Sarcoma
Conditions
Keywords
metastatic osteosarcoma, recurrent adult soft tissue sarcoma, recurrent osteosarcoma, adult rhabdomyosarcoma, metastatic Ewing sarcoma/peripheral primitive neuroectodermal tumor, recurrent Ewing sarcoma/peripheral primitive neuroectodermal tumor, stage IV adult soft tissue sarcoma
Brief summary
RATIONALE: Bortezomib may stop the growth of cancer by blocking the enzymes necessary for tumor cell growth. PURPOSE: Phase II trial to study the effectiveness of bortezomib in treating patients who have advanced or metastatic sarcoma.
Detailed description
OBJECTIVES: * Determine the response rate in patients with advanced or metastatic sarcoma treated with bortezomib. * Correlate levels of cyclins D1, E, p21 (WAF1), p27 (Kip1), mdm\^2, p53, and Ki67 with response in patients treated with this drug. OUTLINE: This is an open-label, multicenter study. Patients are stratified according to disease (stratum I: soft tissue sarcoma not specified in stratum II, osteogenic sarcoma arising from soft tissues, or gastrointestinal stromal tumor vs stratum II: Ewing's sarcoma of soft tissue or bone, rhabdomyosarcoma, or osteogenic sarcoma of bone). (Stratum I closed to accrual as of 10/17/03.) 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. Patients are followed every 3 months for 1 year. PROJECTED ACCRUAL: A total of 21-41 patients will be accrued for stratum I within 5-11 months and 21-41 patients will be accrued for stratum II within 10.5-22 months. (Stratum I closed to accrual as of 10/17/03.)
Interventions
Sponsors
Study design
Eligibility
Inclusion criteria
DISEASE CHARACTERISTICS: * Histologically or cytologically confirmed sarcoma * Soft tissue metastasis or locally recurrent disease * Stratum I (closed to accrual as of 10/17/03): * Soft tissue sarcoma not specified in stratum II * Osteogenic sarcoma arising from soft tissue or gastrointestinal stromal tumor (GIST) * Stratum II: * Ewing's sarcoma of soft tissue or bone (if measurable soft tissue metastasis is present) * Rhabdomyosarcoma * Osteogenic sarcoma of bone (if measurable soft tissue metastasis is present) * At least 1 unidimensionally measurable lesion * At least 20 mm by conventional techniques OR at least 10 mm by spiral CT scan * Disease progression within the past 3 months * No prior or active known brain metastases PATIENT CHARACTERISTICS: Age: * 18 and over Performance status: * Karnofsky 80-100% OR * ECOG 0-1 Life expectancy: * Not specified Hematopoietic: * Absolute neutrophil count at least 1,500/mm\^3 * Platelet count at least 100,000/mm\^3 Hepatic: * Bilirubin no greater than 1.5 mg/dL * AST/ALT no greater than 2.5 times upper limit of normal Renal: * Creatinine no greater than 1.5 mg/dL OR * Creatinine clearance greater than 60 mL/min Cardiovascular: * No peripheral vascular disease requiring surgical management * No history of congestive heart failure even if it is medically controlled * No angina pectoris even if it is medically controlled * No myocardial infarction within the past year * No cardiac arrhythmias * No prior cerebrovascular event * No prior transient ischemic attack * No EKG evidence of acute ischemia or conduction abnormality (e.g., bifascicular block \[left anterior hemiblock in the presence of right bundle branch block\] or second or third degree atrioventricular block) * No history of orthostatic hypotension Other: * Not pregnant or nursing * Negative pregnancy test * Fertile patients must use effective contraception * No prior allergic reaction to compounds of similar chemical or biological composition to study drug * No other uncontrolled concurrent illness * No ongoing or active infection * No psychiatric illness or social situation that would preclude study compliance * No other malignancy within the past 5 years except adequately treated basal cell skin cancer or carcinoma in situ of the cervix * No symptomatic peripheral neuropathy greater than grade 1 PRIOR CONCURRENT THERAPY: Biologic therapy: * At least 4 weeks since prior immunotherapy and recovered * No concurrent biological or immunological agents Chemotherapy: * Stratum I (closed to accrual as of 10/17/03): * At least 1 year since prior chemotherapy in the adjuvant or neoadjuvant setting * No other prior chemotherapy * Stratum II: * No more than 1 prior chemotherapy regimen * No concurrent chemotherapy Endocrine therapy: * Not specified Radiotherapy: * At least 4 weeks since prior radiotherapy and recovered * No concurrent radiotherapy Surgery: * Not specified Other: * Prior imatinib mesylate for GIST (stratum I closed to accrual as of 10/17/03) allowed * No other concurrent investigational agents * No concurrent commercial anticancer agents or therapies * No concurrent combination antiretroviral therapy for HIV-positive patients
Countries
United States