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Doxorubicin and Flavopiridol in Treating Patients With Metastatic or Recurrent Sarcoma That Cannot Be Removed By Surgery
This study is currently recruiting participants.
Verified by National Cancer Institute (NCI), August 2009
First Received: December 7, 2004   Last Updated: August 21, 2009   History of Changes
Sponsor: Memorial Sloan-Kettering Cancer Center
Collaborator: National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00098579
  Purpose

RATIONALE: Drugs used in chemotherapy, such as doxorubicin and flavopiridol, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Flavopiridol may also help doxorubicin work better by making tumor cells more sensitive to the drug. Giving more than one drug may kill more tumor cells.

PURPOSE: This phase I trial is studying the side effects and best dose of flavopiridol when given with doxorubicin in treating patients with metastatic or recurrent sarcoma that cannot be removed by surgery.


Condition Intervention Phase
Gastrointestinal Stromal Tumor
Sarcoma
Drug: alvocidib
Drug: doxorubicin hydrochloride
Phase I

Study Type: Interventional
Study Design: Treatment, Open Label
Official Title: Phase I Trial of Doxorubicin and Flavopiridol (NCI Supplied Agent, NSC 649890) in the Treatment of Metastatic Sarcoma

Resource links provided by NLM:


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

Estimated Enrollment: 36
Study Start Date: October 2004
Estimated Primary Completion Date: June 2010 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • Determine the maximum tolerated dose of flavopiridol when administered with a fixed dose of doxorubicin in patients with unresectable metastatic or locally recurrent sarcoma.

Secondary

  • Determine the clinical pharmacokinetics of this regimen in these patients.
  • Determine, preliminarily, the therapeutic activity of this regimen in these patients.
  • Correlate pRb, p53, and p21 protein levels with treatment response and apoptosis in patients treated with this regimen.
  • Correlate NMR biochemical patterns with response in patients treated with this regimen.

OUTLINE: This is an open-label, dose-escalation study of flavopiridol.

Patients receive doxorubicin IV over 5-10 minutes and flavopiridol IV over 1 hour on day 1. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. Patients reaching a cumulative doxorubicin dose of 600 mg/m^2 or experiencing cardiotoxicity may receive flavopiridol alone at the discretion of the investigator.

Cohorts of 3-6 patients receive escalating doses of flavopiridol 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. Ten additional patients receive treatment at the MTD.

Patients are followed every 3 months for 1 year.

PROJECTED ACCRUAL: A total of 3-36 patients will be accrued for this study within 1-2 years.

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Histologically or cytologically confirmed soft-tissue sarcoma*

    • Unresectable disease
    • Locally recurrent or metastatic disease
  • Disease amenable to biopsy (patients treated at the maximum tolerated dose only)
  • No known prior or concurrent brain metastases NOTE: *Patients with gastrointestinal stromal tumors should receive therapy with imatinib mesylate first if eligible for both types of therapy

PATIENT CHARACTERISTICS:

Age

  • 18 and over

Performance status

  • Karnofsky 60-100% OR
  • ECOG 0-2

Life expectancy

  • Not specified

Hematopoietic

  • Absolute neutrophil count ≥ 1,500/mm^3
  • Platelet count ≥ 100,000/mm^3

Hepatic

  • Bilirubin ≤ 1.5 mg/dL
  • AST and ALT ≤ 2.5 times upper limit of normal

Renal

  • Creatinine ≤ 1.5 mg/dL OR
  • Creatinine clearance ≥ 60 mL/min

Cardiovascular

  • Ejection fraction ≥ 50% by MUGA or echocardiogram
  • No uncontrolled hypertension
  • No myocardial infarction
  • No New York Heart Association class II-IV congestive heart failure
  • No unstable angina
  • No serious cardiac arrhythmia requiring medication
  • No peripheral vascular disease ≥ grade 2 within the past year
  • No other clinically significant cardiac disease
  • No prior deep vein thrombosis
  • No other prior vascular thrombus

Pulmonary

  • No prior pulmonary embolism

Other

  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No symptomatic peripheral neuropathy ≥ grade 2
  • No other malignancy within the past 5 years except adequately treated basal cell skin cancer or carcinoma in situ of the cervix

    • Carcinoma in situ not considered a second malignancy
  • No history of allergic reaction attributed to compounds of similar chemical or biologic composition to study drugs
  • No psychiatric illness or social situation that would preclude study compliance
  • No ongoing or active infection
  • No other uncontrolled illness

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • See Chemotherapy
  • At least 3 weeks since prior immunotherapy and recovered

Chemotherapy

  • At least 3 weeks since prior chemotherapy (6 weeks for carmustine or mitomycin) and recovered
  • No more than 2 prior cytotoxic chemotherapy regimens

    • Peroxisome proliferator-activated receptor (PPAR)-gamma agonists, thalidomide, or targeted therapy (i.e., tyrosine kinase inhibitors including imatinib mesylate, sorafenib, or sunitinib malate) do not count as a prior chemotherapy regimen
  • No prior anthracyclines

Endocrine therapy

  • Not specified

Radiotherapy

  • At least 3 weeks since prior radiotherapy and recovered
  • No prior extensive radiotherapy to bone marrow-producing sites (e.g., radiotherapy to both the pelvis and spine)

Surgery

  • Not specified

Other

  • At least a 1 week washout period since prior tyrosine kinase inhibitors or other targeted therapy
  • Concurrent low-dose warfarin (1 mg per day) to prevent thrombus of a central line allowed
  • No concurrent combination antiretroviral therapy for HIV-positive patients
  • No other concurrent investigational agents
  • No other concurrent anticancer therapy
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00098579

Locations
United States, New York
Memorial Sloan-Kettering Cancer Center Recruiting
New York, New York, United States, 10065
Contact: David R. D'Adamo, MD, PhD     212-639-7573        
Sponsors and Collaborators
Memorial Sloan-Kettering Cancer Center
Investigators
Principal Investigator: David R. D'Adamo, MD, PhD Memorial Sloan-Kettering Cancer Center
  More Information

Additional Information:
No publications provided

Study ID Numbers: CDR0000398181, MSKCC-04075, NCI-6204
Study First Received: December 7, 2004
Last Updated: August 21, 2009
ClinicalTrials.gov Identifier: NCT00098579     History of Changes
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
gastrointestinal stromal tumor
recurrent adult soft tissue sarcoma
stage IV adult soft tissue sarcoma

Additional relevant MeSH terms:
Digestive System Neoplasms
Neoplasms by Histologic Type
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Gastrointestinal Diseases
Growth Substances
Physiological Effects of Drugs
Enzyme Inhibitors
Antibiotics, Antineoplastic
Protein Kinase Inhibitors
Pharmacologic Actions
Doxorubicin
Neoplasms, Connective and Soft Tissue
Flavopiridol
Neoplasms
Neoplasms by Site
Digestive System Diseases
Therapeutic Uses
Sarcoma
Gastrointestinal Neoplasms
Growth Inhibitors
Gastrointestinal Stromal Tumors

ClinicalTrials.gov processed this record on November 30, 2009