Sunitinib and Gemcitabine in Treating Patients With Pancreatic Cancer or Other Solid Tumors
Adenocarcinoma of the Pancreas, Recurrent Pancreatic Cancer, Stage III Pancreatic Cancer
About this trial
This is an interventional treatment trial for Adenocarcinoma of the Pancreas
Eligibility Criteria
Criteria:
Histologically or cytologically confirmed pancreatic adenocarcinoma OR other solid tumor:
- Not amenable to curative therapy
- Previously untreated metastatic pancreatic adenocarcinoma allowed
- Measurable or evaluable disease
- No history of or known brain metastases, spinal cord compression, carcinomatous meningitis, or new evidence of brain or leptomeningeal disease on screening CT scan or MRI scan
- ECOG performance status (PS) 0-2 OR Karnofsky PS 60-100%
- Life expectancy >= 12 weeks
- Absolute neutrophil count >= 1,500/mm3
- Platelet count >= 100,000/mm3
- Hemoglobin >= 8.5 g/dL
- Bilirubin =< 1.5 mg/dL
- Creatinine normal OR creatinine clearance >= 60 mL/min
- AST and ALT =< 2.5 times upper limit of normal (ULN) (=< 5 times ULN if due to underlying disease)
- Calcium =< 12.0 mg/dL
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception during and for at least 6 months after completion of study therapy
- LVEF normal by MUGA scan or ECHO at baseline
- Deep venous thrombosis or pulmonary embolism allowed provided they are clinically stable and adequately treated
- No preexisting thyroid abnormality that results in the inability to maintain thyroid function in the normal range while using medication
- No history of allergic reactions attributed to compounds of similar chemical or biological composition to sunitinib malate
No history of any of the following within the past 6 months:
- Myocardial infarction
- Ventricular arrhythmia (i.e., ventricular tachycardia or ventricular fibrillation >= 3 beats in a row)
- Severe/unstable angina
- Severe peripheral vascular disease (i.e., claudication)
- Procedure on peripheral vasculature
- Coronary/peripheral artery bypass graft
- Cerebrovascular accident
No history of any of the following within the past 6 months:
- Transient ischemic attack;
- Clinically significant bleeding requiring red blood cell transfusion
No NYHA class III or IV heart disease:
- Patients with NYHA class II disease who are stable and on medication are eligible
- No ongoing cardiac dysrhythmias >= grade 2, atrial fibrillation of any grade, or any significant EKG abnormalities
- No hypertension that cannot be controlled by medications to a systolic blood pressure (BP) of < 140 mm Hg and diastolic BP of < 90 mm Hg
No condition that impairs the ability to swallow and retain sunitinib malate tablets, including any of the following:
- Gastrointestinal tract disease resulting in an inability to take oral medication
- Requirement for IV alimentation
- Prior surgical procedures affecting absorption
- Active peptic ulcer disease
- No gastrointestinal perforation or intra-abdominal abscess within the past 28 days
- No serious nonhealing infection or bone fracture
- No other severe acute or chronic medical condition, psychiatric condition, or laboratory abnormality that would preclude study therapy
- May have received any number of prior systemic therapies
- More than 4 weeks since prior radiotherapy or surgery and recovered
- More than 4 weeks since other prior therapies and recovered
- Prior gemcitabine hydrochloride allowed
- No prior sunitinib malate or other therapy directed against VEGF, including any of the following:
Sorafenib; Bevacizumab; Vatalanib; AZD2171; VEGF Trap; Investigational antiangiogenic therapy
More than 7 days since prior and no concurrent CYP3A4 inhibitors, including any of the following:
- Ketoconazole
- Itraconazole
- Clarithromycin
- Erythromycin
- Diltiazem
- Verapamil
- Indinavir
- Ritonavir
- Nelfinavir
- Saquinavir
- Atazanavir
- Delavirdine
More than 12 days since prior and no concurrent CYP3A4 inducers, including any of the following:
- Rifampin
- Rifabutin
- Carbamazepine
- Phenobarbital
- Phenytoin
- Hypericum perforatum (St. John's wort)
- Efavirenz
- Tipranavir
No concurrent agents with proarrhythmic potential, including any of the following:
- Terfenadine
- Quinidine
- Procainamide
- Disopyramide
- Sotalol
- Probucol
- Bepridil
- Haloperidol
- Risperidone
- Indapamide
- Flecainide
- No concurrent combination antiretroviral therapy for HIV-positive patients
- No concurrent treatment on another clinical trial:
Participation in non-therapeutic clinical trials allowed
- QTc < 500 msec
Sites / Locations
- Case Western Reserve University
Arms of the Study
Arm 1
Experimental
Arm I
Patients receive gemcitabine hydrochloride IV over 30 minutes on days 1 and 8 OR on days 1, 8, and 15. Patients also receive oral sunitinib malate once daily on days 1-21 OR days 1-28. Treatment repeats every 21 days OR every 28 days in the absence of disease progression or unacceptable toxicity.