Riluzole and Sorafenib Tosylate in Treating Patients With Advanced Solid Tumors or Melanoma

This study is currently recruiting participants. (see Contacts and Locations)
Verified April 2014 by National Cancer Institute (NCI)
Sponsor:
Information provided by (Responsible Party):
National Cancer Institute (NCI)
ClinicalTrials.gov Identifier:
NCT01303341
First received: February 22, 2011
Last updated: June 30, 2014
Last verified: April 2014
  Purpose

This phase I trial is studying the side effects and best dose of sorafenib tosylate when given together with riluzole in treating patients with advanced solid tumors or melanoma. Riluzole may stop or slow the growth of tumor cells. Sorafenib tosylate may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Giving riluzole together with sorafenib tosylate may kill more tumor cells.


Condition Intervention Phase
Recurrent Melanoma
Stage IIIA Melanoma
Stage IIIB Melanoma
Stage IIIC Melanoma
Stage IV Melanoma
Unspecified Adult Solid Tumor, Protocol Specific
Drug: riluzole
Drug: sorafenib tosylate
Other: laboratory biomarker analysis
Other: pharmacological study
Phase 1

Study Type: Interventional
Study Design: Endpoint Classification: Safety Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Phase I Trial of Riluzole and Sorafenib in Patients With Advanced Solid Tumors and Melanoma

Resource links provided by NLM:


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

Primary Outcome Measures:
  • Maximum-tolerated dose of sorafenib tosylate and riluzole in patients with all types of solid tumors [ Time Frame: 28 days ] [ Designated as safety issue: Yes ]
    Maximum tolerated dose is defined as the first dose level at which exactly 2/6 patients experience dose limiting toxicity (DLT), or at which 1/6 experience DLT and (due to de-escalation) at least 2/3 or 3/6 patients treated with the next higher dose level had DLT.


Secondary Outcome Measures:
  • Suppression of MAPK and PI3K/AKT pathways [ Time Frame: Up to 3 years ] [ Designated as safety issue: No ]
  • Change in BCL-2 expression [ Time Frame: Baseline to 3 years ] [ Designated as safety issue: No ]
    Appropriate parametric (such as paired t-test) or nonparametric (such as Wilcoxon signed rank test) methods will be used.

  • Change in MCL-1 expression [ Time Frame: Baseline to 3 years ] [ Designated as safety issue: No ]
    Appropriate parametric (such as paired t-test) or nonparametric (such as Wilcoxon signed rank test) methods will be used.

  • Change in BIM expression [ Time Frame: Baseline to 3 years ] [ Designated as safety issue: No ]
    Appropriate parametric (such as paired t-test) or nonparametric (such as Wilcoxon signed rank test) methods will be used.

  • Pharmacokinetic parameters of the combination of riluzole with sorafenib tosylate [ Time Frame: On days 2, 8, 10, and 15 of each course ] [ Designated as safety issue: No ]
  • Change in microvesicle quantification [ Time Frame: Baseline to 3 years ] [ Designated as safety issue: No ]

Estimated Enrollment: 36
Study Start Date: February 2011
Estimated Primary Completion Date: November 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Treatment (riluzole and sorafenib tosylate)
Patients receive riluzole PO BID and sorafenib tosylate PO QD on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
Drug: riluzole
Given PO
Other Name: Rilutek
Drug: sorafenib tosylate
Given PO
Other Names:
  • BAY 43-9006
  • BAY 43-9006 Tosylate Salt
  • BAY 54-9085
  • Nexavar
  • SFN
Other: laboratory biomarker analysis
Correlative studies
Other: pharmacological study
Correlative studies
Other Name: pharmacological studies

Detailed Description:

PRIMARY OBJECTIVES:

I. To define a safe dose of sorafenib (sorafenib tosylate) to combine with riluzole in the treatment of patients with all types of solid tumors refractory to standard therapy or for whom no standard therapy exists.

SECONDARY OBJECTIVES:

I. To examine the correlation of clinical or radiologic response with signaling through the mitogen-activated protein kinase (MAPK) and phosphoinositide 3-kinase (PI3K)/protein kinase B (AKT) pathways.

II. To determine if response to therapy with riluzole and sorafenib correlates with expression levels of B-cell lymphoma (BCL)-2, myeloid cell leukemia (MCL)-1, or BIM.

III. To characterize the pharmacokinetics of the combination of riluzole with sorafenib and determine if any drug-drug interactions exist.

IV. To evaluate the microvesicle (an inter-cellular communication approach which may cargo proteins, ribonucleic acids [RNAs] and deoxyribonucleic acids [DNAs] to its host cell) quantification difference between pre-treatment and post-treatment peripheral blood samples of patients.

OUTLINE: This is a dose-escalation study of sorafenib tosylate.

Patients receive riluzole orally (PO) twice daily (BID) and sorafenib tosylate PO once daily (QD) on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

After completion of study therapy, patients are followed up for approximately 2-3 years.

  Eligibility

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

Inclusion Criteria:

  • Patients must have histologically proven solid tumors (Phase I) or stage III unresectable or stage IV metastatic melanoma with biopsiable tumor (expansion cohort) refractory to standard therapy or for whom no standard therapy exists or who decline standard therapy
  • Eastern Cooperative Oncology Group (ECOG) performance status =< 2
  • Patients must be willing and able to sign informed consent
  • Unlimited prior therapies are permitted for patients enrolled in the dose escalation phase of the study; patients in the expansion cohort of the study may not have any prior therapy with riluzole or sorafenib
  • Patients may have measurable or evaluable disease
  • Absolute neutrophil count (ANC) >= 1,500/μL
  • Platelets >= 100,000/μL
  • Total bilirubin =< 1.5 x institutional upper limit of normal (ULN)
  • Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT]) and alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) =< 2.5 x institutional ULN
  • International normalized ratio (INR) =< 1.5 x institutional ULN
  • Creatinine =< 2 x ULN
  • Patients with brain lesions that have been treated with whole brain radiotherapy and are clinically stable for at least 4 weeks, are not taking steroids and are not receiving enzyme-inducing anticonvulsants will be eligible

Exclusion Criteria:

  • Serious concomitant systemic disorders (including active infections) that would compromise the safety of the patient or compromise the patient's ability to complete the study, at the discretion of the investigator
  • For patients who have received gamma knife or stereotactic radiosurgery, a 2 week washout is required; patients who have had other types of radiotherapy, chemotherapy or biologic agents within 3 weeks (6 weeks for nitrosoureas or mitomycin C) prior to entering the study or those who have not recovered from adverse events due to agents administered more than 3 weeks earlier to =< grade 1; at least 4 weeks must have elapsed since any major surgery; patients with prostate cancer may continue to receive hormonal therapy
  • History of allergic reactions attributed to riluzole or sorafenib
  • Women of child-bearing potential and men must agree to use adequate contraception (hormonal, barrier method of birth control, or abstinence) prior to study entry, for the duration of study participation, and for 2 weeks after discontinuation of riluzole and/or sorafenib; should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately; pregnant (positive pregnancy test) or lactating patients cannot participate
  • Known human immunodeficiency virus (HIV) infection, or known history of active hepatitis B or C infection
  • Current, recent (within 4 weeks of the first treatment of this study), or planned participation in an experimental drug study (prevention trials are permitted if the trial is not testing a novel experimental agent)
  • Cardiac disease, including congestive heart failure > class II New York Heart Association(NYHA); patients must not have unstable angina (anginal symptoms at rest) or new onset angina (began within the last 3 months) or myocardial infarction within the past 6 months
  • History of stroke within six months
  • Clinically significant peripheral vascular disease
  • Cardiac ventricular arrhythmias requiring anti-arrhythmic therapy
  • Uncontrolled hypertension, defined as systolic blood pressure > 150 mm Hg or diastolic blood pressure > 90 mm Hg, despite optimal medical management
  • Active clinically serious infection > Common Terminology Criteria for Adverse Events (CTCAE) grade 2
  • Any of the following within 6 months prior to first dose of treatment: myocardial infarction, symptomatic coronary artery disease (severe or unstable angina), artery bypass graft, uncontrolled arrhythmias, symptomatic congestive heart failure, cerebrovascular accident or transient ischemic attack, or pulmonary embolus
  • Pulmonary hemorrhage/bleeding event >= CTCAE grade 2 within 4 weeks of first-dose of study drug
  • Any other hemorrhage/bleeding event >= CTCAE Grade 3 within 4 weeks of first dose of study drug
  • Evidence or history of bleeding diathesis or coagulopathy
  • Major surgery or significant traumatic injury within 4 weeks of first study drug
  • Because sorafenib is metabolized primarily by the cytochrome P450 3A4 (CYP3A4) liver enzyme and is a strong inhibitor of CYP2B6, 2C8, and riluzole is metabolized by CYP1A2, the eligibility of patients taking medications that are potent modulators of these enzymes will be determined following a review of their case by the Principal Investigator; every effort should be made to switch patients taking such agents or substances to other medications
  • Any condition that impairs the patient's ability to swallow whole pills
  • Any malabsorption problem
  • Anticipation of need for major surgical procedure during the course of the study
  • History of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within 6 months prior to Day 1 of treatment
  • Serious, non-healing wound, ulcer, or bone fracture
  • Inability to comply with study and/or follow-up procedures
  • Anticoagulation with Lovenox (enoxaparin) is permitted, however, patients on anticoagulation with warfarin are not permitted on this study
  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: NCT01303341

Locations
United States, New Jersey
Rutgers Cancer Institute of New Jersey Recruiting
New Brunswick, New Jersey, United States, 08903
Contact: Janice M. Mehnert    732-235-6031    mehnerja@cinj.rutgers.edu   
Principal Investigator: Janice M. Mehnert         
Sponsors and Collaborators
Investigators
Principal Investigator: Janice Mehnert Rutgers Cancer Institute of New Jersey
  More Information

No publications provided

Responsible Party: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT01303341     History of Changes
Other Study ID Numbers: NCI-2011-02597, NCI-2011-02597, CDR0000695355, 090906, 8850, P30CA072720, U01CA132194, R01CA149627
Study First Received: February 22, 2011
Last Updated: June 30, 2014
Health Authority: United States: Food and Drug Administration

Additional relevant MeSH terms:
Melanoma
Nevi and Melanomas
Neoplasms
Neuroendocrine Tumors
Neuroectodermal Tumors
Neoplasms, Germ Cell and Embryonal
Neoplasms by Histologic Type
Neoplasms, Nerve Tissue
Riluzole
Sorafenib
Excitatory Amino Acid Antagonists
Excitatory Amino Acid Agents
Neurotransmitter Agents
Molecular Mechanisms of Pharmacological Action
Pharmacologic Actions
Physiological Effects of Drugs
Neuroprotective Agents
Protective Agents
Central Nervous System Agents
Therapeutic Uses
Anticonvulsants
Antineoplastic Agents
Protein Kinase Inhibitors
Enzyme Inhibitors

ClinicalTrials.gov processed this record on July 22, 2014