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Neoadjuvant Tipifarnib, Docetaxel, and Capecitabine in Treating Patients With Locally Advanced or Metastatic Solid Tumors or Stage IIIA or Stage IIIB Breast Cancer

Primary Purpose

Adult Solid Neoplasm, Inflammatory Breast Carcinoma, Male Breast Carcinoma

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Capecitabine
Docetaxel
Laboratory Biomarker Analysis
Pharmacological Study
Tipifarnib
Sponsored by
National Cancer Institute (NCI)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Adult Solid Neoplasm

Eligibility Criteria

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

Inclusion Criteria: Histologically or cytologically confirmed solid tumor Locally advanced or metastatic No known standard therapy that is potentially curative or definitely capable of extending life expectancy No history of metastatic brain disease within the past 6 months Treated metastatic brain disease is allowed provided disease has been stable for more than 6 months and does not require concurrent steroids or anti-seizure medication Histologically confirmed breast cancer Stage IIIA or stage IIIB, including ipsilateral palpable supraclavicular lymph node(s) without other distant metastasis Invasive disease confirmed by 1 of the following*: Incisional biopsy Punch biopsy (applicable for clinical T4b tumors) Core needle (cutting needle) biopsies No distant metastatic disease Hormone receptor status: Not specified Male or female Performance status - ECOG 0-1 Absolute neutrophil count at least 2,000/mm^3 Platelet count at least 100,000/mm^3 Hemoglobin at least 10.0 g/dL Bilirubin no greater than upper limit of normal (ULN) Alkaline phosphatase no greater than 2.5 times ULN AST no greater than 2.5 times ULN Creatinine no greater than 1.25 times ULN Creatinine clearance at least 50 mL/min No cardiac arrhythmia Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception No active infection requiring antibiotics No diabetes No symptomatic neurologic condition No other uncontrolled serious medical condition No other malignancy within the past 3 years except adequately treated basal cell or squamous cell skin cancer or carcinoma in situ of the cervix No history of hypersensitivity to intravenous paclitaxel or other medication containing Cremophor EL or polysorbate 80 as a carrier (phase Ib) Phase Ib only: More than 4 weeks since prior immunotherapy More than 4 weeks since prior biologic therapy No concurrent immunotherapy Phase Ib and II: No concurrent prophylactic filgrastim (G-CSF) Phase Ib only: More than 1 year since prior adjuvant docetaxel before metastatic relapse More than 4 weeks since prior chemotherapy and recovered No prior capecitabine AND docetaxel (in combination or as single agents) Prior capecitabine OR docetaxel allowed No other concurrent chemotherapy Phase II only: No prior cytotoxic chemotherapy for breast cancer Phase Ib only: More than 3 weeks since prior radiotherapy No prior radiotherapy to more than 25% of bone marrow No concurrent radiotherapy Phase II only: No prior radiotherapy for breast cancer Phase Ib only: More than 4 weeks since prior major surgery Phase II only: No prior surgery (other than core or incisional biopsy for diagnostic purposes) for breast cancer Phase Ib only: No other ancillary investigational therapy Phase Ib and II: No concurrent sorivudine or brivudine

Sites / Locations

  • Mayo Clinic in Arizona
  • Howard University Cancer Center CCOP
  • Mayo Clinic in Florida
  • Barbara Ann Karmanos Cancer Institute
  • Mayo Clinic
  • Washington University School of Medicine
  • University of Wisconsin Medical School

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treatment (tipifarnib, capecitabine, docetaxel)

Arm Description

Phase Ib: Patients receive oral tipifarnib twice daily and oral capecitabine twice daily on days 1-14 and docetaxel IV over 30-60 minutes on days 1 and 8. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. Phase II: Patients receive oral tipifarnib twice daily for 6 days. Beginning at least 48 hours after completion of the initial dose of tipifarnib, patients receive treatment as in phase Ib for up to 6 courses at the MTD of capecitabine.

Outcomes

Primary Outcome Measures

Dose-limiting toxicity (DLT) as assessed by Common Terminology Criteria for Adverse Events (CTCAE) version 3.0 (Phase I)
Pathologic complete response rate (Phase II)
Estimated by the number of patients with a complete pathologic response divided by the total number of evaluable patients. Ninety-five percent confidence intervals for the true pathologic complete response probability will be calculated according to the approach of Duffy and Santner.

Secondary Outcome Measures

Clinical tumor response (complete response [CR] or partial response [PR]) (Phase I)
Clinical responses will be summarized by simple descriptive summary statistics.
Overall survival
The distribution of survival time will be estimated using the method of Kaplan-Meier.
Toxicity as assessed by the National Cancer Institute (NCI) CTCAE version 3.0

Full Information

First Posted
October 3, 2003
Last Updated
May 1, 2015
Sponsor
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00070252
Brief Title
Neoadjuvant Tipifarnib, Docetaxel, and Capecitabine in Treating Patients With Locally Advanced or Metastatic Solid Tumors or Stage IIIA or Stage IIIB Breast Cancer
Official Title
Phase Ib/II Neoadjuvant Trial of the Farnesyltransferase Inhibitor, R115777 With Docetaxel and Capecitabine for Patients With Stage IIIA or IIIB Breast Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
December 2012
Overall Recruitment Status
Completed
Study Start Date
September 2003 (undefined)
Primary Completion Date
February 2006 (Actual)
Study Completion Date
June 2010 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
Phase I/II trial to study the effectiveness of neoadjuvant tipifarnib combined with docetaxel and capecitabine in treating patients who have locally advanced or metastatic solid tumors or stage IIIA or stage IIIB breast cancer. Tipifarnib may stop the growth of tumor cells by blocking the enzymes necessary for cancer cell growth. Drugs used in chemotherapy, such as docetaxel and capecitabine, use different ways to stop tumor cells from dividing so they stop growing or die. Combining tipifarnib with docetaxel and capecitabine may kill more tumor cells.
Detailed Description
PRIMARY OBJECTIVES: I. Determine the maximum tolerated dose and recommended dose of capecitabine in combination with docetaxel and tipifarnib in patients with locally advanced or metastatic solid tumors. (Phase Ib) II. Determine the complete pathological and clinical response rate in patients with stage IIIA or IIIB breast cancer treated with this regimen. (Phase II) SECONDARY OBJECTIVES: I. Determine the toxicity of this regimen in these patients. II. Determine disease-free and overall survival of patients treated with this regimen. OUTLINE: This is a multicenter, dose-escalation study of capecitabine. Patients in phase II are stratified according to type of breast cancer (inflammatory vs noninflammatory). Phase Ib: Patients receive oral tipifarnib twice daily and oral capecitabine twice daily on days 1-14 and docetaxel IV over 30-60 minutes on days 1 and 8. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of capecitabine until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. Phase II: Patients receive oral tipifarnib twice daily for 6 days. Beginning at least 48 hours after completion of the initial dose of tipifarnib, patients receive treatment as in phase Ib for up to 6 courses at the MTD of capecitabine. Patients in phase Ib are followed at 3 months. Patients in phase II are followed every 4 months for up to 5 years. PROJECTED ACCRUAL: A total of 24-53 patients (9-18 for phase Ib and 15-35 for phase II) will be accrued for this study within 14-35 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Adult Solid Neoplasm, Inflammatory Breast Carcinoma, Male Breast Carcinoma, Stage IIIA Breast Cancer, Stage IIIB Breast Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
53 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Treatment (tipifarnib, capecitabine, docetaxel)
Arm Type
Experimental
Arm Description
Phase Ib: Patients receive oral tipifarnib twice daily and oral capecitabine twice daily on days 1-14 and docetaxel IV over 30-60 minutes on days 1 and 8. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. Phase II: Patients receive oral tipifarnib twice daily for 6 days. Beginning at least 48 hours after completion of the initial dose of tipifarnib, patients receive treatment as in phase Ib for up to 6 courses at the MTD of capecitabine.
Intervention Type
Drug
Intervention Name(s)
Capecitabine
Other Intervention Name(s)
Ro 09-1978/000, Xeloda
Intervention Description
Given PO
Intervention Type
Drug
Intervention Name(s)
Docetaxel
Other Intervention Name(s)
RP56976, Taxotere, Taxotere Injection Concentrate
Intervention Description
Given IV
Intervention Type
Other
Intervention Name(s)
Laboratory Biomarker Analysis
Intervention Description
Correlative studies
Intervention Type
Other
Intervention Name(s)
Pharmacological Study
Intervention Description
Correlative studies
Intervention Type
Drug
Intervention Name(s)
Tipifarnib
Other Intervention Name(s)
R115777, Zarnestra
Intervention Description
Given orally (PO)
Primary Outcome Measure Information:
Title
Dose-limiting toxicity (DLT) as assessed by Common Terminology Criteria for Adverse Events (CTCAE) version 3.0 (Phase I)
Time Frame
21 days
Title
Pathologic complete response rate (Phase II)
Description
Estimated by the number of patients with a complete pathologic response divided by the total number of evaluable patients. Ninety-five percent confidence intervals for the true pathologic complete response probability will be calculated according to the approach of Duffy and Santner.
Time Frame
Up to 5 years
Secondary Outcome Measure Information:
Title
Clinical tumor response (complete response [CR] or partial response [PR]) (Phase I)
Description
Clinical responses will be summarized by simple descriptive summary statistics.
Time Frame
Up to 5 years
Title
Overall survival
Description
The distribution of survival time will be estimated using the method of Kaplan-Meier.
Time Frame
From registration to death due to any cause, assessed up to 5 years
Title
Toxicity as assessed by the National Cancer Institute (NCI) CTCAE version 3.0
Time Frame
Up to 5 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically or cytologically confirmed solid tumor Locally advanced or metastatic No known standard therapy that is potentially curative or definitely capable of extending life expectancy No history of metastatic brain disease within the past 6 months Treated metastatic brain disease is allowed provided disease has been stable for more than 6 months and does not require concurrent steroids or anti-seizure medication Histologically confirmed breast cancer Stage IIIA or stage IIIB, including ipsilateral palpable supraclavicular lymph node(s) without other distant metastasis Invasive disease confirmed by 1 of the following*: Incisional biopsy Punch biopsy (applicable for clinical T4b tumors) Core needle (cutting needle) biopsies No distant metastatic disease Hormone receptor status: Not specified Male or female Performance status - ECOG 0-1 Absolute neutrophil count at least 2,000/mm^3 Platelet count at least 100,000/mm^3 Hemoglobin at least 10.0 g/dL Bilirubin no greater than upper limit of normal (ULN) Alkaline phosphatase no greater than 2.5 times ULN AST no greater than 2.5 times ULN Creatinine no greater than 1.25 times ULN Creatinine clearance at least 50 mL/min No cardiac arrhythmia Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception No active infection requiring antibiotics No diabetes No symptomatic neurologic condition No other uncontrolled serious medical condition No other malignancy within the past 3 years except adequately treated basal cell or squamous cell skin cancer or carcinoma in situ of the cervix No history of hypersensitivity to intravenous paclitaxel or other medication containing Cremophor EL or polysorbate 80 as a carrier (phase Ib) Phase Ib only: More than 4 weeks since prior immunotherapy More than 4 weeks since prior biologic therapy No concurrent immunotherapy Phase Ib and II: No concurrent prophylactic filgrastim (G-CSF) Phase Ib only: More than 1 year since prior adjuvant docetaxel before metastatic relapse More than 4 weeks since prior chemotherapy and recovered No prior capecitabine AND docetaxel (in combination or as single agents) Prior capecitabine OR docetaxel allowed No other concurrent chemotherapy Phase II only: No prior cytotoxic chemotherapy for breast cancer Phase Ib only: More than 3 weeks since prior radiotherapy No prior radiotherapy to more than 25% of bone marrow No concurrent radiotherapy Phase II only: No prior radiotherapy for breast cancer Phase Ib only: More than 4 weeks since prior major surgery Phase II only: No prior surgery (other than core or incisional biopsy for diagnostic purposes) for breast cancer Phase Ib only: No other ancillary investigational therapy Phase Ib and II: No concurrent sorivudine or brivudine
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Philip Philip
Organizational Affiliation
Mayo Clinic
Official's Role
Principal Investigator
Facility Information:
Facility Name
Mayo Clinic in Arizona
City
Scottsdale
State/Province
Arizona
ZIP/Postal Code
85259
Country
United States
Facility Name
Howard University Cancer Center CCOP
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20060
Country
United States
Facility Name
Mayo Clinic in Florida
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
32224-9980
Country
United States
Facility Name
Barbara Ann Karmanos Cancer Institute
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48201
Country
United States
Facility Name
Mayo Clinic
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55905
Country
United States
Facility Name
Washington University School of Medicine
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
University of Wisconsin Medical School
City
Milwaukee
State/Province
Wisconsin
ZIP/Postal Code
53201
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Neoadjuvant Tipifarnib, Docetaxel, and Capecitabine in Treating Patients With Locally Advanced or Metastatic Solid Tumors or Stage IIIA or Stage IIIB Breast Cancer

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