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Phase I and Pharmacokinetic Trial of Phenylbutyrate Given as a Continuous Infusion in Pediatric Patients With Refractory Malignancy

Primary Purpose

Brain Neoplasms, Neuroblastoma

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

About this trial

This is an interventional treatment trial for Brain Neoplasms focused on measuring Brain Tumors, Differentiation, Maximally Tolerated Dose, Neuroblastoma, Phenylacetate

Eligibility Criteria

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

Disease Characteristics: Histologically proven cancer that is refractory to standard therapy. Patients with neurofibromatosis having progressive inoperable plexiform neurofibromas with potential to cause significant morbidity are eligible. Patients with brainstem gliomas histology may have histology requirements waived. Patients without prior therapy are eligible if they have diseases with no available standard therapy. Patients with evidence of bone marrow involvement by tumor, or a history of either bone marrow transplantation or extensive radiotherapy will be eligible, but inevaluable for hematologic toxicities. Patients with greater than grade 2 neurocortical toxicity will be excluded. PRIOR/CONCURRENT THERAPY: Biologic Therapy: No concurrent hematopoietic growth factor. Chemotherapy: No chemotherapy within 3 weeks of study. No nitrosoursea within 6 weeks of study. No concurrent chemotherapy allowed. Must be on stable or decreasing dose of dexamethasone within 2 weeks of study. Endocrine Therapy: Not specified. Radiotherapy: No radiotherapy within 6 weeks of study. Surgery: Not specified. Other: Patient must be recovered from toxic effects of all prior therapy. Concurrent antibiotic therapy when appropriate. Patient Characteristics: Age: 2 to 21. Performance Status: ECOG 0-2. Life Expectancy: At least 8 weeks. Hematopoietic (hematologic requirements below do not apply to patients with histologically confirmed bone marrow involvement or history of either bone marrow transplantation or extensive radiotherapy; these patients are inevaluable for hematologic toxicity): Absolute granulocyte count (AGC) at least 1500/mm3. Platelet count at least 100,000/mm3. Hemoglobin at least 8 g/dL. Hepatic: Bilirubin no greater than 2 mg/Dl. SGPT less than 2 times normal. Renal: Creatinine no greater than 1.5 mg/Dl OR Creatinine clearance at least 60 Ml/min/square meter. Other: No systemic illness. Not pregnant or nursing. No amino acidurias or organic acidemias.

Sites / Locations

  • National Cancer Institute (NCI)

Outcomes

Primary Outcome Measures

Secondary Outcome Measures

Full Information

First Posted
November 3, 1999
Last Updated
March 3, 2008
Sponsor
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00001565
Brief Title
Phase I and Pharmacokinetic Trial of Phenylbutyrate Given as a Continuous Infusion in Pediatric Patients With Refractory Malignancy
Official Title
Phase I and Pharmacokinetic Trial of Phenylbutyrate Given as a Continuous Infusion in Pediatric Patients With Refractory Malignancy
Study Type
Interventional

2. Study Status

Record Verification Date
November 1999
Overall Recruitment Status
Completed
Study Start Date
December 1996 (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
October 2000 (undefined)

3. Sponsor/Collaborators

Name of the Sponsor
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
This is a pharmacokinetic trial. Patients receive phenylbutyrate through a central venous catheter for each 28 day cycle. The first several days of drug administration should be inpatient. Cycles may be repeated if there is no tumor progression or dose limiting toxicities (DLT). There are no breaks between cycles. Once a minimum of 3 patients have completed at least 4 weeks of therapy without DLT, new patients will be entered at the next dose level.
Detailed Description
Phenylbutyrate is an aromatic fatty acid that is converted to phenylacetate in vivo by mitochondrial beta-oxidation to phenylacetate. Preclinical studies have shown that continuous exposure to phenylacetate or phenylbutyrate can induce tumor cytostasis and differentiation in a wide variety of cell lines including malignant gliomas and neuroblastomas. However, phenylbutyrate has been shown to be a more potent differentiating agent than phenylacetate in a variety of tumor cell lines. In addition, phenylbutyrate appears to have molecular activities that are distinct from phenylacetate. The objective of this trial is to determine the maximum tolerated dose and the toxicities of phenylbutyrate administered as a continuous intravenous infusion for 28 days. In addition, the pharmacokinetics of phenylbutyrate and its metabolite, phenylacetate, will be studied using both model-dependent and model-independent parameters.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Brain Neoplasms, Neuroblastoma
Keywords
Brain Tumors, Differentiation, Maximally Tolerated Dose, Neuroblastoma, Phenylacetate

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Enrollment
35 (false)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
phenylbutyrate

10. Eligibility

Sex
All
Accepts Healthy Volunteers
No
Eligibility Criteria
Disease Characteristics: Histologically proven cancer that is refractory to standard therapy. Patients with neurofibromatosis having progressive inoperable plexiform neurofibromas with potential to cause significant morbidity are eligible. Patients with brainstem gliomas histology may have histology requirements waived. Patients without prior therapy are eligible if they have diseases with no available standard therapy. Patients with evidence of bone marrow involvement by tumor, or a history of either bone marrow transplantation or extensive radiotherapy will be eligible, but inevaluable for hematologic toxicities. Patients with greater than grade 2 neurocortical toxicity will be excluded. PRIOR/CONCURRENT THERAPY: Biologic Therapy: No concurrent hematopoietic growth factor. Chemotherapy: No chemotherapy within 3 weeks of study. No nitrosoursea within 6 weeks of study. No concurrent chemotherapy allowed. Must be on stable or decreasing dose of dexamethasone within 2 weeks of study. Endocrine Therapy: Not specified. Radiotherapy: No radiotherapy within 6 weeks of study. Surgery: Not specified. Other: Patient must be recovered from toxic effects of all prior therapy. Concurrent antibiotic therapy when appropriate. Patient Characteristics: Age: 2 to 21. Performance Status: ECOG 0-2. Life Expectancy: At least 8 weeks. Hematopoietic (hematologic requirements below do not apply to patients with histologically confirmed bone marrow involvement or history of either bone marrow transplantation or extensive radiotherapy; these patients are inevaluable for hematologic toxicity): Absolute granulocyte count (AGC) at least 1500/mm3. Platelet count at least 100,000/mm3. Hemoglobin at least 8 g/dL. Hepatic: Bilirubin no greater than 2 mg/Dl. SGPT less than 2 times normal. Renal: Creatinine no greater than 1.5 mg/Dl OR Creatinine clearance at least 60 Ml/min/square meter. Other: No systemic illness. Not pregnant or nursing. No amino acidurias or organic acidemias.
Facility Information:
Facility Name
National Cancer Institute (NCI)
City
Bethesda
State/Province
Maryland
ZIP/Postal Code
20892
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
8486788
Citation
Samid D, Shack S, Myers CE. Selective growth arrest and phenotypic reversion of prostate cancer cells in vitro by nontoxic pharmacological concentrations of phenylacetate. J Clin Invest. 1993 May;91(5):2288-95. doi: 10.1172/JCI116457.
Results Reference
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PubMed Identifier
8313377
Citation
Samid D, Ram Z, Hudgins WR, Shack S, Liu L, Walbridge S, Oldfield EH, Myers CE. Selective activity of phenylacetate against malignant gliomas: resemblance to fetal brain damage in phenylketonuria. Cancer Res. 1994 Feb 15;54(4):891-5.
Results Reference
background
PubMed Identifier
1372534
Citation
Samid D, Shack S, Sherman LT. Phenylacetate: a novel nontoxic inducer of tumor cell differentiation. Cancer Res. 1992 Apr 1;52(7):1988-92.
Results Reference
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Phase I and Pharmacokinetic Trial of Phenylbutyrate Given as a Continuous Infusion in Pediatric Patients With Refractory Malignancy

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