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17-N-Allylamino-17-Demethoxygeldanamycin and Paclitaxel in Treating Patients With Metastatic or Unresectable Solid Tumor

Phase 1
Completed
Conditions
Unspecified Adult Solid Tumor, Protocol Specific
Interventions
Other: laboratory biomarker analysis
Other: pharmacological study
Registration Number
NCT00087217
Lead Sponsor
National Cancer Institute (NCI)
Brief Summary

This phase I trial is studying the side effects and best dose of 17-N-allylamino-17-demethoxygeldanamycin when given together with paclitaxel in treating patients with metastatic or unresectable solid tumor. Drugs used in chemotherapy, such as 17-N-allylamino-17-demethoxygeldanamycin and paclitaxel, work in different ways to stop tumor cells from dividing so they stop growing or die. Combining 17-N-allylamino-17-demethoxygeldanamycin with paclitaxel may kill more tumor cells

Detailed Description

OBJECTIVES:

I. Determine the maximum tolerated dose and recommended phase II dose of 17-N-allylamino-17-demethoxygeldanamycin (17-AAG) when administered with paclitaxel in patients with metastatic or unresectable solid malignancy.

II. Determine the dose-limiting and non-dose-limiting toxic effects of this regimen in these patients.

III. Determine the pharmacokinetics of this regimen in these patients. IV. Determine tumor response in patients treated with this regimen.

OUTLINE: This is a multicenter, dose-escalation study of 17-N-allylamino-17-demethoxygeldanamycin (17-AAG). Patients receive 17-AAG IV over 1 hour on days 1\*, 4, 8, 11, 15 and 18 and paclitaxel IV over 1 hour on days 1, 8, and 15. Treatment repeats every 28 days for 6 courses in the absence of disease progression or unacceptable toxicity.

NOTE: \*17-AAG is not administered on day 1 of course 1. Cohorts of 3-6 patients receive escalating doses of 17-AAG 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. Once the MTD is determined, 6-12 patients are treated at the recommended phase II dose.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
35
Inclusion Criteria
  • Histologically confirmed solid malignancy

    • Metastatic or unresectable disease
  • Not amenable to standard curative or palliative therapy

  • No known brain metastases

  • Performance status - ECOG 0-2

  • More than 12 weeks

  • Absolute neutrophil count ≥ 1,500/mm^3

  • Platelet count ≥ 100,000/mm^3

  • WBC ≥ 3,000/mm^3

  • AST and ALT ≤ 2.5 times upper limit of normal

  • Bilirubin normal

  • Creatinine normal

  • Creatinine clearance ≥ 60 mL/min

  • QTc < 450 msec for male patients (470 msec for female patients)

  • LVEF > 40% by MUGA

  • No history of serious ventricular arrhythmia (i.e., ventricular tachycardia or ventricular fibrillation ≥ 3 beats in a row)

  • No myocardial infarction within the past year

  • No New York Heart Association class III or IV congestive heart failure

  • No poorly controlled angina

  • No history of uncontrolled dysrhythmia or requirement for antiarrhythmic drugs

  • No history of congenital long QT syndrome

  • No active ischemic heart disease within the past year

  • No left bundle branch block

  • No other significant cardiac disease

  • Not pregnant or nursing

  • Negative pregnancy test

  • Fertile patients must use effective double barrier contraception for at least 1 week before, during, and for at least 2 weeks after study participation

  • No prior allergy to eggs

  • No prior allergic reaction to compounds of similar chemical or biologic composition to 17-AAG or paclitaxel

  • No peripheral neuropathy > grade 1

  • No concurrent uncontrolled illness

  • No active or ongoing infection

  • No psychiatric illness or social situation that would preclude study compliance

  • No concurrent granulocyte colony-stimulating factors

  • Prior paclitaxel allowed

  • More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin) and recovered

  • No prior 17-N-allylamino-17-demethoxygeldanamycin (17-AAG)

  • More than 4 weeks since prior radiotherapy

  • No prior radiotherapy that included the heart in the field (e.g., mantle radiotherapy)

  • No concurrent combination antiretroviral therapy for HIV-positive patients

  • No concurrent therapeutic-dose warfarin for anticoagulation

  • No concurrent medications that may prolong QTc interval

  • No other concurrent investigational agents

  • No other concurrent anticancer agents or therapies

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Treatment (tanespimycin, paclitaxel)tanespimycinPatients receive 17-AAG IV over 1 hour on days 1\*, 4, 8, 11, 15 and 18 and paclitaxel IV over 1 hour on days 1, 8, and 15. Treatment repeats every 28 days for 6 courses in the absence of disease progression or unacceptable toxicity.
Treatment (tanespimycin, paclitaxel)laboratory biomarker analysisPatients receive 17-AAG IV over 1 hour on days 1\*, 4, 8, 11, 15 and 18 and paclitaxel IV over 1 hour on days 1, 8, and 15. Treatment repeats every 28 days for 6 courses in the absence of disease progression or unacceptable toxicity.
Treatment (tanespimycin, paclitaxel)pharmacological studyPatients receive 17-AAG IV over 1 hour on days 1\*, 4, 8, 11, 15 and 18 and paclitaxel IV over 1 hour on days 1, 8, and 15. Treatment repeats every 28 days for 6 courses in the absence of disease progression or unacceptable toxicity.
Treatment (tanespimycin, paclitaxel)paclitaxelPatients receive 17-AAG IV over 1 hour on days 1\*, 4, 8, 11, 15 and 18 and paclitaxel IV over 1 hour on days 1, 8, and 15. Treatment repeats every 28 days for 6 courses in the absence of disease progression or unacceptable toxicity.
Primary Outcome Measures
NameTimeMethod
Phase 2 recommended doses of tanespimycin28 days

Tabulated according to the NCI CTC.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

University of Pennsylvania Medical Center

🇺🇸

Philadelphia, Pennsylvania, United States

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