Irinotecan Plus Gemcitabine in Treating Patients With Unresectable or Metastatic Solid Tumors

NCT ID: NCT00004095

Last Updated: 2017-04-18

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE1
• Total Enrollment: 38 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 1999-08-31
• Study Completion Date: 2008-10-31

Brief Summary

RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Combining more than one drug may kill more tumor cells.

PURPOSE: Phase I trial to study the effectiveness of combining irinotecan and gemcitabine in treating patients who have unresectable or metastatic solid tumors.

Detailed Description

OBJECTIVES:

• Determine the maximum tolerated dose (MTD) and the principal toxicities of irinotecan and gemcitabine in patients with surgically unresectable or metastatic solid tumors.
• Determine if the principal toxicities and MTD of this combination regimen are affected by drug sequencing in this patient population.
• Determine the potential for gemcitabine to alter the pharmacokinetic characteristics when administered with irinotecan in these patients.
• Describe the influence effected by varying the administration sequence of this combination regimen in this patient population.
• Obtain preliminary data regarding efficacy of this combination regimen in these patients.

OUTLINE: This is a dose-escalation study.

Patients receive irinotecan IV over 90 minutes followed by gemcitabine IV over 30 minutes on days 1 and 15. Treatment repeats every 4 weeks in the absence of disease progression or unacceptable toxicity. Once the maximum tolerated dose (MTD) is reached, patients receive subsequent doses of the inverse sequence of the combination drugs until a new MTD is determined.

Cohorts of 3-6 patients receive escalating doses of irinotecan and gemcitabine until the MTD is reached. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose limiting toxicities.

Patients are followed every 3 months until death.

PROJECTED ACCRUAL: At least 12 patients will be accrued for this study.

Conditions

Bladder Cancer; Breast Cancer; Colorectal Cancer; Kidney Cancer; Lung Cancer; Pancreatic Cancer

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Irinotecan Plus Gemcitabine

Group Type: EXPERIMENTAL

gemcitabine hydrochloride

Intervention Type: DRUG

irinotecan hydrochloride

Intervention Type: DRUG

Interventions

gemcitabine hydrochloride

Intervention Type: DRUG

irinotecan hydrochloride

Intervention Type: DRUG

Eligibility Criteria

Inclusion Criteria

DISEASE CHARACTERISTICS:

• Histologically confirmed metastatic or surgically unresectable solid tumor, having received the following maximum number of prior therapies for advanced disease:

• Bladder cancer - no more than 1 prior therapy
• Breast cancer - no more than 2 prior therapies
• Colorectal cancer - no more than 1 prior therapy
• Kidney cancer - no prior therapy
• Lung cancer - no more than 1 prior therapy
• Pancreatic cancer - no prior therapy
• Bidimensionally measurable disease outside a previously irradiated field

• At least 2 cm x 2 cm
• No known bone metastases
• CNS involvement allowed if successfully controlled by surgery or radiotherapy and not requiring corticosteroids
• Hormone receptor status:

• Not specified

PATIENT CHARACTERISTICS:

Age:

• 18 and over

Menopausal status:

• Not specified

Performance status:

• ECOG 0-2

Life expectancy:

• At least 3 months

Hematopoietic:

• Granulocyte count at least 1,500/mm^3
• Platelet count at least 100,000/mm^3

Hepatic:

• Bilirubin no greater than 1.5 mg/dL regardless of liver involvement secondary to tumor
• SGOT no greater than 3 times upper limit of normal (ULN) (no greater than 5 times ULN if liver metastases present)
• No known Gilbert's disease

Renal:

• Creatinine no greater than 1.8 mg/dL
• Calcium less than 12.0 mg/dL

Cardiovascular:

• No myocardial infarction within the past 6 months
• No congestive heart failure requiring therapy

Other:

• No active uncontrolled bacterial, viral (including HIV), or invasive fungal infection
• No psychiatric disorders that would prevent compliance
• No other malignancy within the past 5 years except adequately treated basal or squamous cell skin cancer or carcinoma in situ of the cervix
• No history of seizures
• Not pregnant or nursing
• Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

Biologic therapy:

• No concurrent sargramostim (GM-CSF)
• No concurrent immunotherapy

Chemotherapy:

• No prior irinotecan, topotecan, or gemcitabine
• Prior adjuvant chemotherapy allowed, if at least 1 year between last dose of adjuvant chemotherapy and recurrence of cancer
• No other concurrent chemotherapy

Endocrine therapy:

• Not specified

Radiotherapy:

• See Disease Characteristics
• At least 4 weeks since prior radiotherapy to less than 30% of bone marrow
• No prior whole pelvic radiotherapy
• No concurrent radiotherapy

Surgery:

• See Disease Characteristics

Other:

• No concurrent phenytoin, phenobarbital, or other antiepileptic prophylaxis

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 120 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

National Cancer Institute (NCI)

NIH

Sponsor Role: collaborator

Northwestern University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Al B. Benson, MD, FACP

Role: STUDY_CHAIR

Robert H. Lurie Cancer Center

Locations

Robert H. Lurie Comprehensive Cancer Center at Northwestern University

Chicago, Illinois, United States

Countries

United States

References

Wisinski KB, Mulcahy MF, Newman S, et al.: A phase I study of irinotecan and gemcitabine in solid tumors. [Abstract] American Society of Clinical Oncology 2007 Gastrointestinal Cancers Symposium, 19 -21 January 2007, Orlando, Florida A-140, 2007.

Reference Type: RESULT

Other Identifiers

NU-98X3

Identifier Type: -

Identifier Source: secondary_id

P-UPJOHN-976475157

Identifier Type: -

Identifier Source: secondary_id

NCI-G99-1588

Identifier Type: -

Identifier Source: secondary_id

NU 98X3

Identifier Type: -

Identifier Source: org_study_id