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Suberoylanilide Hydroxamic Acid, Fluorouracil, Leucovorin, and Oxaliplatin in Treating Patients With Progressive Metastatic or Unresectable Colorectal Cancer or Other Solid Tumors

Primary Purpose

Recurrent Colon Cancer, Recurrent Rectal Cancer, Stage III Colon Cancer

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
oxaliplatin
leucovorin calcium
vorinostat
fluorouracil
Sponsored by
National Cancer Institute (NCI)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Recurrent Colon Cancer

Eligibility Criteria

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

Inclusion Criteria: Histologically confirmed colorectal cancer Metastatic or unresectable disease OR diagnosis of solid tumor No known brain metastases ECOG 0-1 OR Karnofsky 70-100% Life expectancy > 12 weeks Absolute neutrophil count ≥ 1,500/mm^3 WBC ≥ 3,000/mm^3 Platelet count ≥ 100,000/mm^3 Bilirubin normal AST and ALT ≤ 3 times upper limit of normal Creatinine normal OR creatinine clearance ≥ 60 mL/min No symptomatic congestive heart failure No unstable angina pectoris No cardiac arrhythmia Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception during and for 3 months after study participation No ongoing or active infection No neuropathy > grade 1 No history of allergic reaction attributed to compounds of similar chemical or biological composition to study drugs No psychiatric illness or social situation that would preclude study compliance No psychiatric illness or social situation that would preclude study compliance No other uncontrolled illness Prior bevacizumab and/or cetuximab allowed No concurrent routine or prophylactic filgrastim (G-CSF) or sargramostim (GM-CSF) More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin) More than 4 weeks since prior radiotherapy Recovered from prior therapy At least 2 weeks since prior valproic acid No concurrent combination anti-retroviral therapy for HIV-positive patients No other concurrent investigational agents No other concurrent anticancer therapy

Sites / Locations

  • Roswell Park Cancer Institute

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treatment (vorinostat, mFOLFOX)

Arm Description

Patients receive oral SAHA once or twice daily on days 1-3. Patients also receive oxaliplatin IV over 2 hours and leucovorin calcium IV over 2 hours on day 4 followed by fluorouracil IV over 46 hours on days 4-5. Courses repeat every 14 days in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of SAHA until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. A total of 10 patients are treated at the MTD.

Outcomes

Primary Outcome Measures

Maximum tolerated dose of vorinostat
Graded according to the NCI CTCAE.
Grade 3, 4, or 5 adverse events graded using the NCI CTCAE version 4.0

Secondary Outcome Measures

Response, evaluated using the new international criteria proposed by the RECIST committee
To be assigned a status of PR or CR, changes in tumor measurements must be confirmed by repeat assessments that should be performed 4 weeks or more after the criteria for response are first met.
Gene expression studies for evidence of up-regulation or down-regulation, obtained from microarray testing and changes in expression patterns of TS
Carried out with real time quantitative RT-PCR assays.
Pharmacokinetic analysis for vorinostat and 5-FU
DPD activity
Tabulated by dose level.

Full Information

First Posted
August 29, 2005
Last Updated
September 27, 2013
Sponsor
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00138177
Brief Title
Suberoylanilide Hydroxamic Acid, Fluorouracil, Leucovorin, and Oxaliplatin in Treating Patients With Progressive Metastatic or Unresectable Colorectal Cancer or Other Solid Tumors
Official Title
A Phase I Study of Suberoylanilide Hydroxamic Acid (Vorinostat) in Combination With 5-Fluorouracil, Leucovorin, and Oxaliplatin (mFOLFOX) in Patients With Colorectal Cancer and Other Solid Tumors
Study Type
Interventional

2. Study Status

Record Verification Date
September 2013
Overall Recruitment Status
Completed
Study Start Date
July 2005 (undefined)
Primary Completion Date
August 2011 (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
This phase I trial is studying the side effects and best dose of suberoylanilide hydroxamic acid when given together with fluorouracil, leucovorin, and oxaliplatin in treating patients with progressive metastatic or unresectable colorectal cancer or solid tumor. Drugs used in chemotherapy, such as suberoylanilide hydroxamic acid, fluorouracil, leucovorin, and oxaliplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Suberoylanilide hydroxamic acid may also stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Giving more than one drug (combination chemotherapy) may kill more tumor cells.
Detailed Description
PRIMARY OBJECTIVES: I. Determine the maximum tolerated dose of suberoylanilide hydroxamic acid when administered with fluorouracil, leucovorin calcium, and oxaliplatin in patients with progressive metastatic or unresectable colorectal cancer or other solid tumors. SECONDARY OBJECTIVES: I. Determine the toxicity of this regimen in these patients. II. Determine the pharmacokinetics of oxaliplatin, fluorouracil, and suberoylanilide hydroxamic acid in these patients. OUTLINE: This is a dose-escalation study of suberoylanilide hydroxamic acid (SAHA). Patients receive oral SAHA once or twice daily on days 1-3. Patients also receive oxaliplatin IV over 2 hours and leucovorin calcium IV over 2 hours on day 4 followed by fluorouracil IV over 46 hours on days 4-5. Courses repeat every 14 days in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of SAHA until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. A total of 10 patients are treated at the MTD. After completion of study treatment, patients are followed for 4 weeks.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Recurrent Colon Cancer, Recurrent Rectal Cancer, Stage III Colon Cancer, Stage III Rectal Cancer, Stage IV Colon Cancer, Stage IV Rectal Cancer, Unspecified Adult Solid Tumor, Protocol Specific

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Treatment (vorinostat, mFOLFOX)
Arm Type
Experimental
Arm Description
Patients receive oral SAHA once or twice daily on days 1-3. Patients also receive oxaliplatin IV over 2 hours and leucovorin calcium IV over 2 hours on day 4 followed by fluorouracil IV over 46 hours on days 4-5. Courses repeat every 14 days in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of SAHA until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. A total of 10 patients are treated at the MTD.
Intervention Type
Drug
Intervention Name(s)
oxaliplatin
Other Intervention Name(s)
1-OHP, Dacotin, Dacplat, Eloxatin, L-OHP
Intervention Description
Given IV
Intervention Type
Drug
Intervention Name(s)
leucovorin calcium
Other Intervention Name(s)
CF, CFR, LV
Intervention Description
Given IV
Intervention Type
Drug
Intervention Name(s)
vorinostat
Other Intervention Name(s)
L-001079038, SAHA, suberoylanilide hydroxamic acid, Zolinza
Intervention Description
Given orally
Intervention Type
Drug
Intervention Name(s)
fluorouracil
Other Intervention Name(s)
5-fluorouracil, 5-Fluracil, 5-FU
Intervention Description
Given IV
Primary Outcome Measure Information:
Title
Maximum tolerated dose of vorinostat
Description
Graded according to the NCI CTCAE.
Time Frame
2 weeks
Title
Grade 3, 4, or 5 adverse events graded using the NCI CTCAE version 4.0
Time Frame
Up to 30 days after completion of study treatment
Secondary Outcome Measure Information:
Title
Response, evaluated using the new international criteria proposed by the RECIST committee
Description
To be assigned a status of PR or CR, changes in tumor measurements must be confirmed by repeat assessments that should be performed 4 weeks or more after the criteria for response are first met.
Time Frame
Up to 4 weeks after completion of study treatment
Title
Gene expression studies for evidence of up-regulation or down-regulation, obtained from microarray testing and changes in expression patterns of TS
Description
Carried out with real time quantitative RT-PCR assays.
Time Frame
Up to 4 weeks after completion of study treatment
Title
Pharmacokinetic analysis for vorinostat and 5-FU
Time Frame
Days 1 and 15
Title
DPD activity
Description
Tabulated by dose level.
Time Frame
Up to 8 days after the first dose of vorinostat (course 1)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically confirmed colorectal cancer Metastatic or unresectable disease OR diagnosis of solid tumor No known brain metastases ECOG 0-1 OR Karnofsky 70-100% Life expectancy > 12 weeks Absolute neutrophil count ≥ 1,500/mm^3 WBC ≥ 3,000/mm^3 Platelet count ≥ 100,000/mm^3 Bilirubin normal AST and ALT ≤ 3 times upper limit of normal Creatinine normal OR creatinine clearance ≥ 60 mL/min No symptomatic congestive heart failure No unstable angina pectoris No cardiac arrhythmia Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception during and for 3 months after study participation No ongoing or active infection No neuropathy > grade 1 No history of allergic reaction attributed to compounds of similar chemical or biological composition to study drugs No psychiatric illness or social situation that would preclude study compliance No psychiatric illness or social situation that would preclude study compliance No other uncontrolled illness Prior bevacizumab and/or cetuximab allowed No concurrent routine or prophylactic filgrastim (G-CSF) or sargramostim (GM-CSF) More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin) More than 4 weeks since prior radiotherapy Recovered from prior therapy At least 2 weeks since prior valproic acid No concurrent combination anti-retroviral therapy for HIV-positive patients No other concurrent investigational agents No other concurrent anticancer therapy
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Marwan Fakih
Organizational Affiliation
Roswell Park Cancer Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
Roswell Park Cancer Institute
City
Buffalo
State/Province
New York
ZIP/Postal Code
14263
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Suberoylanilide Hydroxamic Acid, Fluorouracil, Leucovorin, and Oxaliplatin in Treating Patients With Progressive Metastatic or Unresectable Colorectal Cancer or Other Solid Tumors

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