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Iododoxorubicin in Treating Patients With Primary Systemic Amyloidosis
This study has been completed.
First Received: February 14, 2002   Last Updated: July 23, 2008   History of Changes
Sponsor: Mayo Clinic
Collaborator: National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00030381
  Purpose

RATIONALE: Iododoxorubicin may dissolve protein deposits and be an effective treatment for primary systemic amyloidosis.

PURPOSE: Phase I trial to determine the effectiveness of iododoxorubicin in treating patients who have primary systemic amyloidosis.


Condition Intervention Phase
Multiple Myeloma and Plasma Cell Neoplasm
Drug: 4'-iodo-4'-deoxydoxorubicin
Phase I

Study Type: Interventional
Study Design: Treatment
Official Title: Phase I Trial of 4'-IODO-4'-Deoxydoxorubicin in Primary Amyloidosis (AL)

Resource links provided by NLM:


Further study details as provided by National Cancer Institute (NCI):

Study Start Date: December 2001
Detailed Description:

OBJECTIVES:

  • Determine the maximum tolerated dose of iododoxorubicin in patients with primary systemic amyloidosis.
  • Determine the safety, especially cardiac safety, of this drug in these patients.
  • Determine the survival rate of patients treated with this drug.
  • Determine, preliminarily, the clinical efficacy of this drug in these patients.
  • Determine the pharmacokinetics of this drug in these patients.

OUTLINE: This is a dose-escalation study.

Patients receive iododoxorubicin IV over 15 minutes on days 1, 8, 15, and 22. Treatment repeats every 12 weeks for a total of 4 courses or a cumulative dose of 400 mg/m^2 in the absence of disease progression or unacceptable toxicity.

Cohorts of 3-6 patients receive escalating doses of iododoxorubicin 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.

Patients are followed at 3 months.

PROJECTED ACCRUAL: A total of 9-22 patients will be accrued for this study within 12 months.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Histochemically confirmed amyloidosis by polarizing microscopy of green birefringent material in Congo red-stained tissue specimens
  • At least one of the following:

    • Demonstrable M-protein in serum or urine
    • Clonal population of plasma cells in bone marrow
    • Immunohistochemical stain with anti-light chain antisera of amyloid fibrils
  • Symptomatic organ involvement, including liver involvement, mild cardiac involvement, renal involvement, grade 1 or 2 peripheral neuropathy, or soft tissue involvement (including tongue)

    • No purpura or carpal tunnel syndrome as sole manifestation of disease
  • No clinically overt multiple myeloma defined as monoclonal bone marrow platelet concentration greater than 20% and at least one of the following:

    • Bone lesions
    • Anemia
    • Hypercalcemia

PATIENT CHARACTERISTICS:

Age:

  • 18 and over

Performance status:

  • ECOG 0-3 (3 allowed only if related to muscular infiltration by amyloid or peripheral neuropathy)

Life expectancy:

  • Not specified

Hematopoietic:

  • Platelet count at least 100,000/mm^3
  • Absolute neutrophil count at least 1,500/mm^3

Hepatic:

  • Total bilirubin no greater than 2.0 mg/dL OR
  • Direct bilirubin no greater than 1.0 mg/dL
  • Alkaline phosphatase no greater than 4 times upper limit of normal (ULN)
  • AST or ALT no greater than 3 times ULN

Renal:

  • Creatinine clearance at least 40 mL/min

Cardiovascular:

  • Ejection fraction at least 50% by echocardiogram
  • No New York Heart Association class III or IV heart disease
  • No enzyme-documented myocardial infarction within the past 3 years
  • No chronic atrial fibrillation
  • No grade 2 or 3 atrioventricular block (Mobitz type I allowed)
  • No sustained (greater than 30 seconds) ventricular tachycardia, more than 1 episode of non-sustained ventricular tachycardia (3 consecutive ventricular beats), or frequent (more than 20 in 24 hours) ventricular pairs by 24-hour ambulatory electrocardiographic monitoring
  • No intraventricular septum greater than 16 mm by echocardiogram

Other:

  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No uncontrolled infection
  • No other active malignancy except nonmelanoma skin cancer or cervical cancer
  • No psychiatric illness or social situation that would preclude study
  • No severe diarrhea (greater than grade 3) that is not controllable with medication or that requires total parenteral nutrition

PRIOR CONCURRENT THERAPY:

Biologic therapy:

  • More than 4 weeks since prior interferon alfa
  • No concurrent immunotherapy

Chemotherapy:

  • More than 4 weeks since prior melphalan or other alkylating agents
  • No prior anthracycline exposure greater than 120 mg/m^2
  • Recovered from prior chemotherapy
  • No other concurrent chemotherapy

Endocrine therapy:

  • More than 4 weeks since prior high-dose dexamethasone

Radiotherapy:

  • No concurrent radiotherapy

Surgery:

  • Not specified

Other:

  • No concurrent investigational ancillary therapy
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00030381

Locations
United States, Minnesota
Mayo Clinic Cancer Center
Rochester, Minnesota, United States, 55905
Sponsors and Collaborators
Mayo Clinic
Investigators
Study Chair: Angela Dispenzieri, MD Mayo Clinic
  More Information

Additional Information:
No publications provided

Study ID Numbers: CDR0000069160, MAYO-MC0113, NCI-5718
Study First Received: February 14, 2002
Last Updated: July 23, 2008
ClinicalTrials.gov Identifier: NCT00030381     History of Changes
Health Authority: United States: Federal Government

Keywords provided by National Cancer Institute (NCI):
primary systemic amyloidosis

Additional relevant MeSH terms:
Immunoproliferative Disorders
Metabolic Diseases
Neoplasms by Histologic Type
Immune System Diseases
Antineoplastic Agents
Blood Protein Disorders
Hematologic Diseases
Vascular Diseases
Paraproteinemias
Antibiotics, Antineoplastic
Hemostatic Disorders
Pharmacologic Actions
Doxorubicin
Multiple Myeloma
4'-deoxydoxorubicin
Amyloidosis
Neoplasms
Hemorrhagic Disorders
Therapeutic Uses
Cardiovascular Diseases
Lymphoproliferative Disorders
Neoplasms, Plasma Cell

ClinicalTrials.gov processed this record on November 22, 2009