplement), 2007: 15622 / For RCC (renal / sub-population) |
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| ID | Term |
|---|---|
| D009369 | Neoplasms |
| D008223 | Lymphoma |
| ID | Term |
|---|---|
| D009370 | Neoplasms by Histologic Type |
| D008232 | Lymphoproliferative Disorders |
| D008206 | Lymphatic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
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| ID | Term |
|---|---|
| C105905 | perifosine |
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To obtain perifosine plasma levels in a subset of patients to evaluate variability in drug uptake between patients, and to correlate plasma levels with outcomes to insure good compliance in future studies of these two regimens |
| Every treatment cycle |
| D007160 | Immunoproliferative Disorders |
| D007154 | Immune System Diseases |