A Phase I Study of PS-341 (Velcade, Bortezomib) in Pediatric Patients With Refractory/Recurrent Leukemias
bortezomib
+ pharmacological study
+ laboratory biomarker analysis
Crise Blastoïde+20
+ Maladies de la moelle osseuse
+ Transformation cellulaire néoplasique
Étude thérapeutique
Résumé
Date de début de l'étude : 1 janvier 2004
Date à laquelle le premier participant a commencé l'étude.OBJECTIVES: Primary I. Determine the maximum tolerated dose and recommended phase II dose of bortezomib in children with refractory or recurrent leukemia. II. Determine the toxic effects of this drug in these patients. III. Determine the pharmacokinetics of this drug in these patients. Secondary I. Determine, preliminarily, the antitumor activity of this drug in these patients. II. Determine, preliminarily, the biologic activity of this drug in these patients. OUTLINE: This is a dose-escalation, open-label, multicenter study. Patients receive bortezomib IV over 3-5 seconds on days 1, 4, 8, and 11. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of bortezomib 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. PROJECTED ACCRUAL: A total of 3-36 patients will be accrued for this study within 1.5-36 months.
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.36 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.De 1 à 21 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
Inclusion Criteria: * Histologically confirmed leukemia of 1 of the following types: * Acute lymphoblastic leukemia * Acute myeloid leukemia * Chronic myelogenous leukemia in blast crisis * Relapsed or refractory disease * Immunophenotypically confirmed disease, either at initial diagnosis or relapse * More than 25% blasts in the bone marrow (M3 bone marrow) * Active extramedullary disease (except leptomeningeal disease) allowed * No known curative therapy or therapy proven to prolong survival with an acceptable quality of life available * Performance status - Karnofsky 50-100% (for patients age 11 to 21) * Performance status - Lansky 50-100% (for patients age 10 and under) * Platelet count ≥ 20,000/mm\^3\* * Hemoglobin ≥ 8.0 g/dL\* * WBC \< 20,000/mm\^3\*\* (hydroxyurea for cytoreduction allowed) * No hyperleukocytosis (i.e., WBC \> 100,000/mm\^3) * Bilirubin ≤ 1.5 times upper limit of normal (ULN) * ALT ≤ 5 times ULN * Albumin ≥ 2 g/dL * Creatinine clearance or radioisotope glomerular filtration rate ≥ 70 mL/min * Creatinine based on age as follows: * ≤ 0.8 mg/dL for patients age 5 and under * ≤ 1.0 mg/dL for patients age 6 to 10 * ≤ 1.2 mg/dL for patients age 11 to 15 * ≤ 1.5 mg/dL for patients age 16 to 21 * Not pregnant or nursing * Negative pregnancy test * Fertile patients must use effective contraception * No uncontrolled infection * Recovered from prior immunotherapy * At least 7 days since prior filgrastim (G-CSF) or sargramostim (GM-CSF) * At least 7 days since prior biologic agents * At least 3 months since prior stem cell transplantation or rescue and no evidence of active graft-versus-host disease * No concurrent prophylactic G-CSF during course 1 of study * No concurrent immunotherapy * No concurrent biologic therapy * Recovered from prior chemotherapy * At least 24 hours since prior hydroxyurea for cytoreduction * At least 6 weeks since prior nitrosoureas * No concurrent chemotherapy * At least 7 days since prior steroids (except as premedication prior to blood product transfusion) * Recovered from prior radiotherapy * At least 2 weeks since prior small port local palliative radiotherapy * At least 3 months since prior total body irradiation, craniospinal irradiation, or irradiation to more than 50% of the pelvis * At least 6 weeks since other prior substantial bone marrow radiotherapy * No concurrent radiotherapy * At least 7 days since prior retinoids * No other concurrent investigational agents * No other concurrent anticancer agents * No concurrent anticonvulsant medications known to activate the cytochrome p450 system (e.g., phenytoin, carbamazepine, or phenobarbital) * Concurrent benzodiazepines and gabapentin are allowed
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
ExpérimentalObjectifs de l'étude
Objectifs principaux
Objectifs secondaires
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 1 site