Trial Outcomes & Findings for Bortezomib and Temozolomide in Treating Patients With Advanced Refractory Solid Tumors or Melanoma (NCT NCT00512798)

NCT ID: NCT00512798

Last Updated: 2012-10-02

Results Overview

The optimal biologic dose (OBD) defined as the dose that achieves the greatest degree of inhibition of NF-κB activation in peripheral blood mononuclear cells when co-administered with Temozolomide

Recruitment status

TERMINATED

Study phase

PHASE1/PHASE2

Target enrollment

47 participants

Primary outcome timeframe

up to 42 days

Results posted on

2012-10-02

Participant Flow

This study remained open to accrual from 6/3/03 to 3/11/08.

19 participants were enrolled to the phase I portion of this trial and 28 were enrolled to the phase II portion of this trial. There were also 3 participants that were consented to take part in this trial, but were determined to be ineligible.

Participant milestones

Participant milestones
Measure
Phase I
PS-341 will be administered intravenously at 1.0 mg/m2 of body weight beginning on days 1, 4, 8, and 11 of every 21 days. If toxicity occurs, dose will be lowered to 0.7 mg/m2. Dose can be raised to a maximum of 1.5 mg/m2. Temozolomide will be orally administered daily at 50 mg/m2 of body weight beginning on day 8 for 6 weeks of every 9-week cycle, followed by a 3-week rest. Minimum dose is 50 mg/m2 and maximum dose is 75 mg/m2.
Phase II
PS-341 and Temozolomide will be administered in the same manner as in Phase I at doses as determined by the Phase I portion of the trial.
Overall Study
STARTED
19
28
Overall Study
COMPLETED
0
1
Overall Study
NOT COMPLETED
19
27

Reasons for withdrawal

Reasons for withdrawal
Measure
Phase I
PS-341 will be administered intravenously at 1.0 mg/m2 of body weight beginning on days 1, 4, 8, and 11 of every 21 days. If toxicity occurs, dose will be lowered to 0.7 mg/m2. Dose can be raised to a maximum of 1.5 mg/m2. Temozolomide will be orally administered daily at 50 mg/m2 of body weight beginning on day 8 for 6 weeks of every 9-week cycle, followed by a 3-week rest. Minimum dose is 50 mg/m2 and maximum dose is 75 mg/m2.
Phase II
PS-341 and Temozolomide will be administered in the same manner as in Phase I at doses as determined by the Phase I portion of the trial.
Overall Study
Death
0
3
Overall Study
Adverse Event
2
4
Overall Study
Progression of disease
14
20
Overall Study
Withdrawal by Subject
3
0

Baseline Characteristics

Bortezomib and Temozolomide in Treating Patients With Advanced Refractory Solid Tumors or Melanoma

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Phase I
n=19 Participants
Phase II
n=28 Participants
Total
n=47 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Age, Categorical
Between 18 and 65 years
15 Participants
n=93 Participants
18 Participants
n=4 Participants
33 Participants
n=27 Participants
Age, Categorical
>=65 years
4 Participants
n=93 Participants
10 Participants
n=4 Participants
14 Participants
n=27 Participants
Age Continuous
58 years
n=93 Participants
58 years
n=4 Participants
58 years
n=27 Participants
Sex: Female, Male
Female
4 Participants
n=93 Participants
9 Participants
n=4 Participants
13 Participants
n=27 Participants
Sex: Female, Male
Male
15 Participants
n=93 Participants
19 Participants
n=4 Participants
34 Participants
n=27 Participants
Region of Enrollment
United States
19 participants
n=93 Participants
28 participants
n=4 Participants
47 participants
n=27 Participants

PRIMARY outcome

Timeframe: up to 42 days

Population: All Phase I patients who received the study drugs

The optimal biologic dose (OBD) defined as the dose that achieves the greatest degree of inhibition of NF-κB activation in peripheral blood mononuclear cells when co-administered with Temozolomide

Outcome measures

Outcome measures
Measure
Phase I
n=19 Participants
Patients with advanced, incurable melanoma who are chemotherapy-naive or patients who had undergone prior therapy with Dacarbazine or Temozolomide with treatment failure.
Optimal Doses of Temozolomide and Bortezomib (Phase I)
bortezomib
1.3 mg/m2
Optimal Doses of Temozolomide and Bortezomib (Phase I)
temozolomide
75 mg/m2

PRIMARY outcome

Timeframe: every 9 weeks to a maximum of 54 weeks

Population: Patients who were available to measure response to the study drugs.

Per RECIST criteria v. 1.0: measurable lesions: complete response (CR) disappearance of target lesions, partial response (PR) \> 30% decrease in the sum of the longest diameter (LD) of target lesions, progressive disease (PD) \> 20% increase in the sum of the LD of target lesions or appearance of new lesions, stable disease (SD) neither sufficient decrease nor increase of the sum of smallest sum of the LD of target lesions. Patients with CR + PR + SD

Outcome measures

Outcome measures
Measure
Phase I
n=28 Participants
Patients with advanced, incurable melanoma who are chemotherapy-naive or patients who had undergone prior therapy with Dacarbazine or Temozolomide with treatment failure.
Number of Patients With Clinical Anti-tumor Activity Phase II)
Complete Response
0 participants
Number of Patients With Clinical Anti-tumor Activity Phase II)
Partial Response
1 participants
Number of Patients With Clinical Anti-tumor Activity Phase II)
Stable Disease
5 participants
Number of Patients With Clinical Anti-tumor Activity Phase II)
Progressive Disease
22 participants

SECONDARY outcome

Timeframe: at baseline, on day 8 and on day 29

Population: Phase I patients for whom blood was taken at baseline,on day 8 and on day 29 of each cycle. There was no correlation of change in NF-kB activation with changes in tumor tissue

Patient with a minimum of 50% reduction from baseline on day 8 or day 29 in NF-kB, measured by picograms/milliliter in peripheral mononuclear blood cells

Outcome measures

Outcome measures
Measure
Phase I
n=19 Participants
Patients with advanced, incurable melanoma who are chemotherapy-naive or patients who had undergone prior therapy with Dacarbazine or Temozolomide with treatment failure.
Patients With Inhibition in NF-kB Activation (Phase I)
0 participants

SECONDARY outcome

Timeframe: every 9 weeks up to a maximum of 54 weeks

Population: Patients who received treatment and who were available for measurement of lesions.

Per RECIST criteria v. 1.0: measurable lesions: complete response (CR) disappearance of target lesions, partial response (PR) \> 30% decrease in the sum of the longest diameter (LD) of target lesions, progressive disease (PD) \> 20% increase in the sum of the LD of target lesions or appearance of new lesions, stable disease (SD) neither sufficient decrease nor increase of the sum of smallest sum of the LD of target lesions

Outcome measures

Outcome measures
Measure
Phase I
n=19 Participants
Patients with advanced, incurable melanoma who are chemotherapy-naive or patients who had undergone prior therapy with Dacarbazine or Temozolomide with treatment failure.
Patients With Clinical Anti-tumor Activity (Phase I)
Complete Response
0 participants
Patients With Clinical Anti-tumor Activity (Phase I)
Partial Response
4 participants
Patients With Clinical Anti-tumor Activity (Phase I)
Stable Disease
1 participants
Patients With Clinical Anti-tumor Activity (Phase I)
Progressive Disease
14 participants

SECONDARY outcome

Timeframe: at baseline, on day 8 and on day 29

Population: Patients with advanced, incurable melanoma who are chemotherapy-naive and patients who had undergone prior chemotherapy with either Dacarbazine or Temozolomide with treatment failure. No degree of inhibition of NF-kB was observed. Phase II not completed due to lack of efficacy.

Patient with a minimum of 50% reduction from baseline on day 8 or day 29 in NF-kB, measured by picograms/milliliter in peripheral mononuclear blood cells

Outcome measures

Outcome measures
Measure
Phase I
n=28 Participants
Patients with advanced, incurable melanoma who are chemotherapy-naive or patients who had undergone prior therapy with Dacarbazine or Temozolomide with treatment failure.
Patients With Inhibition of NF-kB (Phase II)
0 participants

Adverse Events

Phase I

Serious events: 6 serious events
Other events: 19 other events
Deaths: 0 deaths

Phase II

Serious events: 4 serious events
Other events: 28 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Phase I
n=19 participants at risk
Phase II
n=28 participants at risk
Investigations
Platelet count decreased
0.00%
0/19
3.6%
1/28 • Number of events 1
Cardiac disorders
Ischemia/infarction
0.00%
0/19
3.6%
1/28 • Number of events 1
Cardiac disorders
Edema
0.00%
0/19
3.6%
1/28 • Number of events 1
Vascular disorders
Thrombosis/embolism
0.00%
0/19
3.6%
1/28 • Number of events 1
General disorders
Fatigue
5.3%
1/19 • Number of events 1
3.6%
1/28 • Number of events 1
Infections and infestations
Wound - infection
5.3%
1/19 • Number of events 1
3.6%
1/28 • Number of events 2
Gastrointestinal disorders
Nausea
5.3%
1/19 • Number of events 1
7.1%
2/28 • Number of events 2
Gastrointestinal disorders
Pancreatitis
0.00%
0/19
3.6%
1/28 • Number of events 1
Musculoskeletal and connective tissue disorders
Muscle weakness
0.00%
0/19
3.6%
1/28 • Number of events 1
Respiratory, thoracic and mediastinal disorders
Dyspnea
10.5%
2/19 • Number of events 2
3.6%
1/28 • Number of events 1
Gastrointestinal disorders
Death
0.00%
0/19
7.1%
2/28 • Number of events 2
Investigations
hemoglobin
5.3%
1/19 • Number of events 1
0.00%
0/28
Cardiac disorders
conduction abnormality/atrioventricular heart block
5.3%
1/19 • Number of events 1
0.00%
0/28
Gastrointestinal disorders
vomiting
5.3%
1/19 • Number of events 1
3.6%
1/28 • Number of events 1
Metabolism and nutrition disorders
hyperkalemia
5.3%
1/19 • Number of events 1
0.00%
0/28
Nervous system disorders
depressed level of consciousness
5.3%
1/19 • Number of events 1
0.00%
0/28
Respiratory, thoracic and mediastinal disorders
pleuritic pain
5.3%
1/19 • Number of events 1
0.00%
0/28
Musculoskeletal and connective tissue disorders
right groin pain
5.3%
1/19 • Number of events 1
0.00%
0/28
General disorders
fever
0.00%
0/19
3.6%
1/28 • Number of events 1
Investigations
creatinine
5.3%
1/19 • Number of events 1
0.00%
0/28

Other adverse events

Other adverse events
Measure
Phase I
n=19 participants at risk
Phase II
n=28 participants at risk
Respiratory, thoracic and mediastinal disorders
Allergic rhinitis
10.5%
2/19 • Number of events 11
3.6%
1/28 • Number of events 12
Gastrointestinal disorders
abdominal pain or cramping
42.1%
8/19 • Number of events 57
17.9%
5/28 • Number of events 11
Investigations
alkaline phosphatase
15.8%
3/19 • Number of events 22
3.6%
1/28 • Number of events 4
Immune system disorders
allergic reaction/hypersensivity
5.3%
1/19 • Number of events 1
0.00%
0/28
Metabolism and nutrition disorders
anorexia
73.7%
14/19 • Number of events 159
42.9%
12/28 • Number of events 83
Respiratory, thoracic and mediastinal disorders
apnea
5.3%
1/19 • Number of events 1
0.00%
0/28
Musculoskeletal and connective tissue disorders
Arthralgia
26.3%
5/19 • Number of events 52
17.9%
5/28 • Number of events 33
Musculoskeletal and connective tissue disorders
arthritis
5.3%
1/19 • Number of events 11
3.6%
1/28 • Number of events 4
Nervous system disorders
Ataxia
5.3%
1/19 • Number of events 4
0.00%
0/28
Musculoskeletal and connective tissue disorders
bone pain
15.8%
3/19 • Number of events 10
3.6%
1/28 • Number of events 3
Cardiac disorders
Chest pain
10.5%
2/19 • Number of events 12
0.00%
0/28
Cardiac disorders
circulatory or cardiac other
5.3%
1/19 • Number of events 1
0.00%
0/28
Eye disorders
conjunctivitis
5.3%
1/19 • Number of events 2
0.00%
0/28
Gastrointestinal disorders
constipation
68.4%
13/19 • Number of events 103
32.1%
9/28 • Number of events 48
General disorders
Constitutional symptoms Other
21.1%
4/19 • Number of events 10
3.6%
1/28 • Number of events 7
Investigations
Creatinine
5.3%
1/19 • Number of events 1
3.6%
1/28 • Number of events 4
Metabolism and nutrition disorders
Dehydration
0.00%
0/19
7.1%
2/28 • Number of events 4
Gastrointestinal disorders
Diarrhea patients without colostomy
36.8%
7/19 • Number of events 25
39.3%
11/28 • Number of events 31
Nervous system disorders
Dizziness/lightheadedness
31.6%
6/19 • Number of events 33
10.7%
3/28 • Number of events 15
Skin and subcutaneous tissue disorders
Dry skin
5.3%
1/19 • Number of events 6
0.00%
0/28
Gastrointestinal disorders
Dyspepsia/heartburn
15.8%
3/19 • Number of events 53
28.6%
8/28 • Number of events 38
Gastrointestinal disorders
Dysphagia, esophagitis, odynophagia
10.5%
2/19 • Number of events 3
3.6%
1/28 • Number of events 14
Respiratory, thoracic and mediastinal disorders
Dyspnea
31.6%
6/19 • Number of events 71
32.1%
9/28 • Number of events 27
General disorders
Edema
26.3%
5/19 • Number of events 63
28.6%
8/28 • Number of events 124
Endocrine disorders
Endocrine other
0.00%
0/19
7.1%
2/28 • Number of events 14
Respiratory, thoracic and mediastinal disorders
Epistaxis
5.3%
1/19 • Number of events 2
0.00%
0/28
General disorders
Fatigue
94.7%
18/19 • Number of events 241
85.7%
24/28 • Number of events 234
General disorders
Fever
26.3%
5/19 • Number of events 14
17.9%
5/28 • Number of events 30
Gastrointestinal disorders
GI other
31.6%
6/19 • Number of events 66
7.1%
2/28 • Number of events 18
Nervous system disorders
Headache
47.4%
9/19 • Number of events 44
14.3%
4/28 • Number of events 7
Investigations
Hemoglobin
100.0%
19/19 • Number of events 150
78.6%
22/28 • Number of events 199
Blood and lymphatic system disorders
Hemorrhage/bleeding with grade 3 or 4 thrombocytopenia
5.3%
1/19 • Number of events 1
0.00%
0/28
Blood and lymphatic system disorders
Hemorrhage/bleeding without grade 3 or 4 thrombocytopenia
5.3%
1/19 • Number of events 2
0.00%
0/28
Hepatobiliary disorders
Hepatic pain
5.3%
1/19 • Number of events 1
0.00%
0/28
Investigations
Hypercholesterolemia
0.00%
0/19
14.3%
4/28 • Number of events 30
Metabolism and nutrition disorders
Hyperglycemia
10.5%
2/19 • Number of events 5
42.9%
12/28 • Number of events 76
Metabolism and nutrition disorders
Hyperkalemia
5.3%
1/19 • Number of events 1
0.00%
0/28
Metabolism and nutrition disorders
Hypermagnesemia
5.3%
1/19 • Number of events 1
0.00%
0/28
Vascular disorders
Hypertension
10.5%
2/19 • Number of events 15
32.1%
9/28 • Number of events 76
Metabolism and nutrition disorders
Hyperuricemia
0.00%
0/19
14.3%
4/28 • Number of events 24
Metabolism and nutrition disorders
Hypoglycemia
0.00%
0/19
10.7%
3/28 • Number of events 27
Metabolism and nutrition disorders
hypocalcemia
5.3%
1/19 • Number of events 3
0.00%
0/28
Metabolism and nutrition disorders
hypokalemia
5.3%
1/19 • Number of events 1
17.9%
5/28 • Number of events 16
Metabolism and nutrition disorders
Hypomagnesemia
5.3%
1/19 • Number of events 5
10.7%
3/28 • Number of events 7
Metabolism and nutrition disorders
Hyponatremia
21.1%
4/19 • Number of events 18
25.0%
7/28 • Number of events 37
Vascular disorders
Hypotension
21.1%
4/19 • Number of events 9
0.00%
0/28
Infections and infestations
Infection without neutropenia
5.3%
1/19 • Number of events 2
14.3%
4/28 • Number of events 9
Psychiatric disorders
Insomnia
15.8%
3/19 • Number of events 28
25.0%
7/28 • Number of events 34
Musculoskeletal and connective tissue disorders
Joint, muscle, bone Other
15.8%
3/19 • Number of events 34
0.00%
0/28
Blood and lymphatic system disorders
Leukocytes
21.1%
4/19 • Number of events 15
7.1%
2/28 • Number of events 6
Nervous system disorders
Memory loss
0.00%
0/19
7.1%
2/28 • Number of events 18
Psychiatric disorders
Mood alteration - depression
15.8%
3/19 • Number of events 34
25.0%
7/28 • Number of events 45
Psychiatric disorders
Mood alteration - anxiety, agitation
5.3%
1/19 • Number of events 1
10.7%
3/28 • Number of events 26
Gastrointestinal disorders
Mucositis
5.3%
1/19 • Number of events 8
7.1%
2/28 • Number of events 4
Metabolism and nutrition disorders
Muscle weakness
0.00%
0/19
10.7%
3/28 • Number of events 28
Musculoskeletal and connective tissue disorders
Myalgia
31.6%
6/19 • Number of events 61
10.7%
3/28 • Number of events 25
Gastrointestinal disorders
Nausea
68.4%
13/19 • Number of events 123
82.1%
23/28 • Number of events 146
Nervous system disorders
Neurologic Other
10.5%
2/19 • Number of events 18
0.00%
0/28
Nervous system disorders
Neuropathy - motor
5.3%
1/19 • Number of events 2
0.00%
0/28
Nervous system disorders
Neuropathy - sensory
26.3%
5/19 • Number of events 107
42.9%
12/28 • Number of events 178
Investigations
Neutrophils/granulocytes
10.5%
2/19 • Number of events 7
0.00%
0/28
Eye disorders
Occular Other
15.8%
3/19 • Number of events 19
0.00%
0/28
General disorders
Pain Other
57.9%
11/19 • Number of events 150
21.4%
6/28 • Number of events 43
Cardiac disorders
Palpitations
10.5%
2/19 • Number of events 4
0.00%
0/28
Skin and subcutaneous tissue disorders
pigmentation changes
5.3%
1/19 • Number of events 12
0.00%
0/28
Investigations
Platelets
36.8%
7/19 • Number of events 30
32.1%
9/28 • Number of events 79
Respiratory, thoracic and mediastinal disorders
Pleuritic pain
5.3%
1/19 • Number of events 5
0.00%
0/28
Skin and subcutaneous tissue disorders
Pruritis
10.5%
2/19 • Number of events 12
10.7%
3/28 • Number of events 11
Respiratory, thoracic and mediastinal disorders
Pulmonary Other
10.5%
2/19 • Number of events 24
0.00%
0/28
Injury, poisoning and procedural complications
Radiation dermatitis
5.3%
1/19 • Number of events 8
0.00%
0/28
Skin and subcutaneous tissue disorders
Rash/desquamation
36.8%
7/19 • Number of events 45
35.7%
10/28 • Number of events 45
Renal and urinary disorders
Renal/Genitourinary Other
10.5%
2/19 • Number of events 3
7.1%
2/28 • Number of events 4
General disorders
Rigor, chills
10.5%
2/19 • Number of events 3
0.00%
0/28
General disorders
Sense of smell
5.3%
1/19 • Number of events 8
0.00%
0/28
Investigations
SGOT (AST)
15.8%
3/19 • Number of events 18
14.3%
4/28 • Number of events 13
Investigations
SGPT (ALT)
15.8%
3/19 • Number of events 16
14.3%
4/28 • Number of events 18
Cardiac disorders
Sinus tachycardia
5.3%
1/19 • Number of events 1
0.00%
0/28
Skin and subcutaneous tissue disorders
Skin Other
26.3%
5/19 • Number of events 27
7.1%
2/28 • Number of events 12
Infections and infestations
Stomatitis/phyaryngitis
10.5%
2/19 • Number of events 3
0.00%
0/28
Cardiac disorders
Supraventricular arrhythmias
0.00%
0/19
7.1%
2/28 • Number of events 14
Skin and subcutaneous tissue disorders
Sweating
31.6%
6/19 • Number of events 48
10.7%
3/28 • Number of events 29
General disorders
Taste disturbance
10.5%
2/19 • Number of events 10
7.1%
2/28 • Number of events 9
General disorders
Tumor Pain
15.8%
3/19 • Number of events 37
39.3%
11/28 • Number of events 80
Renal and urinary disorders
Urinary frequency/urgency
10.5%
2/19 • Number of events 30
7.1%
2/28 • Number of events 17
Eye disorders
Vision/blurred vision
5.3%
1/19 • Number of events 3
0.00%
0/28
Respiratory, thoracic and mediastinal disorders
Voice changes/stridor/layrynx
10.5%
2/19 • Number of events 11
0.00%
0/28
Gastrointestinal disorders
Vomiting
63.2%
12/19 • Number of events 56
50.0%
14/28 • Number of events 54
Investigations
Weight gain
5.3%
1/19 • Number of events 2
0.00%
0/28
Investigations
Weight loss
0.00%
0/19
14.3%
4/28 • Number of events 24
Infections and infestations
Wound infection
5.3%
1/19 • Number of events 1
14.3%
4/28 • Number of events 12
Infections and infestations
Wound non-infectious
0.00%
0/19
7.1%
2/28 • Number of events 6
Respiratory, thoracic and mediastinal disorders
Cough
36.8%
7/19 • Number of events 65
21.4%
6/28 • Number of events 18
Injury, poisoning and procedural complications
bruising
10.5%
2/19 • Number of events 6
0.00%
0/28

Additional Information

Jeffrey Sosman, M.D.

Vanderbilt-Ingram Cancer Center

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place