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A Phase I Study of Continuous Intravenous Infusion of PSC 833 and Vinblastine in Patients With Metastatic Renal Cancer

This study has been completed.
Study NCT00001570.   Last updated on March 3, 2008.   Information provided by National Institutes of Health Clinical Center (CC)

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Descriptive Information Fields
Brief Title  A Phase I Study of Continuous Intravenous Infusion of PSC 833 and Vinblastine in Patients With Metastatic Renal Cancer
Official Title  A Phase I Study of Continuous Intravenous Infusion of PSC 833 and Vinblastine in Patients With Metastatic Renal Cancer
Brief Summary

Bolus PSC 833 is administered on Day 1 simultaneously with initiation of 24 hour continuous infusion of PSC 833, followed by another continuous infusion lasting an additional 6 days. To ensure the safety of a 7 day infusion of PSC 833, one patient is treated for 5 days and a second for 6 days, before the first cohort is enrolled.

Vinblastine is administered in escalating doses on days 2-5. At least 3 patients are entered at each dose level. The MTD will be defined as the dose immediately below that at which 2 patients experience dose limiting toxicity.

Treatment continues every 28 days.

Detailed Description

The Phase I clinical trial of the combination of 120-hour continuous intravenous infusion of vinblastine with oral PSC 833 has shown activity in patients with advanced malignancies, particularly renal cell cancer. The MTD of vinblastine in combination with the oral drink solution of PSC 833 was determined to be 0.9 mg/m2/day for five days and 12.5 mg/kg po q 12 hours for eight days, respectively. For the soft gel capsule formulation, the MTD was determined to be 0.6 mg/m2/day vinblastine for five days and 4 mg/kg po q 6 hours PSC 833 for eight days. Ataxia was the dose limiting toxicity. Of the 46 patients, two complete remissions and one partial remission were seen among 29 patients with renal cell carcinoma.

In this Phase I study, patients with advanced renal carcinoma will be treated with escalating doses of vinblastine given as a 72 hour infusion, starting at approximately 40% of the total standard dose. A shorter infusion schedule of vinblastine was chosen since there is evidence in other cytotoxic combinations that PSC 833 increases the AUC and decreases the plasma clearance of chemotherapeutic agents by approximately twofold. Cytochrome P 450 3A or CYP3A, which is the major cytochrome enzyme in the metabolism of vinblastine and PSC 833, will be measured during the first and fourth cycle through an in vivo test using a single intravenous dose of midazolam, a short-acting benzodiazepine. Vinblastine and PSC 833 pharmacokinetics will be performed at the same time. For patients with accessible lesions, tumor biopsy will be requested.

Study Phase Phase I
Study Type  Interventional
Study Design  Treatment, Safety Study
Primary Outcome Measure 
Secondary Outcome Measure 
Condition  Kidney Neoplasms
Neoplasm Metastasis
Intervention  Drug: PSC 833
Drug: vinblastine
MEDLINE PMIDs 7855615,   8636778,   1359150
Links
Recruitment Information Fields
Recruitment Status  Completed
Enrollment  46
Start Date  February 1997
Completion Date January 2001
Eligibility Criteria 

DISEASE CHARACTERISTICS:

Histologically proven renal cancer with clear cell component:

Measurable or evaluable disease;

No brain metastases;

No grade 2 or greater peripheral neuropathy or neurologic toxicity symptoms.

PRIOR/CONCURRENT THERAPY:

Biologic Therapy: Not specified.

Chemotherapy: No prior or concurrent hypersensitivity to PSC 833 or cyclosporine A.

Endocrine Therapy: Not specified.

Radiotherapy: No prior radiation therapy within 4 weeks of study.

Surgery: No major surgery within 4 weeks of study.

Other: No concurrent treatments that interfere with cyclosporine blood concentrations.

PATIENT CHARACTERISTICS:

Age: 18 and over.

Performance Status: ECOG 0-2.

Life Expectancy: At least 16 weeks.

Hematopoietic:

ANC greater than or equal to 1500/mm(3);

Platelet count greater than or equal to 100,000/mm(3).

Hepatic:

Bilirubin no greater than 1.5 x normal;

AST no greater than 2.5 x normal.

Renal:

Creatinine no greater than 2.0 mg/dL OR;

Creatinine clearance greater than or equal to 50 mL/min.

Cardiovascular:

No concurrent angina or myocardial infarction that has not been appropriately treated.

Other:

Not pregnant or nursing.

Effective contraceptive required of all fertile patients.

Patients with a history of curatively treated basal cell or squamous cell carcinoma are eligible.

No HIV seropositivity.

No chronic hepatitis or cirrhosis.

Patients with concurrent reversible conditions such as diabetes, hypercalcemia, hyperuricemia, hyperviscosity, infection, renal disease, or spinal cord compression are eligible with appropriate therapy.

Patients must give written informed consent.

Gender Both
Ages
Accepts Healthy Volunteers No
Contacts ††
Location Countries  United States
Administrative Information Fields
NCT ID  NCT00001570
Organization ID 970074
Secondary IDs †† 97-C-0074
Study Sponsor  National Cancer Institute (NCI)
Collaborators ††
Investigators 
Information Provided By National Institutes of Health Clinical Center (CC)
Verification Date January 2000
First Received Date  November 3, 1999
Last Updated Date March 3, 2008

 †    Required WHO trial registration data element.
††   WHO trial registration data element that is required only if it exists.




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