Cilengitide and Paclitaxel in Treating Patients With Advanced Solid Tumors That Cannot Be Removed By Surgery

This study is currently recruiting participants.
Verified March 2013 by National Cancer Institute (NCI)
Sponsor:
Information provided by (Responsible Party):
National Cancer Institute (NCI)
ClinicalTrials.gov Identifier:
NCT01276496
First received: January 12, 2011
Last updated: March 15, 2013
Last verified: March 2013
  Purpose

This phase I trial studies the side effects and the best dose of cilengitide when given together with paclitaxel in treating patients with advanced solid tumors that cannot be removed by surgery. Cilengitide may stop the growth of tumor cells by blocking blood flow to the tumor. Drugs used in chemotherapy, such as paclitaxel, work in different ways to the stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving cilengitide together with paclitaxel may kill more tumor cells


Condition Intervention Phase
Male Breast Cancer
Recurrent Breast Cancer
Stage IV Breast Cancer
Unspecified Adult Solid Tumor, Protocol Specific
Drug: cilengitide
Drug: paclitaxel
Other: laboratory biomarker analysis
Other: pharmacological study
Phase 1

Study Type: Interventional
Study Design: Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Phase I, Open Label, Dose Escalation Study of the Safety, Tolerability and Pharmacokinetic Properties of the Combination of Cilengitide and Paclitaxel in Patients With Advanced Solid Malignancies

Resource links provided by NLM:


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

Primary Outcome Measures:
  • Number and severity of all adverse events (overall, by dose-level, and by tumor group), graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) v4.0 [ Time Frame: Up to 3 months ] [ Designated as safety issue: Yes ]
    Tabulated and summarized in this patient population.

  • Hematologic toxicity measures of thrombocytopenia, neutropenia, and leukopenia, graded according to the NCI Common Toxicity Criteria [ Time Frame: Up to 3 months ] [ Designated as safety issue: Yes ]
    Assessed using continuous variables as the outcome measures (primarily nadir). Frequency distributions, graphical techniques and other descriptive measures will form the basis of these analyses.

  • Best response defined to be complete response (CR) or partial response (PR) as assessed by the Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 [ Time Frame: From start of the treatment until disease progression/recurrence, assessed up to 2 years ] [ Designated as safety issue: No ]
    Summarized by simple descriptive summary statistics.

  • Time until any treatment related toxicity [ Time Frame: Up to 2 years ] [ Designated as safety issue: Yes ]
  • Time until treatment related grade 3+ toxicity [ Time Frame: Up to 2 years ] [ Designated as safety issue: Yes ]
  • Time until hematologic nadirs (WBC, ANC, platelets) [ Time Frame: Up to 2 years ] [ Designated as safety issue: No ]
  • Time to progression [ Time Frame: Up to 2 years ] [ Designated as safety issue: No ]
  • Time to treatment failure [ Time Frame: Time from registration to documentation of progression, unacceptable toxicity, or refusal to continue participation by the patient, assessed up to 2 years ] [ Designated as safety issue: No ]
  • Cyr61 expression levels [ Time Frame: Up to day 43 ] [ Designated as safety issue: No ]
    Data will be summarized descriptively at baseline and at each cycle. Graphical methods will also be used to see how the biomarker changes during the course of treatment.


Estimated Enrollment: 32
Study Start Date: December 2010
Estimated Primary Completion Date: May 2013 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Treatment (cilengitide, paclitaxel)

Patients receive cilengitide IV over 1 hour on days* 1, 8, and 15 and paclitaxel IV over 1 hour on days 1, 8, and 15. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.

NOTE: *Some patients receive cilengitide IV over 1 hour on days 1, 2, 8, 9, 15, and 16.

Drug: cilengitide
Given IV
Other Name: EMD 121974
Drug: paclitaxel
Given IV
Other Names:
  • Anzatax
  • Asotax
  • TAX
  • Taxol
Other: laboratory biomarker analysis
Correlative studies
Other: pharmacological study
Correlative studies
Other Name: pharmacological studies

Detailed Description:

PRIMARY OBJECTIVES:

I. To determine the maximally tolerated dose (MTD) of cilengitide and paclitaxel at weekly dose schedule.

II. To describe the toxicities associated with cilengitide and paclitaxel. III. To describe any antitumor activity of cilengitide and paclitaxel at weekly dose schedule.

IV. To characterize pharmacokinetics (PK) of cilengitide and paclitaxel with the proposed schedule and correlate PK parameters to clinical outcome.

V. To evaluate the effect of cilengitide and paclitaxel on circulating Cyr61 using a novel "sandwich ELISA" assay and to correlate this effect with clinical response.

VI. To evaluate the information obtained through use of items from the Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) in Phase I studies.

OUTLINE: This is a dose-escalation study of cilengitide.

Patients receive cilengitide intravenously (IV) over 1 hour on days* 1, 8, and 15 and paclitaxel IV over 1 hour on days 1, 8, and 15. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.

NOTE: *Some patients receive cilengitide IV over 1 hour on days 1, 2, 8, 9, 15, and 16.

After completion of study treatment, patients are followed up for 3 months.

  Eligibility

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

Inclusion Criteria:

  • Histologic proof of cancer that is now unresectable (solid tumors, excluding lymphoma)
  • For Cohort II only: breast cancer patients who have progressed on taxanes are eligible ("progression on taxanes" is defined as any type of prior taxane exposure, that is, patients that progress during taxane treatment, immediately after taxane treatment)
  • ANC ≥ 1500/μL
  • Hgb ≥ 9 g/dL
  • PLT ≥ 100,000/μL
  • Total bilirubin ≤ 1.5 x upper limit of normal (ULN)
  • AST ≤ 3 x ULN or AST ≤ 5 x ULN if liver involvement
  • Creatinine ≤ 1.5 x ULN
  • ECOG performance status (PS) 0, or 1 (or KPS > 70)
  • Ability to provide informed consent
  • Willingness to return to the enrolling Mayo Clinic institution for follow-up
  • Life expectancy ≥ 12 weeks
  • Willingness to provide blood samples for the mandatory correlative research component
  • For Cohort II, available tissue is mandatory (tissue has to be enough to allow testing for the proposed biomarkers; otherwise, a biopsy to obtain new tissue is mandated)
  • Women of childbearing potential only: Negative serum pregnancy test done ≤ 7 days prior to registration, for women of childbearing potential including women within 2 years of postmenopause
  • Patients on hormonal therapy for breast cancer are allowed to continue their hormonal therapy

Exclusion Criteria:

  • Known standard therapy for the patient's disease that is potentially curative or definitely capable of extending life expectancy
  • Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
  • Any of the following prior therapies:

    • Chemotherapy ≤ 21 days prior to registration
    • Mitomycin C/nitrosoureas ≤ 42 days prior to registration
    • Immunotherapy ≤ 14 days prior to registration
    • Biologic therapy ≤ 14 days prior to registration
    • Prior investigational therapy ≤ 28 days prior to registration
    • Full* field radiation therapy ≤ 28 days prior to registration or limited** field radiation therapy < 14 days prior to registration
    • Full field radiation encompasses the entire area of known disease involvement and surrounding uninvolved but at-risk areas, e.g. subtotal nodal (mantle and upper abdomen) or total nodal irradiation

      • Limited field radiation is restricted to treating only the known areas of clinical disease, e.g. involved-field therapy for lymphoma
    • Major surgery (i.e., laparotomy) ≤ 4 weeks prior to registration; minor surgery ≤ 2 weeks prior to registration; NOTE: Insertion of a vascular access device is not considered major or minor surgery in this regard
  • Failure to fully recover from acute, reversible effects of prior chemotherapy regardless of interval since last treatment
  • New York Heart Association classification III or IV
  • CNS metastases or seizure disorder; Note: CNS metastases are allowed if previously treated and stable for at least 4 weeks
  • Any of the following:

    • Pregnant women
    • Nursing women
    • Men or women of childbearing potential who are unwilling to employ adequate contraception (condoms, diaphragm, injections, intrauterine device [IUD], or abstinence, etc.); oral, implantable, or injectable contraceptives may be affected by cytochrome P450 interactions, and are therefore not considered effective for this study
    • NOTE: This study involves an investigational agent whose genotoxic, mutagenic and teratogenic effects on the developing fetus and newborn are unknown
  • Other concurrent chemotherapy, immunotherapy, radiotherapy, or any ancillary therapy considered investigational (utilized for a non-FDA-approved indication and in the context of a research investigation)
  • Co-morbid systemic illnesses or other severe concurrent disease which, in the judgment of the investigator, would make the patient inappropriate for entry into this study or interfere significantly with the proper assessment of safety and toxicity of the prescribed regimens
  • Immunocompromised patients (other than that related to the use of corticosteroids) including patients known to be HIV positive on HAART therapy as there is a risk for drug interaction with antiretroviral treatment
  • Receiving any other investigational agent which would be considered as a treatment for the primary neoplasm
  • Other active malignancy =< 3 years prior to registration; EXCEPTIONS: Nonmelanotic skin cancer or carcinoma-in-situ of the cervix; NOTE: If there is a history of prior malignancy, they must not be receiving other specific treatment for their cancer
  • History of myocardial infarction ≤ 6 months prior to registration, or congestive heart failure requiring use of ongoing maintenance therapy for life-threatening ventricular arrhythmias
  • Uncontrolled hypertension, labile hypertension of history of poor compliance with antihypertensive medication
  • Patients with active, bleeding diathesis
  • Non-disease related- major surgery, =< 28 days or minor surgery =< 7 days prior to registration
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT01276496

Locations
United States, Florida
Mayo Clinic in Florida Recruiting
Jacksonville, Florida, United States, 32224-9980
Contact: Julian R. Molina         molina.julian@mayo.edu    
Principal Investigator: Julian R. Molina            
United States, Minnesota
Mayo Clinic Recruiting
Rochester, Minnesota, United States, 55905
Contact: Julian R. Molina     507-284-2511     molina.julian@mayo.edu    
Principal Investigator: Julian R. Molina            
Sponsors and Collaborators
Investigators
Principal Investigator: Julian Molina Mayo Clinic
  More Information

No publications provided

Responsible Party: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT01276496     History of Changes
Obsolete Identifiers: NCT01647139
Other Study ID Numbers: NCI-2013-00619, MC0915, U01CA069912
Study First Received: January 12, 2011
Last Updated: March 15, 2013
Health Authority: United States: Food and Drug Administration

Additional relevant MeSH terms:
Breast Neoplasms
Breast Neoplasms, Male
Neoplasms by Site
Neoplasms
Breast Diseases
Skin Diseases
Paclitaxel
Tubulin Modulators
Antimitotic Agents
Mitosis Modulators
Molecular Mechanisms of Pharmacological Action
Pharmacologic Actions
Antineoplastic Agents, Phytogenic
Antineoplastic Agents
Therapeutic Uses

ClinicalTrials.gov processed this record on May 22, 2013