Now Available for Public Comment: Notice of Proposed Rulemaking (NPRM) for FDAAA 801 and NIH Draft Reporting Policy for NIH-Funded Trials

Doxorubicin Hydrochloride Liposome and Bortezomib in Treating Patients With Refractory Hematologic Cancer or Malignant Solid Tumor or Metastatic Breast Cancer

This study has been completed.
Sponsor:
Collaborator:
Information provided by (Responsible Party):
UNC Lineberger Comprehensive Cancer Center
ClinicalTrials.gov Identifier:
NCT00237627
First received: October 7, 2005
Last updated: May 16, 2012
Last verified: May 2012
  Purpose

RATIONALE: Drugs used in chemotherapy, such as doxorubicin hydrochloride liposome, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Bortezomib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Giving doxorubicin hydrochloride liposome together with bortezomib may kill more cancer cells.

PURPOSE: This phase I/II trial is studying the side effects and best dose of bortezomib when given together with doxorubicin hydrochloride liposome and to see how well they work in treating patients with refractory hematologic cancer or malignant solid tumor or metastatic breast cancer.


Condition Intervention Phase
Breast Cancer
Leukemia
Lymphoma
Multiple Myeloma and Plasma Cell Neoplasm
Ovarian Cancer
Unspecified Adult Solid Tumor, Protocol Specific
Drug: PS-341
Drug: Doxil
Drug: Velcade
Phase 1
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Phase I Evaluation of the Combination of Pegylated Liposomal Doxorubicin (Doxil®) With PS-341 in Patients With Refractory Hematologic and Solid Malignancies

Resource links provided by NLM:

Genetic and Rare Diseases Information Center resources: Acute Lymphoblastic Leukemia Acute Myelocytic Leukemia Acute Myeloid Leukemia, Adult Acute Non Lymphoblastic Leukemia Anaplastic Large Cell Lymphoma Anaplastic Plasmacytoma Angioimmunoblastic Lymphadenopathy With Dysproteinemia Angioimmunoblastic T-cell Lymphoma B-cell Lymphomas Breast Cancer, Male Burkitt Lymphoma Central Nervous System Lymphoma, Primary Chronic Lymphocytic Leukemia Chronic Myeloid Leukemia Chronic Myelomonocytic Leukemia Cutaneous T-cell Lymphoma Follicular Lymphoma Hairy Cell Leukemia Hodgkin Lymphoma Large Granular Lymphocyte Leukemia Leukemia, B-cell, Chronic Leukemia, Myeloid Leukemia, T-cell, Chronic Lymphoblastic Lymphoma Lymphoma, Large-cell Lymphoma, Large-cell, Immunoblastic Lymphoma, Small Cleaved-cell, Diffuse Lymphomatoid Granulomatosis Lymphosarcoma Mantle Cell Lymphoma Multiple Myeloma Mycosis Fungoides Ovarian Cancer Ovarian Epithelial Cancer Ovarian Germ Cell Tumor Plasmablastic Lymphoma Sezary Syndrome Systemic Mastocytosis Waldenstrom Macroglobulinemia
U.S. FDA Resources

Further study details as provided by UNC Lineberger Comprehensive Cancer Center:

Primary Outcome Measures:
  • Maximum tolerated dose (MTD) of PS-341 in combination with Doxil (Phase I) [ Time Frame: 1 year ] [ Designated as safety issue: Yes ]
    When the current dose level exceeds the MTD, the preceding dose-level will be considered to be the MTD if there have been six patients treated at that dose level. Otherwise, 3 additional patients will be treated at the presumed MTD. No further dose escalation will occur. MTD, like dose limiting toxicity (DLT), will be defined based on toxicities seen within the first cycle. Among the additional 3 patients enrolled in a cohort, if one or more DLT is observed, the MTD will be considered to have been exceeded

  • Response rate of the combination of Velcade and Doxil in patients with metastatic breast cancer [ Time Frame: every 42 days ] [ Designated as safety issue: No ]
    Radiographic response will be measured using RECIST criteria


Enrollment: 107
Study Start Date: May 2001
Study Completion Date: January 2010
Primary Completion Date: December 2006 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Part 1
Doxil + PS-341
Drug: PS-341
PS-341 will be administered as an intravenous push into a side arm of either a peripheral or central intravenous line infusing normal saline at 100 ml/hr. Patients will be treated twice weekly for two weeks, followed by a one week rest period, such that the typical days of treatment will be days 1, 4, 8, 11 of each three-week cycle. The initial dose level for PS-341 will be 0.9 mg/m2/dose intravenously, while subsequent dose levels will be determined according to a modified Fibonacci schema
Drug: Doxil
Doxil will be administered at a dose of 30 mg/m2 as a 1 hour infusion through either a peripheral or central intravenous line every 3 weeks (on day 4 of each 21 day cycle)
Other Name: pegylated liposomal doxorubicin
Experimental: Part 2
Doxil + Velcade
Drug: Doxil
Doxil will be administered at a dose of 30 mg/m2 as a 1 hour infusion through either a peripheral or central intravenous line every 3 weeks (on day 4 of each 21 day cycle)
Other Name: pegylated liposomal doxorubicin
Drug: Velcade
Velcade will be adminstered intravenously at 1.3 mg/m2 days 1, 4, 8, 11 every 3 weeks
Other Name: Bortezomib

Detailed Description:

OBJECTIVES:

Primary

  • Determine the maximum tolerated dose of bortezomib when administered with pegylated doxorubicin hydrochloride liposome in patients with refractory hematologic or solid tumor malignancies. (Phase I [closed to accrual as of 10/15/2007])
  • Determine the dose-limiting toxicity of this regimen in these patients. (Phase I [closed to accrual as of 10/15/2007])
  • Determine the response rate in patients with metastatic breast cancer treated with this regimen. (Phase II)

Secondary

  • Determine the response in patients with hematologic or solid tumor malignancies treated with this regimen. (Phase I [closed to accrual as of 10/15/2007])
  • Determine the time to disease progression in patients with metastatic breast cancer treated with this regimen. (Phase II)
  • Obtain further evidence of the safety of this regimen in patients with metastatic breast cancer. (Phase II)

OUTLINE: This is a phase I (closed to accrual as of 10/15/2007), dose-escalation study of bortezomib followed by a phase II study.

  • Phase I (closed to accrual as of 10/15/2007): Patients receive bortezomib IV on days 1, 4, 8, and 11 and pegylated doxorubicin hydrochloride liposome IV over 1 hour on day 4. Treatment repeats every 21 days in the absence of disease progression or unacceptable toxicity.
  • Phase II: Patients receive bortezomib (at the maximum tolerated dose determined in phase I) and pegylated doxorubicin hydrochloride liposome as in phase I.

After completion of study therapy, patients are followed at 1 week.

PROJECTED ACCRUAL: A total of 72 patients will be accrued for the phase I portion of the study and 40 for the phase II portion.

  Eligibility

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

DISEASE CHARACTERISTICS:

Phase I (closed to accrual as of 10/15/2007)

  • Histologically or cytologically confirmed solid tumor or hematologic malignancy, including, but not limited to, any of the following:

    • Breast cancer
    • Ovarian cancer
    • Myeloid or lymphoid leukemia
    • Hodgkin or non-Hodgkin lymphoma
    • Multiple myeloma
  • Measurable or evaluable disease
  • Must meet 1 of the following criteria:

    • Refractory to at least one prior conventional treatment regimen
    • Not a candidate for conventional therapy
    • No conventional therapy exists
  • No clinically or radiographically significant pleural or pericardial effusion

    • Patients with ascites may be eligible at the discretion of the investigator
  • Previously treated central nervous system disease allowed provided it has been stable for > 3 months and it is not the only site of measurable disease
  • Not eligible for a higher priority protocol

Phase II

  • Diagnosis of breast cancer

    • Metastatic disease
  • Measurable disease by RECIST criteria
  • No symptomatic brain metastases

    • Patients with treated brain metastases that have been stable for > 3 months and does not require chronic steroids are eligible
  • Hormone receptor status not specified

PATIENT CHARACTERISTICS:

Phase I (closed to accrual as of 10/15/2007)

  • Karnofsky performance status 60-100%
  • Life expectancy ≥ 2 months
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • WBC ≥ 2,000/mm³
  • ANC ≥ 1,500/mm³ (≥ 1,000/mm³ for patients with marrow infiltration)
  • Platelet count ≥ 100,000/mm³ (≥ 50,000/mm³ for patients with marrow infiltration)
  • Hemoglobin ≥ 8 g/dL
  • Creatinine ≤ 2.5 mg/dL OR creatinine clearance ≥ 30 mL/min
  • AST and ALT < 2.5 times upper limit of normal (ULN)
  • Total bilirubin < 1.2 times ULN
  • Prothrombin time (PT) and activated partial thromboplastin time (aPTT) < 1.5 times ULN

    • Patients receiving warfarin or heparin therapy for a history of thrombosis, embolism, or other indication must have PT and/or aPTT within the accepted therapeutic ranges for those indications
  • Patients with a history of reactions to other liposomal drug formulations that are not due to the liposome itself may be eligible at the discretion of the investigator
  • No known HIV seropositivity
  • No known active hepatitis A, B, or C viral infection
  • No New York Heart Association class III or IV congestive heart failure
  • LVEF ≥ 45% by 2-D ECHO or MUGA
  • No acute ischemia or new conduction system abnormality by EKG
  • No conduction system abnormality (e.g., left bundle branch block) by EKG that would preclude the ability to detect new ischemic episodes
  • No myocardial infarction within the past 6 months
  • No significant comorbidity, such as poorly controlled hypertension, diabetes mellitus, or other serious medical or psychiatric illness that, in the opinion of the investigator, might compromise any aspect of the study
  • No uncontrolled infection

    • Patients may have febrile episodes up to 38.5°C if these are felt to be due to tumor fever and the possibility of infection has been ruled out by evaluation
  • No prior hypersensitivity reaction to pegylated doxorubicin hydrochloride liposome or doxorubicin hydrochloride

    • Patients with a history of reactions to other liposomal drug formulations and/or to the liposome itself, as opposed to the encapsulated agent, may be excluded at the discretion of the investigator

Phase II

  • Female or male
  • Menopausal status not specified
  • Karnofsky performance status 70-100%
  • Life expectancy ≥ 3 months
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for 3 months after completion of study therapy
  • ANC ≥ 1,500/mm³
  • Platelet count ≥ 100,000/mm³
  • Hemoglobin ≥ 9.0 g/dL
  • Creatinine ≤ 2.5 mg/dL (≤ 200 µmol/L)
  • AST and ALT ≤ 2 times ULN
  • Alkaline phosphatase ≤ 2 times ULN (unless attributed to tumor)
  • Bilirubin ≤ ULN
  • Cardiac ejection fraction > 50% by MUGA or 2-D ECHO
  • No clinical evidence of congestive heart failure
  • No New York Heart Association class II-IV cardiac disease
  • No myocardial infarction within the past 6 months
  • No uncontrolled angina
  • No severe uncontrolled ventricular arrhythmias
  • No evidence of acute ischemia or active conduction system abnormalities by EKG

    • Any EKG abnormality at screening must be documented by the investigator as not medically relevant
  • No grade 2 peripheral neuropathy within the past 14 days
  • No significant comorbidity that would impair compliance with study therapy or interpretation of study results
  • No history of hypersensitivity reactions attributed to a conventional formulation of doxorubicin hydrochloride or the components of pegylated doxorubicin hydrochloride liposome
  • No hypersensitivity to bortezomib, boron, or mannitol
  • No serious medical or psychiatric illness likely to interfere with participation in this study

PRIOR CONCURRENT THERAPY:

Phase I (closed to accrual as of 10/15/2007)

  • More than 3 weeks since prior major surgery
  • More than 3 weeks since prior and no concurrent radiotherapy
  • More than 4 weeks since prior and no concurrent immunotherapy (i.e., interferon, interleukin, or other cytokine-based treatment)
  • More than 3 weeks since prior and no concurrent participation in another therapeutic clinical trial with an experimental drug
  • More than 3 weeks since prior and no other concurrent chemotherapy
  • No prior doxorubicin dose > 400 mg/m²
  • No other concurrent antineoplastic therapy

Phase II

  • More than 6 months since prior anthracyclines
  • More than 14 days since other prior investigational drugs
  • No more than 300 mg/m² of prior doxorubicin or 540 mg/m² of prior epirubicin
  • No more than two prior chemotherapy regimens for metastatic disease
  • No other concurrent antineoplastic therapy
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00237627

Locations
United States, North Carolina
Lineberger Comprehensive Cancer Center at University of North Carolina - Chapel Hill
Chapel Hill, North Carolina, United States, 27599-7295
Sponsors and Collaborators
UNC Lineberger Comprehensive Cancer Center
Investigators
Principal Investigator: Elizabeth C. Dees, MD UNC Lineberger Comprehensive Cancer Center
Principal Investigator: Robert Z. Orlowski, MD, PhD UNC Lineberger Comprehensive Cancer Center
  More Information

Additional Information:
Publications:
Responsible Party: UNC Lineberger Comprehensive Cancer Center
ClinicalTrials.gov Identifier: NCT00237627     History of Changes
Other Study ID Numbers: LCCC 2020, UNC-LCCC-2020, CDR0000368767
Study First Received: October 7, 2005
Last Updated: May 16, 2012
Health Authority: United States: Food and Drug Administration
United States: Institutional Review Board

Keywords provided by UNC Lineberger Comprehensive Cancer Center:
stage IIIA breast cancer
stage IIIB breast cancer
stage IIIC breast cancer
stage IV breast cancer
male breast cancer
recurrent ovarian epithelial cancer
stage III ovarian epithelial cancer
stage IV ovarian epithelial cancer
recurrent adult acute lymphoblastic leukemia
recurrent adult acute myeloid leukemia
adult acute myeloid leukemia with 11q23 (MLL) abnormalities
adult acute myeloid leukemia with inv(16)(p13;q22)
adult acute myeloid leukemia with t(15;17)(q22;q12)
adult acute myeloid leukemia with t(16;16)(p13;q22)
adult acute myeloid leukemia with t(8;21)(q22;q22)
secondary acute myeloid leukemia
mast cell leukemia
stage III chronic lymphocytic leukemia
stage IV chronic lymphocytic leukemia
refractory chronic lymphocytic leukemia
T-cell large granular lymphocyte leukemia
atypical chronic myeloid leukemia
accelerated phase chronic myelogenous leukemia
blastic phase chronic myelogenous leukemia
chronic phase chronic myelogenous leukemia
meningeal chronic myelogenous leukemia
relapsing chronic myelogenous leukemia
chronic myelomonocytic leukemia
refractory hairy cell leukemia
progressive hairy cell leukemia, initial treatment

Additional relevant MeSH terms:
Breast Neoplasms
Leukemia
Lymphoma
Multiple Myeloma
Neoplasms, Plasma Cell
Ovarian Neoplasms
Plasmacytoma
Adnexal Diseases
Blood Protein Disorders
Breast Diseases
Cardiovascular Diseases
Endocrine Gland Neoplasms
Endocrine System Diseases
Genital Diseases, Female
Genital Neoplasms, Female
Gonadal Disorders
Hematologic Diseases
Hemorrhagic Disorders
Hemostatic Disorders
Immune System Diseases
Immunoproliferative Disorders
Lymphatic Diseases
Lymphoproliferative Disorders
Neoplasms
Neoplasms by Histologic Type
Neoplasms by Site
Ovarian Diseases
Paraproteinemias
Skin Diseases
Urogenital Neoplasms

ClinicalTrials.gov processed this record on November 23, 2014