Aerosol Gemcitabine in Treating Participants with Solid Tumors and Lung Metastases
This phase I trial studies the best dose and side effects of aerosol gemcitabine in treating participants with solid tumors that have spread to the lungs. Drugs used in chemotherapy, such as aerosol gemcitabine, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Giving gemcitabine by inhalation (breathing it as a mist), may work better in treating participants with solid tumors and lung metastases.
Inclusion Criteria
- Patients with diagnosis of solid tumor with lung metastases and patient’s current disease state must be one for which there is no known curative therapy or therapy proven to prolong survival with an acceptable quality of life
- Willing to comply with protocol therapy and required safety monitoring (self-report, pulse oximetry, remote spirometry, labs)
- Peripheral absolute neutrophil count (ANC) >= 750/mm^3 (must be performed within 14 days prior to enrollment)
- Platelet count >= 50,000/mm^3 (transfusion independent defined as not receiving platelet transfusions within a 7 day period prior to enrollment) (must be performed within 14 days prior to enrollment)
- Hemoglobin >= 8.0g/dl (may receive red blood cell [RBC] transfusions) (must be performed within 14 days prior to enrollment) (must be performed within 14 days prior to enrollment)
- Creatinine =< 2 x upper limit of normal (ULN) (must be performed within 14 days prior to enrollment)
- Bilirubin =< 5 x ULN (must be performed within 14 days prior to enrollment)
- Alanine aminotransferase (ALT) =< 5 x ULN (must be performed within 14 days prior to enrollment)
- Forced vital capacity (FVC) >= 50% predicted (must be performed within 14 days prior to enrollment)
- Oxyhemoglobin saturation at rest >= 95% (off supplemental oxygen) (must be performed within 14 days prior to enrollment)
- Patient age >= 10 years and =< 50 years
- Eastern Cooperative Oncology group (ECOG) =< 2 for patients >= 16 years old or Lansky play >= 60% for patients =< 15 years old
- Patients must have resolution of all acute toxic effects (excluding alopecia) of any prior anti-cancer therapy to National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) grade =< 1 or to the baseline laboratory values as defined in the inclusion criteria
- No radiotherapy within 2 weeks
- Subjects who received GCB systemically previously are eligible for participation
Exclusion Criteria
- Currently being treated with bronchodilators or corticosteroids or known to have active asthma. This will not include patients who suffered from asthma as a child and outgrew it
- Pregnant or breastfeeding women will not be entered into this study due to risks of fetal and teratogenic adverse events as seen in animal studies. Pregnancy tests must be obtained in females who are post-menarchal and of child bearing potential (e.g. female that has not been amenorrheic for at least 12 consecutive months or surgically sterilized). Males or females of reproductive potential will not participate unless they have agreed to use effective contraception for the entire period in which they are receiving protocol therapy and for at least one month after treatment ends. Effective contraception is defined as intrauterine device (IUD), hormonal (birth control pill, injections, implants, patch), tubal ligation and partner’s vasectomy. Abstinence is an acceptable method of birth control
- Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, bradycardia, related to cardiac disease, bundle branch block, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
- Subjects with baseline symptoms of fever and/or cough and/or shortness of breath and/or wheezing and/or fatigue grade >= 2 (CTCAE version [v]4.0)
- Patients receiving other concurrent cancer therapy including chemotherapy, immunotherapy, or biologic therapy
- Unresolved toxicities from prior anticancer therapy, defined as having not resolved to NCI CTCAE grade =< 1 with the exception of alopecia and laboratory values listed per the inclusion criteria. Subjects with irreversible toxicity that is not reasonably expected to be exacerbated by the investigational product may be included (eg, hearing loss)
Additional locations may be listed on ClinicalTrials.gov for NCT03093909.
Locations matching your search criteria
United States
Texas
Houston
PRIMARY OBJECTIVES:
I. To estimate the maximum tolerated dose (MTD) and recommend a Phase 2 dose of aerosol gemcitabine (GCB) administered to patients >= 10 years and =< 50 years with lung metastases.
II. To describe the toxicities of aerosol GCB administered to patients >= 10 years and =< 50 years with lung metastases.
SECONDARY OBJECTIVES:
I. To assess serum levels of GCB on day 1 of therapy for evidence of spillover into the circulation and correlate with presence or absence of toxicity.
II. To preliminarily assess the antitumor activity of aerosol GCB in patients >= 10 years and =< 50 years with lung metastases within the confines of a Phase 1 study.
EXPLORATORY OBJECTIVES:
I. To evaluate the effect of aerosol GCB treatment on histologic response in tumor specimens in patients who undergo tumor resection or biopsy.
II. To evaluate immune-correlates to preliminary assess the local effect of aerosol GCB on immune cell infiltration in the lung from tumor specimens pre and post treatment.
III. To preliminary assess the effect of therapy on autophagy, apoptosis, Hsp27, gammaH2AX and hENT1 expression by immunohistochemistry (IHC) and reverse phase protein array (RPPA) in tissue specimens.
OUTLINE: This is a dose-escalation study.
Participants receive aerosol gemcitabine via inhalation using a nebulizer twice a week. Treatment repeats every 28 days (4 weeks) for up to 12 courses in the absence of disease progression or unacceptable toxicity. Patients undergo computed tomography (CT) scan and blood sample collection throughout the study.
After completion of study treatment, participants are followed up within 30 days.
Trial PhasePhase I
Trial Typetreatment
Lead OrganizationM D Anderson Cancer Center
Principal InvestigatorNajat C. Daw
- Primary ID2015-0720
- Secondary IDsNCI-2018-01314
- ClinicalTrials.gov IDNCT03093909