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Vinorelbine in Treating Patients With Advanced Solid Tumors That Have Not Responded to Treatment and Liver Dysfunction

Phase 1
Completed
Conditions
Unspecified Adult Solid Tumor, Protocol Specific
Lung Cancer
Interventions
Other: high performance liquid chromatography
Other: intracellular fluorescence polarization analysis
Other: liquid chromatography
Other: mass spectrometry
Other: pharmacological study
Registration Number
NCT00540982
Lead Sponsor
City of Hope Medical Center
Brief Summary

RATIONALE: Drugs used in chemotherapy, such as vinorelbine, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing.

PURPOSE: This pilot trial is studying the side effects and best dose of vinorelbine in treating patients with advanced solid tumors that have not responded to treatment and liver dysfunction.

Detailed Description

OBJECTIVES:

* To correlate indocyanine green and lidocaine metabolism with vinorelbine ditartrate pharmacokinetics in patients with advanced, refractory solid tumors and varying degrees of liver dysfunction.

* To determine the pharmacokinetics of vinorelbine ditartrate in these patients.

* To test a plan of dose adjustment for vinorelbine ditartrate administration in these patients.

OUTLINE: Patients are stratified according to extent of clinical liver dysfunction (normal vs mild vs moderate vs severe).

Patients receive dose-adjusted vinorelbine ditartrate IV over 10 minutes once weekly in the absence of disease progression or unacceptable toxicity. Patients achieving an objective complete response receive 2 additional courses of study therapy.

Patients undergo blood sample collection periodically during study for pharmacokinetic and pharmacodynamic correlative studies. Blood is also collected after patients receive lidocaine IV push and indocyanine green (ICG) IV push. Samples are analyzed for whole blood and plasma concentrations of vinorelbine ditartrate and its metabolites by high performance liquid chromatography (15) or by liquid chromatography/tandem mass spectrometry assay. Samples are also analyzed for ICG clearance and lidocaine hydrochloride metabolic capacity by fluorescent polarization immunoassay.

After completion of study therapy, patients are followed periodically.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
47
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Normal Liver Functionintracellular fluorescence polarization analysis-
Mild Liver Dysfunctionhigh performance liquid chromatography-
Severe Liver Dysfunctionindocyanine green-
Severe Liver Dysfunctionmass spectrometry-
Moderate Liver Dysfunctionhigh performance liquid chromatography-
Moderate Liver Dysfunctionliquid chromatography-
Severe Liver Dysfunctionintracellular fluorescence polarization analysis-
Severe Liver Dysfunctionvinorelbine ditartrate-
Normal Liver Functionpharmacological study-
Mild Liver Dysfunctionintracellular fluorescence polarization analysis-
Normal Liver Functionvinorelbine ditartrate-
Mild Liver Dysfunctionliquid chromatography-
Mild Liver Dysfunctionmass spectrometry-
Mild Liver Dysfunctionpharmacological study-
Moderate Liver Dysfunctionintracellular fluorescence polarization analysis-
Severe Liver Dysfunctionliquid chromatography-
Moderate Liver Dysfunctionmass spectrometry-
Normal Liver Functionhigh performance liquid chromatography-
Normal Liver Functionliquid chromatography-
Normal Liver Functionmass spectrometry-
Mild Liver Dysfunctionvinorelbine ditartrate-
Moderate Liver Dysfunctionindocyanine green-
Moderate Liver Dysfunctionvinorelbine ditartrate-
Severe Liver Dysfunctionpharmacological study-
Moderate Liver Dysfunctionpharmacological study-
Severe Liver Dysfunctionhigh performance liquid chromatography-
Severe Liver Dysfunctionlidocaine-
Normal Liver Functionindocyanine green-
Normal Liver Functionlidocaine-
Mild Liver Dysfunctionlidocaine-
Mild Liver Dysfunctionindocyanine green-
Moderate Liver Dysfunctionlidocaine-
Primary Outcome Measures
NameTimeMethod
Number of Participants With Grade 3 and 4 Toxicities3 weeks after the stop of treatment

Grade 3 \& 4 toxicities at least possible related to study drugs during any cycle of treatment. Toxicity graded according to Common Terminology Criteria for Adverse Events version 2.0.

Area Under the Curve2 months post treatment

Pharmacokinetics were evaluated in patients with sufficient dosing information and plasma concentration versus time data over 0-24 hours following vinorelbine infusion to allow calculation of area-under-the-curve from zero to 24 hours after infusion (AUC0-24). Furthermore, dose-normalization of AUC0-24 to the standard 30 mg/m2 dose was performed to allow evaluation of the relationship between liver function and AUC of vinorelbine. Data were collected at 0 and 24 hours post-dose.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (2)

City of Hope Medical Group

🇺🇸

Pasadena, California, United States

City of Hope Comprehensive Cancer Center

🇺🇸

Duarte, California, United States

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