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Bortezomib in Treating Patients With Advanced Cancer and Liver Dysfunction

Primary Purpose

Hepatic Complications, Malignant Neoplasm

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
bortezomib
pharmacological study
Sponsored by
National Cancer Institute (NCI)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hepatic Complications

Eligibility Criteria

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

Inclusion Criteria: Histologically confirmed malignancy for which no known standard therapy that is potentially curative or definitely capable of extending life expectancy exists Tumor types may include any of the following: solid tumors: Non-Hodgkin's lymphoma Hepatocellular carcinoma, as evidenced by liver mass, elevated alpha-fetoprotein level (>= 500 ng/mL), and positive serology for hepatitis Pathological confirmation is not required Confirmatory evidence for a prior Hepatitis B infection (HBsAg, HBcAb and/or HBsAb) required No symptomatic CNS metastases Brain metastasis allowed if the following criteria are met: Received prior definitive treatment (radiation and/or surgery Stable disease for >= 4 weeks Not currently on enzyme-inducing anticonvulsants and steroids Life expectancy of at least 12 weeks Absolute neutrophil count >= 1,000/mm^3 Platelet count >= 100,000/mm^3 Biliary obstruction for which a shunt has been placed allowed provided the shunt has been in place for >= 10 days AND liver function is stable, defined as 2 measurements taken >= 2 days apart that qualify the patient for the same hepatic dysfunction stratum No biliary sepsis Creatinine =< 1.5 mg/dL No symptomatic congestive heart failure No unstable angina pectoris No cardiac arrhythmia No New York Heart Association class III or IV heart disease Not pregnant or nursing Negative pregnancy test No preexisting neuropathy >= grade 2 No ongoing or active infection No other concurrent uncontrolled illness that would preclude study participation No psychiatric illness or social situation that would preclude study compliance More than 4 weeks since prior immunotherapy More than 4 weeks since prior biologic therapy No concurrent prophylactic colony-stimulating factors No concurrent immunotherapy No concurrent thalidomide Concurrent epoetin alfa or darbepoetin alfa for management of cancer-associated anemia allowed Recovered from prior chemotherapy (not including liver function) More than 3 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin) No concurrent chemotherapy More than 2 weeks since prior radiotherapy No prior radiotherapy to > 50% of the bone marrow No concurrent radiotherapy More than 3 weeks since prior surgery No prior bortezomib No concurrent antiretroviral therapy for HIV-positive patients No other concurrent investigational agents Concurrent cytochrome P450 interacting agents are allowed provided they are used with caution Concurrent bisphosphonate therapy allowed (e.g., pamidronate or zoledronate), except during course 1 of bortezomib administration ECOG 0-2 Fertile patients must use effective contraception during and for 30 days after study participation

Sites / Locations

  • City of Hope Medical Center
  • Johns Hopkins University
  • Wayne State University

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treatment

Arm Description

Patients receive bortezomib IV over 3-5 seconds on days 1, 4, 8, and 11. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.

Outcomes

Primary Outcome Measures

DLT
MTD

Secondary Outcome Measures

Full Information

First Posted
September 7, 2004
Last Updated
December 13, 2013
Sponsor
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00091117
Brief Title
Bortezomib in Treating Patients With Advanced Cancer and Liver Dysfunction
Official Title
A Phase I Pharmacokinetic Study of PS-341 in Patients With Advanced Malignancies and Varying Degrees of Liver Dysfunction for the CTEPSponsored Organ Dysfunction Working Group
Study Type
Interventional

2. Study Status

Record Verification Date
December 2013
Overall Recruitment Status
Completed
Study Start Date
July 2004 (undefined)
Primary Completion Date
March 2013 (Actual)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

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

4. Oversight

5. Study Description

Brief Summary
Bortezomib may stop the growth of cancer cells by blocking the enzymes necessary for their growth. This phase I trial is studying the side effects and best dose of bortezomib in treating patients with advanced cancer and liver dysfunction.
Detailed Description
PRIMARY OBJECTIVES: I. Determine the maximum tolerated dose of bortezomib in patients with advanced malignancies and varying degrees of liver dysfunction. II. Determine the safety and tolerability of this drug in these patients. III. Determine the pharmacokinetics and pharmacodynamics of this drug in these patients with mild, moderate, or severe liver insufficiency. IV. Examine the dietary influences on bortezomib disposition and efficacy. V. Examine the influences of proteasome inhibition on CYP 450 activity. OUTLINE: This is a multicenter, dose-escalation study. Patients are stratified according to hepatic function (normal vs mild dysfunction vs moderate dysfunction vs severe dysfunction). Patients receive bortezomib IV over 3-5 seconds on days 1, 4, 8, and 11. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients per stratum receive escalating doses of bortezomib until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 6 patients experience dose-limiting toxicity. [Note: Patients with normal hepatic function do not receive escalating doses of bortezomib.]

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hepatic Complications, Malignant Neoplasm

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Treatment
Arm Type
Experimental
Arm Description
Patients receive bortezomib IV over 3-5 seconds on days 1, 4, 8, and 11. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.
Intervention Type
Drug
Intervention Name(s)
bortezomib
Other Intervention Name(s)
LDP 341, MLN341, VELCADE
Intervention Description
Given IV
Intervention Type
Other
Intervention Name(s)
pharmacological study
Other Intervention Name(s)
pharmacological studies
Intervention Description
Correlative studies
Primary Outcome Measure Information:
Title
DLT
Time Frame
21 days
Title
MTD
Time Frame
21 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically confirmed malignancy for which no known standard therapy that is potentially curative or definitely capable of extending life expectancy exists Tumor types may include any of the following: solid tumors: Non-Hodgkin's lymphoma Hepatocellular carcinoma, as evidenced by liver mass, elevated alpha-fetoprotein level (>= 500 ng/mL), and positive serology for hepatitis Pathological confirmation is not required Confirmatory evidence for a prior Hepatitis B infection (HBsAg, HBcAb and/or HBsAb) required No symptomatic CNS metastases Brain metastasis allowed if the following criteria are met: Received prior definitive treatment (radiation and/or surgery Stable disease for >= 4 weeks Not currently on enzyme-inducing anticonvulsants and steroids Life expectancy of at least 12 weeks Absolute neutrophil count >= 1,000/mm^3 Platelet count >= 100,000/mm^3 Biliary obstruction for which a shunt has been placed allowed provided the shunt has been in place for >= 10 days AND liver function is stable, defined as 2 measurements taken >= 2 days apart that qualify the patient for the same hepatic dysfunction stratum No biliary sepsis Creatinine =< 1.5 mg/dL No symptomatic congestive heart failure No unstable angina pectoris No cardiac arrhythmia No New York Heart Association class III or IV heart disease Not pregnant or nursing Negative pregnancy test No preexisting neuropathy >= grade 2 No ongoing or active infection No other concurrent uncontrolled illness that would preclude study participation No psychiatric illness or social situation that would preclude study compliance More than 4 weeks since prior immunotherapy More than 4 weeks since prior biologic therapy No concurrent prophylactic colony-stimulating factors No concurrent immunotherapy No concurrent thalidomide Concurrent epoetin alfa or darbepoetin alfa for management of cancer-associated anemia allowed Recovered from prior chemotherapy (not including liver function) More than 3 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin) No concurrent chemotherapy More than 2 weeks since prior radiotherapy No prior radiotherapy to > 50% of the bone marrow No concurrent radiotherapy More than 3 weeks since prior surgery No prior bortezomib No concurrent antiretroviral therapy for HIV-positive patients No other concurrent investigational agents Concurrent cytochrome P450 interacting agents are allowed provided they are used with caution Concurrent bisphosphonate therapy allowed (e.g., pamidronate or zoledronate), except during course 1 of bortezomib administration ECOG 0-2 Fertile patients must use effective contraception during and for 30 days after study participation
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Patricia LoRusso
Organizational Affiliation
Wayne State University
Official's Role
Principal Investigator
Facility Information:
Facility Name
City of Hope Medical Center
City
Duarte
State/Province
California
ZIP/Postal Code
91010
Country
United States
Facility Name
Johns Hopkins University
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21287-8936
Country
United States
Facility Name
Wayne State University
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48202
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
22394984
Citation
LoRusso PM, Venkatakrishnan K, Ramanathan RK, Sarantopoulos J, Mulkerin D, Shibata SI, Hamilton A, Dowlati A, Mani S, Rudek MA, Takimoto CH, Neuwirth R, Esseltine DL, Ivy P. Pharmacokinetics and safety of bortezomib in patients with advanced malignancies and varying degrees of liver dysfunction: phase I NCI Organ Dysfunction Working Group Study NCI-6432. Clin Cancer Res. 2012 May 15;18(10):2954-63. doi: 10.1158/1078-0432.CCR-11-2873. Epub 2012 Mar 6.
Results Reference
derived

Learn more about this trial

Bortezomib in Treating Patients With Advanced Cancer and Liver Dysfunction

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