Bevacizumab and Temsirolimus Alone or in Combination With Valproic Acid or Cetuximab in Treating Patients With Advanced or Metastatic Malignancy or Other Benign Disease
Advanced Malignant Neoplasm, Castleman Disease, Digestive System Carcinoma
About this trial
This is an interventional treatment trial for Advanced Malignant Neoplasm focused on measuring Temsirolimus, CCI-779, Torisel, Bevacizumab, Avastin, rhuMAb-VEGF, Anti-VEGF Monoclonal Antibody, Advanced Cancers, Advanced Malignancy, Metastatic, cancer, Cetuximab, C225, Erbitux, IMC-C225, Valproic Acid
Eligibility Criteria
Inclusion Criteria:
- Patients with advanced or metastatic cancer that is refractory to standard therapy, relapsed after standard therapy, or have no standard therapy that induces a complete response of at least 10% or improves survival by at least three months; in addition, patients with disease that are "benign" by pathology, but relentlessly progressive, leading to disability, pain, and premature death in the majority of cases (including, but not limited to lymphangioleiomyomatosis [LAM], type 2 neurofibromatosis [NF], Erdheim Chester disease, and Castleman's disease) may also be considered for enrollment
- Patients should be at least four weeks from the last day of therapeutic radiation or cytotoxic chemotherapy or from antibody therapy, or at least five half-lives from non-cytotoxic targeted or biologic therapy; patients may have received palliative radiation immediately before (or during) treatment provided radiation is not to the only target lesion available
- Eastern Cooperative Oncology Group (ECOG) performance status =< 2
- Karnofsky >= 60%
- Lansky performance status of >= 60% for participants 16 years old or younger
- Absolute neutrophil count >= 1,000/mL
- Platelets >= 50,000/mL
- Creatinine =< 3 X upper limit of normal (ULN)
- Total bilirubin =< 3.0
- Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) =< 5 X ULN
- Fasting level of total cholesterol of no more than 350 mg/dL
- Triglyceride level of no more than 400 mg/dL
- Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry, for the duration of study participation, and for 90 days after the last dose
- Ability to understand and the willingness to sign a written informed consent document
- Patients may not be receiving any other investigational agents and/or any other concurrent anticancer agents or therapies
Exclusion Criteria:
- Patients with clinically significant unexplained bleeding within 28 days prior to entering the study
- Uncontrolled systemic vascular hypertension (systolic blood pressure > 140 mmHg, diastolic blood pressure > 90 mmHg on medication)
- Patients with clinically significant cardiovascular disease: History of CVA (cerebrovascular accident) within 6 months, myocardial infarction or unstable angina within 6 months, unstable angina pectoris
- Pregnant or breast-feeding women
- History of hypersensitivity to bevacizumab, murine products, or any component of the formulation
- History of hypersensitivity to temsirolimus or its metabolites (including sirolimus), polysorbate 80, or to any component of the formulation
- History of hypersensitivity to cetuximab, murine products, or any component of the formulation
- Patients that are taking cytochrome P450 family 3, subfamily A, polypeptide 4 (CYP3A4) inducers and/or inhibitors; if a patient has a history of taking CYP3A4 inducers and/or inhibitors prior to enrollment on the protocol, it is strongly recommended that the patient stops the drug and waits at least 5 half-lives of said drug before initiating therapy on protocol
- Colorectal cancer patients with known v-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog (KRAS) mutation (for the arm combining bevacizumab, temsirolimus and cetuximab)
- Patients who have had major surgery within 6 weeks of enrollment in the study
Sites / Locations
- M D Anderson Cancer Center
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Experimental
Experimental
Group I (temsirolimus, bevacizumab, cetuximab)
Group II (temsirolimus, bevacizumab, valproic acid)
Group III (temsirolimus, bevacizumab)
Patients receive temsirolimus IV over 30-60 minutes on days 1, 8, 15, and 22; bevacizumab IV over 30-90 minutes on days 1 and 15; and cetuximab IV over 60-120 minutes on days 1, 8, 15, and 22. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
Patients receive temsirolimus and bevacizumab as in Group I and valproic acid PO on days 1-7 and 15-21. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
Patients receive temsirolimus and bevacizumab as in Group I. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.