17-N-Allylamino-17-Demethoxygeldanamycin and Paclitaxel in Treating Patients With Metastatic or Unresectable Solid Tumor

National Cancer Institute (NCI)

Status and phase: Completed; Phase 1

Conditions: Unspecified Adult Solid Tumor, Protocol Specific

Treatments: Drug: paclitaxel; Drug: tanespimycin; Other: laboratory biomarker analysis; Other: pharmacological study

Study type: Interventional

Funder types: NIH

Identifiers

NCT00087217

U01CA062502 (U.S. NIH Grant/Contract)

NCI-2012-02610

U01CA099168 (U.S. NIH Grant/Contract)

CDR0000373824 (Registry Identifier)

PCI-03-152

Details and patient eligibility

About

This phase I trial is studying the side effects and best dose of 17-N-allylamino-17-demethoxygeldanamycin when given together with paclitaxel in treating patients with metastatic or unresectable solid tumor. Drugs used in chemotherapy, such as 17-N-allylamino-17-demethoxygeldanamycin and paclitaxel, work in different ways to stop tumor cells from dividing so they stop growing or die. Combining 17-N-allylamino-17-demethoxygeldanamycin with paclitaxel may kill more tumor cells

Full description

OBJECTIVES:

I. Determine the maximum tolerated dose and recommended phase II dose of 17-N-allylamino-17-demethoxygeldanamycin (17-AAG) when administered with paclitaxel in patients with metastatic or unresectable solid malignancy.

II. Determine the dose-limiting and non-dose-limiting toxic effects of this regimen in these patients.

III. Determine the pharmacokinetics of this regimen in these patients. IV. Determine tumor response in patients treated with this regimen.

OUTLINE: This is a multicenter, dose-escalation study of 17-N-allylamino-17-demethoxygeldanamycin (17-AAG). Patients receive 17-AAG IV over 1 hour on days 1*, 4, 8, 11, 15 and 18 and paclitaxel IV over 1 hour on days 1, 8, and 15. Treatment repeats every 28 days for 6 courses in the absence of disease progression or unacceptable toxicity.

NOTE: *17-AAG is not administered on day 1 of course 1. Cohorts of 3-6 patients receive escalating doses of 17-AAG 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. Once the MTD is determined, 6-12 patients are treated at the recommended phase II dose.

Enrollment: 35 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria:

• Histologically confirmed solid malignancy

  • Metastatic or unresectable disease

• Not amenable to standard curative or palliative therapy

• No known brain metastases

• Performance status - ECOG 0-2

• More than 12 weeks

• Absolute neutrophil count ≥ 1,500/mm^3

• Platelet count ≥ 100,000/mm^3

• WBC ≥ 3,000/mm^3

• AST and ALT ≤ 2.5 times upper limit of normal

• Bilirubin normal

• Creatinine normal

• Creatinine clearance ≥ 60 mL/min

• QTc < 450 msec for male patients (470 msec for female patients)

• LVEF > 40% by MUGA

• No history of serious ventricular arrhythmia (i.e., ventricular tachycardia or ventricular fibrillation ≥ 3 beats in a row)

• No myocardial infarction within the past year

• No New York Heart Association class III or IV congestive heart failure

• No poorly controlled angina

• No history of uncontrolled dysrhythmia or requirement for antiarrhythmic drugs

• No history of congenital long QT syndrome

• No active ischemic heart disease within the past year

• No left bundle branch block

• No other significant cardiac disease

• Not pregnant or nursing

• Negative pregnancy test

• Fertile patients must use effective double barrier contraception for at least 1 week before, during, and for at least 2 weeks after study participation

• No prior allergy to eggs

• No prior allergic reaction to compounds of similar chemical or biologic composition to 17-AAG or paclitaxel

• No peripheral neuropathy > grade 1

• No concurrent uncontrolled illness

• No active or ongoing infection

• No psychiatric illness or social situation that would preclude study compliance

• No concurrent granulocyte colony-stimulating factors

• Prior paclitaxel allowed

• More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin) and recovered

• No prior 17-N-allylamino-17-demethoxygeldanamycin (17-AAG)

• More than 4 weeks since prior radiotherapy

• No prior radiotherapy that included the heart in the field (e.g., mantle radiotherapy)

• No concurrent combination antiretroviral therapy for HIV-positive patients

• No concurrent therapeutic-dose warfarin for anticoagulation

• No concurrent medications that may prolong QTc interval

• No other concurrent investigational agents

• No other concurrent anticancer agents or therapies

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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35 participants in 1 patient group

Treatment (tanespimycin, paclitaxel)

Experimental group

Description:

Patients receive 17-AAG IV over 1 hour on days 1\*, 4, 8, 11, 15 and 18 and paclitaxel IV over 1 hour on days 1, 8, and 15. Treatment repeats every 28 days for 6 courses in the absence of disease progression or unacceptable toxicity.

Treatment:

Other: laboratory biomarker analysis

Other: pharmacological study

Drug: tanespimycin

Drug: paclitaxel