Terminé

The Safety and Effectiveness of Interferon Alfa-2B Plus Didanosine in Patients With Kaposi's Sarcoma

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Ce qui est testé

Interferon alfa-2b

+ Didanosine
Médicament
Qui peut participer

Sarcoma, Kaposi

+ HIV Infections
À partir de 12 ans
Comment se déroule l'étude

Étude thérapeutique

Phase 2
Interventionnel

Résumé

Sponsor principalNational Institute of Allergy and Infectious Diseases (NIAID)
Dernière mise à jour : 1 novembre 2021
Issu d'une base de données validée par les autorités. Revendiquer cette étude

Primary: To evaluate the safety, toxicity, and antitumor activity of two doses of interferon alfa-2b (IFN-alpha) combined with a fixed dose of didanosine (ddI) in patients with Kaposi's sarcoma associated with HIV infection. Secondary: To evaluate the effects of combined IFN-alpha and ddI treatment on HIV expression and markers of immune function. Previous studies have shown that IFN-alpha can induce regression of Kaposi's sarcoma and suppression of HIV in some patients. Although various trials using IFN-alpha in combination with the nucleoside analogue zidovudine have demonstrated a high degree of antitumor activity and evidence of HIV suppression, the overlapping toxicity (primarily neutropenia) of these two agents has proven dose-limiting. The toxicity profile of ddI suggests that this drug may be better tolerated than zidovudine when combined with IFN-alpha. Previous studies have shown that IFN-alpha can induce regression of Kaposi's sarcoma and suppression of HIV in some patients. Although various trials using IFN-alpha in combination with the nucleoside analogue zidovudine have demonstrated a high degree of antitumor activity and evidence of HIV suppression, the overlapping toxicity (primarily neutropenia) of these two agents has proven dose-limiting. The toxicity profile of ddI suggests that this drug may be better tolerated than zidovudine when combined with IFN-alpha. Up to 90 patients are randomized to receive either low or high doses of IFN-alpha (1 or 10 million Units/day) in combination with a fixed dose of ddI. Fourteen patients are initially entered at each dose level. If no objective antitumor responses are observed among the first 14 patients at a given dose, no further patients are entered on that treatment arm. If one or more antitumor responses are seen at a given dose, up to 45 patients may be entered on that treatment arm. Patients must complete at least 4 weeks of study therapy to be considered evaluable for tumor response. Treatment is continued until tumor progression or unacceptable toxicity occurs. PER AMENDMENT 9/19/96: NOTE - After 16 weeks of treatment subjects may receive any FDA approved antiretroviral drug regimen in addition to or in place of ddI.

Titre officielA Randomized Phase II Trial to Determine the Safety, Tolerance, and Efficacy of Two Doses of Interferon Alfa-2b Combined With Didanosine in Patients With Kaposi's Sarcoma 
Sponsor principalNational Institute of Allergy and Infectious Diseases (NIAID)
Dernière mise à jour : 1 novembre 2021
Issu d'une base de données validée par les autorités. Revendiquer cette étude

Protocole

Cette section fournit des détails sur le plan de l'étude, y compris la manière dont l'étude est conçue et ce qu'elle évalue.
Détails du design
90 participants à inclureNombre total de participants que l'essai clinique vise à recruter.
Traitement
Cette étude teste un ou plusieurs traitements pour évaluer leur efficacité contre une maladie ou un problème de santé spécifique. L'objectif est de voir si un nouveau médicament ou une thérapie fonctionne mieux, ou provoque moins d'effets secondaires que les options existantes.

Éligibilité

Les chercheurs recherchent des patients correspondant à une certaine description appelée critères d'éligibilité : état de santé général ou traitements antérieurs du patient.
Conditions
Critères
Tout sexeLe sexe biologique des participants éligibles à s'inscrire.
À partir de 12 ansTranche d'âge des participants éligibles à participer.
Volontaires sains non autorisésIndique si les individus en bonne santé et ne présentant pas la condition étudiée peuvent participer.
Conditions
Pathologie
Sarcoma, Kaposi
HIV Infections
Critères

Inclusion Criteria Concurrent Medication: Allowed: * Chemoprophylaxis for candidiasis and herpes simplex. * Up to 14 days of metronidazole. * Recombinant erythropoietin. * G-CSF (for severe cases of neutropenia). * Isoniazid for treatment of TB if given in conjunction with pyridoxine. Required in patients with CD4 counts \< 200 cells/mm3: * Prophylaxis for PCP. PER AMENDMENT 9/19/96: * After the first 16 weeks of combined IFN alpha-2b and ddI treatment subjects may at the discretion of the investigator receive any FDA approved antiretroviral drug regimen in addition to or in place of ddI. Patients must have: * Positive antibody to HIV. * Biopsy-proven Kaposi's sarcoma (at least 5 measurable lesions, with at least 1 measurable cutaneous lesion) involving the skin, lymph nodes, oral cavity, or asymptomatic lesions of the GI tract not requiring systemic chemotherapy. Lung involvement with Kaposi's sarcoma excludes. * Consent of parent or guardian if less than 18 years of age. Exclusion Criteria Co-existing Condition: Patients with the following symptoms and conditions are excluded: * Concurrent opportunistic infection or B symptoms including unexplained fever, night sweats, weight loss \> 10 percent, and diarrhea lasting more than 2 weeks. * Visceral (non-nodal) Kaposi's sarcoma requiring cytotoxic chemotherapy. * Severe (\> 2+) tumor-associated edema. * Concurrent neoplasia other than basal cell carcinoma, or anogenital intraepithelial neoplasia. * Current clinical evidence of peripheral neuropathy (= or \> grade 1), pancreatitis, intractable diarrhea, or active seizure disorder not well controlled by anti-seizure medications. * Significant symptomatic cardiac disease. * Medical contraindication. Concurrent Medication: Excluded: * Other investigational, antiviral, immunomodulating, or antitumor agents. * Drugs associated with peripheral neuropathy (other than ddI). PER AMENDMENT 9/19/96: * Other antiretroviral agents may not be taken during the first 16 weeks of combined IFN alpha-2b and ddI treatment. Concurrent Treatment: Excluded: * Radiation therapy. Patients with the following prior conditions are excluded: * Opportunistic infection or B symptoms including unexplained fever, night sweats, weight loss \> 10 percent, and diarrhea lasting more than 2 weeks. * Prior grade 3 or 4 toxicity attributed to ddI therapy. * Prior history of peripheral neuropathy (= or \> grade 1), pancreatitis, intractable diarrhea, or active seizure disorder not well controlled by anti-seizure medications. * History of myocardial infarction or ventricular arrhythmias. Prior Medication: Excluded: * Prior IFN-alpha. * Corticosteroids, biological response modifiers, cytotoxic chemotherapy, or known neurotoxic drugs (other than ddI or ddC) within 30 days prior to study entry. * Therapy with antiretroviral drugs (other than ddI) within 7 days prior to study entry. Prior Treatment: Excluded: * Radiation therapy within 30 days prior to study entry. Risk Behavior: * Alcohol consumption is strongly discouraged. * Patients considered to be noncompliant should be excluded.



Centres d'étude

Ce sont les hôpitaux, cliniques ou centres de recherche où l'essai est conduit. Vous pouvez trouver le site le plus proche de vous ainsi que son statut.
Cette étude comporte 13 sites
Suspendu
Stanford CRSPalo Alto, United StatesVoir le site
Suspendu
University of Colorado Hospital CRSAurora, United States
Suspendu
Northwestern University CRSChicago, United States
Suspendu
Rush Univ. Med. Ctr. ACTG CRSChicago, United States

Terminé13 Centres d'Étude