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Fenretinide in Treating Patients With Refractory or Relapsed Hematologic Cancer

Primary Purpose

Chronic Myeloproliferative Disorders, Leukemia, Lymphoma

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
fenretinide
Sponsored by
California Cancer Consortium
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Chronic Myeloproliferative Disorders focused on measuring adult acute myeloid leukemia with 11q23 (MLL) abnormalities, adult acute myeloid leukemia with inv(16)(p13;q22), adult acute myeloid leukemia with t(15;17)(q22;q12), adult acute myeloid leukemia with t(16;16)(p13;q22), adult acute myeloid leukemia with t(8;21)(q22;q22), recurrent grade 1 follicular lymphoma, recurrent grade 2 follicular lymphoma, recurrent grade 3 follicular lymphoma, recurrent small lymphocytic lymphoma, recurrent mantle cell lymphoma, Waldenstrom macroglobulinemia, adult grade III lymphomatoid granulomatosis, recurrent adult grade III lymphomatoid granulomatosis, secondary acute myeloid leukemia, recurrent adult Burkitt lymphoma, recurrent adult immunoblastic large cell lymphoma, refractory chronic lymphocytic leukemia, recurrent adult lymphoblastic lymphoma, recurrent adult Hodgkin lymphoma, refractory multiple myeloma, recurrent adult acute lymphoblastic leukemia, relapsing chronic myelogenous leukemia, chronic eosinophilic leukemia, primary myelofibrosis, chronic neutrophilic leukemia, essential thrombocythemia, polycythemia vera, stage II multiple myeloma, stage III multiple myeloma, recurrent adult diffuse large cell lymphoma, recurrent adult diffuse mixed cell lymphoma, recurrent adult diffuse small cleaved cell lymphoma, extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue, nodal marginal zone B-cell lymphoma, recurrent marginal zone lymphoma, splenic marginal zone lymphoma, recurrent adult acute myeloid leukemia

Eligibility Criteria

18 Years - 120 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

DISEASE CHARACTERISTICS: Histologically or cytologically confirmed diagnosis of 1 of the following hematologic malignancies: Non-Hodgkin's lymphoma (NHL) Hodgkin's lymphoma Multiple myeloma Acute lymphoblastic leukemia Acute myeloid leukemia Chronic hematologic malignancy with a poor prognosis (e.g., failed 3 prior standard therapies), including any of the following: Chronic lymphocytic leukemia Chronic myelogenous leukemia Indolent NHL Myeloproliferative disorders Refractory or relapsed disease, as defined by 1 of the following: Resistant to standard therapy for refractory or relapsed disease Progressed after standard therapy for advanced disease No effective treatment exists Measurable or evaluable disease No active CNS disease Previously treated leptomeningeal disease or brain metastases allowed provided there is no evidence of remaining cancer by positron-emission tomography, MRI, or spinal fluid cytology PATIENT CHARACTERISTICS: Age 18 and over Performance status ECOG 0-2 Life expectancy At least 3 months Hematopoietic Absolute neutrophil count ≥ 1,500/mm^3 (unless due to bone marrow involvement of disease) Platelet count ≥ 75,000/mm^3 (unless due to bone marrow involvement of disease) Hemoglobin ≥ 8.0 g/dL (transfusion allowed) No coagulation disorders Hepatic AST and ALT < 2.5 times upper limit of normal (ULN) (≤ 5 times ULN for patients with liver metastasis) Bilirubin ≤ 1.5 times ULN Renal Creatinine ≤ 1.5 times ULN Cardiovascular No major cardiovascular disease Pulmonary No major respiratory disease Other Not pregnant or nursing Negative pregnancy test Fertile patients must use effective double-method contraception prior to study entry, during study, and for at least 6 months after study participation No uncontrolled systemic infection No uncontrolled hypertriglyceridemia (i.e., triglyceride level > 500 mg/dL) No known HIV positivity No known allergy to egg products No known familial hyperlipidemia disorders No previously undiscovered hypertriglyceridemia No poorly controlled diabetes PRIOR CONCURRENT THERAPY: Biologic therapy Not specified Chemotherapy More than 2 weeks since prior chemotherapy except hydroxyurea No concurrent hydroxyurea during study drug administration No other concurrent anticancer chemotherapy Endocrine therapy No concurrent hormone-ablative agents No concurrent steroids No concurrent tamoxifen or any of its analogues Radiotherapy No prior cranial radiotherapy More than 2 weeks since prior radiotherapy Surgery More than 20 days since prior surgery except for biopsy Other Recovered from all prior therapy More than 2 weeks since prior investigational agents No other concurrent investigational agents No other concurrent antineoplastic therapy No other concurrent antioxidants No concurrent herbal or other alternative therapies No concurrent vitamin supplements (e.g., vitamin A, ascorbic acid, or vitamin E) Standard dose multivitamin allowed No other concurrent medications that may act as modulators of intracellular ceramide levels or ceramide cytotoxicity, sphingolipid transport, or p-glycoprotein or multidrug resistance protein 1 (MRP1) drug/lipid transporters, including any of the following: Cyclosporine or any of its analogues Verapamil Ketoconazole Chlorpromazine Mifepristone Indomethacin Sulfinpyrazone No concurrent medications that may cause pseudotumor cerebri, including any of the following: Tetracycline Nalidixic acid Nitrofurantoin Phenytoin Sulfonamides Lithium Amiodarone No concurrent medication to control hypertriglyceridemia

Sites / Locations

  • USC/Norris Comprehensive Cancer Center and Hospital
  • Warren Grant Magnuson Clinical Center - NCI Clinical Trials Referral Office
  • M. D. Anderson Cancer Center at University of Texas
  • Joe Arrington Cancer Research and Treatment Center

Outcomes

Primary Outcome Measures

To determine the maximum tolerated dose of fenretinide
To describe the toxicities of fenretinide

Secondary Outcome Measures

Full Information

First Posted
March 3, 2005
Last Updated
July 18, 2017
Sponsor
California Cancer Consortium
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00104923
Brief Title
Fenretinide in Treating Patients With Refractory or Relapsed Hematologic Cancer
Official Title
Phase I Trial of Intravenous Fenretinide (4-HPR) for Patients With Hematologic Malignancies
Study Type
Interventional

2. Study Status

Record Verification Date
July 2017
Overall Recruitment Status
Completed
Study Start Date
February 2005 (undefined)
Primary Completion Date
April 2017 (Actual)
Study Completion Date
April 2017 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
RATIONALE: Drugs used in chemotherapy, such as fenretinide, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Giving fenretinide in a different way may kill more cancer cells. PURPOSE: This phase I trial is studying the side effects and best dose of intravenous fenretinide in treating patients with refractory or relapsed hematologic cancer.
Detailed Description
OBJECTIVES: Determine the maximum tolerated dose of intravenous emulsified fenretinide in patients with refractory or relapsed hematologic malignancies. Determine the toxic effects of this drug in these patients. Determine the pharmacokinetics and in vivo activity of this drug in these patients. Determine, preliminarily, disease or tumor response in patients treated with this drug. OUTLINE: This is a pilot, dose-escalation, multicenter study. Patients receive emulsified fenretinide IV continuously over 5 days. Treatment repeats every 21 days for up to 6 courses in the absence of disease progression or unacceptable toxicity. Patients who achieve a complete or partial response may continue to receive fenretinide at the discretion of the study chair. Cohorts of 1 patient receive accelerated escalating doses of fenretinide until 2 patients experience moderate toxicity (cumulative across all dose levels) OR 1 patient experiences dose-limiting toxicity (DLT). After completion of the accelerated dose-escalation portion, the standard dose-escalation portion begins. Cohorts of 3-6 patients receive escalating doses of fenretinide until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 6 patients experience DLT. At least 6 patients are treated at the MTD. An additional 12 patients are treated at the MTD. After completion of study treatment, patients are followed every 3 months for 2 years, every 6 months for 3 years, and then annually thereafter. PROJECTED ACCRUAL: Approximately 40 patients will be accrued for this study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Myeloproliferative Disorders, Leukemia, Lymphoma, Multiple Myeloma and Plasma Cell Neoplasm
Keywords
adult acute myeloid leukemia with 11q23 (MLL) abnormalities, adult acute myeloid leukemia with inv(16)(p13;q22), adult acute myeloid leukemia with t(15;17)(q22;q12), adult acute myeloid leukemia with t(16;16)(p13;q22), adult acute myeloid leukemia with t(8;21)(q22;q22), recurrent grade 1 follicular lymphoma, recurrent grade 2 follicular lymphoma, recurrent grade 3 follicular lymphoma, recurrent small lymphocytic lymphoma, recurrent mantle cell lymphoma, Waldenstrom macroglobulinemia, adult grade III lymphomatoid granulomatosis, recurrent adult grade III lymphomatoid granulomatosis, secondary acute myeloid leukemia, recurrent adult Burkitt lymphoma, recurrent adult immunoblastic large cell lymphoma, refractory chronic lymphocytic leukemia, recurrent adult lymphoblastic lymphoma, recurrent adult Hodgkin lymphoma, refractory multiple myeloma, recurrent adult acute lymphoblastic leukemia, relapsing chronic myelogenous leukemia, chronic eosinophilic leukemia, primary myelofibrosis, chronic neutrophilic leukemia, essential thrombocythemia, polycythemia vera, stage II multiple myeloma, stage III multiple myeloma, recurrent adult diffuse large cell lymphoma, recurrent adult diffuse mixed cell lymphoma, recurrent adult diffuse small cleaved cell lymphoma, extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue, nodal marginal zone B-cell lymphoma, recurrent marginal zone lymphoma, splenic marginal zone lymphoma, recurrent adult acute myeloid leukemia

7. Study Design

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

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
fenretinide
Intervention Description
Current dose level as an IV continuous infusion via central line over 5 days. Cycle is repeated every 3 weeks for up to 6 cycles
Primary Outcome Measure Information:
Title
To determine the maximum tolerated dose of fenretinide
Time Frame
participants will be followed for the duration of cycle 1, which is expected to be 3 weeks.
Title
To describe the toxicities of fenretinide
Time Frame
participants will be followed for the duration of treatment, which is expected to be 18 weeks or less

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
120 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically or cytologically confirmed diagnosis of 1 of the following hematologic malignancies: Non-Hodgkin's lymphoma (NHL) Hodgkin's lymphoma Multiple myeloma Acute lymphoblastic leukemia Acute myeloid leukemia Chronic hematologic malignancy with a poor prognosis (e.g., failed 3 prior standard therapies), including any of the following: Chronic lymphocytic leukemia Chronic myelogenous leukemia Indolent NHL Myeloproliferative disorders Refractory or relapsed disease, as defined by 1 of the following: Resistant to standard therapy for refractory or relapsed disease Progressed after standard therapy for advanced disease No effective treatment exists Measurable or evaluable disease No active CNS disease Previously treated leptomeningeal disease or brain metastases allowed provided there is no evidence of remaining cancer by positron-emission tomography, MRI, or spinal fluid cytology PATIENT CHARACTERISTICS: Age 18 and over Performance status ECOG 0-2 Life expectancy At least 3 months Hematopoietic Absolute neutrophil count ≥ 1,500/mm^3 (unless due to bone marrow involvement of disease) Platelet count ≥ 75,000/mm^3 (unless due to bone marrow involvement of disease) Hemoglobin ≥ 8.0 g/dL (transfusion allowed) No coagulation disorders Hepatic AST and ALT < 2.5 times upper limit of normal (ULN) (≤ 5 times ULN for patients with liver metastasis) Bilirubin ≤ 1.5 times ULN Renal Creatinine ≤ 1.5 times ULN Cardiovascular No major cardiovascular disease Pulmonary No major respiratory disease Other Not pregnant or nursing Negative pregnancy test Fertile patients must use effective double-method contraception prior to study entry, during study, and for at least 6 months after study participation No uncontrolled systemic infection No uncontrolled hypertriglyceridemia (i.e., triglyceride level > 500 mg/dL) No known HIV positivity No known allergy to egg products No known familial hyperlipidemia disorders No previously undiscovered hypertriglyceridemia No poorly controlled diabetes PRIOR CONCURRENT THERAPY: Biologic therapy Not specified Chemotherapy More than 2 weeks since prior chemotherapy except hydroxyurea No concurrent hydroxyurea during study drug administration No other concurrent anticancer chemotherapy Endocrine therapy No concurrent hormone-ablative agents No concurrent steroids No concurrent tamoxifen or any of its analogues Radiotherapy No prior cranial radiotherapy More than 2 weeks since prior radiotherapy Surgery More than 20 days since prior surgery except for biopsy Other Recovered from all prior therapy More than 2 weeks since prior investigational agents No other concurrent investigational agents No other concurrent antineoplastic therapy No other concurrent antioxidants No concurrent herbal or other alternative therapies No concurrent vitamin supplements (e.g., vitamin A, ascorbic acid, or vitamin E) Standard dose multivitamin allowed No other concurrent medications that may act as modulators of intracellular ceramide levels or ceramide cytotoxicity, sphingolipid transport, or p-glycoprotein or multidrug resistance protein 1 (MRP1) drug/lipid transporters, including any of the following: Cyclosporine or any of its analogues Verapamil Ketoconazole Chlorpromazine Mifepristone Indomethacin Sulfinpyrazone No concurrent medications that may cause pseudotumor cerebri, including any of the following: Tetracycline Nalidixic acid Nitrofurantoin Phenytoin Sulfonamides Lithium Amiodarone No concurrent medication to control hypertriglyceridemia
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ann Mohrbacher, MD
Organizational Affiliation
University of Southern California
Official's Role
Study Chair
Facility Information:
Facility Name
USC/Norris Comprehensive Cancer Center and Hospital
City
Los Angeles
State/Province
California
ZIP/Postal Code
90089-9181
Country
United States
Facility Name
Warren Grant Magnuson Clinical Center - NCI Clinical Trials Referral Office
City
Bethesda
State/Province
Maryland
ZIP/Postal Code
20892-1182
Country
United States
Facility Name
M. D. Anderson Cancer Center at University of Texas
City
Houston
State/Province
Texas
ZIP/Postal Code
77030-4009
Country
United States
Facility Name
Joe Arrington Cancer Research and Treatment Center
City
Lubbock
State/Province
Texas
ZIP/Postal Code
79410-1894
Country
United States

12. IPD Sharing Statement

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Fenretinide in Treating Patients With Refractory or Relapsed Hematologic Cancer

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