Docetaxel and Flavopiridol in Treating Patients With Locally Advanced or Metastatic Breast Cancer

Sponsor

National Cancer Institute (NCI) (NIH)

Overall Status

Completed

CT.gov ID

NCT00020332

Collaborator

(none)

Location

28.9

Duration (Months)

Study Details

Study Description

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/II trial to study the effectiveness of combination chemotherapy in treating patients who have locally advanced or metastatic breast cancer.

Condition or Disease	Intervention/Treatment	Phase
Breast Cancer	Drug: alvocidib Drug: docetaxel	Phase 1/Phase 2

Detailed Description

OBJECTIVES:

Determine the maximum tolerated dose of docetaxel and flavopiridol in patients with previously treated locally advanced or metastatic breast cancer.
Determine the dose-limiting toxicity, toxicity profile, and pharmacokinetics of this regimen in these patients.
Determine the activity of this regimen in these patients.
Determine the objective response rate in patients treated with this regimen.
Determine immune dysfunction produced by this regimen as measured by lymphocyte subpopulations, including T-cell activation/memory subsets and natural killer cell/lymphokine-activated killer cell functional subsets in these patients.
Determine the ability of positron emission tomography scanning to predict response in patients treated with this regimen.
Determine the response duration, time to treatment failure, and overall survival of patients treated with this regimen.
Determine the quality of life of patients treated with this regimen.
Determine whether this regimen is associated with the development of a prothrombotic state in these patients.

OUTLINE: This is a dose-escalation study.

Patients receive docetaxel IV over 1 hour on day 1 followed by flavopiridol IV over 1 hour or IV continuously on days 2-4. Treatment repeats every 3 weeks in the absence of disease progression or unacceptable toxicity.

Sequential dose escalation of docetaxel is preceded or followed by sequential dose escalation of flavopiridol. Cohorts of 3-6 patients receive escalating doses of docetaxel preceded or followed by escalating doses of flavopiridol until the maximum tolerated dose (MTD) of the combination is determined. The MTD is defined as the dose preceding that at which 2 of 6 patients experience dose-limiting toxicity. Once the MTD is determined, 22 additional patients are accrued to receive flavopiridol and docetaxel at the recommended phase II dose.

Quality of life is assessed at baseline, every 3 courses during study, and then at completion of study.

PROJECTED ACCRUAL: A total of 49 patients (27 for phase I and 22 for phase II) will be accrued for this study within 2 years.

Study Design

Study Type:

Interventional

Primary Purpose:

Treatment

Official Title:

A Phase I/II Trial of Docetaxel Followed by Infusional Flavopiridol Over 72 Hours in Patients With Previously Treated Locally Advanced or Metastatic Breast Cancer

Study Start Date :

Oct 1, 2000

Actual Study Completion Date :

Mar 1, 2003

Outcome Measures

Primary Outcome Measures

Eligibility Criteria

Criteria

Ages Eligible for Study:

18 Years and Older

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

DISEASE CHARACTERISTICS:

Histologically confirmed stage III or IV adenocarcinoma of the breast
Phase I:
Evaluable disease allowed
Phase II:
At least 1 site of measurable disease
No bone metastasis as only site of disease
No carcinomatous meningitis or brain metastases
Hormone receptor status:
Not specified

PATIENT CHARACTERISTICS:

Age:

18 and over

Sex:

Male or female

Menopausal status:

Not specified

Performance status:

ECOG 0-2

Life expectancy:

Not specified

Hematopoietic:

Granulocyte count at least 1,500/mm^3
Platelet count at least 100,000/mm^3
No active coagulopathy requiring therapeutic anticoagulation

Hepatic:

Bilirubin no greater than upper limit of normal (ULN)
SGOT no greater than 1.5 times ULN
Alkaline phosphatase no greater than 2.5 times ULN
No Gilbert's disease

Renal:

Creatinine no greater than 1.5 mg/dL

Cardiovascular:

Left ventricular ejection fraction at least 50% without clinical signs or symptoms of heart failure
No uncontrolled hypertension (sustained systolic blood pressure (BP) greater than 180 mm Hg or diastolic BP greater than 100 mm Hg)
No uncontrolled cardiac arrhythmia
No myocardial infarction within the past year
No significant ischemia or valvular heart disease

Other:

Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception
No medical or psychiatric condition that would increase risk
No other malignancy within the past 5 years except carcinoma in situ of the cervix or nonmelanomatous skin cancer
No grade 2 or greater peripheral neuropathy
No diabetes mellitus with a fasting blood sugar greater than 200 mg/dL
No active unresolved infection
No serious concurrent medical illness
No history of hypersensitivity reaction to products containing polysorbate 80 (Tween

PRIOR CONCURRENT THERAPY:

Biologic therapy:

Not specified

Chemotherapy:

No prior flavopiridol
Prior adjuvant chemotherapy for advanced disease allowed if within 6 months of diagnosis of metastatic disease
At least 4 weeks since prior chemotherapy (6 weeks for nitrosourea or 8 weeks for UCN-01) and recovered
Phase I:
Any number of prior chemotherapy regimens for metastatic carcinoma of the breast allowed
Phase II:
No more than 2 prior chemotherapy regimens for metastatic carcinoma of the breast

Endocrine therapy:

Prior hormonal therapy in the metastatic or adjuvant setting allowed
At least 2 weeks since prior hormonal therapy and no evidence of disease improvement by radiography after therapy
Concurrent corticosteroids allowed if for study premedication or hypersensitivity reactions/adverse events