Topotecan in Treating Patients With Gynecologic Cancer That Cannot Be Removed by Surgery
Study Details
Study Description
Brief Summary
RATIONALE: Drugs used in chemotherapy, such as topotecan, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing.
PURPOSE: This phase I trial is studying the side effects and best dose of topotecan in treating patients with gynecologic cancer that cannot be removed by surgery.
Condition or Disease | Intervention/Treatment | Phase |
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Phase 1 |
Detailed Description
OBJECTIVES:
Primary
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To establish the maximum tolerated dose (MTD) of oral topotecan hydrochloride in patients with unresectable gynecologic malignancies.
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To determine the safety and tolerability of this drug in these patients.
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To obtain pharmacokinetic data to assess plasma concentrations of this drug when administered at the MTD.
Secondary
- To explore the response in patients treated with this drug.
OUTLINE: Patients receive oral topotecan hydrochloride on days 1, 8, and 15. Treatment repeats every 28 days for up to 6 courses in the absence of disease progression or unacceptable toxicity.
Patients treated at the maximum tolerated dose undergo blood sample collection periodically on day 1 of course 1 for pharmacokinetic studies.
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
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Experimental: Oral Topotecan
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Drug: topotecan hydrochloride
Patients receive oral topotecan hydrochloride on days 1, 8, and 15. Treatment repeats every 28 days for up to 6 courses in the absence of disease progression or unacceptable toxicity.
Other: pharmacological study
Patients treated at the maximum tolerated dose undergo blood sample collection periodically on day 1 of course 1 for pharmacokinetic studies.
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Outcome Measures
Primary Outcome Measures
- Maximum tolerated dose (MTD) [Treatment repeats every 28 days for up to 6 courses in the absence of unacceptable toxicity.]
- Safety and tolerability [Treatment repeats every 28 days for up to 6 courses in the absence of unacceptable toxicity.]
- Plasma concentration of topotecan hydrochloride when administered at the MTD [blood sample collection periodically on day 1 of course 1 for pharmacokinetic studies]
Secondary Outcome Measures
- Response [Treatment repeats every 28 days for up to 6 courses in the absence of disease progression.]
Eligibility Criteria
Criteria
DISEASE CHARACTERISTICS:
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Histologically* or cytologically confirmed unresectable gynecologic malignancy for which standard curative or palliative care is not available
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All tumor types allowed NOTE: *Histologic confirmation of recurrence is not required
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Measurable or nonmeasurable disease
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If CT scan was used to evaluate measurable disease, lesions must be clearly defined and be ≥ 10 mm on spiral CT scan
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No "borderline tumors" or tumors with low malignant potential
PATIENT CHARACTERISTICS:
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Karnofsky performance status 60-100%
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Life expectancy ≥ 12 weeks
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ANC ≥ 1,500/μL
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Platelet count ≥ 100,000/μL
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Hemoglobin ≥ 9 g/dL
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Creatinine ≤ 1.5 times upper limit of normal (ULN)
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Creatinine clearance ≥ 60 mL/min
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AST/ALT ≤ 2.5 times ULN (< 5 times ULN if liver metastases are present)
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Alkaline phosphatase ≤ 2.5 times ULN (< 5 times ULN if liver metastases are present)
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Not pregnant or nursing
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Negative pregnancy test
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Fertile patients must use effective contraception
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Adequate intestinal function (i.e., no gastrostomy tube or requirement for IV hydration or nutritional support)
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No severe gastrointestinal bleeding or intestinal obstruction
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No other condition that would affect gastrointestinal absorption and motility
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No septicemia, severe infection, or acute hepatitis
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No other malignancies requiring chemotherapy or radiotherapy within the past 5 years, except skin cancer
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No concurrent severe medical problem unrelated to the malignancy that would significantly limit full compliance with the study, expose the patient to extreme risk, or decrease life expectancy
PRIOR CONCURRENT THERAPY:
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At least 28 days since prior investigational drugs (including cytotoxic drugs)
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At least 4 weeks since prior chemotherapy, radiotherapy, biologic therapy, or surgery and recovered
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No more than 3 prior chemotherapy regimens
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No prior topotecan hydrochloride or other camptothecin analogs
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No prior radiotherapy to > 25% of the bone marrow
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No other concurrent chemotherapy, radiotherapy, biologic therapy, immunotherapy, or hormonal therapy for cancer
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No concurrent administration of any of the following:
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P-glycoprotein (ABCB1, Pgp, MDR1) inhibitors or inducers
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Breast cancer-resistant protein (ABCG2, BCRP, MXR) inhibitors or inducers
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No concurrent chronic H2 antagonists, proton pump inhibitors, or antacids for gastritis, gastroesophageal reflux disease, or gastric or duodenal ulcers
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Intermittent antacid therapy is allowed provided it is given ≥ 6 hours prior to and ≥ 90 minutes after study drug administration
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
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1 | Case Medical Center, University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center | Cleveland | Ohio | United States | 44106 |
Sponsors and Collaborators
- Steven Waggoner, MD
- National Cancer Institute (NCI)
Investigators
- Principal Investigator: Stephen Waggoner, MD, Case Medical Center, University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- CASE2Y08
- P30CA043703
- CASE2Y08
- CASE 2Y08-CC630
- NCI-2009-01290