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| Sponsor: | Thomas Jefferson University |
|---|---|
| Collaborator: |
Merck |
| Information provided by: | Thomas Jefferson University |
| ClinicalTrials.gov Identifier: | NCT00838929 |
Purpose
This is a multi-center, open-label, non-randomized Phase I study in patients with brain metastases. Patients will be administered oral Vorinostat and radiation therapy and will be treated for 3 weeks. Patients will be enrolled in cohorts and will be treated at sequentially rising dose levels of Vorinostat combined with radiation therapy. We will initially enter 3 subjects at each dose. If none of the three experiences a dose-limiting toxicity we will proceed to the next dose. If one of the three experiences that level of toxicity, we will accrue 3 more subjects at that dose. If at any time there are two or more dose-limiting toxicities (in the 3-6 subjects) on a given dose, we will drop down to a lower dose. Dose escalation will continue until the MTD of Vorinostat and radiation therapy is established. The MTD will then be one dose below the DLT occurring in at least 1 out of 3 subjects (2 out of 6 patients).
Hypothesis: Vorinostat in combination with radiation therapy can be administered safely and will be tolerated in patients with brain metastases, while providing an assessment of the anti-tumor activity of this combination.
| Condition | Intervention | Phase |
|---|---|---|
|
Brain Metastases |
Drug: Vorinostat Radiation: Radiation Therapy |
Phase I |
| Study Type: | Interventional |
| Study Design: | Treatment, Non-Randomized, Open Label, Single Group Assignment, Safety/Efficacy Study |
| Official Title: | Phase I Study of the Combination of Vorinostat and Radiation Therapy for the Treatment of Patients With Brain Metastases |
| Estimated Enrollment: | 24 |
| Study Start Date: | March 2009 |
| Estimated Study Completion Date: | December 2011 |
| Estimated Primary Completion Date: | February 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Vorinostat and Radiation: Experimental
Patients will be treated on a dose escalation model for vorinostat and concurrently receive radiation therapy.
|
Drug: Vorinostat
All doses given for 3 weeks Dose level -2 - 50 mg PO qd (to be used in de-escalation if toxicity occurs) Dose level -1 - 100 mg PO qd (to be used in de-escalation if toxicity occurs) Dose level I - 200 mg PO qd (initial starting dose) Dose level II - 300 mg PO qd Dose level III - 400 mg PO qd |
In recent years, a number of investigators have shown that combining signal transduction agents with ionizing radiation results in significant antitumor effects without an increase in normal tissue toxicity. There are numerous lines of evidence that Histone deacetylase (HDAC) inhibitors have been shown to enhance the radiosensitivity of tumor cells in vitro and in vivo 1-6. Vorinostat (Zolinza, suberoylanilide hydroxamic acid - SAHA) a potent histone deacetylase, has recently been approved for clinical use for cutaneous T-cell lymphoma. It has the potential to inhibit tumor growth and proliferation7-13, tumor angiogenesis14 and enhance radiation response15 with minimal toxicity. This phase I study, is based on the range of efficacy of Vorinostat and its ability to cross the blood-brain barrier. This study will evaluate the safety of combination of Vorinostat and daily-fractionated radiation therapy. This information is critical for any combined future combined modality trials that involves radiation therapy to the brain.
Vorinostat was approved by the US Food and Drug Administration (FDA) on 6-Oct-2006 for the treatment of cutaneous manifestations in patients with cutaneous T-cell lymphoma (CTCL) who have progressive, persistent or recurrent disease on or following two systemic therapies.
Based on preclinical, clinical efficacy and safety data, it is anticipated that Vorinostat in combination with radiation therapy can be administered safely and will be tolerated in patients with brain metastases. In addition, within the recognized limits of a Phase I clinical trial, this study may provide an assessment of the anti-tumor activity of Vorinostat in combination with radiation therapy in patients with brain metastases.
The present study will investigate the safety, tolerability and spectrum of side effects of Vorinostat in combination with radiation therapy. As such, this study will characterize the dose limiting toxicities (DLT) and maximum tolerated dose (MTD) of in combination with radiation therapy in patients with brain metastases.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria Based on Disease & Status
Adequate organ function as defined by the following criteria:
2.3 SUBJECT/PATIENT EXCLUSION CRITERIA
A patient meeting any of the following criteria is not eligible to participate in this study:
Exclusion Criteria Based on Prior or Concomitant Therapy
Patient has a history of a gastrointestinal surgery or other procedures that might, in the opinion of the investigator, interfere with the absorption or swallowing of the study drugs.
Exclusion Criteria Based on Medical History or Current Medical Status
Contacts and Locations| Contact: Vanita Patel | 215-955-8619 | vanita.patel@jeffersonhospital.org |
| Contact: Mathew I Green-Leibovitz | 215-955-8619 | mathew.green-leibovitz@jeffersonhospital.org |
| United States, Pennsylvania | |
| Thomas Jefferson University Kimmel Cancer Center Bodine Center for Cancer Treatment | Recruiting |
| Philadelphia, Pennsylvania, United States, 19107 | |
| Contact: Yaacov R Lawrence, MD 215-955-6700 richard.lawrence@jefferson.edu | |
| Principal Investigator: Yaacov R. Lawrence, MD | |
| United States, Texas | |
| The University of Texas Southwestern Medical Center | Recruiting |
| Dallas, Texas, United States, 75390-9183 | |
| Contact: Hak Choy, MD 214-645-7600 Hak.Choy@UTSouthwestern.edu | |
| Principal Investigator: Hak Choy, MD | |
| Israel | |
| Sheba Medical Center | Recruiting |
| Tel Hashomer, Israel, 52621 | |
| Contact: Raphael Pfeffer, MBBS raphipf@sheba.health.gov.il | |
| Principal Investigator: Raphael Pfeffer, MBBS | |
| Principal Investigator: | Yaacov R Lawrence, MD | Thomas Jefferson Universtiy Radiation Oncology |
More Information
| Responsible Party: | Thomas Jefferson University ( Yaacov Richard Lawrence, MD, Assistant Professor, Radiation Oncology Dept. ) |
| Study ID Numbers: | 08C.522 |
| Study First Received: | February 6, 2009 |
| Last Updated: | November 17, 2009 |
| ClinicalTrials.gov Identifier: | NCT00838929 History of Changes |
| Health Authority: | United States: Food and Drug Administration |
|
brain metastases radiation vorinostat lung cancer breast cancer |
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Anticarcinogenic Agents Anti-Inflammatory Agents Molecular Mechanisms of Pharmacological Action Antineoplastic Agents Physiological Effects of Drugs Central Nervous System Neoplasms Brain Diseases Neoplastic Processes Neoplasms by Site Pathologic Processes Sensory System Agents Therapeutic Uses Neoplasm Metastasis Anti-Inflammatory Agents, Non-Steroidal |
Analgesics Nervous System Neoplasms Vorinostat Nervous System Diseases Central Nervous System Diseases Enzyme Inhibitors Protective Agents Pharmacologic Actions Brain Neoplasms Neoplasms Analgesics, Non-Narcotic Peripheral Nervous System Agents Antirheumatic Agents Central Nervous System Agents |