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Temozolomide and Vinorelbine in Treating Patients With Recurrent Brain Metastases

Primary Purpose

Metastatic Cancer

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
temozolomide
vinorelbine tartrate
Sponsored by
Memorial Sloan Kettering Cancer Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Metastatic Cancer focused on measuring tumors metastatic to brain

Eligibility Criteria

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

INCLUSION CRITERIAL: Age > or = 18 years. Karnofsky performance score > or = 60. Histopathologic confirmation of the diagnosis of a solid tumor malignancy. The brain metastasis diagnosis per se does not have to be pathologically confirmed if the clinical and neuro radiographic picture is typical. MRI (or CT if the patient cannot undergo MRI) evidence of evaluable disease in the brain. Absolute neutrophil count > or = 1,500/mm³. Platelet count > or = 100,000/mm³. Hemoglobin > or = 10 g/dl. BUN and serum creatinine both < 1.5 times upper limit of normal. Total and direct bilirubin both < 1.5 times upper limit of normal. SGOT and SGPT both < or = 3 times upper limit of normal. Alkaline phosphatase < or = 2 times upper limit of normal. At least two weeks must have elapsed from brain biopsy, craniotomy, or other surgery. Life expectancy > or = 8 weeks. Patient or their legal guardian or legal next-of-kin must provide written informed consent prior to patient's registration on study. At least four weeks must have elapsed from previous external beam radiation therapy, or eight weeks from stereotactic radiosurgery. Patients treated with radiosurgery should have evidence of progression at a distant site in the brain, or confirmation of tumor progression by biopsy or PET scan. EXCLUSION CRITERIA: Previous treatment with temozolomide, dacarbazine or vinorelbine. Patients who have not recovered from all acute toxicities of prior therapies. Patients with evidence of leptomeningeal metastases or primary dural metastases. Patients who are poor medical risks because of nonmalignant systemic disease, as well as those with acute infection requiring treatment with intravenous antibiotics. Patients whose psychiatric condition would, in the judgment of the principal investigator, make it unlikely that they could adhere to the requirements of the protocol.

Sites / Locations

  • Robert H. Lurie Comprehensive Cancer Center at Northwestern University
  • Memorial Sloan-Kettering Cancer Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Temozolomide and Vinorelbine

Arm Description

Patients will be treated with vinorelbine on days 1 and 8 of each cycle; temozolomide will be administered on days 1 to 7 and 15 to 21 of each cycle. The dose level of temozolomide will be given at a dose of 150 mg/m2/day. A cycle will be defined as 28 days of treatment.

Outcomes

Primary Outcome Measures

Radiographic Response Assessed by Macdonald Criteria Every 2 Months
All patients will have their tumor measurements recorded at baseline and at the time of each MRI scan. Lesions must be measured in two dimensions.

Secondary Outcome Measures

Full Information

First Posted
November 9, 2001
Last Updated
December 15, 2015
Sponsor
Memorial Sloan Kettering Cancer Center
Collaborators
National Cancer Institute (NCI), Northwestern Memorial Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT00026494
Brief Title
Temozolomide and Vinorelbine in Treating Patients With Recurrent Brain Metastases
Official Title
A Phase I/II Trial Of Temozolomide And Vinorelbine For Patients With Recurrent Brain Metastases
Study Type
Interventional

2. Study Status

Record Verification Date
December 2015
Overall Recruitment Status
Completed
Study Start Date
July 2001 (undefined)
Primary Completion Date
April 2008 (Actual)
Study Completion Date
April 2008 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Memorial Sloan Kettering Cancer Center
Collaborators
National Cancer Institute (NCI), Northwestern Memorial Hospital

4. Oversight

5. Study Description

Brief Summary
RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. PURPOSE: Phase I/II trial to study the effectiveness of temozolomide and vinorelbine in treating patients who have recurrent brain metastases.
Detailed Description
OBJECTIVES: Determine the maximum tolerated dose of vinorelbine when administered in combination with temozolomide in patients with recurrent brain metastases (phase I accrual completed). Determine the safety and feasibility of this treatment regimen in these patients. Determine the efficacy of this treatment regimen, in terms of objective radiographic response and overall and progression-free survival, in these patients. OUTLINE: This is a dose-escalation study of vinorelbine. Patients receive vinorelbine IV over 5-10 minutes on days 1 and 8 and oral temozolomide once daily on days 1-7 and 15-21. Courses repeat every 28 days for up to 1 year in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of vinorelbine until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 6 patients experience dose-limiting toxicity. Once the MTD is determined, an additional 20-35 patients will be treated at that dose level. Patients are followed every 3-4 months. PROJECTED ACCRUAL: A minimum of 3 patients will be accrued for the phase I portion of this study and 20-35 patients will be accrued for the phase II portion of this study within 2 years.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metastatic Cancer
Keywords
tumors metastatic to brain

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
49 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Temozolomide and Vinorelbine
Arm Type
Experimental
Arm Description
Patients will be treated with vinorelbine on days 1 and 8 of each cycle; temozolomide will be administered on days 1 to 7 and 15 to 21 of each cycle. The dose level of temozolomide will be given at a dose of 150 mg/m2/day. A cycle will be defined as 28 days of treatment.
Intervention Type
Drug
Intervention Name(s)
temozolomide
Intervention Type
Drug
Intervention Name(s)
vinorelbine tartrate
Primary Outcome Measure Information:
Title
Radiographic Response Assessed by Macdonald Criteria Every 2 Months
Description
All patients will have their tumor measurements recorded at baseline and at the time of each MRI scan. Lesions must be measured in two dimensions.
Time Frame
2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
INCLUSION CRITERIAL: Age > or = 18 years. Karnofsky performance score > or = 60. Histopathologic confirmation of the diagnosis of a solid tumor malignancy. The brain metastasis diagnosis per se does not have to be pathologically confirmed if the clinical and neuro radiographic picture is typical. MRI (or CT if the patient cannot undergo MRI) evidence of evaluable disease in the brain. Absolute neutrophil count > or = 1,500/mm³. Platelet count > or = 100,000/mm³. Hemoglobin > or = 10 g/dl. BUN and serum creatinine both < 1.5 times upper limit of normal. Total and direct bilirubin both < 1.5 times upper limit of normal. SGOT and SGPT both < or = 3 times upper limit of normal. Alkaline phosphatase < or = 2 times upper limit of normal. At least two weeks must have elapsed from brain biopsy, craniotomy, or other surgery. Life expectancy > or = 8 weeks. Patient or their legal guardian or legal next-of-kin must provide written informed consent prior to patient's registration on study. At least four weeks must have elapsed from previous external beam radiation therapy, or eight weeks from stereotactic radiosurgery. Patients treated with radiosurgery should have evidence of progression at a distant site in the brain, or confirmation of tumor progression by biopsy or PET scan. EXCLUSION CRITERIA: Previous treatment with temozolomide, dacarbazine or vinorelbine. Patients who have not recovered from all acute toxicities of prior therapies. Patients with evidence of leptomeningeal metastases or primary dural metastases. Patients who are poor medical risks because of nonmalignant systemic disease, as well as those with acute infection requiring treatment with intravenous antibiotics. Patients whose psychiatric condition would, in the judgment of the principal investigator, make it unlikely that they could adhere to the requirements of the protocol.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Lauren E. Abrey, MD
Organizational Affiliation
Memorial Sloan Kettering Cancer Center
Official's Role
Study Chair
Facility Information:
Facility Name
Robert H. Lurie Comprehensive Cancer Center at Northwestern University
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611-3013
Country
United States
Facility Name
Memorial Sloan-Kettering Cancer Center
City
New York
State/Province
New York
ZIP/Postal Code
10021
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
17987262
Citation
Iwamoto FM, Omuro AM, Raizer JJ, Nolan CP, Hormigo A, Lassman AB, Gavrilovic IT, Abrey LE. A phase II trial of vinorelbine and intensive temozolomide for patients with recurrent or progressive brain metastases. J Neurooncol. 2008 Mar;87(1):85-90. doi: 10.1007/s11060-007-9491-3. Epub 2007 Nov 7.
Results Reference
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Temozolomide and Vinorelbine in Treating Patients With Recurrent Brain Metastases

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