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UCN-01 and Irinotecan in Treating Patients With Metastatic or Unresectable Solid Tumors or Triple-Negative Breast Cancer (Currently Accruing Only Triple-negative Breast Cancer Patients Since 6/8/2007)
This study is currently recruiting participants.
Verified by National Cancer Institute (NCI), August 2009
First Received: March 8, 2002   Last Updated: August 27, 2009   History of Changes
Sponsor: University of Virginia
Collaborators: National Cancer Institute (NCI)
Siteman Cancer Center at Barnes-Jewish Hospital - Saint Louis
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00031681
  Purpose

RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Giving UCN-01 together with irinotecan may help kill more cancer cells by making tumor cells more sensitive to the drug.

PURPOSE: This phase I trial is studying the side effects and best dose of giving UCN-01 together with irinotecan in treating patients with metastatic or unresectable solid tumors, including triple-negative breast cancer (currently enrolling only patients with triple-negative breast cancer since 6/8/2007).


Condition Intervention Phase
Cancer
Drug: 7-hydroxystaurosporine
Drug: irinotecan hydrochloride
Other: laboratory biomarker analysis
Phase I

Study Type: Interventional
Study Design: Treatment
Official Title: A Phase I Study Of UCN-01 In Combination With Irinotecan In Resistant Solid Tumor Malignancies (Part I) and in Triple Negative (ER-negative, PgR-negative, HER-2 Not Amplified) Recurrent Breast Cancers (Part II)

Resource links provided by NLM:


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

Primary Outcome Measures:
  • Anti-tumor activity (overall response rate [partial response and complete response], clinical benefit rate [partial response, complete response, and stable disease], and time to disease progression) [ Designated as safety issue: No ]
  • Side effect profile [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • In vivo mechanisms [ Designated as safety issue: No ]

Estimated Enrollment: 41
Study Start Date: December 2001
Estimated Primary Completion Date: July 2002 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • Determine the maximum tolerated dose of UCN-01 and irinotecan in patients with resistant solid tumors. (Part I [closed to accrual as of 6/8/2007])
  • Determine the dose-limiting toxicity of this regimen in these patients. (Part I [closed to accrual as of 6/8/2007])
  • Determine the types of toxic effects of this regimen in these patients. (Part I [closed to accrual as of 6/8/2007])
  • Determine the anti-tumor activity in terms of overall response rate (partial response [PR] and complete response [CR]), clinical benefit rate (PR, CR, and stable disease), and time to disease progression in patients with estrogen receptor-negative, progesterone receptor-negative, and HER-2 not amplified (triple negative) locally recurrent or metastatic breast cancer treated with this regimen. (Part II)
  • Determine the side effect profile of this regimen in patients with triple negative recurrent breast cancer. (Part II)

Secondary

  • Determine any anti-tumor activity of this regimen in these patients. (Part I [closed to accrual as of 6/8/2007])
  • Determine the pharmacokinetics of this regimen in these patients. (Part I [closed to accrual as of 6/8/2007])
  • Determine the activity of the serum α-acid glycoprotein and correlate this level with free UCN-01 concentrations. (Part I [closed to accrual as of 6/8/2007])
  • Determine the in vivo mechanisms of UCN-01 activity in these patients.

OUTLINE:

  • Part I (treatment of resistant solid tumors [closed to accrual as of 6/8/2007]):

This is a dose-escalation study.

Patients receive irinotecan IV over 90 minutes on days 1, 8, 15, and 22 and UCN-01 IV over 3 hours on days 2 and 23. Courses repeat every 42 days in the absence of disease progression or unacceptable toxicity.

Cohorts of 3-6 patients receive escalating doses of irinotecan and UCN-01 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.

Blood samples are collected periodically during study treatment.

  • Part II (treatment of triple negative recurrent breast cancer):

Patients receive irinotecan IV and UCN-01 IV as in part I at the MTD and undergo blood sample collection.

PROJECTED ACCRUAL: A total of 41 patients (21 part I [closed to accrual as of 6/8/2007] and 20 part II) will be accrued for this study.

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Part I (closed to accrual as of 6/8/2007)

    • Histologically confirmed solid tumor that is metastatic or unresectable for which standard curative measures do not exist or are no longer effective, including the following:

      • Gastrointestinal tract cancer
      • Lung cancer
      • Breast cancer
      • Ovarian cancer
      • Endometrial cancer
      • Cervical cancer
      • Prostate cancer
      • Head and neck cancer
    • Patients with or without measurable or evaluable disease allowed

      • Measurable disease, defined as ≥ 1 unidimensionally measurable lesion > 20 mm by conventional techniques or ≥ 10 mm with spiral CT scan

        • Tumor markers allowed for evaluable disease
        • Positive bone scan, osteoblastic metastases, and pleural or peritoneal effusions are not considered measurable or evaluable disease
    • No known brain metastases
  • Part II

    • Histologically confirmed (either primary or the recurrent site) locally recurrent or metastatic breast cancer not amendable to surgery

      • Measurable disease

        • For skin lesions, documentation by color photography and estimation of lesion size with a ruler are required
    • Must have undergone prior therapy with an anthracycline and a taxane either in the adjuvant or metastatic setting
    • CNS metastasis allowed provided stable disease (i.e., no evidence of local progression) ≥ 3 months after local therapy
    • Hormone receptor status:

      • Estrogen receptor negative
      • Progesterone receptor negative
      • HER-2 not amplified by fluorescence in situ hybridization

PATIENT CHARACTERISTICS:

Age:

  • 18 and over

Sex:

  • Not specified

Menopausal status:

  • Not specified

Performance status:

  • ECOG 0-2 OR
  • Karnofsky 60-100%

Life expectancy:

  • More than 12 weeks

Hematopoietic:

  • WBC at least 3,000/mm^3
  • Absolute neutrophil count at least 1,500/mm^3
  • Platelet count at least 100,000/mm^3
  • Hemoglobin ≥ 10 g/dL

Hepatic:

  • Bilirubin normal
  • AST/ALT no greater than 3 times upper limit of normal (ULN)
  • No Gilbert's disease
  • No chronic unconjugated hyperbilirubinemia

Renal:

  • Creatinine no greater than 1.5 times ULN OR
  • Creatinine clearance at least 60 mL/min

Cardiovascular:

  • No symptomatic cardiac dysfunction

Pulmonary:

  • No symptomatic pulmonary dysfunction
  • Oxygen saturation at least 90% by pulse oximetry on room air at rest and after walking 6 minutes

Other:

  • No insulin-dependent diabetes mellitus
  • No other uncontrolled concurrent illness
  • No active or ongoing infection
  • No psychiatric illness or social situation that would preclude study entry
  • No prior allergic reactions attributed to compounds of similar chemical or biological composition to UCN-01 or irinotecan
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

Biologic therapy:

  • No concurrent granulocyte colony-stimulating factors (filgrastim [G-CSF] or sargramostim [GM-CSF]) during the first course of study

Chemotherapy:

  • See Disease Characteristics (Part II)
  • More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin) and recovered
  • Prior irinotecan allowed
  • Less than 4 prior chemotherapy regimens in the adjuvant and/or metastatic setting (Part II)

Endocrine therapy:

  • Not specified

Radiotherapy:

  • More than 4 weeks since prior radiotherapy and recovered

Surgery:

  • Not specified

Other:

  • Concurrent warfarin allowed
  • Concurrent subcutaneous heparin allowed
  • No other concurrent investigational agents
  • No concurrent anticonvulsants (e.g., carbamazepine, phenobarbital, or phenytoin)
  • No concurrent combination antiretroviral therapy for HIV-positive patients
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00031681

Locations
United States, Missouri
Siteman Cancer Center at Barnes-Jewish Hospital - Saint Louis Recruiting
Saint Louis, Missouri, United States, 63110
Contact: Tibu N. Mwandoro, CCRC     314-747-5376        
United States, Virginia
University of Virginia Cancer Center Recruiting
Charlottesville, Virginia, United States, 22908
Contact: Mary Oliveri     434-924-9496        
Sponsors and Collaborators
University of Virginia
Siteman Cancer Center at Barnes-Jewish Hospital - Saint Louis
Investigators
Study Chair: Paula M. Fracasso, MD, PhD University of Virginia
Principal Investigator: Cynthia X. Ma, MD, PhD Siteman Cancer Center at Barnes-Jewish Hospital - Saint Louis
  More Information

Additional Information:
No publications provided

Study ID Numbers: CDR0000069215, UVACC-SCC-0102, WUSM-SCC-0102, NCI-5582
Study First Received: March 8, 2002
Last Updated: August 27, 2009
ClinicalTrials.gov Identifier: NCT00031681     History of Changes
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
stage IV colon cancer
stage IV breast cancer
recurrent breast cancer
stage IV gastric cancer
recurrent gastric cancer
recurrent non-small cell lung cancer
recurrent pancreatic cancer
stage IV rectal cancer
recurrent colon cancer
recurrent rectal cancer
stage IV anal cancer
recurrent anal cancer
stage IV esophageal cancer
recurrent esophageal cancer
recurrent cervical cancer
stage IVB cervical cancer
stage IVA cervical cancer
stage IV ovarian epithelial cancer
recurrent ovarian epithelial cancer
extensive stage small cell lung cancer
recurrent small cell lung cancer
metastatic gastrointestinal carcinoid tumor
recurrent gastrointestinal carcinoid tumor
advanced adult primary liver cancer
recurrent adult primary liver cancer
stage IV endometrial carcinoma
recurrent endometrial carcinoma
small intestine adenocarcinoma
small intestine lymphoma
small intestine leiomyosarcoma

Additional relevant MeSH terms:
Skin Diseases
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Irinotecan
Breast Neoplasms
Enzyme Inhibitors
7-hydroxystaurosporine
Protein Kinase Inhibitors
Camptothecin
Pharmacologic Actions
Neoplasms
Neoplasms by Site
Therapeutic Uses
Staurosporine
Antineoplastic Agents, Phytogenic
Breast Diseases

ClinicalTrials.gov processed this record on November 09, 2009