Purpose

RATIONALE: Bortezomib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth and by blocking blood flow to the tumor. Drugs used in chemotherapy, such as temozolomide, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving bortezomib together with temozolomide may kill more tumor cells.

PURPOSE: This phase I trial is studying the side effects and best dose of bortezomib when given together with temozolomide in treating patients with brain tumors or other solid tumors that have not responded to treatment.


Condition Intervention Phase
Brain and Central Nervous System Tumors
Lymphoma
Unspecified Adult Solid Tumor, Protocol Specific
Drug: bortezomib
Drug: temozolomide
Procedure: pharmacological study
Phase I

Genetics Home Reference related topics:   Benign Tumors   Cancer  

MedlinePlus related topics:   Brain Cancer   Cancer   Lymphoma  

ChemIDplus related topics:   Temozolomide   Bortezomib  

U.S. FDA Resources

Study Type:   Interventional
Study Design:   Treatment
Official Title:   A Phase I Study of Bortezomib and Temozolomide in Patients With Refractory Solid Tumors

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

Primary Outcome Measures:
  • Dose-limiting toxicity and maximum tolerated dose [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Pharmacokinetics [ Designated as safety issue: No ]
  • Confirmed complete or partial response [ Designated as safety issue: No ]
  • Percentage of patients with 6-month progression-free survival [ Designated as safety issue: No ]

Estimated Enrollment:   72
Study Start Date:   January 2005
Estimated Primary Completion Date:   September 2010 (Final data collection date for primary outcome measure)

Detailed Description:

OBJECTIVES:

Primary

  • To determine the dose-limiting toxicities and maximum tolerated doses of bortezomib and temozolomide in patients with recurrent high-grade gliomas, recurrent metastatic brain tumors, or other refractory solid tumors.

Secondary

  • To evaluate the pharmacokinetics of bortezomib in patients taking hepatic enzyme-inducing anticonvulsants (Group A) and in those who are not (Group B).
  • To describe the proportion of study patients treated with bortezomib and temozolomide who obtain a confirmed complete response or partial response.
  • To report the percentage of patients with 6-month progression-free survival.

OUTLINE: Patients are stratified according to concurrent hepatic enzyme-inducing anticonvulsants (HEIAs) (Group A) versus concurrent anticonvulsant drugs that cause modest or no induction of hepatic metabolic enzymes OR no anticonvulsant drugs (Group B).

  • Group A: Patients receive oral temozolomide once a day on days 1-5 and bortezomib IV on days 2, 5, 9, and 12. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
  • Group B: Patients receive temozolomide and bortezomib as in group A. Cohorts of patients in both groups receive escalating doses of both study drugs until the maximum tolerated doses are determined.

All patients undergo blood sample collection periodically for pharmacokinetic studies. Samples are analyzed for bortezomib concentration (groups A and B) and trough levels of anticonvulsants (group A only).

  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 solid tumors including the following

    • Recurrent high-grade glioma
    • Recurrent metastatic brain tumors
    • Recurrent primary brain tumor including primary CNS lymphoma
    • Other refractory solid tumors
  • Unresectable disease for which standard curative or palliative measures do not exist or are no longer effective
  • Measurable or nonmeasurable disease

PATIENT CHARACTERISTICS:

Inclusion criteria:

  • Karnofsky performance status 60-100%
  • Absolute neutrophil count %u2265 1,500/mm^3
  • Platelet count %u2265 100,000/mm^3
  • Serum creatinine %u2264 1.5 x upper limit of normal (ULN)
  • Total bilirubin %u2264 2.0 mg/dL
  • AST %u2264 4.0 x ULN
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • Patient must be able to understand and is willing to sign a written informed consent document

Exclusion criteria:

  • Any of the following conditions:

    • Myocardial infarction within the past 6 months or New York Heart Association class III or IV heart failure
    • Uncontrolled angina
    • Severe uncontrolled ventricular arrhythmias
    • ECG evidence of acute ischemia or active conduction system abnormalities

      • Any ECG abnormalities prior to study entry must be documented by the investigator as not medically relevant
  • Serious medical or psychiatric illness that would, in the opinion of the investigator, potentially interfere with the completion of treatment
  • History of sensitivity to boron or mannitol

PRIOR CONCURRENT THERAPY:

Inclusion criteria:

  • At least 4 weeks since prior chemotherapy (6 weeks for nitrosourea-containing chemotherapy), immunotherapy, or radiotherapy and recovered
  • More than 10 days since prior anticonvulsant drugs that induce hepatic metabolic enzymes for patients in group A
  • Recovered from major surgery

    • Corticosteroids for cerebral edema allowed provided the patient is on a stable dose for at least 1 week

Exclusion criteria:

  • Patients enrolled on another clinical trial
  • HIV-positive patients on antiretroviral therapy
  • Concurrent chemotherapy or radiotherapy
  • Patient requires anti-seizure medication but is not on a stable dose and agent of anti-seizure medication
  Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00544284

Locations
United States, California
City of Hope Comprehensive Cancer Center     Recruiting
      Duarte, California, United States, 91010-3000
      Contact: Clinical Trials Office - City of Hope Comprehensive Cancer Cen     800-826-4673     becomingapatient@coh.org    
City of Hope Medical Group     Recruiting
      Pasadena, California, United States, 91105
      Contact: Contact Person     800-826-4673        

Sponsors and Collaborators
Beckman Research Institute
National Cancer Institute (NCI)

Investigators
Principal Investigator:     Jana Portnow, MD     Beckman Research Institute    
United States, California
City of Hope Comprehensive Cancer Center     Recruiting
      Duarte, California, United States, 91010-3000
      Contact: Clinical Trials Office - City of Hope Comprehensive Cancer Cen     800-826-4673     becomingapatient@coh.org    
City of Hope Medical Group     Recruiting
      Pasadena, California, United States, 91105
      Contact: Contact Person     800-826-4673        
Beckman Research Institute
National Cancer Institute (NCI)
Principal Investigator:     Jana Portnow, MD     Beckman Research Institute    
  More Information

Clinical trial summary from the National Cancer Institute's PDQ® database  This link exits the ClinicalTrials.gov site
 

Study ID Numbers:   CDR0000570245, CHNMC-04032
First Received:   October 13, 2007
Last Updated:   May 23, 2008
ClinicalTrials.gov Identifier:   NCT00544284
Health Authority:   Unspecified

Keywords provided by National Cancer Institute (NCI):
adult meningeal hemangiopericytoma  
adult glioblastoma  
adult anaplastic astrocytoma  
adult giant cell glioblastoma  
recurrent adult brain tumor  
adult gliosarcoma  
mixed gliomas  
adult anaplastic oligodendroglioma  
primary central nervous system lymphoma  
adult diffuse astrocytoma  
adult brain stem glioma
adult central nervous system germ cell tumor
adult choroid plexus tumor
adult craniopharyngioma
adult ependymoblastoma
adult medulloblastoma
adult supratentorial primitive neuroectodermal tumor (PNET)
adult anaplastic ependymoma
adult ependymoma
adult myxopapillary ependymoma

Study placed in the following topic categories:
Glioblastoma
Choroid Plexus Neoplasms
Neuroectodermal Tumors, Primitive
Central Nervous System Neoplasms
Ependymoma
Central nervous system lymphoma, primary
Craniopharyngioma
Neuroepithelioma
Meningioma
Glioma
Choroid Plexus neoplasms
Lymphoma
Nervous System Neoplasms
Immunoproliferative Disorders
Astrocytoma
Bortezomib
Temozolomide
Hemangiopericytoma
Recurrence
Neuroectodermal Tumors

Additional relevant MeSH terms:
Neoplasms by Histologic Type
Hemic and Lymphatic Diseases
Immune System Diseases
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Nervous System Diseases
Enzyme Inhibitors
Pharmacologic Actions
Protease Inhibitors
Neoplasms
Neoplasms by Site
Therapeutic Uses
Antineoplastic Agents, Alkylating
Alkylating Agents

Source: National Library of Medicine (NLM) July 02, 2008