Erlotinib Hydrochloride and Irinotecan Hydrochloride in Treating Patients With Advanced Solid Tumors
Phase I trial to study the effectiveness of combining erlotinib hydrochloride with irinotecan hydrochloride in treating patients who have advanced solid tumors. Erlotinib hydrochloride may stop the growth of tumor cells by blocking the enzymes necessary for tumor cell growth. Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Combining erlotinib hydrochloride and chemotherapy may kill more tumor cells.
Adult Solid Neoplasm
Drug: Erlotinib Hydrochloride
Drug: Irinotecan Hydrochloride
|Study Design:||Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
|Official Title:||Phase I Trial of OSI-774 and CPT-11 in Patients With Advanced Solid Tumors|
- MTD of erlotinib hydrochloride and irinotecan hydrochloride in patients with advanced solid tumors that overexpress epidermal growth factor receptor [ Time Frame: At least 4 weeks ] [ Designated as safety issue: Yes ]Defined as the highest safely tolerated dose where at most one patient experiences DLT with the next higher dose having at least 2 patients who experience DLT. Three patients will be entered at a given dose level and observed for at least 4 weeks to assess toxicity. MTD will be determined independently for each cohort.
- Dose limiting toxicity of the combination in all cohorts [ Time Frame: At least 4 weeks ] [ Designated as safety issue: Yes ]Defined as an adverse event attributed (definitely, probably, or possibly) to the study treatment. Graded using the National Cancer Institute Common Toxicity Criteria (CTC) version 2.0. Defined by the NCI Common Terminology Criteria for Adverse Events (CTCAE) versioun 4.0.
- Effect of erlotinib hydrochloride on the disposition of irinotecan hydrochloride [ Time Frame: Weekly during course 1 ] [ Designated as safety issue: No ]Analysis performed using high performance liquid chromatography assays. Serial blood samples will be obtained during Cycle 1 only to determine the pharmacokinetics of irinotecan hydrochloride and erlotinib hydrochloride.
- Effect of erlotinib on EGFR phosphorylation at MTD [ Time Frame: Weekly during course 1 ] [ Designated as safety issue: No ]
- Genetic variation in UGT1A1 and BCRP [ Time Frame: Weekly during course 1 ] [ Designated as safety issue: No ]Detected using allele-specific restriction fragment length polymorphism (RFLP) assays and GeneScan assays. The overall incidence of UTG1A1 polymorphism will be estimated and summarized.
- Tumor BCRP expression in patients treated at the MTD [ Time Frame: Weekly during course 1 ] [ Designated as safety issue: No ]
- Evidence of anti tumor activity [ Time Frame: Every 3 weeks ] [ Designated as safety issue: No ]Evaluated using modified Response Evaluation Criteria in Solid Tumors (RECIST) criteria.
- Correlation of EGFR phosphorylation and/or BCRP expression with response to this combination [ Time Frame: Every 3 weeks ] [ Designated as safety issue: No ]Evaluated using modified RECIST criteria.
|Study Start Date:||June 2002|
|Primary Completion Date:||June 2009 (Final data collection date for primary outcome measure)|
Experimental: Treatment (enzyme inhibitor, chemotherapy)
Patients receive oral erlotinib hydrochloride daily on days -6 to -1. Patients then receive irinotecan hydrochloride IV over 90 minutes on day 1 and oral erlotinib hydrochloride once daily on days 1-21. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.
Drug: Erlotinib Hydrochloride
Other Name: Cp-358,774Drug: Irinotecan Hydrochloride
I. Determine the maximum tolerated dose (MTD) of erlotinib (erlotinib hydrochloride) and irinotecan (irinotecan hydrochloride), in relation to presence or absence of UGT1A1*28 polymorphism, in patients with advanced solid tumors that overexpress epidermal growth factor receptor.
II. Determine the dose-limiting toxicity of these regimens in these patients. III. Determine whether erlotinib alters the disposition of irinotecan using a previously described limited sampling model.
IV. Determine factors that influence the disposition of these drugs, including genetic variation in UGT1A1 and BCRP, in patients treated with these regimens.
V. Determine factors that influence the disposition of these drugs, in terms of tumor BCRP-expression, in tumor samples from patients treated with these drugs at the MTD.
VI. Evaluate the effect of this regimen on epidermal growth factor receptor phosphorylation in these patients.
VII. Assess, preliminarily, any antitumor activity in patients treated with these regimens.
VIII. Correlate, preliminarily, EGFR phosphorylation and/or BCRP -expression with response in tumor samples from these patients.
OUTLINE: This is a dose-escalation study. Patients are stratified according to UGTA1A genotype (all patients regardless of genotype [closed to accrual as of 9/15/04] vs UGT1A1 6/6 genotype vs UGTA1A 6/7 or 7/7 genotype).
Patients receive oral erlotinib hydrochloride daily on days -6 to -1. Patients then receive irinotecan hydrochloride intravenously (IV) over 90 minutes on day 1 and oral erlotinib once daily on days 1-21. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.
Cohorts of 3-6 patients per stratum receive escalating doses of erlotinib hydrochloride and irinotecan hydrochloride until the MTD is determined. The MTD is defined as the dose preceding that at which at least 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. Additional patients are treated at the MTD.
Patients are followed for 3 months.
Please refer to this study by its ClinicalTrials.gov identifier: NCT00045201
|United States, Minnesota|
|Rochester, Minnesota, United States, 55905|
|Principal Investigator:||Henry Pitot||Mayo Clinic|