Imatinib Mesylate and 17-N-Allylamino-17-Demethoxygeldanamycin in Treating Patients With Chronic Myelogenous Leukemia
Study Details
Study Description
Brief Summary
RATIONALE: Imatinib mesylate may stop the growth of cancer cells by blocking the enzymes necessary for cancer cell growth. Drugs used in chemotherapy such as 17-N-allylamino-17-demethoxygeldanamycin use different ways to stop cancer cells from dividing so they stop growing or die. Combining imatinib mesylate with chemotherapy may kill more cancer cells.
PURPOSE: This phase I trial is studying the side effects and best dose of 17-N-allylamino-17-demethoxygeldanamycin when given together with imatinib mesylate in treating patients with chronic myelogenous leukemia.
Condition or Disease | Intervention/Treatment | Phase |
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|
Phase 1 |
Detailed Description
OBJECTIVES:
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Determine the maximum tolerated dose and dose-limiting toxicity of 17-N-allylamino-17-demethoxygeldanamycin (17-AAG) when administered with imatinib mesylate in patients with chronic myelogenous leukemia.
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Determine the pharmacokinetics of this regimen in these patients.
OUTLINE: This is an open-label, nonrandomized, multicenter, dose-escalation study of 17-N-allylamino-17-demethoxygeldanamycin (17-AAG).
Patients receive oral imatinib mesylate on days 1-21 and 17-AAG IV over 1 hour on days 1, 4, 8, and 12. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.
Cohorts of 3-6 patients receive escalating doses of 17-AAG 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, an additional cohort of 6-10 patients receives treatment at the recommended phase II dose.
PROJECTED ACCRUAL: Approximately 21-42 patients will be accrued for this study within 1.5 years.
Study Design
Outcome Measures
Primary Outcome Measures
Eligibility Criteria
Criteria
DISEASE CHARACTERISTICS:
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Diagnosis of chronic myelogenous leukemia, including any of the following phases:
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Blastic phase
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Greater than 30% blasts in the peripheral blood or bone marrow
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Previously untreated disease OR refractory to or relapsed after most recent therapy
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Accelerated phase, defined by 1 of the following:
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At least 15, but less than 30%, blasts in the peripheral blood or bone marrow
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At least 30% blasts and promyelocytes in the peripheral blood or bone marrow
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Greater than 20% peripheral blood basophilia
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Chronic phase
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No major cytogenetic response (less than 65% Philadelphia chromosome negative) after 12 months of prior imatinib mesylate therapy
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Philadelphia chromosome positive by routine cytogenetics
PATIENT CHARACTERISTICS:
Age
- 18 and over
Performance status
- ECOG 0-2
Life expectancy
- At least 3 months
Hematopoietic
- Not specified
Hepatic
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Bilirubin no greater than 1.5 mg/dL
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ALT and AST no greater than 2.5 times upper limit of normal
Renal
- Creatinine less than 1.5 mg/dL
Cardiovascular
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No symptomatic congestive heart failure
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No unstable angina pectoris
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No cardiac arrhythmia
Other
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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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No known allergy to eggs
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Able to swallow pills
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No ongoing or active infection
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No psychiatric illness or social situation that would preclude study compliance
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No other concurrent uncontrolled medical illness
PRIOR CONCURRENT THERAPY:
Biologic therapy
- No prior stem cell transplantation
Chemotherapy
- More than 4 weeks since prior chemotherapy (except hydroxyurea or anagrelide) (at least 6 weeks for nitrosoureas or mitomycin)
Endocrine therapy
- Not specified
Radiotherapy
- More than 4 weeks since prior radiotherapy
Surgery
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No prior liver, kidney, or lung transplantation
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More than 14 days since prior major surgery (e.g., thoracotomy or intra-abdominal surgery)
Other
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Prior imatinib mesylate administered within the past 4 weeks is allowed
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No concurrent tacrolimus or cyclosporine as immunosuppressive agents
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No other concurrent investigational agents
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No concurrent combination antiretroviral therapy for HIV-positive patients
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No concurrent agents that alter CYP3A4 activity, including any of the following:
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Grapefruit juice
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Ketoconazole
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Fluconazole
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Itraconazole
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Erythromycin
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Clarithromycin
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Cimetidine
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Terfenadine
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Astemizole
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HIV protease inhibitors (e.g., indinavir and nelfinavir)
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
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1 | Barbara Ann Karmanos Cancer Institute | Detroit | Michigan | United States | 48201-1379 |
Sponsors and Collaborators
- Barbara Ann Karmanos Cancer Institute
- National Cancer Institute (NCI)
Investigators
- Study Chair: Charles A. Schiffer, MD, Barbara Ann Karmanos Cancer Institute
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- CDR0000315521
- U01CA062487
- P30CA022453
- WSU-C-2599
- NCI-5932