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| ID | Type | Description | Link |
|---|---|---|---|
| SCCC-2005097 | Other Identifier | University of Miami Sylvester Comprehensive Cancer Center | |
| WIRB-20051340 | Other Identifier | Western Institutional Review Board |
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RATIONALE: Radiation therapy uses high-energy x-rays to kill tumor cells. Drugs, such as cytochlor and tetrahydrouridine, may make tumor cells more sensitive to radiation therapy.
PURPOSE: This phase I trial is studying the side effects and best dose of cytochlor when given together with tetrahydrouridine and external-beam radiation therapy in treating patients with cancer that has spread to the brain.
OBJECTIVES:
Primary
Secondary
OUTLINE: This is a dose-escalation study of cytochlor.
Patients receive cytochlor IV and tetrahydrouridine (H4U) IV over 5 minutes on 3 days in week 1 and on days 1-5 in weeks 2 and 3. Patients also undergo external-beam radiotherapy 5 days a week in weeks 2 and 3 initiated 3-4 hours after infusions of cytochlor and H4U. Treatment may repeat in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed monthly for 3 months, every 3 months for 1 year, every 4 months for 1 year, every 6 months for 1 year, and then yearly thereafter.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| CldC + H4U | Experimental |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Cytochlor | Drug | The study's starting dose of CldC is 50 mg/m2/day. The dose of CldC will be escalated / de-escalated for patients. Patients will receive CldC+H4U on 3 days (Wed, Thr, Fri) in week 1, which precedes the initiation of radiation therapy. Patients will receive H4U and CldC IV by bolus infusion. Treatment with CldC+H4U will then continue for 5 days (Mon-Fri) during each of weeks 2 and 3, and will be accompanied by radiation therapy at 3 Gy/fraction initiated 3-4 h after bolus infusion of CldC+H4U. Treatment with CldC+H4U and radiation will then stop at the end of week 3. |
| Measure | Description | Time Frame |
|---|---|---|
| To establish a dose range of CldC for further clinical studies (Phase II clinical trials) based on safety and toxicity. | 2 Years | |
| b) Establish the safety and toxicity profile of CldC+ H4U when given in combination with RT for 2 weeks following treatment with the drug alone for 3 days in the week prior to the combined treatment. | Duration of study treatment |
| Measure | Description | Time Frame |
|---|---|---|
| a) Determine the effectiveness of H4U to inhibit systemic cytidine deaminase (CD) during the course of treatment with CldC + H4U. | Baseline Levels of CD will be obtained by assaying CD in serum prior to initiation of treatment on Wednesday of week 1. Follow-up assays of CD in serum will be made on the Fridays of weeks 1 to 3 after each day's treatment with CldC + H4U. In weeks 2 and 3 this will take place prior to RT |
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DISEASE CHARACTERISTICS:
Diagnosis of metastatic cancer to the brain by contrast-enhanced MRI or CT scan
Eligible for whole-brain radiotherapy (WBRT)
No leptomeningeal metastasis documented by contrast-enhanced MRI/CT scan or cerebrospinal fluid evaluation
PATIENT CHARACTERISTICS:
Inclusion criteria:
Exclusion criteria:
Uncontrolled intercurrent illness including, but not limited to, any of the following:
Pregnant or lactating
Alcohol dependence
PRIOR CONCURRENT THERAPY:
No prior radiotherapy to the brain
No concurrent combination antiretroviral therapy for HIV-positive patients
No other concurrent chemotherapy, immunotherapy, hormonal therapy (excluding contraceptives and replacement steroids), or other experimental medication
No other concurrent anticancer therapy outside the protocol
No concurrent heparin or coumadin
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| Name | Affiliation | Role |
|---|---|---|
| Fazilat Ishkanian, MD | University of Miami | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Miami | Miami | Florida | 33136 | United States |
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| Tetrahydrouridine | Drug | A fixed dose of H4U at 720 mg/m2/day will be used, regardless of the dose of CldC administered. H4U will be delivered by an IV bolus infusion over a period of 5 minutes, followed 5 minutes later by an IV bolus infusion of CldC. Patients will receive CldC+H4U on 3 days (Wed, Thr, Fri) in week 1, which precedes the initiation of radiation therapy. Patients will receive H4U and CldC IV by bolus infusion. Treatment with CldC+H4U will then continue for 5 days (Mon-Fri) during each of weeks 2 and 3, and will be accompanied by radiation therapy at 3 Gy/fraction initiated 3-4 h after bolus infusion of CldC+H4U. Treatment with CldC+H4U and radiation will then stop at the end of week 3. |
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| Radiation Therapy | Radiation | One treatment of 3 Gy will be given daily 5 days per week (10 fractions) for a total of 30 Gy over two weeks. |
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| At protocol specified timepoints during treatment |
| Cytochlor and metabolite levels in serum at weeks 1, 2, and 3 | Pharmacokinetic sampling at protocol-specified timepoints during duration of treatment |
| Cytochlor and metabolite levels in urine at weeks 1, 2, and 3 | Pharmacokinetic sampling at protocol-specified timepoints during duration of treatment |
| ID | Term |
|---|---|
| D016543 | Central Nervous System Neoplasms |
| D001932 | Brain Neoplasms |
| ID | Term |
|---|---|
| D009423 | Nervous System Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D009422 | Nervous System Diseases |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
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| ID | Term |
|---|---|
| D002487 | Centers for Disease Control and Prevention, U.S. |
| D013767 | Tetrahydrouridine |
| D011878 | Radiotherapy |
| ID | Term |
|---|---|
| D014492 | United States Public Health Service |
| D014483 | United States Dept. of Health and Human Services |
| D037041 | United States Government Agencies |
| D035082 | Federal Government |
| D006076 | Government |
| D009938 | Organizations |
| D004472 | Health Care Economics and Organizations |
| D014529 | Uridine |
| D011741 | Pyrimidine Nucleosides |
| D011743 | Pyrimidines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D009705 | Nucleosides |
| D009706 | Nucleic Acids, Nucleotides, and Nucleosides |
| D012263 | Ribonucleosides |
| D013812 | Therapeutics |
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