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Low accrual, competing studies
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The purpose of this study is to learn whether oral Ribavirin is safe and effective in treating patients with solid tumour cancers, that have high levels of the protein eIF4E.
This is a dose escalating, open-label, Phase I/II study of single agent oral ribavirin administered daily in solid tumour cancer patients who have failed standard treatments, overexpress eIF4E, and have easily accessible disease for serial biopsies.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Ribavirin, nucleoside analog | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ribavirin | Drug | Dose Level: 1 1400 mg po BID Dose Level: 2 1800 mg po BID Dose Level: 3 2200 mg po BID Dose Level: 4 2600 mg po BID Dose Level: 5 3000 mg po BID |
|
| Measure | Description | Time Frame |
|---|---|---|
| Phase I: Maximum Tolerated Dose (MTD) and/or recommended phase II dose (RP2D) | Average 1.5 years | |
| Phase II: Determine the overall response rate to therapy with ribavirin | Average 1.5 years |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence and nature of DLTs | 3 years | |
| Incidence, nature and severity of adverse events | 3 years | |
| Time to and duration of response, defined as the first occurence of documented objective response until the time of recurrence or death from any cause |
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Inclusion Criteria:
Phase I part of study : Histologically or cytologically confirmed cancer at diagnosis, with advanced, incurable disease at the time of screening, who have progressed on or are not suitable for standard therapy.
Phase II part of study: Histologically or cytologically confirmed BC or HNSCC at diagnosis, with advanced, incurable disease at the time of screening, who have progressed on or are not suitable for standard therapy.
Willing to have a screening biopsy performed from an easily accessible lesion (ex. skin, superficial lymph node) AND whose tumour must overexpress eIF4E.
Easily accessible lesion for serial biopsies (ex. skin, superficial lymph node, or other easily accessible site).
At least 1 unidimensionally measurable lesion (based on the RECIST criteria) outside the CNS.
ECOG 0, 1, or 2.
Adequate recovery (excluding alopecia) from previous surgery, radiation, and chemotherapy.
Adequate wash-out period from last therapy (at least 3 weeks).
Life expectancy ≥ 12 weeks.
Age ≥ 18 years old.
Female patients of childbearing potential must have a negative serum (beta-HCG) pregnancy test within 14 days of starting protocol and must not be breastfeeding. Men and women of childbearing potential (including men who have had a vasectomy and women who have had tubal ligation) must agree to use two effective means of contraception throughout the study and for at least 6 months after completion of protocol. Post-menopausal women (defined as 12 or more consecutive months of amenorrhea, or follicle stimulating hormone (FSH) in the post-menopausal range), or surgically sterile women (defined as removal of the uterus or ovaries), do not require methods of contraception.
Adequate renal and hepatic function: serum creatinine < 1.5 x ULN; AST or ALT < 2.5 x ULN (or < 5 x ULN if liver involvement with metastases); serum bilirubin < 1.5 x ULN.
Adequate hematopoietic function: neutrophils ≥ 1.0 x 109/L, platelets ≥ 75 x 109/L.
Provide written consent after the investigational nature, study design, risks and benefits of the study have been explained.
Accessible for treatment and follow up.
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Jewish General Hospital | Montreal | Quebec | H3T 1E2 | Canada |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 19433856 | Background | Assouline S, Culjkovic B, Cocolakis E, Rousseau C, Beslu N, Amri A, Caplan S, Leber B, Roy DC, Miller WH Jr, Borden KL. Molecular targeting of the oncogene eIF4E in acute myeloid leukemia (AML): a proof-of-principle clinical trial with ribavirin. Blood. 2009 Jul 9;114(2):257-60. doi: 10.1182/blood-2009-02-205153. Epub 2009 May 11. | |
| 15601771 |
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| ID | Term |
|---|---|
| D012254 | Ribavirin |
| ID | Term |
|---|---|
| D012263 | Ribonucleosides |
| D009705 | Nucleosides |
| D009706 | Nucleic Acids, Nucleotides, and Nucleosides |
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| 3 years |
| Clinical benefit rate, defined as the overall response rate and stable disease for greater than or equal to 24 weeks | 3 years |
| Pharmacokinetic parameters of ribavirin determine by total exposure, maximum plasma concentration, etc. | 3 years |
| Correlation between eIF4E activity and response | 3 years |
| To determine the effect of ribavirin on the activity of eIF4E related pathways through correlative studies | 3 years |
| Kentsis A, Topisirovic I, Culjkovic B, Shao L, Borden KL. Ribavirin suppresses eIF4E-mediated oncogenic transformation by physical mimicry of the 7-methyl guanosine mRNA cap. Proc Natl Acad Sci U S A. 2004 Dec 28;101(52):18105-10. doi: 10.1073/pnas.0406927102. Epub 2004 Dec 15. |