Topoisomerase I Inhibitor LMP400 and Topoisomerase I Inhibitor LMP776 in Treating Patients with Relapsed Solid Tumors or Lymphomas
This phase I trial studies the side effects and best dose of topoisomerase I inhibitor LMP400 and topoisomerase I inhibitor LMP776 in treating patients with solid tumors or lymphomas that have come back. Drugs used in chemotherapy, such as topoisomerase I inhibitor LMP400 and topoisomerase I inhibitor LMP776, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing or stopping them from spreading.
Inclusion Criteria
- Patients must have histologically documented (confirmed at the Laboratory of Pathology, National Cancer Institute [NCI]), relapsed solid tumor malignancy or Hodgkin's disease/non-Hodgkin lymphoma that is metastatic or unresectable for which standard curative measures do not exist, or are associated with minimal patient survival benefit
- Patients must have measurable or evaluable disease
- Patients must have recovered to at least eligibility levels due to adverse events (AEs) and/or toxicity of prior chemotherapy or biologic therapy; they must not have had chemotherapy or biologic therapy within 4 weeks (6 weeks for nitrosoureas and mitomycin C, or 2 months for UCN-01), or therapy with tyrosine kinase inhibitors within 5 times the half-life of the inhibitors prior to entering the study; patients must be >= 2 weeks since any investigational agent administered as part of a phase 0 study (also referred to as an “early phase I study” or “pre-phase I study” where a sub-therapeutic dose of drug is administered) at the principal investigator's (PI) discretion, and should have recovered to eligibility levels from any toxicities
- Patients must have recovered to at least a grade =< 1 toxicity eligibility levels due to adverse events (AEs) and/or toxicity of prior chemotherapy or biologic therapy; they must not have had chemotherapy or biologic therapy within 4 weeks (6 weeks for nitrosoureas and mitomycin C, or 2 months for UCN-01), or therapy with tyrosine kinase inhibitors within 5 times the half-life of the inhibitors prior to entering the study; patients must be >= 2 weeks since any prior administration of study drug in an exploratory investigational new drug (IND)/phase 0 study; patients must be >= 1 month since completion of any prior radiation (>= 2 weeks for palliative radiation therapy); however, patients receiving bisphosphonates for any cancer or undergoing androgen deprivation therapy for prostate cancer are eligible for this therapy * Prior therapy with topoisomerase I inhibitors is allowed
- The Eastern Cooperative Oncology Group (ECOG) performance status =< 2 (Karnofsky >= 60 %)
- Life expectancy > 3 months
- Absolute neutrophil count (ANC) >= 1,500/uL
- Platelet count >= 100,000/uL
- Total bilirubin within =< 1.5 normal institutional limits (patients with Gilbert’s syndrome with total bilirubin up to 2.5 mg/dL is allowed)
- Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) =< 2.5 x institutional upper limit of normal (ULN)
- Creatinine < 1.5 x ULN OR creatinine clearance measured >= 60 mL/minute for patients with creatinine levels >= 1.5 x upper limit of normal
- Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control or abstinence) prior to study entry, for the duration of study participation, and for 2 months after discontinuation from the study; women of child bearing potential must have a negative pregnancy test in order to be eligible; should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately
- Breastfeeding should be discontinued if the mother is treated with indenoisoquinolines
- At the point when tumor biopsies become mandatory (expansion phase only), disease amenable to biopsy and willingness to undergo biopsies or patient will be undergoing a procedure due to medical necessity during which the tissue may be collected, or tumor biopsy tissue from a previous research study or medical care is available for submission at registration; criteria for the submission of tissue are: * Tissue must have been collected within 3 months prior to registration * Patient has not received any intervening therapy for their cancer since the collection of the tumor sample * Tumor tissue must meet the minimum requirements outlined
- Ability to understand and the willingness to sign a written informed consent document
Exclusion Criteria
- Patients receiving any other investigational agents
- Patients with known brain metastases are excluded from this clinical trial, with the exception of patients whose brain metastatic disease status has remained stable for >= 2 months after treatment of the brain metastases, without steroids or anti-seizure medications; these patients may be enrolled at the discretion of the principal investigator
- Patients with clinically significant illnesses which could compromise participation in the study, including, but not limited to, active or uncontrolled infection, immune deficiencies, known human immunodeficiency virus (HIV) infection requiring antiretroviral therapy, hepatitis B, hepatitis C, uncontrolled diabetes, uncontrolled hypertension, symptomatic congestive heart failure, unstable angina pectoris, myocardial infarction within the past 6 months, uncontrolled cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
Study sponsor and potential other locations can be found on ClinicalTrials.gov for NCT01051635.
PRIMARY OBJECTIVES:
I. Define the maximum tolerated dose (MTD) of LMP400 (topoisomerase I inhibitor LMP400) (NSC 743400) and LMP776 (topoisomerase I inhibitor LMP776) (NSC 725776) administered intravenously (IV) daily for 5 days (QDx5).
II. Define the dose-limiting toxicities (DLTs) and toxicity profile associated with administration of LMP400 and LMP776.
III. Evaluate the effect of LMP400 and LMP776 on the pharmacodynamic (PD) endpoint, gamma-H2AX, in tumor biopsy pre- and post-treatment. In particular, compare the PD response, defined as the mean percent nuclear area that is gamma-H2AX positive (% nuclear area [NAP]) in tumor biopsies, at the MTD for LMP400 and LMP776, and the toxicity profile versus PD dose-response relationship.
SECONDARY OBJECTIVES:
I. Obtain preliminary evidence of anti-tumor activity of LMP400 and LMP776.
II. Characterize the pharmacokinetic (PK) profile of LMP400 and LMP776.
OUTLINE: This is a dose-escalation study. Patients are alternately assigned to 1 of 2 treatment groups.
GROUP I: Patients receive topoisomerase I inhibitor LMP400 intravenously (IV) over 1 hour once daily (QD) on days 1-5. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
GROUP II: Patients receive topoisomerase I inhibitor LMP776 IV over 1 hour QD on days 1-5. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed up for 30 days.
Trial PhasePhase I
Trial Typetreatment
Lead OrganizationNCI - Center for Cancer Research
Principal InvestigatorA P Chen
- Primary ID8273
- Secondary IDsNCI-2011-02515, 10-C-0056, NCT01245192, 100056, CDR0000662682, P08394
- ClinicalTrials.gov IDNCT01051635