Liposomal Doxorubicin and Interleukin-12 in Treating Patients With AIDS-Related Kaposi's Sarcoma

This study has been completed.
Sponsor:
Information provided by:
National Cancer Institute (NCI)
ClinicalTrials.gov Identifier:
NCT00020449
First received: July 11, 2001
Last updated: June 18, 2013
Last verified: March 2004
  Purpose

RATIONALE: Drugs used in chemotherapy work in different ways to stop tumor cells from dividing so they stop growing or die. Interleukin-12 may kill tumor cells by stopping blood flow to the tumor and by stimulating a person's white blood cells to kill the tumor cells. Combining chemotherapy with interleukin-12 may kill more tumor cells.

PURPOSE: Phase II trial to study the effectiveness of combining liposomal doxorubicin with interleukin-12 in treating patients who have AIDS-related Kaposi's sarcoma.


Condition Intervention Phase
Sarcoma
Biological: recombinant interleukin-12
Drug: paclitaxel
Drug: pegylated liposomal doxorubicin hydrochloride
Phase 2

Study Type: Interventional
Study Design: Masking: Open Label
Primary Purpose: Treatment
Official Title: A Phase II Study of Liposomal Doxorubicin and Interleukin-12 in AIDS-Associated Kaposi's Sarcoma Followed by Chronic Administration of Interleukin-12

Resource links provided by NLM:


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

Study Start Date: January 2001
Study Completion Date: May 2004
Detailed Description:

OBJECTIVES:

  • Determine the overall response rate in patients with AIDS-associated Kaposi's sarcoma (KS) treated with doxorubicin HCl liposome and interleukin-12.
  • Determine the time to response and the number of complete responses in patients treated with this regimen.
  • Determine the progression-free survival of patients treated with this regimen.
  • Provide pilot information on the ability of interleukin-12 to maintain major responses induced with paclitaxel salvage therapy in patients with aggressive or life-threatening KS after treatment failure with doxorubicin HCl liposome and interleukin-12.
  • Determine the effect of this regimen on CD4 counts and viral load in these patients.

OUTLINE: Patients receive doxorubicin HCl liposome (LipoDox) IV over 30 minutes once every 3 weeks for a total of 6 doses. Beginning concurrently with the initiation of LipoDox, patients also receive interleukin-12 (IL-12) subcutaneously twice weekly (at least 3 days apart) for up to 3 years.

Patients with refractory disease are transferred to the paclitaxel salvage therapy regimen comprising paclitaxel IV continuously on days 1-4 once every 3 weeks until a major response is achieved. Beginning concurrently with the initiation of paclitaxel salvage therapy, patients also receive IL-12 as above for up to 3 years.

Treatment continues in the absence of disease progression or unacceptable toxicity. Patients achieving a complete response may discontinue IL-12 administration. If necessary, IL-12 treatment may resume at a later time.

Patients are followed at 4 weeks.

PROJECTED ACCRUAL: A total of 24-36 patients will be accrued for this study within 2-4 years.

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Histologically confirmed Kaposi's sarcoma (KS)
  • HIV positive
  • Evaluable disease involving the skin and/or viscera

    • At least 5 lesions not previously treated with local therapy if restricted to the skin
    • Pulmonary lesions evaluable by CT scan
    • Gastrointestinal lesions evaluable by visualization or fiberoptic instrumentation
  • Presence of at least one of the following indications for cytotoxic chemotherapy:

    • Pulmonary involvement
    • Visceral involvement
    • Pain
    • Edema
    • Ulcerating lesions
    • Decreased range of joint motion due to KS
    • Multiple lesions not amenable to local therapy
    • Lymphedema that impairs mobility or range of motion
    • Significant psychological impact leading to social withdrawal
  • Progressive disease within the past 3 weeks while receiving a stable regimen of highly active antiretroviral therapy for at least 4 weeks unless there is a need for urgent chemotherapy
  • Prior participation on this study allowed, provided patient was removed from study due to non-pancreatic hyperamylasemia and the following are true:

    • No dose-limiting toxicity by clinical and laboratory assessment
    • Pancreatic amylase portion normal by fractionated amylase
    • Lipase normal
    • No symptoms referable to the pancreas

PATIENT CHARACTERISTICS:

Age:

  • 18 and over

Performance status:

  • Karnofsky 30-100%

Life expectancy:

  • More than 2 months

Hematopoietic:

  • Hemoglobin at least 9.0 g/dL
  • Absolute neutrophil count at least 750/mm^3
  • Platelet count at least 75,000/mm^3

Hepatic:

  • Bilirubin no greater than 3.8 mg/dL with direct fraction no greater than 0.3 mg/dL and indirect fraction no greater than 3.5 mg/dL if due to protease inhibitor therapy
  • PT or aPTT no greater than 120% of control unless due to lupus-type anticoagulant
  • AST no greater than 2.5 times upper limit of normal
  • No prior hepatic cirrhosis
  • No hepatic dysfunction

Renal:

  • Creatinine no greater than 1.5 mg/dL
  • Creatinine clearance at least 60 mL/min

Cardiovascular:

  • No congestive heart failure
  • Ejection fraction at least 40% by MUGA or echocardiogram

Other:

  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective barrier contraception during and for 2 months after study participation
  • No clinically significant autoimmune disease
  • No active, gross gastrointestinal bleeding or uncontrolled peptic ulcer disease
  • No prior inflammatory bowel disease
  • No other prior or concurrent malignancy except squamous cell carcinoma in situ of the cervix or anus, completely resected basal cell carcinoma, or malignancy in complete remission for at least 1 year from the time a response was first documented
  • No severe or life-threatening infection within the past 2 weeks
  • No abnormality that would be scored as grade 3 toxicity except lymphopenia or direct manifestations of KS
  • No known hypersensitivity to interleukin-12 (IL-12) or other compounds known to cross-react with IL-12
  • No other medical condition that would preclude study entry

PRIOR CONCURRENT THERAPY:

Biologic therapy:

  • More than 2 weeks since prior cytokines or colony-stimulating factors other than epoetin alfa, filgrastim (G-CSF), or sargramostim (GM-CSF)
  • No prior combination interleukin-12 and doxorubicin HCl liposome except for patients previously treated on this protocol who are being enrolled for paclitaxel salvage therapy
  • No concurrent immunomodulatory agents
  • No concurrent cytokines except epoetin alfa or G-CSF

Chemotherapy:

  • See Disease Characteristics
  • See Biologic therapy
  • At least 3 weeks since prior chemotherapy (6 weeks for mitomycin or nitrosoureas)
  • More 6 months since prior suramin
  • No other concurrent cytotoxic chemotherapy

Endocrine therapy:

  • More than 2 months since prior systemic glucocorticoid steroids at doses sufficient to affect immune response (e.g., more than 20 mg of prednisone for more than 1 week)
  • Concurrent replacement glucocorticoid therapy allowed
  • No other concurrent systemic glucocorticoid therapy

Radiotherapy:

  • Not specified

Surgery:

  • Not specified

Other:

  • Concurrent antiretroviral therapy required
  • No other concurrent anti-KS therapy
  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: NCT00020449

Locations
United States, Maryland
Warren Grant Magnuson Clinical Center - NCI Clinical Studies Support
Bethesda, Maryland, United States, 20892-1182
Sponsors and Collaborators
Investigators
Study Chair: Pallavi P. Kumar, MD NCI - HIV and AIDS Malignancy Branch
  More Information

Additional Information:
Publications:
Little RF, Aleman K, Merced K, et al.: Preliminary results of combination liposomal doxorubicin and interleukin-12 followed by chronic IL-12 maintenance therapy in advanced AIDS-related Kaposi's sarcoma. [Abstract] 10th Conference on Retroviruses and Opportunistic Infections, February 10-14, 2003, Boston, Massachusetts A-816, 2003.

ClinicalTrials.gov Identifier: NCT00020449     History of Changes
Obsolete Identifiers: NCT00008879
Other Study ID Numbers: CDR0000068502, NCI-01-C-0067, NCI-4010
Study First Received: July 11, 2001
Last Updated: June 18, 2013
Health Authority: United States: Federal Government

Keywords provided by National Cancer Institute (NCI):
AIDS-related Kaposi sarcoma
recurrent Kaposi sarcoma

Additional relevant MeSH terms:
Sarcoma, Kaposi
Sarcoma
Herpesviridae Infections
DNA Virus Infections
Virus Diseases
Neoplasms, Connective and Soft Tissue
Neoplasms by Histologic Type
Neoplasms
Neoplasms, Vascular Tissue
Doxorubicin
Paclitaxel
Interleukin-12
Antibiotics, Antineoplastic
Antineoplastic Agents
Therapeutic Uses
Pharmacologic Actions
Tubulin Modulators
Antimitotic Agents
Mitosis Modulators
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents, Phytogenic
Angiogenesis Inhibitors
Angiogenesis Modulating Agents
Growth Substances
Physiological Effects of Drugs
Growth Inhibitors
Adjuvants, Immunologic
Immunologic Factors

ClinicalTrials.gov processed this record on July 24, 2014