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PS-341 Plus Carboplatin in Platinum and Taxane Resistant Recurrent Ovarian Cancer, Primary Peritoneal Cancer, and Fallopian Tube Cancer

Primary Purpose

Ovarian Cancer, Primary Peritoneal Cancer, Fallopian Tube Cancer

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
PS-341 (Bortezomib)
Carboplatin
Sponsored by
M.D. Anderson Cancer Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Ovarian Cancer focused on measuring Platinum Resistant, Taxane Resistant, Ovarian Cancer, Primary Peritoneal Cancer, Fallopian Tube Cancer, Bortezomib, PS-341, Velcade, LDP-341, MLN341, Carboplatin, Paraplatin

Eligibility Criteria

undefined - undefined (Child, Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria: Patients must have histologically-confirmed ovarian cancer, primary peritoneal cancer, or fallopian tube cancer with advanced and/or metastatic disease. All patients must be considered platinum- and taxane- resistant. Platinum resistance is defined as: Progression of disease during platinum or taxane chemotherapy, or Progression of disease within 6 months of completing platinum or taxane chemotherapy Failure to achieve a complete response, with persistent macroscopic disease, after 6 cycles of chemotherapy, if the last two cycles had no measurable change in disease status Patients may have had any number of prior chemotherapy regimens, except high dose chemotherapy an/or peripheral blood stem cell transplantation (high dose: higher than the standard doses of chemotherapy) Patients must have measurable disease. Zubrod performance status of < 2. Patients must give voluntary written informed consent before performance of any study-related procedure not part of normal medical care. Adequate liver, renal and bone marrow function, defined as: Absolute neutrophil count (ANC) > 1.5 x 10^9/L. Platelets > 100 x 10^9/L Total bilirubin < 1.7 umol/L Alanine transaminase (ALT) and aspartate transaminase (AST) < 1.5 x Upper Limits of Normal (ULN) Alkaline phosphatase < 2.5 x ULN. Serum creatinine < 1.5 x ULN. Exclusion Criteria: Chemotherapy within four weeks of first course of PS-341. (Patients may have been on hormonal therapy). Patients who previously received high-dose chemotherapy (higher than the standard doses of chemotherapy) and/or peripheral blood stem cell transplantation. Radiation therapy within four weeks of enrollment (excepting palliative XRT). Patients not recovered from toxic effects of previous chemotherapy, radiation therapy, or antibody therapy. Patients with > Grade 2 peripheral neuropathy. Surgery within four weeks of study enrollment. History of severe hypersensitivity reaction to carboplatin Electrocardiographic evidence of acute ischemia or new conduction system abnormalities. Myocardial infarction within six months of enrollment. Patients with brain metastases or central nervous system disease as evidenced by clinical symptoms. History of other malignancy, except nonmelanoma skin cancer or carcinoma in-situ of the cervix, unless in complete remission and off all therapy for that disease for a minimum of 5 years. Chemotherapy given for prior cancers will not exclude patients from participating in this study. Patients with previously documented human immunodeficiency virus (HIV) infection. HIV-positive patients are excluded from the study based on theoretical concerns regarding the effect of PS-341 on certain aspects of immune function. NF-KB is a critical T cell activation protein (including through CD40L/CD 154 stimulation) and also is involved in cytokine production. Because PS 341 effectively blocks NF-KB and therefore could reduce or block the ability of T lymphocytes and other immune cells to fight HIV, PS-341 should not be administered to HIV-positive patients. Additional experiments in animal models are being conducted to better elucidate the effects of PS-341 on HIV. Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, or cardiac arrhythmia. Other serious medical or psychiatric illness that could, in the investigator's opinion, potentially interfere with the completion of treatment according to this protocol. Patients who are pregnant, suspected to be pregnant, or breast-feeding. Patients with a known hypersensitivity to PS-341, boron, or mannitol.

Sites / Locations

  • University of Texas M. D. Anderson Cancer Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Bortezomib

Arm Description

PS-341 (Bortezomib) 0.8-1.5 mg/m^2 IV push + Carboplatin (AUC 5) IV on Day 1 of each cycle, then Bortezomib alone on Days 4, 8 and 11 in each 28 day cycle.

Outcomes

Primary Outcome Measures

Maximum Tolerated Dose (MTD) of Bortezomib with Carboplatin Chemotherapy

Secondary Outcome Measures

Full Information

First Posted
April 29, 2003
Last Updated
August 1, 2012
Sponsor
M.D. Anderson Cancer Center
Collaborators
Millennium Pharmaceuticals, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT00059618
Brief Title
PS-341 Plus Carboplatin in Platinum and Taxane Resistant Recurrent Ovarian Cancer, Primary Peritoneal Cancer, and Fallopian Tube Cancer
Official Title
A Phase I Study Evaluating the Safety and Tolerability of PS-341(Bortezomib)and Carboplatin in Patients With Platinum- and Taxane-Resistant Recurrent Ovarian Cancer, Primary Peritoneal Cancer, and Fallopian Tube Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
August 2012
Overall Recruitment Status
Completed
Study Start Date
April 2003 (undefined)
Primary Completion Date
April 2007 (Actual)
Study Completion Date
April 2007 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
M.D. Anderson Cancer Center
Collaborators
Millennium Pharmaceuticals, Inc.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The goal of this clinical research study is to find the highest safe dose of PS-341 that can be given with carboplatin chemotherapy as a treatment for patients with ovarian, abdominal, or fallopian tube cancer. Researchers also hope to find out if giving these drugs together will help shrink or slow the growth of tumors in patients who are considered resistant to platinum drugs. The safety of these drugs will also be studied.
Detailed Description
Bortezomib is a drug that turns off certain genes and proteins inside the cancer cell that are responsible for cell growth. Researchers believe that when certain genes and proteins are turned off, the ability of the cancer cell to survive is decreased. Before treatment starts, participants will have a complete checkup, blood tests, a urine test, a heart test, a chest x-ray, and either a CT scan or MRI scan. Women able to have children must have a negative blood pregnancy test within 14 days of beginning treatment. Blood tests and a complete checkup will also be done before each course of therapy and a month after treatment ends. Approximately 2-3 teaspoons of blood will be obtained for routine blood tests each time blood is drawn during this study. Participants in this study will receive Bortezomib and carboplatin through a catheter (tube) placed in a vein. This is Day 1 of therapy. Bortezomib is given first (over 5 to 10 seconds) followed by carboplatin (over one hour). Bortezomib is then given alone on Days 4, 8, and 11. There is no treatment given on Days 12-28. One course of therapy is 28 days long and includes one dose of carboplatin and 4 doses of Bortezomib. All treatment is given on an outpatient basis at M. D. Anderson. There are 4 different dose levels of Bortezomib being studied. The dose of Bortezomib that participants receive will depend on when they are enrolled. It will also depend on whether or not other participants had side effects from their treatment. Up to 6 patients could be treated at each dose. Before each course of therapy, participants will have a physical exam and blood tests. A CT scan or MRI scan is repeated after Cycles 2 and 4 and at the end of treatment. Participants who have a partial or complete response (the tumor shrinks by more than 50% or disappears completely) will have a repeat CT or MRI 4 weeks later to confirm the response. Participants may receive up to 8 courses of treatment. If the disease gets worse or if intolerable side effects occur, participants will be taken off study. This is an investigational study. Bortezomib is approved for use by the FDA, in patients with multiple myeloma. Carboplatin is approved by the FDA, though its use with Bortezomib is experimental. A total of 24 patients will take part in this study. All will be enrolled at M. D. Anderson.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Ovarian Cancer, Primary Peritoneal Cancer, Fallopian Tube Cancer
Keywords
Platinum Resistant, Taxane Resistant, Ovarian Cancer, Primary Peritoneal Cancer, Fallopian Tube Cancer, Bortezomib, PS-341, Velcade, LDP-341, MLN341, Carboplatin, Paraplatin

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
21 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Bortezomib
Arm Type
Experimental
Arm Description
PS-341 (Bortezomib) 0.8-1.5 mg/m^2 IV push + Carboplatin (AUC 5) IV on Day 1 of each cycle, then Bortezomib alone on Days 4, 8 and 11 in each 28 day cycle.
Intervention Type
Drug
Intervention Name(s)
PS-341 (Bortezomib)
Other Intervention Name(s)
Velcade, LDP-341, MLN341
Intervention Description
Starting dose 0.8 mg/m^2 given by vein over 5-10 seconds Day 1, 4, 8 and 11 of 28 day cycle for 8 cycles.
Intervention Type
Drug
Intervention Name(s)
Carboplatin
Other Intervention Name(s)
Paraplatin
Intervention Description
AUC 5 by vein administered over one hour Day 1 of 28 day cycle for 8 cycles.
Primary Outcome Measure Information:
Title
Maximum Tolerated Dose (MTD) of Bortezomib with Carboplatin Chemotherapy
Time Frame
Assessed Day 21 of each 28 Day cycle, up to 4 cohorts for a total of 8 cycles

10. Eligibility

Sex
Female
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients must have histologically-confirmed ovarian cancer, primary peritoneal cancer, or fallopian tube cancer with advanced and/or metastatic disease. All patients must be considered platinum- and taxane- resistant. Platinum resistance is defined as: Progression of disease during platinum or taxane chemotherapy, or Progression of disease within 6 months of completing platinum or taxane chemotherapy Failure to achieve a complete response, with persistent macroscopic disease, after 6 cycles of chemotherapy, if the last two cycles had no measurable change in disease status Patients may have had any number of prior chemotherapy regimens, except high dose chemotherapy an/or peripheral blood stem cell transplantation (high dose: higher than the standard doses of chemotherapy) Patients must have measurable disease. Zubrod performance status of < 2. Patients must give voluntary written informed consent before performance of any study-related procedure not part of normal medical care. Adequate liver, renal and bone marrow function, defined as: Absolute neutrophil count (ANC) > 1.5 x 10^9/L. Platelets > 100 x 10^9/L Total bilirubin < 1.7 umol/L Alanine transaminase (ALT) and aspartate transaminase (AST) < 1.5 x Upper Limits of Normal (ULN) Alkaline phosphatase < 2.5 x ULN. Serum creatinine < 1.5 x ULN. Exclusion Criteria: Chemotherapy within four weeks of first course of PS-341. (Patients may have been on hormonal therapy). Patients who previously received high-dose chemotherapy (higher than the standard doses of chemotherapy) and/or peripheral blood stem cell transplantation. Radiation therapy within four weeks of enrollment (excepting palliative XRT). Patients not recovered from toxic effects of previous chemotherapy, radiation therapy, or antibody therapy. Patients with > Grade 2 peripheral neuropathy. Surgery within four weeks of study enrollment. History of severe hypersensitivity reaction to carboplatin Electrocardiographic evidence of acute ischemia or new conduction system abnormalities. Myocardial infarction within six months of enrollment. Patients with brain metastases or central nervous system disease as evidenced by clinical symptoms. History of other malignancy, except nonmelanoma skin cancer or carcinoma in-situ of the cervix, unless in complete remission and off all therapy for that disease for a minimum of 5 years. Chemotherapy given for prior cancers will not exclude patients from participating in this study. Patients with previously documented human immunodeficiency virus (HIV) infection. HIV-positive patients are excluded from the study based on theoretical concerns regarding the effect of PS-341 on certain aspects of immune function. NF-KB is a critical T cell activation protein (including through CD40L/CD 154 stimulation) and also is involved in cytokine production. Because PS 341 effectively blocks NF-KB and therefore could reduce or block the ability of T lymphocytes and other immune cells to fight HIV, PS-341 should not be administered to HIV-positive patients. Additional experiments in animal models are being conducted to better elucidate the effects of PS-341 on HIV. Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, or cardiac arrhythmia. Other serious medical or psychiatric illness that could, in the investigator's opinion, potentially interfere with the completion of treatment according to this protocol. Patients who are pregnant, suspected to be pregnant, or breast-feeding. Patients with a known hypersensitivity to PS-341, boron, or mannitol.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Pedro T. Ramirez, MD
Organizational Affiliation
M.D. Anderson Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Texas M. D. Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States

12. IPD Sharing Statement

Links:
URL
http://www.mdanderson.org
Description
UT MD Anderson Cancer Center website

Learn more about this trial

PS-341 Plus Carboplatin in Platinum and Taxane Resistant Recurrent Ovarian Cancer, Primary Peritoneal Cancer, and Fallopian Tube Cancer

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