A Phase I and Pharmacokinetic Study of Sequences of NSC 655649 (Rebeccamycin Analogue) and Cisplatin Without and With Granulocyte Colony-Stimulating Factor Support Every 21 Days
filgrastim
+ becatecarin
+ cisplatin
Adénopathie+41
+ Maladie chronique
+ Infections par virus ADN
Étude thérapeutique
Résumé
Date de début de l'étude : 1 octobre 1999
Date à laquelle le premier participant a commencé l'étude.OBJECTIVES: I. Determine the maximum tolerated doses of a rebeccamycin analogue and cisplatin with or without filgrastim (G-CSF) in patients with advanced malignancies. II. Determine the qualitative and quantitative toxicities of these regimens in these patients. III. Determine if the pharmacokinetics of a rebeccamycin analogue are affected by cisplatin and if there are sequence dependent pharmacokinetic effects. IV. Assess any antitumor effects of this regimen in these patients. OUTLINE: This is a dose-escalation, multicenter study of a rebeccamycin analogue and cisplatin. Part I (previously untreated or minimally pretreated patients): The first patient of each cohort receives cisplatin IV over 1 hour followed 2 hours later by a rebeccamycin analogue IV over 1 hour on day 1. The second patient in the same cohort receives the same drugs in the reverse order. The drug sequence for each additional patient within the same cohort is alternated with reference to the preceding patient. During each subsequent course, the study drugs are administered to each patient in the reverse order as compared to the prior course. Treatment repeats every 3 weeks for 4 courses in the absence of disease progression or unacceptable toxicity. Dose escalation is initially performed without filgrastim (G-CSF). Cohorts of 4-6 patients receive escalating doses of a rebeccamycin analogue and cisplatin until the maximum tolerated dose (MTD) of each drug is determined. The MTD is defined as the highest dose at which less than 2 of 6 patients experience dose limiting toxicity (DLT). If 2 of the first 6 patients experience DLT, then dose escalation proceeds in combination with G-CSF treatment. Patients receive G-CSF subcutaneously daily beginning on day 2 and continuing until blood counts have recovered for 2 days or until approximately day 15. Cohorts of 4-6 patients receive escalating doses of a rebeccamycin analogue and cisplatin as above. The MTD is defined as above. Part II (heavily pretreated patients): Heavily pretreated patients receive a rebeccamycin analogue and cisplatin starting at 2 dose levels preceding the MTD from part I. Patients are followed for at least 30 days.
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.40 participants à inclure
Nombre total de participants que l'essai clinique vise à recruter.Traitement
Éligibilité
Les chercheurs recherchent des patients correspondant à une certaine description appelée critères d'éligibilité : état de santé général ou traitements antérieurs du patient.Tout sexe
Le sexe biologique des participants éligibles à s'inscrire.À partir de 18 ans
Tranche d'âge des participants éligibles à participer.Volontaires sains non autorisés
Indique si les individus en bonne santé et ne présentant pas la condition étudiée peuvent participer.Conditions
Pathologie
Critères
DISEASE CHARACTERISTICS: Histologically or cytologically proven advanced malignancy that is refractory to prior therapy or unlikely to benefit from standard therapy (e.g., chemotherapy, radiotherapy, and surgery) Part I: Previously untreated OR minimally pretreated Ineligible for part I and considered heavily pretreated if: Prior radiotherapy to wide ports involving the pelvis or at least 25% of bone marrow Greater than 6 courses of prior combination chemotherapy including alkylating agent Prior nitrosoureas or mitomycin Widespread bone metastases with bone marrow involvement by bone marrow biopsy (positive bilateral bone marrow biopsy for lymphoma patients) Part II: Heavily pretreated as defined above Measurable or evaluable disease PATIENT CHARACTERISTICS: Age: 18 and over Performance status: SWOG 0-2 Life expectancy: At least 3 months Hematopoietic: Absolute neutrophil count greater than 1,500/mm^3 Hemoglobin greater than 9 mg/dL Platelet count greater than 100,000/mm^3 Hepatic: Bilirubin less than 1.5 mg/dL Renal: Creatinine less than 1.5 mg/dL Cardiovascular: No uncontrolled hypertension No angina pectoris No clinically significant, multifocal, uncontrolled cardiac dysrhythmias Other: Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception No active serious infection No clinically severe peripheral neuropathy (grade 1 or worse) No nonmalignant medical condition that would preclude compliance or increase risk of participation in study No hypersensitivity to E. coli derived drug preparations PRIOR CONCURRENT THERAPY: Biologic therapy: No other concurrent colony stimulating factors for prophylactic purposes Chemotherapy: At least 3 weeks since prior chemotherapy (6 weeks since prior nitrosoureas and mitomycin) and recovered Endocrine therapy: No chronic oral corticosteroids No concurrent corticosteroids except as prophylactic antiemetic Radiotherapy: At least 3 weeks since prior radiotherapy and recovered Other: At least 1 month since prior investigational agent No prophylactic oral or IV antibiotics for neutropenia unless fever present No other concurrent anticancer treatment or investigational agent
Plan de l'étude
Découvrez tous les traitements administrés dans cette étude, leur description détaillée et ce qu'ils impliquent.Un seul groupe d'intervention est désigné dans cette étude
Cette étude ne comporte pas de groupe placebo.
Groupes de traitement
Groupe I
ExpérimentalCentres 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 3 sites
University of Texas Health Science Center at San Antonio
San Antonio, United StatesOuvrir University of Texas Health Science Center at San Antonio dans Google MapsCancer Therapy and Research Center
San Antonio, United StatesSt. Luke's Lutheran Hospital
San Antonio, United States