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Fluorouracil and Low-Dose Suramin as Chemosensitization in Treating Patients With Metastatic Renal Cell (Kidney) Cancer

Primary Purpose

Recurrent Renal Cell Carcinoma, Stage IV Renal Cell Cancer

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

About this trial

This is an interventional treatment trial for Recurrent Renal Cell Carcinoma

Eligibility Criteria

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

Inclusion Criteria: Histologically confirmed renal cell cancer Metastatic disease Measurable or evaluable disease Measurable disease required for phase II No untreated CNS metastasis or CNS metastases progressing ≤ 4 weeks after prior radiotherapy Performance status - ECOG 0-1 At least 12 weeks Absolute neutrophil count ≥ 1,500/mm^3 Platelet count ≥ 100,000/mm^3 Hemoglobin ≥ 9.0 g/dL AST ≤ 2.5 times upper limit of normal (ULN) Alkaline phosphatase ≤ 5 times ULN Bilirubin ≤ 1.5 mg/dL Creatinine ≤ 1.8 mg/dL Calcium ≤ ULN No untreated hypercalcemia No symptomatic congestive heart failure No unstable angina pectoris No cardiac arrhythmia Not pregnant or nursing Negative pregnancy test Fertile patients must be surgically sterile or use effective contraception No uncontrolled diabetes mellitus No known severe hypersensitivity to suramin No other concurrent uncontrolled illness No active or ongoing infection No active autoimmune disease No neuropathy ≥ grade 2 No psychiatric illness or social situation that would preclude study compliance No other malignancy within the past 5 years except basal cell skin cancer, carcinoma in situ of the cervix, or localized prostate cancer No concurrent filgrastim (G-CSF) No more than 2 prior chemotherapy regimens for renal cell cancer (phase II only) No concurrent corticosteroid dose more than physiologic replacement levels See Disease Characteristics At least 4 weeks since prior radiotherapy No concurrent radiotherapy Recovered from prior oncologic or other major surgery At least 4 weeks since prior major surgery No concurrent surgery Recovered from all prior anticancer therapy other than alopecia (chronic toxicity < grade 2) At least 4 weeks since prior systemic therapy More than 30 days since prior investigational drugs Concurrent bisphosphonates allowed

Sites / Locations

  • Cleveland Clinic Foundation

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treatment (suramin and fluorouracil)

Arm Description

PHASE I: Patients receive suramin IV over 30 minutes and fluorouracil IV on days 1, 8, 15, 22, 29, and 36. Cohorts of 3-6 patients receive escalating doses suramin and fluorouracil until the dose level allowing 10-50 uM of suramin into the patient's blood is determined without 2 or more of 6 patients experiencing dose-limiting toxicity. PHASE II: Patients receive suramin and fluorouracil (at the dose level determined in phase I) as in phase I. In both phases, courses repeat every 8 weeks for up to 1 year in the absence of disease progression or unacceptable toxicity.

Outcomes

Primary Outcome Measures

Dose of suramin to deliver the target plasma concentrations of 10 to 50 uM (Phase I)
Objective response rate (CR + PR) using RECIST criteria (Phase II)
Summary statistics (e.g. means and standard deviations or medians and ranges, or frequency counts) and 95% confidence intervals will be calculated. Graphical models will also be used to summarize the data.

Secondary Outcome Measures

Progression rate (Phase II)
Summary statistics (e.g. means and standard deviations or medians and ranges, or frequency counts) and 95% confidence intervals will be calculated. Graphical models will also be used to summarize the data.
Progression rate (Phase II)
Summary statistics (e.g. means and standard deviations or medians and ranges, or frequency counts) and 95% confidence intervals will be calculated. Graphical models will also be used to summarize the data.
Time to disease progression (Phase II)
Summary statistics (e.g. means and standard deviations or medians and ranges, or frequency counts) and 95% confidence intervals will be calculated. Graphical models will also be used to summarize the data.
Toxicity assessed using NCI CTCAE version 3.0 (Phase II)
Summary statistics (e.g. means and standard deviations or medians and ranges, or frequency counts) and 95% confidence intervals will be calculated. Graphical models will also be used to summarize the data.

Full Information

First Posted
May 14, 2004
Last Updated
May 22, 2015
Sponsor
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00083109
Brief Title
Fluorouracil and Low-Dose Suramin as Chemosensitization in Treating Patients With Metastatic Renal Cell (Kidney) Cancer
Official Title
Phase I/II Trial Of Low Dose Suramin (CI-1003, NSC#34936) And 5-Fluorouracil In Patients With Metastatic Renal Cell Carcinoma (RCC)
Study Type
Interventional

2. Study Status

Record Verification Date
January 2013
Overall Recruitment Status
Completed
Study Start Date
March 2004 (undefined)
Primary Completion Date
December 2005 (Actual)
Study Completion Date
March 2008 (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
Drugs used in chemotherapy, such as fluorouracil, work in different ways to stop tumor cells from dividing so they stop growing or die. Suramin may increase the effectiveness of fluorouracil by making tumor cells more sensitive to the drug. This phase I/II trial is studying the side effects and best dose of fluorouracil and the chemosensitizer suramin and to see how well they work in treating patients with metastatic renal cell (kidney) cancer.
Detailed Description
PRIMARY OBJECTIVES: I. Determine the dose of suramin and fluorouracil that would result in plasma concentrations of suramin between 10-50 uM in patients with metastatic renal cell cancer. (Phase I) II. Determine the objective response rate (complete response and partial response) in patients treated with this regimen. (Phase II) SECONDARY OBJECTIVES: I. Determine the preliminary efficacy of this regimen in these patients. (Phase I) II. Determine the pharmacokinetics of low-dose suramin in these patients. (Phase I) III. Determine the time to tumor progression and progress rate at 3 and 6 months in patients treated with this regimen. (Phase II) OUTLINE: This is a dose-escalation phase I study followed by a phase II study. PHASE I: Patients receive suramin IV over 30 minutes and fluorouracil IV on days 1, 8, 15, 22, 29, and 36. Cohorts of 3-6 patients receive escalating doses suramin and fluorouracil until the dose level allowing 10-50 uM of suramin into the patient's blood is determined without 2 or more of 6 patients experiencing dose-limiting toxicity. PHASE II: Patients receive suramin and fluorouracil (at the dose level determined in phase I) as in phase I. In both phases, courses repeat every 8 weeks for up to 1 year in the absence of disease progression or unacceptable toxicity. Patients are followed for survival. PROJECTED ACCRUAL: A total of 36 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
Recurrent Renal Cell Carcinoma, Stage IV Renal Cell 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
36 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Treatment (suramin and fluorouracil)
Arm Type
Experimental
Arm Description
PHASE I: Patients receive suramin IV over 30 minutes and fluorouracil IV on days 1, 8, 15, 22, 29, and 36. Cohorts of 3-6 patients receive escalating doses suramin and fluorouracil until the dose level allowing 10-50 uM of suramin into the patient's blood is determined without 2 or more of 6 patients experiencing dose-limiting toxicity. PHASE II: Patients receive suramin and fluorouracil (at the dose level determined in phase I) as in phase I. In both phases, courses repeat every 8 weeks for up to 1 year in the absence of disease progression or unacceptable toxicity.
Intervention Type
Drug
Intervention Name(s)
Fluorouracil
Other Intervention Name(s)
5-Fluoro-2,4(1H, 3H)-pyrimidinedione, 5-Fluorouracil, 5-Fluracil, 5-FU, AccuSite, Actino-Hermal, Adrucil, Arumel, Cytosafe, Efudex, Efurix, Fiverocil, Fluoro Uracil, Fluoroplex, Fluouracil, Flurablastin, Fluracedyl, Fluracil, Fluril, Fluroblastin, Flurox, Ribofluor, Ro 2-9757, Ro-2-9757, Timazin
Intervention Description
Given IV
Intervention Type
Other
Intervention Name(s)
Pharmacological Study
Intervention Description
Correlative studies
Intervention Type
Drug
Intervention Name(s)
Suramin
Intervention Description
Given IV
Primary Outcome Measure Information:
Title
Dose of suramin to deliver the target plasma concentrations of 10 to 50 uM (Phase I)
Time Frame
Up to 48 hours
Title
Objective response rate (CR + PR) using RECIST criteria (Phase II)
Description
Summary statistics (e.g. means and standard deviations or medians and ranges, or frequency counts) and 95% confidence intervals will be calculated. Graphical models will also be used to summarize the data.
Time Frame
Up to 4 years
Secondary Outcome Measure Information:
Title
Progression rate (Phase II)
Description
Summary statistics (e.g. means and standard deviations or medians and ranges, or frequency counts) and 95% confidence intervals will be calculated. Graphical models will also be used to summarize the data.
Time Frame
3 months
Title
Progression rate (Phase II)
Description
Summary statistics (e.g. means and standard deviations or medians and ranges, or frequency counts) and 95% confidence intervals will be calculated. Graphical models will also be used to summarize the data.
Time Frame
6 months
Title
Time to disease progression (Phase II)
Description
Summary statistics (e.g. means and standard deviations or medians and ranges, or frequency counts) and 95% confidence intervals will be calculated. Graphical models will also be used to summarize the data.
Time Frame
Up to 4 years
Title
Toxicity assessed using NCI CTCAE version 3.0 (Phase II)
Description
Summary statistics (e.g. means and standard deviations or medians and ranges, or frequency counts) and 95% confidence intervals will be calculated. Graphical models will also be used to summarize the data.
Time Frame
Up to 4 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically confirmed renal cell cancer Metastatic disease Measurable or evaluable disease Measurable disease required for phase II No untreated CNS metastasis or CNS metastases progressing ≤ 4 weeks after prior radiotherapy Performance status - ECOG 0-1 At least 12 weeks Absolute neutrophil count ≥ 1,500/mm^3 Platelet count ≥ 100,000/mm^3 Hemoglobin ≥ 9.0 g/dL AST ≤ 2.5 times upper limit of normal (ULN) Alkaline phosphatase ≤ 5 times ULN Bilirubin ≤ 1.5 mg/dL Creatinine ≤ 1.8 mg/dL Calcium ≤ ULN No untreated hypercalcemia No symptomatic congestive heart failure No unstable angina pectoris No cardiac arrhythmia Not pregnant or nursing Negative pregnancy test Fertile patients must be surgically sterile or use effective contraception No uncontrolled diabetes mellitus No known severe hypersensitivity to suramin No other concurrent uncontrolled illness No active or ongoing infection No active autoimmune disease No neuropathy ≥ grade 2 No psychiatric illness or social situation that would preclude study compliance No other malignancy within the past 5 years except basal cell skin cancer, carcinoma in situ of the cervix, or localized prostate cancer No concurrent filgrastim (G-CSF) No more than 2 prior chemotherapy regimens for renal cell cancer (phase II only) No concurrent corticosteroid dose more than physiologic replacement levels See Disease Characteristics At least 4 weeks since prior radiotherapy No concurrent radiotherapy Recovered from prior oncologic or other major surgery At least 4 weeks since prior major surgery No concurrent surgery Recovered from all prior anticancer therapy other than alopecia (chronic toxicity < grade 2) At least 4 weeks since prior systemic therapy More than 30 days since prior investigational drugs Concurrent bisphosphonates allowed
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ronald Bukowski
Organizational Affiliation
The Cleveland Clinic
Official's Role
Principal Investigator
Facility Information:
Facility Name
Cleveland Clinic Foundation
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Fluorouracil and Low-Dose Suramin as Chemosensitization in Treating Patients With Metastatic Renal Cell (Kidney) Cancer

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