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Bortezomib in Treating Young Patients With Refractory or Recurrent Leukemia
This study has been completed.
First Received: February 10, 2004   Last Updated: July 23, 2008   History of Changes
Sponsor: Children's Oncology Group
Collaborator: National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00077467
  Purpose

RATIONALE: Bortezomib may stop the growth of cancer cells by blocking the enzymes necessary for their growth.

PURPOSE: This phase I trial is studying the side effects and best dose of bortezomib in treating young patients with refractory or recurrent leukemia.


Condition Intervention Phase
Leukemia
Drug: bortezomib
Phase I

Study Type: Interventional
Study Design: Treatment, Open Label
Official Title: A Phase I Study of PS-341 (Velcade, Bortezomib) in Pediatric Patients With Refractory/Recurrent Leukemias

Resource links provided by NLM:


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

Primary Outcome Measures:
  • Maximum tolerated dose and recommended phase II dose [ Designated as safety issue: Yes ]
  • Toxicity as assessed by CTCAE 3.0 [ Designated as safety issue: Yes ]
  • Pharmacokinetics as assessed by CI, area under the curve (AUC), and half-life (T ½) [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Antitumor activity [ Designated as safety issue: No ]
  • Correlate apoptosis and NF-kB activation [ Designated as safety issue: No ]

Study Start Date: January 2004
Detailed Description:

OBJECTIVES:

Primary

  • Determine the maximum tolerated dose and recommended phase II dose of bortezomib in children with refractory or recurrent leukemia.
  • Determine the toxic effects of this drug in these patients.
  • Determine the pharmacokinetics of this drug in these patients.

Secondary

  • Determine, preliminarily, the antitumor activity of this drug in these patients.
  • Determine, preliminarily, the biologic activity of this drug in these patients.

OUTLINE: This is a dose-escalation, open-label, multicenter study.

Patients receive bortezomib IV over 3-5 seconds on days 1, 4, 8, and 11. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.

Cohorts of 3-6 patients receive escalating doses of bortezomib until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity.

PROJECTED ACCRUAL: A total of 3-36 patients will be accrued for this study within 1.5-36 months.

  Eligibility

Ages Eligible for Study:   1 Year to 21 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Histologically confirmed leukemia of 1 of the following types:

    • Acute lymphoblastic leukemia
    • Acute myeloid leukemia
    • Chronic myelogenous leukemia in blast crisis
  • Relapsed or refractory disease
  • Immunophenotypically confirmed disease, either at initial diagnosis or relapse
  • More than 25% blasts in the bone marrow (M3 bone marrow)
  • Active extramedullary disease (except leptomeningeal disease) allowed
  • No known curative therapy or therapy proven to prolong survival with an acceptable quality of life available

PATIENT CHARACTERISTICS:

Age

  • 1 to 21

Performance status

  • Karnofsky 50-100% (for patients age 11 to 21) OR
  • Lansky 50-100% (for patients age 10 and under)

Life expectancy

  • Not specified

Hematopoietic

  • Platelet count ≥ 20,000/mm^3*
  • Hemoglobin ≥ 8.0 g/dL*
  • WBC < 20,000/mm^3** (hydroxyurea for cytoreduction allowed)
  • No hyperleukocytosis (i.e., WBC > 100,000/mm^3) NOTE: *Transfusion allowed

NOTE: **An exception may be made at the discretion of the investigator

Hepatic

  • Bilirubin ≤ 1.5 times upper limit of normal (ULN)
  • ALT ≤ 5 times ULN
  • Albumin ≥ 2 g/dL

Renal

  • Creatinine clearance or radioisotope glomerular filtration rate ≥ 70 mL/min OR
  • Creatinine based on age as follows:

    • ≤ 0.8 mg/dL for patients age 5 and under
    • ≤ 1.0 mg/dL for patients age 6 to 10
    • ≤ 1.2 mg/dL for patients age 11 to 15
    • ≤ 1.5 mg/dL for patients age 16 to 21

Other

  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No uncontrolled infection

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • Recovered from prior immunotherapy
  • At least 7 days since prior filgrastim (G-CSF) or sargramostim (GM-CSF)
  • At least 7 days since prior biologic agents
  • At least 3 months since prior stem cell transplantation or rescue and no evidence of active graft-versus-host disease
  • No concurrent prophylactic G-CSF during course 1 of study
  • No concurrent immunotherapy
  • No concurrent biologic therapy

Chemotherapy

  • Recovered from prior chemotherapy
  • At least 24 hours since prior hydroxyurea for cytoreduction
  • At least 6 weeks since prior nitrosoureas
  • No concurrent chemotherapy

Endocrine therapy

  • At least 7 days since prior steroids (except as premedication prior to blood product transfusion)

Radiotherapy

  • Recovered from prior radiotherapy
  • At least 2 weeks since prior small port local palliative radiotherapy
  • At least 3 months since prior total body irradiation, craniospinal irradiation, or irradiation to more than 50% of the pelvis
  • At least 6 weeks since other prior substantial bone marrow radiotherapy
  • No concurrent radiotherapy

Surgery

  • Not specified

Other

  • At least 7 days since prior retinoids
  • No other concurrent investigational agents
  • No other concurrent anticancer agents
  • No concurrent anticonvulsant medications known to activate the cytochrome p450 system (e.g., phenytoin, carbamazepine, or phenobarbital)

    • Concurrent benzodiazepines and gabapentin are allowed
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00077467

Locations
United States, California
Stanford Cancer Center at Stanford University Medical Center
Palo Alto, California, United States
United States, District of Columbia
Children's National Medical Center
Washington, District of Columbia, United States
United States, Indiana
Indiana University Cancer Center
Indianapolis, Indiana, United States
United States, Minnesota
Fairview University Medical Center - University Campus
Minneapolis, Minnesota, United States
Mayo Clinic Cancer Center
Rochester, Minnesota, United States
United States, Mississippi
University of Mississippi Medical Center
Jackson, Mississippi, United States
United States, New York
SUNY Upstate Medical University Hospital
Syracuse, New York, United States
United States, Ohio
Cincinnati Children's Hospital Medical Center
Cincinnati, Ohio, United States
United States, Oregon
Cancer Institute at Oregon Health and Science University
Portland, Oregon, United States
United States, Pennsylvania
Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, United States
Children's Hospital of Pittsburgh
Pittsburgh, Pennsylvania, United States
United States, Texas
Simmons Comprehensive Cancer Center at University of Texas Southwestern Medical Center - Dallas
Dallas, Texas, United States
Baylor University Medical Center - Houston
Houston, Texas, United States
United States, Washington
Children's Hospital and Regional Medical Center - Seattle
Seattle, Washington, United States
Canada, Quebec
Hopital Sainte Justine
Montreal, Quebec, Canada
Sponsors and Collaborators
Children's Oncology Group
Investigators
Study Chair: Terzah M. Horton, MD, PhD Texas Children's Cancer Center
Investigator: Lisa Bomgaars, MD Texas Children's Cancer Center
  More Information

Additional Information:
Publications:
Horton TM, Pati D, Plon SE, Thompson PA, Bomgaars LR, Adamson PC, Ingle AM, Wright J, Brockman AH, Paton M, Blaney SM. A Phase 1 Study of the Proteasome Inhibitor Bortezomib in Pediatric Patients with Refractory Leukemia: a Children's Oncology Group Study. Clin Cancer Res. 2007 Mar 1;13(5):1516-22.
Horton TM, Thompson PA, Bomgaars LR, et al.: A phase I study of bortezomib (PS-341) in pediatric patients with relapsed or refractory leukemia: a Children's Oncology Group study. [Abstract] J Clin Oncol 24 (Suppl 18): A-9021, 507s, 2006.

Study ID Numbers: CDR0000350340, COG-ADVL0317
Study First Received: February 10, 2004
Last Updated: July 23, 2008
ClinicalTrials.gov Identifier: NCT00077467     History of Changes
Health Authority: United States: Federal Government

Keywords provided by National Cancer Institute (NCI):
recurrent childhood acute lymphoblastic leukemia
recurrent childhood acute myeloid leukemia
blastic phase chronic myelogenous leukemia
childhood acute promyelocytic leukemia (M3)

Additional relevant MeSH terms:
Leukemia
Neoplasms
Neoplasms by Histologic Type
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Therapeutic Uses
Bortezomib
Enzyme Inhibitors
Pharmacologic Actions
Protease Inhibitors

ClinicalTrials.gov processed this record on March 16, 2010