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Sorafenib, Pemetrexed, and Cisplatin in Treating Patients With Advanced Solid Tumors

This study is currently recruiting participants.
Study NCT00703638.   Last updated on September 22, 2008.   Information provided by National Cancer Institute (NCI)

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Descriptive Information Fields
Brief Title  Sorafenib, Pemetrexed, and Cisplatin in Treating Patients With Advanced Solid Tumors
Official Title  Phase I Study of Sorafenib, Pemetrexed, and Cisplatin for the Treatment of Advanced Solid Tumors.
Brief Summary

RATIONALE: Sorafenib and pemetrexed may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Sorafenib may also stop the growth of tumor cells by blocking blood flow to the tumor. Drugs used in chemotherapy, such as cisplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving sorafenib together with pemetrexed and cisplatin may kill more tumor cells.

PURPOSE: This phase I trial is studying the side effects and best dose of sorafenib when given together with pemetrexed and cisplatin in treating patients with advanced solid tumors.

Detailed Description

OBJECTIVES:

Primary

  • To determine the maximum tolerated dose of sorafenib tosylate when given in combination with pemetrexed disodium and cisplatin in patients with advanced non-squamous cell solid tumor malignancy including, but not limited to, breast, lung, colon, pancreatic, prostate, or head and neck cancer or sarcoma.

Secondary

  • To characterize the quantitative and qualitative toxicities of this regimen in these patients.
  • To obtain preliminary information about the antitumor activity of this regimen in these patients.

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

Patients receive oral sorafenib tosylate once daily on days 1-21 and cisplatin IV over 1-2 hours and pemetrexed disodium IV over 10 minutes on day 1. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed at 30 days, every 8 weeks until disease progression, and then every 3 months for up to 6 months.

Study Phase Phase I
Study Type  Interventional
Study Design  Treatment
Primary Outcome Measure  Maximum tolerated dose of sorafenib tosylate [ Designated as safety issue: Yes ]
Toxicity as assessed by NCI CTCAE v3.0 [ Designated as safety issue: Yes ]
Disease response as assessed by RECIST criteria [ Designated as safety issue: No ]
Secondary Outcome Measure 
Condition  Breast Cancer
Colorectal Cancer
Head and Neck Cancer
Lung Cancer
Malignant Mesothelioma
Pancreatic Cancer
Prostate Cancer
Sarcoma
Intervention  Drug: cisplatin
Drug: pemetrexed disodium
Drug: sorafenib tosylate
MEDLINE PMIDs
Links Clinical trial summary from the National Cancer Institute's PDQ® database This link exits the ClinicalTrials.gov site
Recruitment Information Fields
Recruitment Status  Recruiting
Enrollment  12
Start Date  May 2008
Completion Date
Eligibility Criteria 

DISEASE CHARACTERISTICS:

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

    • Breast cancer
    • Lung cancer
    • Colon cancer
    • Pancreatic cancer
    • Prostate cancer
    • Head and neck cancer
    • Sarcoma
  • No squamous cell lung cancer
  • Advanced disease

    • Must have failed or become intolerant to prior standard therapy and is no longer likely to respond to such therapy

      • Patients with mesothelioma do not have to meet prior therapy requirements in order to be enrolled on the study since the combination of cisplatin and pemetrexed disodium is considered current standard first-line therapy for mesothelioma
  • Measurable or nonmeasurable disease as defined by RECIST criteria
  • Previously treated stable brain metastases allowed
  • No clinically significant third-space fluid, such as pleural effusion or ascites

    • Third-space fluid allowed provided it can be completely drained
  • Hormone receptor status not specified

PATIENT CHARACTERISTICS:

  • Menopausal status not specified
  • ECOG performance status 0-2
  • ANC ≥ 1.5 x 10^9/L
  • Platelet count ≥ 100 x 10^9/L
  • Hemoglobin ≥ 9 g/dL
  • Bilirubin ≤ 1.5 times upper limit of normal (ULN)
  • Alkaline phosphatase ≤ 3 times ULN (5 times ULN if liver has tumor involvement)
  • AST and ALT ≤ 3 times ULN (5 times ULN if liver has tumor involvement)
  • Serum creatinine ≤ 1.5 mg/dL
  • Creatinine clearance > 45 mL/min
  • INR < 1.5 OR PT/PTT normal
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective barrier contraception during and for 2 weeks after completion of study treatment
  • Able to take folic acid and vitamin B_12
  • Able to take oral medications without crushing, dissolving, or chewing tablets
  • No malabsorption problem
  • No other condition that impairs the patient's ability to swallow whole pills
  • No New York Heart Association class III-IV congestive heart failure
  • No unstable angina (anginal symptoms at rest) or new onset angina within the past 3 months
  • No myocardial infarction within the past 6 months
  • No cardiac ventricular arrhythmias requiring anti-arrhythmic therapy
  • No uncontrolled hypertension, defined as systolic blood pressure (BP) > 150 mm Hg or diastolic BP > 90 mm Hg despite optimal medical management
  • No thrombolic or embolic events, such as cerebrovascular accident or transient ischemic attacks, within the past 6 months
  • No pulmonary hemorrhage/bleeding event ≥ CTCAE grade 2 within the past 4 weeks
  • No other hemorrhage/bleeding event ≥ CTCAE grade 3 within the past 4 weeks
  • No evidence or history of bleeding diathesis or coagulopathy
  • No known or suspected allergy to sorafenib tosylate, pemetrexed disodium, cisplatin, or any agent given in the course of this study
  • No known HIV infection or chronic hepatitis B or C infection
  • No active clinically serious infection > CTCAE grade 2
  • No serious nonhealing wound, ulcer, or bone fracture
  • No significant traumatic injury within the past 4 weeks
  • No peripheral neuropathy ≥ CTCAE grade 2
  • No second primary malignancy except in situ carcinoma of the cervix or breast or other in situ malignancies, adequately treated basal cell carcinoma of the skin, or other malignancy treated at least 3 years ago with no evidence of recurrence

PRIOR CONCURRENT THERAPY:

  • At least 3 weeks since prior systemic therapy (6 weeks for bevacizumab) and recovered
  • At least 3 months since prior pemetrexed disodium or cisplatin
  • No prior sorafenib tosylate
  • More than 4 weeks since prior major surgery or open biopsy
  • No NSAIDs or salicylates for 2 days before, during, and for 2 days after pemetrexed disodium administration

    • No NSAIDs or salicylates with a long half-life (e.g., naproxen, piroxicam, diflunisal, albumetone) for 5 days before, during, and for 2 days after pemetrexed disodium administration
  • No concurrent Hypericum perforatum (St. John's wort) or rifampin
  • Concurrent anti-coagulation treatment with warfarin or heparin allowed
Gender Both
Ages 18 Years and older
Accepts Healthy Volunteers No
Contacts ††
Location Countries  United States
Administrative Information Fields
NCT ID  NCT00703638
Organization ID CDR0000597879
Secondary IDs †† UMN-2007LS086, 0712M22703, BAYER-UMN-2007LS086
Study Sponsor  Masonic Cancer Center, University of Minnesota
Collaborators †† National Cancer Institute (NCI)
Investigators 
Principal Investigator:     Priya Kumar, MD     Masonic Cancer Center, University of Minnesota    
Information Provided By National Cancer Institute (NCI)
Verification Date August 2008
First Received Date  June 20, 2008
Last Updated Date September 22, 2008

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




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