Methotrexate, Trimetrexate Glucuronate, and Leucovorin in Treating Patients With Refractory or Recurrent Osteosarcoma
RATIONALE: Drugs used in chemotherapy, such as methotrexate, trimetrexate glucuronate, and leucovorin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more tumor cells.
PURPOSE: This phase I trial is studying the side effects and best dose of trimetrexate glucuronate when given together with methotrexate and leucovorin in treating patients with refractory or recurrent osteosarcoma.
Drug: leucovorin calcium
Drug: trimetrexate glucuronate
|Study Design:||Primary Purpose: Treatment|
|Official Title:||Phase I Study of High Dose Methotrexate With Simultaneous Trimetrexate and Leucovorin in Patients With Recurrent Osteosarcoma|
- Maximum tolerated dose (MTD) after 1 course of treatment [ Designated as safety issue: Yes ]
- Dose-limiting toxicities as assessed by hematology and biochemistry testing on days 1, 8, and 28 of each course [ Designated as safety issue: Yes ]
- Antitumor activity as measured by radiographic response using RECIST criteria after every 2 courses of treatment [ Designated as safety issue: No ]
- Antitumor activity as measured by pathologic response using the Huvos grading system to evaluate post-treatment tumor necrosis at time of tumor resection after completion of study treatment [ Designated as safety issue: No ]
|Study Start Date:||April 2005|
|Primary Completion Date:||April 2007 (Final data collection date for primary outcome measure)|
- Determine the maximum tolerated dose of trimetrexate glucuronate when administered with high-dose methotrexate and leucovorin calcium in patients with refractory or recurrent high-grade osteosarcoma.
- Determine the dose-limiting toxic effects of this regimen in these patients.
- Determine, preliminarily, the antitumor activity of this regimen in these patients.
OUTLINE: This is a dose-escalation study of trimetrexate glucuronate.
Patients receive high-dose methotrexate IV over 4 hours on days 1 and 8 and oral trimetrexate glucuronate twice daily on days 2-6 and 9-13. Patients also receive leucovorin calcium IV continuously over 24 hours or orally 2 or 4 times daily on days 9-14. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
Cohorts of 3-6 patients receive escalating doses of trimetrexate glucuronate 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.
PROJECTED ACCRUAL: A maximum of 18 patients will be accrued for this study within 2 years.
|United States, New York|
|Memorial Sloan-Kettering Cancer Center|
|New York, New York, United States, 10021|
|Study Chair:||Paul A. Meyers, MD||Memorial Sloan-Kettering Cancer Center|