Breast CancerPhase 1/2NCT00237627
Doxorubicin Hydrochloride Liposome and Bortezomib in Treating Patients With Refractory Hematologic Cancer or Malignant Solid Tumor or Metastatic Breast Cancer
A Phase 1/2 study testing PS-341, Doxil and Velcade in people with Breast Cancer and Leukemia, run by UNC Lineberger Comprehensive Cancer Center at 1 site in United States.
Trial summary
RATIONALE: Drugs used in chemotherapy, such as doxorubicin hydrochloride liposome, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Bortezomib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Breast Cancer, Leukemia, Lymphoma
- What is being tested?
- PS-341, Doxil and Velcade
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 107 participants
- Where
- 1 siteUnited States
- Study dates
- May 2001to Jan 2010
- Phase
- Phase 1/2
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
DISEASE CHARACTERISTICS:
Phase I (closed to accrual as of 10/15/2007)
- Histologically or cytologically confirmed solid tumor or hematologic malignancy, including, but not limited to, any of the following:
- Breast cancer
- Ovarian cancer
- Myeloid or lymphoid leukemia
- Hodgkin or non-Hodgkin lymphoma
- Multiple myeloma
- Measurable or evaluable disease
- Must meet 1 of the following criteria:
- Refractory to at least one prior conventional treatment regimen
- Not a candidate for conventional therapy
- No conventional therapy exists
- No clinically or radiographically significant pleural or pericardial effusion
- Patients with ascites may be eligible at the discretion of the investigator
- Previously treated central nervous system disease allowed provided it has been stable for > 3 months and it is not the only site of measurable disease
- Not eligible for a higher priority protocol
Phase II
- Diagnosis of breast cancer
- Metastatic disease
- Measurable disease by RECIST criteria
- No symptomatic brain metastases
- Patients with treated brain metastases that have been stable for > 3 months and does not require chronic steroids are eligible
- Hormone receptor status not specified
PATIENT CHARACTERISTICS:
Phase I (closed to accrual as of 10/15/2007)
- Karnofsky performance status 60-100%
- Life expectancy ≥ 2 months
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
- WBC ≥ 2,000/mm³
- ANC ≥ 1,500/mm³ (≥ 1,000/mm³ for patients with marrow infiltration)
- Platelet count ≥ 100,000/mm³ (≥ 50,000/mm³ for patients with marrow infiltration)
- Hemoglobin ≥ 8 g/dL
- Creatinine ≤ 2.5 mg/dL OR creatinine clearance ≥ 30 mL/min
- AST and ALT < 2.5 times upper limit of normal (ULN)
- Total bilirubin < 1.2 times ULN
- Prothrombin time (PT) and activated partial thromboplastin time (aPTT) < 1.5 times ULN
- Patients receiving warfarin or heparin therapy for a history of thrombosis, embolism, or other indication must have PT and/or aPTT within the accepted therapeutic ranges for those indications
- Patients with a history of reactions to other liposomal drug formulations that are not due to the liposome itself may be eligible at the discretion of the investigator
- No known HIV seropositivity
- No known active hepatitis A, B, or C viral infection
- No New York Heart Association class III or IV congestive heart failure
- LVEF ≥ 45% by 2-D ECHO or MUGA
- No acute ischemia or new conduction system abnormality by EKG
- No conduction system abnormality (e.g., left bundle branch block) by EKG that would preclude the ability to detect new ischemic episodes
- No myocardial infarction within the past 6 months
- No significant comorbidity, such as poorly controlled hypertension, diabetes mellitus, or other serious medical or psychiatric illness that, in the opinion of the investigator, might compromise any aspect of the study
- No uncontrolled infection
- Patients may have febrile episodes up to 38.5°C if these are felt to be due to tumor fever and the possibility of infection has been ruled out by evaluation
- No prior hypersensitivity reaction to pegylated doxorubicin hydrochloride liposome or doxorubicin hydrochloride
- Patients with a history of reactions to other liposomal drug formulations and/or to the liposome itself, as opposed to the encapsulated agent, may be excluded at the discretion of the investigator
Phase II
- Female or male
- Menopausal status not specified
- Karnofsky performance status 70-100%
- Life expectancy ≥ 3 months
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception during and for 3 months after completion of study therapy
- ANC ≥ 1,500/mm³
- Platelet count ≥ 100,000/mm³
- Hemoglobin ≥ 9.0 g/dL
- Creatinine ≤ 2.5 mg/dL (≤ 200 µmol/L)
- AST and ALT ≤ 2 times ULN
- Alkaline phosphatase ≤ 2 times ULN (unless attributed to tumor)
- Bilirubin ≤ ULN
- Cardiac ejection fraction > 50% by MUGA or 2-D ECHO
- No clinical evidence of congestive heart failure
- No New York Heart Association class II-IV cardiac disease
- No myocardial infarction within the past 6 months
- No uncontrolled angina
- No severe uncontrolled ventricular arrhythmias
- No evidence of acute ischemia or active conduction system abnormalities by EKG
- Any EKG abnormality at screening must be documented by the investigator as not medically relevant
- No grade 2 peripheral neuropathy within the past 14 days
- No significant comorbidity that would impair compliance with study therapy or interpretation of study results
- No history of hypersensitivity reactions attributed to a conventional formulation of doxorubicin hydrochloride or the components of pegylated doxorubicin hydrochloride liposome
- No hypersensitivity to bortezomib, boron, or mannitol
- No serious medical or psychiatric illness likely to interfere with participation in this study
PRIOR CONCURRENT THERAPY:
Phase I (closed to accrual as of 10/15/2007)
- More than 3 weeks since prior major surgery
- More than 3 weeks since prior and no concurrent radiotherapy
- More than 4 weeks since prior and no concurrent immunotherapy (i.e., interferon, interleukin, or other cytokine-based treatment)
- More than 3 weeks since prior and no concurrent participation in another therapeutic clinical trial with an experimental drug
- More than 3 weeks since prior and no other concurrent chemotherapy
- No prior doxorubicin dose > 400 mg/m²
- No other concurrent antineoplastic therapy
Phase II
- More than 6 months since prior anthracyclines
- More than 14 days since other prior investigational drugs
- No more than 300 mg/m² of prior doxorubicin or 540 mg/m² of prior epirubicin
- No more than two prior chemotherapy regimens for metastatic disease
- No other concurrent antineoplastic therapy
Trial locations and contacts
1 site in 1 country.
United States1 site
Lineberger Comprehensive Cancer Center at University of North Carolina - Chapel Hill
Chapel Hill, North Carolina, 27599-7295
About this study
Official title: A Phase I Evaluation of the Combination of Pegylated Liposomal Doxorubicin (Doxil®) With PS-341 in Patients With Refractory Hematologic and Solid Malignancies
RATIONALE: Drugs used in chemotherapy, such as doxorubicin hydrochloride liposome, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Bortezomib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Giving doxorubicin hydrochloride liposome together with bortezomib may kill more cancer cells.
PURPOSE: This phase I/II trial is studying the side effects and best dose of bortezomib when given together with doxorubicin hydrochloride liposome and to see how well they work in treating patients with refractory hematologic cancer or malignant solid tumor or metastatic breast cancer.
Read the detailed description
OBJECTIVES:
Primary
- Determine the maximum tolerated dose of bortezomib when administered with pegylated doxorubicin hydrochloride liposome in patients with refractory hematologic or solid tumor malignancies. (Phase I [closed to accrual as of 10/15/2007])
- Determine the dose-limiting toxicity of this regimen in these patients. (Phase I [closed to accrual as of 10/15/2007])
- Determine the response rate in patients with metastatic breast cancer treated with this regimen. (Phase II)
Secondary
- Determine the response in patients with hematologic or solid tumor malignancies treated with this regimen. (Phase I [closed to accrual as of 10/15/2007])
- Determine the time to disease progression in patients with metastatic breast cancer treated with this regimen. (Phase II)
- Obtain further evidence of the safety of this regimen in patients with metastatic breast cancer. (Phase II)
OUTLINE: This is a phase I (closed to accrual as of 10/15/2007), dose-escalation study of bortezomib followed by a phase II study.
- Phase I (closed to accrual as of 10/15/2007): Patients receive bortezomib IV on days 1, 4, 8, and 11 and pegylated doxorubicin hydrochloride liposome IV over 1 hour on day 4. Treatment repeats every 21 days in the absence of disease progression or unacceptable toxicity.
- Phase II: Patients receive bortezomib (at the maximum tolerated dose determined in phase I) and pegylated doxorubicin hydrochloride liposome as in phase I.
After completion of study therapy, patients are followed at 1 week.
PROJECTED ACCRUAL: A total of 72 patients will be accrued for the phase I portion of the study and 40 for the phase II portion.
- Conditions
- Breast Cancer, Leukemia, Lymphoma, Multiple Myeloma and Plasma Cell Neoplasm, Ovarian Cancer, Unspecified Adult Solid Tumor, Protocol Specific
- Being tested
- PS-341, Doxil, Velcade
- Keywords
- stage IIIA breast cancer, stage IIIB breast cancer, stage IIIC breast cancer, stage IV breast cancer, male breast cancer, recurrent ovarian epithelial cancer, stage III ovarian epithelial cancer, stage IV ovarian epithelial cancer, recurrent adult acute lymphoblastic leukemia, recurrent adult acute myeloid leukemia, adult acute myeloid leukemia with 11q23 (MLL) abnormalities, adult acute myeloid leukemia with inv(16)(p13;q22), adult acute myeloid leukemia with t(15;17)(q22;q12), adult acute myeloid leukemia with t(16;16)(p13;q22), adult acute myeloid leukemia with t(8;21)(q22;q22), secondary acute myeloid leukemia, mast cell leukemia, stage III chronic lymphocytic leukemia, stage IV chronic lymphocytic leukemia, refractory chronic lymphocytic leukemia
- Medical subject headings
- Breast Neoplasms, Leukemia, Lymphoma, Multiple Myeloma, Neoplasms, Plasma Cell, Ovarian Neoplasms, Breast Neoplasms, Male, Carcinoma, Ovarian Epithelial
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
PS-341Drug
PS-341 will be administered as an intravenous push into a side arm of either a peripheral or central intravenous line infusing normal saline at 100 ml/hr. Patients will be treated twice weekly for two weeks, followed by a one week rest period, such that the typical days of treatment will be days 1, 4, 8, 11 of each three-week cycle. The initial dose level for PS-341 will be 0.9 mg/m2/dose intravenously, while subsequent dose levels will be determined according to a modified Fibonacci schema
DoxilDrug
Also called pegylated liposomal doxorubicin
Doxil will be administered at a dose of 30 mg/m2 as a 1 hour infusion through either a peripheral or central intravenous line every 3 weeks (on day 4 of each 21 day cycle)
VelcadeDrug
Also called Bortezomib
Velcade will be adminstered intravenously at 1.3 mg/m2 days 1, 4, 8, 11 every 3 weeks
| Study group | Role | What they receive |
|---|---|---|
| Part 1 | Experimental | Doxil + PS-341 Receives: Drug: PS-341; Drug: Doxil |
| Part 2 | Experimental | Doxil + Velcade Receives: Drug: Doxil; Drug: Velcade |
What is being measured
The primary outcome is the main question the study is designed to answer.
Maximum tolerated dose (MTD) of PS-341 in combination with Doxil (Phase I)
When the current dose level exceeds the MTD, the preceding dose-level will be considered to be the MTD if there have been six patients treated at that dose level. Otherwise, 3 additional patients will be treated at the presumed MTD. No further dose escalation will occur. MTD, like dose limiting toxicity (DLT), will be defined based on toxicities seen within the first cycle. Among the additional 3 patients enrolled in a cohort, if one or more DLT is observed, the MTD will be considered to have been exceeded
Measured: 1 year
Response rate of the combination of Velcade and Doxil in patients with metastatic breast cancer
Radiographic response will be measured using RECIST criteria
Measured: every 42 days
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted12 Oct 2005 (estimated)
- Study startMay 2001
- Primary completionDec 2006
- Study completionJan 2010
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Breast CancerStudies of the same condition, open and under way.
- More trials run by UNC Lineberger Comprehensive Cancer CenterThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 1/2
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 107 participants (actual)
Sponsor and investigators
- Lead sponsor
- UNC Lineberger Comprehensive Cancer Center
- Sponsor type
- University, hospital or other
- Collaborators
- National Cancer Institute (NCI)
- Responsible party
- Sponsor
- Investigators
- Elizabeth C. Dees, MD, Principal investigator, UNC Lineberger Comprehensive Cancer CenterRobert Z. Orlowski, MD, PhD, Principal investigator, UNC Lineberger Comprehensive Cancer Center
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00237627
- Sponsor's protocol ID
- LCCC 2020
- Other IDs
- UNC-LCCC-2020, CDR0000368767
- Status last verified
- May 2012
- First submitted
- 7 Oct 2005
- Last updated
- 18 May 2012
- Results posted
- No
- Data monitoring committee
- Yes
Publications
Dees EC, O'Neil BH, Lindley CM, Collichio F, Carey LA, Collins J, Riordan WJ, Ivanova A, Esseltine D, Orlowski RZ. A phase I and pharmacologic study of the combination of bortezomib and pegylated liposomal doxorubicin in patients with refractory solid tumors. Cancer Chemother Pharmacol. 2008 Dec;63(1):99-107. doi: 10.1007/s00280-008-0716-8. Epub 2008 Mar 8.
PubMed 18327587
Study at a glance
From the registry record, last updated by the sponsor on 18 May 2012. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase I Evaluation of the Combination of Pegylated Liposomal Doxorubicin (Doxil®) With PS-341 in Patients With Refractory Hematologic and Solid Malignancies
- ClinicalTrials.gov ID
- NCT00237627
- Acronym / sponsor ID
- LCCC 2020
- Conditions
- Breast Cancer, Leukemia, Lymphoma, Multiple Myeloma and Plasma Cell Neoplasm, Ovarian Cancer, Unspecified Adult Solid Tumor, Protocol Specific
- Keywords
- stage IIIA breast cancer, stage IIIB breast cancer, stage IIIC breast cancer, stage IV breast cancer, male breast cancer, recurrent ovarian epithelial cancer, stage III ovarian epithelial cancer, stage IV ovarian epithelial cancer
- Phase
- Phase 1/2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 107 participants (actual)
- Lead sponsor
- UNC Lineberger Comprehensive Cancer CenterUniversity, hospital or other
- Collaborators
- National Cancer Institute (NCI)
- Study start
- May 2001
- Primary completion
- Dec 2006 (actual)
- Study completion
- Jan 2010 (actual)
- First posted
- 12 Oct 2005 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
RATIONALE: Drugs used in chemotherapy, such as doxorubicin hydrochloride liposome, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Bortezomib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Giving doxorubicin hydrochloride liposome together with bortezomib may kill more cancer cells.
PURPOSE: This phase I/II trial is studying the side effects and best dose of bortezomib when given together with doxorubicin hydrochloride liposome and to see how well they work in treating patients with refractory hematologic cancer or malignant solid tumor or metastatic breast cancer.
Detailed description
OBJECTIVES:
Primary
- Determine the maximum tolerated dose of bortezomib when administered with pegylated doxorubicin hydrochloride liposome in patients with refractory hematologic or solid tumor malignancies. (Phase I [closed to accrual as of 10/15/2007])
- Determine the dose-limiting toxicity of this regimen in these patients. (Phase I [closed to accrual as of 10/15/2007])
- Determine the response rate in patients with metastatic breast cancer treated with this regimen. (Phase II)
Secondary
- Determine the response in patients with hematologic or solid tumor malignancies treated with this regimen. (Phase I [closed to accrual as of 10/15/2007])
- Determine the time to disease progression in patients with metastatic breast cancer treated with this regimen. (Phase II)
- Obtain further evidence of the safety of this regimen in patients with metastatic breast cancer. (Phase II)
OUTLINE: This is a phase I (closed to accrual as of 10/15/2007), dose-escalation study of bortezomib followed by a phase II study.
- Phase I (closed to accrual as of 10/15/2007): Patients receive bortezomib IV on days 1, 4, 8, and 11 and pegylated doxorubicin hydrochloride liposome IV over 1 hour on day 4. Treatment repeats every 21 days in the absence of disease progression or unacceptable toxicity.
- Phase II: Patients receive bortezomib (at the maximum tolerated dose determined in phase I) and pegylated doxorubicin hydrochloride liposome as in phase I.
After completion of study therapy, patients are followed at 1 week.
PROJECTED ACCRUAL: A total of 72 patients will be accrued for the phase I portion of the study and 40 for the phase II portion.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Part 1 | Experimental | Drug: PS-341, Drug: DoxilDoxil + PS-341 |
| Part 2 | Experimental | Drug: Doxil, Drug: VelcadeDoxil + Velcade |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| PS-341PS-341 will be administered as an intravenous push into a side arm of either a peripheral or central intravenous line infusing normal saline at 100 ml/hr. Patients will be treated twice weekly for two weeks, followed by a one week rest period, such that the typical days of treatment will be days 1, 4, 8, 11 of each three-week cycle. The initial dose level for PS-341 will be 0.9 mg/m2/dose intravenously, while subsequent dose levels will be determined according to a modified Fibonacci schema | Drug | Part 1 |
| DoxilAlso: pegylated liposomal doxorubicinDoxil will be administered at a dose of 30 mg/m2 as a 1 hour infusion through either a peripheral or central intravenous line every 3 weeks (on day 4 of each 21 day cycle) | Drug | Part 1, Part 2 |
| VelcadeAlso: BortezomibVelcade will be adminstered intravenously at 1.3 mg/m2 days 1, 4, 8, 11 every 3 weeks | Drug | Part 2 |
Primary outcome
Maximum tolerated dose (MTD) of PS-341 in combination with Doxil (Phase I)
Time frame: 1 year
When the current dose level exceeds the MTD, the preceding dose-level will be considered to be the MTD if there have been six patients treated at that dose level. Otherwise, 3 additional patients will be treated at the presumed MTD. No further dose escalation will occur. MTD, like dose limiting toxicity (DLT), will be defined based on toxicities seen within the first cycle. Among the additional 3 patients enrolled in a cohort, if one or more DLT is observed, the MTD will be considered to have been exceeded
Response rate of the combination of Velcade and Doxil in patients with metastatic breast cancer
Time frame: every 42 days
Radiographic response will be measured using RECIST criteria
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 18 May 2012.
- Results publication: PubMed 18327587Dees EC, O'Neil BH, Lindley CM, Collichio F, Carey LA, Collins J, Riordan WJ, Ivanova A, Esseltine D, Orlowski RZ. A phase I and pharmacologic study of the combination of bortezomib and pegylated liposomal doxorubicin in patients with refractory solid tumors. Cancer Chemother Pharmacol. 2008 Dec;63(1):99-107. doi: 10.1007/s00280-008-0716-8. Epub 2008 Mar 8.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Elizabeth C. Dees, MD principal investigator
UNC Lineberger Comprehensive Cancer Center
Robert Z. Orlowski, MD, PhD principal investigator
UNC Lineberger Comprehensive Cancer Center
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 1/2 study testing PS-341, Doxil and Velcade in people with Breast Cancer and Leukemia, run by UNC Lineberger Comprehensive Cancer Center at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 18 May 2012. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this combined phase mean?
Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Maximum tolerated dose (MTD) of PS-341 in combination with Doxil (Phase I) (time frame: 1 year). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00237627, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 May 2012.