Gemcitabine Hydrochloride and Alvocidib in Treating Patients With Solid Tumors

NCT ID: NCT00072436

Last Updated: 2013-07-02

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE1
• Total Enrollment: 58 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2003-09-30

Brief Summary

This phase I trial is studying the side effects and best dose of gemcitabine hydrochloride and alvocidib in treating patients with solid tumors. Drugs used in chemotherapy, such as gemcitabine hydrochloride and alvocidib, 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

Detailed Description

PRIMARY OBJECTIVES:

I. Determine the maximum tolerated dose of gemcitabine and flavopiridol in patients with solid tumors.

SECONDARY OBJECTIVES:

I. Determine the safety profile and toxic effects of this regimen in these patients.

II. Determine the pharmacokinetics of flavopiridol with and without gemcitabine in these patients.

III. Determine, using pharmacodynamic assays, the activity of flavopiridol as a cdk inhibitor in these patients.

IV. Determine, using pharmacodynamic assays, the markers of this regimen in these patients.

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

Some patients receive an initial dose of alvocidib IV over 1-7 hours on day 1 (course 0). Beginning 1 week later and for all subsequent courses, all patients receive gemcitabine hydrochloride IV over 60-150 minutes on days 1 and 15 and alvocidib IV over 1-7 hours on days 2 and 16. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

Cohorts of 3-6 patients receive escalating doses of gemcitabine hydrochloride and alvocidib 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. Once the MTD is determined, up to 10 additional patients receive treatment at that dose.

Patients are followed at 30 days after study completion.

Conditions

Unspecified Adult Solid Tumor, Protocol Specific

Study Design

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

Study Groups

Treatment

Some patients receive an initial dose of alvocidib IV over 1-7 hours on day 1 (course 0). Beginning 1 week later and for all subsequent courses, all patients receive gemcitabine hydrochloride IV over 60-150 minutes on days 1 and 15 and alvocidib IV over 1-7 hours on days 2 and 16. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

Cohorts of 3-6 patients receive escalating doses of gemcitabine hydrochloride and alvocidib until the 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. Once the MTD is determined, up to 10 additional patients receive treatment at that dose.

Group Type: EXPERIMENTAL

gemcitabine hydrochloride

Intervention Type: DRUG

Given IV

alvocidib

Intervention Type: DRUG

Given IV

pharmacological study

Intervention Type: OTHER

Correlative studies

Interventions

gemcitabine hydrochloride

Given IV

Intervention Type: DRUG

alvocidib

Given IV

Intervention Type: DRUG

pharmacological study

Correlative studies

Intervention Type: OTHER

Other Intervention Names

dFdC; difluorodeoxycytidine hydrochloride; gemcitabine; Gemzar; FLAVO; flavopiridol; HMR 1275; L-868275; pharmacological studies

Eligibility Criteria

Inclusion Criteria

• Negative pregnancy test
• Fertile patients must use effective contraception
• No active infection
• No severe malnutrition
• No more than 2 prior chemotherapy regimens:

• Prior combined modality therapy (e.g., full-dose chemotherapy with radiosensitizing chemotherapy and radiotherapy) is considered 1 prior regimen if all therapy was delivered as part of 1 comprehensive treatment plan
• More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin) and recovered
• No other concurrent chemotherapy
• At least 6 months since prior radiotherapy to the lung parenchyma or mediastinum and no evidence of radiation pneumonitis on chest CT scan
• At least 4 weeks since other prior radiotherapy and recovered
• No prior radiotherapy to more than 50% of marrow volume
• No concurrent radiotherapy
• Histologically confirmed solid tumor for which gemcitabine is a treatment option OR for which no efficacious therapy exists
• Must meet criteria for 1 of the following:

• Measurable disease:

• At least 1 unidimensionally measurable lesion at least 20 mm by conventional techniques OR at least 10 mm by spiral CT scan
• Nonmeasurable disease, including any of the following:

• Small lesions (less than 20 mm by conventional techniques OR less than 10 mm by spiral CT scan)
• Bone lesions
• Cytologically positive pleural or peritoneal disease
• Elevated tumor markers (e.g., carcinoembryonic antigen, CA 125, CA 19-9, or other tumor marker)
• Multinodular or confluent nonmeasurable pulmonary, hepatic, adrenal, intra-abdominal, or skin metastases
• No active CNS metastases
• Previously treated CNS metastases must be stable with no symptoms for 4 weeks after completion of treatment AND patient must be off steroid therapy or on a stable dose for at least the past 2 weeks
• No known leptomeningeal metastases
• Performance status:

• ECOG 0-1
• Hematopoietic:

• Absolute neutrophil count at least 1,500/mm3;
• Platelet count at least 100,000/mm3
• Hepatic:

• Bilirubin no greater than 1.5 mg/dL;
• SGOT no greater than 2.5 times upper limit of normal
• Renal:

• Creatinine no greater than 1.5 mg/dL OR
• Creatinine clearance at least 50 mL/min
• Cardiovascular:

• None of the following within the past 6 months:

• Myocardial infarction;
• Unstable angina;
• Transient ischemic attack;
• Cerebrovascular accident

• No new cardiac arrhythmia possibly related to cardiac ischemia;
• No large and potentially symptomatic pericardial effusion;
• No cardiac disease that would preclude study participation
• Pulmonary:

• No pulmonary embolism within the past 6 months;
• No large and potentially symptomatic pleural effusion;
• No pulmonary disease that would preclude study participation
• Gastrointestinal:

• No intractable emesis;
• No grade 2 or greater chronic diarrheal disease within the past 6 months
• Not pregnant or nursing

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

Sponsors

National Cancer Institute (NCI)

NIH

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Geoffrey Shapiro

Role: PRINCIPAL_INVESTIGATOR

Dana-Farber Cancer Institute

Locations

Massachusetts General Hospital Cancer Center

Boston, Massachusetts, United States

Dana-Farber Cancer Institute

Boston, Massachusetts, United States

Memorial Sloan Kettering Cancer Center

New York, New York, United States

Countries

United States

Other Identifiers

6051

Identifier Type: -

Identifier Source: secondary_id

P30CA006516

Identifier Type: NIH

Identifier Source: secondary_id

View Link

U01CA062490

Identifier Type: NIH

Identifier Source: secondary_id

View Link

CDR0000339727

Identifier Type: REGISTRY

Identifier Source: secondary_id

NCI-2009-00038

Identifier Type: -

Identifier Source: org_study_id