Full Text View
Tabular View
No Study Results Posted
Related Studies
Oblimersen Plus Combination Chemotherapy and Dexrazoxane in Treating Children and Adolescents With Relapsed or Refractory Solid Tumors
This study has been completed.
First Received: June 6, 2002   Last Updated: May 9, 2009   History of Changes
Sponsor: Children's Oncology Group
Collaborator: National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00039481
  Purpose

RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Oblimersen may increase the effectiveness of doxorubicin and cyclophosphamide by making the tumor cells more sensitive to the drug. Chemoprotective drugs such as dexrazoxane may protect normal cells from the side effects of chemotherapy.

PURPOSE: Phase I trial to study the effectiveness of oblimersen plus combination chemotherapy and dexrazoxane in treating children and adolescents who have relapsed or refractory solid tumors.


Condition Intervention Phase
Cardiac Toxicity
Unspecified Childhood Solid Tumor, Protocol Specific
Biological: filgrastim
Biological: oblimersen sodium
Drug: cyclophosphamide
Drug: dexrazoxane hydrochloride
Drug: doxorubicin hydrochloride
Phase I

Study Type: Interventional
Study Design: Treatment
Official Title: A Phase I Trial Of G3139 (BCL-2 Antisense, NSC# 683428, IND# 58842) Combined With Cytotoxic Chemotherapy In Relapsed Childhood Solid Tumors

Resource links provided by NLM:


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

Study Start Date: November 2002
Detailed Description:

OBJECTIVES:

  • Determine the dose-limiting toxic effects and recommended phase II dose of oblimersen when combined with cyclophosphamide, doxorubicin, and dexrazoxane in pediatric patients with relapsed or refractory solid tumors.
  • Determine the pharmacokinetic behavior of this regimen in these patients.
  • Determine, preliminarily, the antitumor activity of oblimersen in these patients.
  • Assess the biologic activity of oblimersen in mononuclear cells and tumor tissues, in terms of bcl-2 and related protein expression, in these patients.

OUTLINE: This is a 2-part, multicenter, dose-escalation study.

  • Part A: Patients receive oblimersen IV continuously on days 1-7. Patients also receive dexrazoxane IV followed by doxorubicin IV over 15 minutes followed by cyclophosphamide IV over 1 hour on days 5 and 6. Filgrastim (G-CSF) is administered subcutaneously once daily beginning on day 8 and continuing until blood counts recover. Treatment repeats every 21 days for up to 18 courses (1 year) in the absence of disease progression or unacceptable toxicity. Patients with stable or responding disease whose shortening fraction falls below 28% by echocardiogram or whose total life-time cumulative anthracycline dose exceeds 750 mg/m^2 may receive additional courses of oblimersen and cyclophosphamide without doxorubicin and dexrazoxane.

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

  • Part B: Patients receive oblimersen at the MTD determined in part A and escalating doses of dexrazoxane, doxorubicin, and cyclophosphamide on the same treatment schedule as in part A.

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

Patients are followed for survival.

PROJECTED ACCRUAL: A total of 12-15 patients will be accrued for this study within 1-2 years.

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Histologically confirmed solid tumor at original diagnosis that has failed standard therapy or for which no standard therapy exists

    • Patients must have a disease for which there is no known curative potential
  • Patients must meet the following criteria for bone marrow function:

    • Status post stem cell transplantation (SCT)
    • Absolute neutrophil count at least 1,500/mm^3
    • Platelet count at least 100,000/mm^3 (transfusion independent)
    • Hemoglobin at least 8.0 g/dL (RBC transfusions allowed)
  • No lymphomas
  • No CNS tumors or known metastatic disease to the brain or spinal cord

PATIENT CHARACTERISTICS:

Age:

  • 1 to 21

Performance status:

  • Karnofsky 50-100% (age 11 to 21)
  • Lansky 50-100% (age 1 to 10)

Life expectancy:

  • At least 8 weeks

Hematopoietic:

  • See Disease Characteristics

Hepatic:

  • Bilirubin no greater than 1.5 times upper limit of normal (ULN)
  • ALT no greater than 3 times ULN
  • No significant hepatic dysfunction

Renal:

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

    • Age 1 to 5: no greater than 0.8 mg/dL
    • Age 6 to 10: no greater than 1.0 mg/dL
    • Age 11 to 15: no greater than 1.2 mg/dL
    • Age 16 to 21: no greater than 1.5 mg/dL
  • No significant renal dysfunction

Cardiovascular:

  • Shortening fraction at least 28% by echocardiogram OR
  • Ejection fraction at least 45% by MUGA

Pulmonary:

  • No significant pulmonary dysfunction

Other:

  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No serious uncontrolled infections
  • No other end-organ dysfunction that would preclude study entry
  • No other clinically significant systemic illness

PRIOR CONCURRENT THERAPY:

Biologic therapy:

  • See Disease Characteristics
  • Recovered from prior immunotherapy
  • At least 1 week since prior growth factors or other biologic agents
  • At least 6 months since prior autologous SCT
  • At least 6 months since prior allogeneic bone marrow transplantation and recovered with no evidence of graft-versus-host disease
  • No concurrent immunomodulating agents
  • No concurrent prophylactic growth factors during the first course of the study
  • No concurrent immunotherapy or other biologic therapy

Chemotherapy:

  • Recovered from prior chemotherapy
  • At least 2 weeks since prior myelosuppressive chemotherapy (6 weeks for nitrosoureas)
  • No prior life-time cumulative doxorubicin dose of more than 450 mg/m^2 or equivalent
  • No other concurrent chemotherapy

Endocrine therapy:

  • Concurrent chronic steroids allowed

Radiotherapy:

  • Recovered from prior radiotherapy
  • More than 2 weeks since prior localized palliative radiotherapy (small port)
  • More than 6 months since prior substantial radiotherapy to bone marrow (craniospinal radiotherapy, total body irradiation, or hemi-pelvic radiotherapy)
  • No concurrent radiotherapy

Surgery:

  • Not specified

Other:

  • Concurrent chronic medications (e.g., narcotics or antiepileptics) allowed
  • No other concurrent investigational agents
  • No other concurrent cancer therapy
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00039481

  Show 22 Study Locations
Sponsors and Collaborators
Children's Oncology Group
Investigators
Study Chair: Susan Rheingold, MD Children's Hospital of Philadelphia
  More Information

Additional Information:
Publications:
Rheingold SR, Hogarty MD, Blaney SM, Zwiebel JA, Sauk-Schubert C, Chandula R, Krailo MD, Adamson PC; Children's Oncology Group Study. Phase I Trial of G3139, a bcl-2 antisense oligonucleotide, combined with doxorubicin and cyclophosphamide in children with relapsed solid tumors: a Children's Oncology Group Study. J Clin Oncol. 2007 Apr 20;25(12):1512-8.
Rheingold S, Krailo M, Blaney S, et al.: A Phase I trial of G3139 (Bcl-2 Antisense) combined with cytotoxic chemotherapy in relapsed pediatric solid tumors - a Children's Oncology Group study. [Abstract] J Clin Oncol 23 (Suppl 16): A-3102, 217s, 2005.

Study ID Numbers: CDR0000069387, COG-ADVL0211, NCI-03-C-0202
Study First Received: June 6, 2002
Last Updated: May 9, 2009
ClinicalTrials.gov Identifier: NCT00039481     History of Changes
Health Authority: United States: Federal Government

Keywords provided by National Cancer Institute (NCI):
cardiac toxicity
unspecified childhood solid tumor, protocol specific

Additional relevant MeSH terms:
Immunologic Factors
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Physiological Effects of Drugs
Cardiovascular Agents
Cyclophosphamide
Antibiotics, Antineoplastic
Immunosuppressive Agents
Doxorubicin
Pharmacologic Actions
Razoxane
Neoplasms
Therapeutic Uses
Myeloablative Agonists
Chelating Agents
Antineoplastic Agents, Alkylating
Antirheumatic Agents
Alkylating Agents

ClinicalTrials.gov processed this record on November 30, 2009