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Liposomal Doxorubicin and Interleukin-12 in Treating Patients With AIDS-Related Kaposi's Sarcoma

A Phase II Study of Liposomal Doxorubicin and Interleukin-12 in AIDS-Associated Kaposi's Sarcoma Followed by Chronic Administration of Interleukin-12

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00020449
Enrollment
Unknown
Registered
2003-01-27
Start date
2001-01-31
Completion date
2004-05-31
Last updated
2013-06-19

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Sarcoma

Keywords

AIDS-related Kaposi sarcoma, recurrent Kaposi sarcoma

Brief summary

RATIONALE: Drugs used in chemotherapy work in different ways to stop tumor cells from dividing so they stop growing or die. Interleukin-12 may kill tumor cells by stopping blood flow to the tumor and by stimulating a person's white blood cells to kill the tumor cells. Combining chemotherapy with interleukin-12 may kill more tumor cells. PURPOSE: Phase II trial to study the effectiveness of combining liposomal doxorubicin with interleukin-12 in treating patients who have AIDS-related Kaposi's sarcoma.

Detailed description

OBJECTIVES: * Determine the overall response rate in patients with AIDS-associated Kaposi's sarcoma (KS) treated with doxorubicin HCl liposome and interleukin-12. * Determine the time to response and the number of complete responses in patients treated with this regimen. * Determine the progression-free survival of patients treated with this regimen. * Provide pilot information on the ability of interleukin-12 to maintain major responses induced with paclitaxel salvage therapy in patients with aggressive or life-threatening KS after treatment failure with doxorubicin HCl liposome and interleukin-12. * Determine the effect of this regimen on CD4 counts and viral load in these patients. OUTLINE: Patients receive doxorubicin HCl liposome (LipoDox) IV over 30 minutes once every 3 weeks for a total of 6 doses. Beginning concurrently with the initiation of LipoDox, patients also receive interleukin-12 (IL-12) subcutaneously twice weekly (at least 3 days apart) for up to 3 years. Patients with refractory disease are transferred to the paclitaxel salvage therapy regimen comprising paclitaxel IV continuously on days 1-4 once every 3 weeks until a major response is achieved. Beginning concurrently with the initiation of paclitaxel salvage therapy, patients also receive IL-12 as above for up to 3 years. Treatment continues in the absence of disease progression or unacceptable toxicity. Patients achieving a complete response may discontinue IL-12 administration. If necessary, IL-12 treatment may resume at a later time. Patients are followed at 4 weeks. PROJECTED ACCRUAL: A total of 24-36 patients will be accrued for this study within 2-4 years.

Interventions

BIOLOGICALrecombinant interleukin-12
DRUGpaclitaxel
DRUGpegylated liposomal doxorubicin hydrochloride

Sponsors

National Cancer Institute (NCI)
Lead SponsorNIH

Study design

Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

DISEASE CHARACTERISTICS: * Histologically confirmed Kaposi's sarcoma (KS) * HIV positive * Evaluable disease involving the skin and/or viscera * At least 5 lesions not previously treated with local therapy if restricted to the skin * Pulmonary lesions evaluable by CT scan * Gastrointestinal lesions evaluable by visualization or fiberoptic instrumentation * Presence of at least one of the following indications for cytotoxic chemotherapy: * Pulmonary involvement * Visceral involvement * Pain * Edema * Ulcerating lesions * Decreased range of joint motion due to KS * Multiple lesions not amenable to local therapy * Lymphedema that impairs mobility or range of motion * Significant psychological impact leading to social withdrawal * Progressive disease within the past 3 weeks while receiving a stable regimen of highly active antiretroviral therapy for at least 4 weeks unless there is a need for urgent chemotherapy * Prior participation on this study allowed, provided patient was removed from study due to non-pancreatic hyperamylasemia and the following are true: * No dose-limiting toxicity by clinical and laboratory assessment * Pancreatic amylase portion normal by fractionated amylase * Lipase normal * No symptoms referable to the pancreas PATIENT CHARACTERISTICS: Age: * 18 and over Performance status: * Karnofsky 30-100% Life expectancy: * More than 2 months Hematopoietic: * Hemoglobin at least 9.0 g/dL * Absolute neutrophil count at least 750/mm\^3 * Platelet count at least 75,000/mm\^3 Hepatic: * Bilirubin no greater than 3.8 mg/dL with direct fraction no greater than 0.3 mg/dL and indirect fraction no greater than 3.5 mg/dL if due to protease inhibitor therapy * PT or aPTT no greater than 120% of control unless due to lupus-type anticoagulant * AST no greater than 2.5 times upper limit of normal * No prior hepatic cirrhosis * No hepatic dysfunction Renal: * Creatinine no greater than 1.5 mg/dL * Creatinine clearance at least 60 mL/min Cardiovascular: * No congestive heart failure * Ejection fraction at least 40% by MUGA or echocardiogram Other: * Not pregnant or nursing * Negative pregnancy test * Fertile patients must use effective barrier contraception during and for 2 months after study participation * No clinically significant autoimmune disease * No active, gross gastrointestinal bleeding or uncontrolled peptic ulcer disease * No prior inflammatory bowel disease * No other prior or concurrent malignancy except squamous cell carcinoma in situ of the cervix or anus, completely resected basal cell carcinoma, or malignancy in complete remission for at least 1 year from the time a response was first documented * No severe or life-threatening infection within the past 2 weeks * No abnormality that would be scored as grade 3 toxicity except lymphopenia or direct manifestations of KS * No known hypersensitivity to interleukin-12 (IL-12) or other compounds known to cross-react with IL-12 * No other medical condition that would preclude study entry PRIOR CONCURRENT THERAPY: Biologic therapy: * More than 2 weeks since prior cytokines or colony-stimulating factors other than epoetin alfa, filgrastim (G-CSF), or sargramostim (GM-CSF) * No prior combination interleukin-12 and doxorubicin HCl liposome except for patients previously treated on this protocol who are being enrolled for paclitaxel salvage therapy * No concurrent immunomodulatory agents * No concurrent cytokines except epoetin alfa or G-CSF Chemotherapy: * See Disease Characteristics * See Biologic therapy * At least 3 weeks since prior chemotherapy (6 weeks for mitomycin or nitrosoureas) * More 6 months since prior suramin * No other concurrent cytotoxic chemotherapy Endocrine therapy: * More than 2 months since prior systemic glucocorticoid steroids at doses sufficient to affect immune response (e.g., more than 20 mg of prednisone for more than 1 week) * Concurrent replacement glucocorticoid therapy allowed * No other concurrent systemic glucocorticoid therapy Radiotherapy: * Not specified Surgery: * Not specified Other: * Concurrent antiretroviral therapy required * No other concurrent anti-KS therapy

Countries

United States

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Apr 6, 2026