Unspecified Adult Solid Tumor, Protocol Specific
Conditions
Keywords
unspecified adult solid tumor, protocol specific
Brief summary
RATIONALE: Drugs used in chemotherapy, such as 17-dimethylaminoethylamino-17-demethoxygeldanamycin (17-DMAG), work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. PURPOSE: This phase I trial is studying the side effects and best dose of 17-DMAG in treating patients with metastatic solid tumors or tumors that cannot be removed by surgery.
Detailed description
OBJECTIVES: Primary * Determine the maximum tolerated dose, dose-limiting toxicity, and recommended phase II dose of 17-dimethylaminoethylamino-17-demethoxygeldanamycin (17-DMAG) in patients with unresectable or metastatic solid tumors. * Determine the feasibility, safety, and toxicity profile of this drug in these patients. Secondary * Determine the clinical pharmacokinetic profile of this drug in these patients. * Determine tumor response in patients treated with this drug. * Determine the biologically effective dose. OUTLINE: This is an open-label, non-randomized, dose-escalation, multicenter study. Patients receive 17-dimethylaminoethylamino-17-demethoxygeldanamycin (17-DMAG) IV over 1 hour on days 1, 8, 15, and 22. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of 17-DMAG 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. An additional 10 patients are treated at the MTD. After completion of study treatment, patients are followed for 28 days. PROJECTED ACCRUAL: Approximately 25-35 patients will be accrued for this study within 12-18 months.
Interventions
Sponsors
Study design
Eligibility
Inclusion criteria
DISEASE CHARACTERISTICS: * Histologically or cytologically confirmed solid tumor * Unresectable or metastatic disease * Standard curative or palliative measures do not exist OR are no longer effective OR patient refused such measures * No known brain metastases PATIENT CHARACTERISTICS: Age * 18 and over Performance status * ECOG 0-1 Life expectancy * More than 12 weeks Hematopoietic * Absolute neutrophil count \> 1,500/mm\^3 * Platelet count ≥ 100,000/mm\^3 * Hemoglobin ≥ 9.0 g/dL Hepatic * Bilirubin normal * ALT and AST ≤ 1.5 times upper limit of normal * No chronic liver disease * Hepatitis B or C negative Renal * Creatinine normal OR * Creatinine clearance normal Cardiovascular * No symptomatic New York Heart Association class III-IV cardiac disease * No myocardial infarction within the past year * No active ischemic heart disease within the past year * No poorly controlled angina * No uncontrolled dysrhythmia or dysrhythmias requiring antiarrhythmic drugs * No transient ischemic attack * No stroke * No peripheral vascular disease * No congenital long QT syndrome * No history of serious ventricular arrhythmia (ventricular tachycardia or ventricular fibrillation ≥ 3 beats in a row) * QTc \< 450 msec (for men) and 470 msec (for woman) * LVEF \> 40% by MUGA * No left bundle branch block Pulmonary * No symptomatic pulmonary disease requiring medication, including any of the following: * Dyspnea with or without exertion * Paroxysmal nocturnal dyspnea * Oxygen requirement * Significant pulmonary disease (e.g., chronic obstructive/restrictive pulmonary disease Other * Not pregnant or nursing * Negative pregnancy test * Fertile patients must use effective contraception 4 weeks before, during, and for 6 months after completion of study treatment * No known HIV positivity * No other malignancy within the past 5 years except adequately treated cone biopsied carcinoma in situ of the cervix or basal cell or squamous cell skin cancer * No ongoing or active infection * No diabetes mellitus (with evidence of severe peripheral vascular disease or ulcers) * No psychiatric illness or social situation that would preclude study compliance * No other uncontrolled illness PRIOR CONCURRENT THERAPY: Biologic therapy * More than 4 weeks since prior immunotherapy * Concurrent epoetin alfa allowed Chemotherapy * More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin) * No prior 17-N-allylamino-17-demethoxygeldanamycin (17-AAG) Endocrine therapy * More than 4 weeks since prior endocrine therapy * Concurrent luteinizing hormone-releasing hormone analogues for androgen-insensitive prostate cancer and rising prostate-specific antigen allowed Radiotherapy * More than 4 weeks since prior radiotherapy (except for palliative treatment) * No prior irradiation field that potentially included the heart (e.g., mantle) Surgery * Not specified Other * Recovered from all prior therapy * Concurrent bisphosphonates allowed * At least 5 half-lives since prior and no concurrent medication that prolong QTc * No other concurrent anticancer or investigational agents * No concurrent grapefruit juice
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Recommended phase II dose of 17-dimethylaminoethylamino-17-demethoxygeldanamycin (17-DMAG) at 28 days after treatment | — |
Secondary
| Measure | Time frame |
|---|---|
| Heat shock protein 90 (HSP90) client protein and co-chaperone changes up to 29 days after treatment | — |
| Tumor response by RECIST criteria every 6 weeks while on study | — |
| Clinical pharmacokinetic profile established during the first course of treatment | — |
Countries
United Kingdom