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Combretastatin A4 Phosphate in Treating Patients With Advanced Anaplastic Thyroid Cancer

Primary Purpose

Head and Neck Cancer

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
fosbretabulin disodium
Sponsored by
Case Comprehensive Cancer Center
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Head and Neck Cancer focused on measuring anaplastic thyroid cancer, recurrent thyroid cancer

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

DISEASE CHARACTERISTICS: Histologically confirmed* anaplastic or poorly differentiated variant thyroid cancer, including 1 of the following: Recurrent/regionally advanced disease no longer amenable to definitive curative surgery or radiotherapy Untreated metastatic disease NOTE: *If original/diagnostic tumor blocks are unavailable, tumor must be accessible for pretreatment core needle biopsy Must have relapsed or progressed during or after prior combined modality therapy (e.g., systemic chemotherapy and radiotherapy) for regionally advanced (but not metastatic) disease Measurable or evaluable disease Patent trachea and airway by screening direct and indirect laryngoscopy* NOTE: *For patients with bulky thyroid/neck masses and/or suspected airway obstruction No active brain metastases, as evidenced by any of the following: Symptomatic involvement Cerebral edema by CT scan or MRI Radiographic evidence of progression since definitive therapy Continued requirement for corticosteroids PATIENT CHARACTERISTICS: Age 18 and over Performance status ECOG 0-2 Life expectancy At least 12 weeks Hematopoietic Absolute granulocyte count at least 1,500/mm^3 Platelet count at least 75,000/mm^3 Hemoglobin at least 8.5 g/dL Hepatic Bilirubin no greater than 1.5 times upper limit of normal (ULN) ALT and AST no greater than 3.5 times ULN Renal Creatinine no greater than 1.5 times ULN Cardiovascular LVEF at least 50% by MUGA EKG normal No evidence of prior myocardial infarction (e.g., significant Q waves), QTc greater than 450 msec, or other clinically significant abnormalities No history of angina (even if controlled by medication) No congestive heart failure No uncontrolled atrial arrhythmias No clinically significant arrhythmias, including any of the following: Conduction abnormalities Nodal junctional arrhythmias and dysrhythmias Sinus bradycardia or tachycardia Supraventricular arrhythmias Atrial fibrillation or flutter Syncope or vasovagal episodes No significant heart wall abnormality or heart muscle damage by MUGA No uncontrolled hypertension (blood pressure consistently greater than 150 mm Hg systolic and 100 mm Hg diastolic regardless of medication) Patients with previous hypertension are allowed provided there is clinical documentation of controlled blood pressure for 2 months prior to study enrollment No symptomatic peripheral vascular disease No symptomatic cerebrovascular disease Other Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception No grade 2 or greater preexisting motor or sensory peripheral neuropathy No uncontrolled hypokalemia or hypomagnesemia No concurrent serious infection No other nonmalignant medical illness that is uncontrolled or whose control may be jeopardized by study therapy No psychiatric disorders or other conditions that would preclude study compliance PRIOR CONCURRENT THERAPY: Biologic therapy No concurrent biologic therapy No concurrent immunotherapy No concurrent prophylactic colony-stimulating factors (e.g., filgrastim [G-CSF] or sargramostim [GM-CSF]) Chemotherapy See Disease Characteristics At least 3 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin) No other concurrent chemotherapy Endocrine therapy See Disease Characteristics No concurrent hormonal therapy, except any of the following: Gonadotropin-releasing hormone agonists for hormone-refractory prostate cancer Hormone replacement therapy Oral contraceptives Megestrol for anorexia/cachexia Radiotherapy See Disease Characteristics More than 4 weeks since prior radiotherapy with progressive disease beyond radiation ports No prior radiotherapy to more than 30% of the bone marrow No concurrent radiotherapy Surgery See Disease Characteristics More than 4 weeks since prior major surgery Other At least 6 weeks since other prior therapy associated with delayed toxicity No prior therapy for metastatic disease No concurrent medication(s) known to prolong the QTc interval, unless medication(s) can be held for at least 72 hours before, during, and for at least 6 hours after study drug administration No other concurrent investigational therapy No other concurrent antineoplastic or cytotoxic therapy

Sites / Locations

  • Josephine Ford Cancer Center at Henry Ford Hospital
  • Ireland Cancer Center at University Hosptials Case Medical Center, Case Comprehensive Cancer Center
  • Hillman Cancer Center at University of Pittsburgh Cancer Institute

Outcomes

Primary Outcome Measures

Median survival

Secondary Outcome Measures

Objective disease response

Full Information

First Posted
May 6, 2003
Last Updated
June 10, 2010
Sponsor
Case Comprehensive Cancer Center
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00060242
Brief Title
Combretastatin A4 Phosphate in Treating Patients With Advanced Anaplastic Thyroid Cancer
Official Title
Phase II Trial Of Combretastatin A-4 Phosphate (CA4P) In Advanced Anaplastic Carcinoma Of The Thyroid
Study Type
Interventional

2. Study Status

Record Verification Date
June 2010
Overall Recruitment Status
Completed
Study Start Date
February 2003 (undefined)
Primary Completion Date
February 2007 (Actual)
Study Completion Date
January 2008 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Case Comprehensive Cancer Center
Collaborators
National Cancer Institute (NCI)

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
RATIONALE: Combretastatin A4 phosphate may stop the growth of anaplastic thyroid cancer by stopping blood flow to the tumor. PURPOSE: This phase II trial is studying how well combretastatin A4 phosphate works in treating patients with advanced recurrent or metastatic anaplastic thyroid cancer.
Detailed Description
OBJECTIVES: Determine the objective response rate of patients with advanced anaplastic thyroid cancer treated with combretastatin A4 phosphate. Determine whether this drug alters the natural history of anaplastic thyroid cancer, in terms of doubling the median survival from 4-6 months to 12 months, in these patients. Determine the safety profile of this drug in these patients. Correlate clinical response with pretreatment tumor microvessel density and immature vessel staining, changes in sICAM-1 levels over the course of treatment, and pharmacokinetic parameters in patients treated with this drug. OUTLINE: This is a multicenter study. Patients receive combretastatin A4 phosphate IV over 10 minutes on days 1, 8, and 15. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients achieving a complete response (CR) receive 2 courses beyond documentation of the CR. Patients are followed monthly. PROJECTED ACCRUAL: A total of 32 patients will be accrued for this study within 18-24 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Head and Neck Cancer
Keywords
anaplastic thyroid cancer, recurrent thyroid cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
26 (Actual)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
fosbretabulin disodium
Other Intervention Name(s)
Combretastatin A4 phosphate
Intervention Description
Combretastatin A4 phosphate IV over 10 minutes on days 1, 8, and 15. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients achieving a complete response (CR) receive 2 courses beyond documentation of the CR.
Primary Outcome Measure Information:
Title
Median survival
Time Frame
every 8 weeks
Secondary Outcome Measure Information:
Title
Objective disease response
Time Frame
every 8 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically confirmed* anaplastic or poorly differentiated variant thyroid cancer, including 1 of the following: Recurrent/regionally advanced disease no longer amenable to definitive curative surgery or radiotherapy Untreated metastatic disease NOTE: *If original/diagnostic tumor blocks are unavailable, tumor must be accessible for pretreatment core needle biopsy Must have relapsed or progressed during or after prior combined modality therapy (e.g., systemic chemotherapy and radiotherapy) for regionally advanced (but not metastatic) disease Measurable or evaluable disease Patent trachea and airway by screening direct and indirect laryngoscopy* NOTE: *For patients with bulky thyroid/neck masses and/or suspected airway obstruction No active brain metastases, as evidenced by any of the following: Symptomatic involvement Cerebral edema by CT scan or MRI Radiographic evidence of progression since definitive therapy Continued requirement for corticosteroids PATIENT CHARACTERISTICS: Age 18 and over Performance status ECOG 0-2 Life expectancy At least 12 weeks Hematopoietic Absolute granulocyte count at least 1,500/mm^3 Platelet count at least 75,000/mm^3 Hemoglobin at least 8.5 g/dL Hepatic Bilirubin no greater than 1.5 times upper limit of normal (ULN) ALT and AST no greater than 3.5 times ULN Renal Creatinine no greater than 1.5 times ULN Cardiovascular LVEF at least 50% by MUGA EKG normal No evidence of prior myocardial infarction (e.g., significant Q waves), QTc greater than 450 msec, or other clinically significant abnormalities No history of angina (even if controlled by medication) No congestive heart failure No uncontrolled atrial arrhythmias No clinically significant arrhythmias, including any of the following: Conduction abnormalities Nodal junctional arrhythmias and dysrhythmias Sinus bradycardia or tachycardia Supraventricular arrhythmias Atrial fibrillation or flutter Syncope or vasovagal episodes No significant heart wall abnormality or heart muscle damage by MUGA No uncontrolled hypertension (blood pressure consistently greater than 150 mm Hg systolic and 100 mm Hg diastolic regardless of medication) Patients with previous hypertension are allowed provided there is clinical documentation of controlled blood pressure for 2 months prior to study enrollment No symptomatic peripheral vascular disease No symptomatic cerebrovascular disease Other Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception No grade 2 or greater preexisting motor or sensory peripheral neuropathy No uncontrolled hypokalemia or hypomagnesemia No concurrent serious infection No other nonmalignant medical illness that is uncontrolled or whose control may be jeopardized by study therapy No psychiatric disorders or other conditions that would preclude study compliance PRIOR CONCURRENT THERAPY: Biologic therapy No concurrent biologic therapy No concurrent immunotherapy No concurrent prophylactic colony-stimulating factors (e.g., filgrastim [G-CSF] or sargramostim [GM-CSF]) Chemotherapy See Disease Characteristics At least 3 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin) No other concurrent chemotherapy Endocrine therapy See Disease Characteristics No concurrent hormonal therapy, except any of the following: Gonadotropin-releasing hormone agonists for hormone-refractory prostate cancer Hormone replacement therapy Oral contraceptives Megestrol for anorexia/cachexia Radiotherapy See Disease Characteristics More than 4 weeks since prior radiotherapy with progressive disease beyond radiation ports No prior radiotherapy to more than 30% of the bone marrow No concurrent radiotherapy Surgery See Disease Characteristics More than 4 weeks since prior major surgery Other At least 6 weeks since other prior therapy associated with delayed toxicity No prior therapy for metastatic disease No concurrent medication(s) known to prolong the QTc interval, unless medication(s) can be held for at least 72 hours before, during, and for at least 6 hours after study drug administration No other concurrent investigational therapy No other concurrent antineoplastic or cytotoxic therapy
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Panayiotis Savvides, MD
Organizational Affiliation
Ireland Cancer Center at University Hosptials Case Medical Center, Case Comprehensive Cancer Center
Official's Role
Study Chair
Facility Information:
Facility Name
Josephine Ford Cancer Center at Henry Ford Hospital
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48202
Country
United States
Facility Name
Ireland Cancer Center at University Hosptials Case Medical Center, Case Comprehensive Cancer Center
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44106-5065
Country
United States
Facility Name
Hillman Cancer Center at University of Pittsburgh Cancer Institute
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15232
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
19265494
Citation
Mooney CJ, Nagaiah G, Fu P, Wasman JK, Cooney MM, Savvides PS, Bokar JA, Dowlati A, Wang D, Agarwala SS, Flick SM, Hartman PH, Ortiz JD, Lavertu PN, Remick SC. A phase II trial of fosbretabulin in advanced anaplastic thyroid carcinoma and correlation of baseline serum-soluble intracellular adhesion molecule-1 with outcome. Thyroid. 2009 Mar;19(3):233-40. doi: 10.1089/thy.2008.0321.
Results Reference
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Combretastatin A4 Phosphate in Treating Patients With Advanced Anaplastic Thyroid Cancer

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