Colorectal Cancer
Conditions
Keywords
recurrent colon cancer, recurrent rectal cancer
Brief summary
RATIONALE: Monoclonal antibodies can locate tumor cells and either kill them or deliver tumor-killing substances to them without harming normal cells. PURPOSE: Phase I/II trial to study the effectiveness of monoclonal antibody therapy in treating patients who have advanced colorectal cancer that has not responded to irinotecan.
Detailed description
OBJECTIVES: * Determine the recommended phase II dose of monoclonal antibody anti-anb3 integrin in patients with irinotecan-refractory advanced colorectal cancer. * Determine the safety and tolerance of this drug in these patients. * Determine any antitumor activity of this drug in these patients. * Determine the objective response rate, response duration, and time to progression in patients treated with this drug. * Determine the pharmacokinetics of this drug in these patients. OUTLINE: This is a dose-escalation study. Patients receive monoclonal antibody anti-anb3 integrin IV over 30 minutes once weekly on weeks 1-52 in the absence of disease progression or unacceptable toxicity. Patients with responding disease may continue therapy. Cohort of 4-6 patients receive escalating doses of monoclonal antibody anti-anb3 integrin until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 4 or 6 patients experience dose-limiting toxicity. Once the MTD is determined, additional patients are treated at that dose in the phase II portion of the study. Patients are followed every 3 months for 2 years. PROJECTED ACCRUAL: A total of 4-24 patients will be accrued for phase I of this study and a total of 40 patients will be accrued for phase II of this study.
Interventions
Sponsors
Study design
Eligibility
Inclusion criteria
DISEASE CHARACTERISTICS: * Histologically confirmed advanced colorectal cancer * Disease progression while receiving an irinotecan-containing regimen for metastatic colorectal cancer OR * Disease recurrence within 6 months after completing an irinotecan-containing regimen in the adjuvant setting * At least 1 measurable lesion (for phase II only) * At least 20 mm by x-ray, CT scan, MRI, or photograph * Recurrent disease after surgery or radiotherapy is considered measurable if it has been at least 4 weeks since treatment and measurable disease is outside the port of prior radiotherapy or there is evidence of disease progression within the port of prior radiotherapy * The following are not considered measurable: * Pleural effusion * Ascites * Osteoblastic lesion or evidence of disease on bone scan alone * Progressive irradiated lesions alone * Bone marrow involvement * Brain metastases * Malignant hepatomegaly by physical exam alone * Chemical markers (e.g., carcinoembryonic antigen) * No known brain metastases or primary brain tumors * No symptomatic pleural effusion or ascites requiring paracentesis * No clinical evidence of bowel obstruction PATIENT CHARACTERISTICS: Age: * 18 and over Performance status: * 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 * Hemoglobin greater than 10.0 g/dL Hepatic: * Bilirubin no greater than 2.0 mg/dL * AST/ALT no greater than 5 times upper limit of normal (ULN) * PT/PTT less than ULN OR * INR less than 1.12 * No hepatitis virus infection Renal: * Creatinine no greater than 1.5 mg/dL OR * Creatinine clearance greater than 50 mL/min Cardiovascular: * No prior myocardial infarction * No angina * No uncontrolled hypertension (systolic blood pressure greater than 150 mm Hg) * No prior cerebrovascular accident or transient ischemic attack Pulmonary: * No respiratory insufficiency requiring oxygen treatment * No lymphangitic involvement of lungs Other: * Not pregnant or nursing * Negative pregnancy test * Fertile patients must use effective contraception for 30 days before, during, and for 30 days after study * Thyroxine and thyroid-stimulating hormone normal * No hematemesis, melena, hematochezia, or gross hematuria * No prior significant adverse reaction to a humanized monoclonal antibody * No known HIV infection * No active infection requiring systemic anti-infective therapy * No other medical or psychological condition or behavior, including substance dependence or abuse, that would preclude study * No other malignancy within the past 5 years except basal cell skin cancer or completely excised carcinoma in situ of the cervix PRIOR CONCURRENT THERAPY: Biologic therapy: * Prior immunotherapy with approved agents allowed * No prior monoclonal antibody anti-anb3 integrin or its precursor (MEDI-523) * No other concurrent immunotherapy Chemotherapy: * See Disease Characteristics * At least 4 weeks since prior chemotherapy * No concurrent palliative chemotherapy Endocrine therapy: * No concurrent hormonal therapy Radiotherapy: * See Disease Characteristics * At least 4 weeks since prior radiotherapy Surgery: * See Disease Characteristics * At least 4 weeks since prior surgery and surgical wounds must have healed Other: * Recovered from all prior therapy * At least 4 weeks since prior investigational agents
Countries
United States