Imatinib Mesylate and Sunitinib in Treating Patients With Gastrointestinal Stromal Tumors

Vanderbilt University Medical Center

Status and phase

Terminated

Phase 1

Conditions

Gastrointestinal Stromal Tumor

Treatments

Drug: imatinib mesylate

Drug: sunitinib malate

Other: pharmacological study

Study type

Interventional

Funder types

Other

NIH

Identifiers

NCT00573404

VICC GI 0621

VU-VICC-GI-0621

P30CA068485 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

RATIONALE: Imatinib mesylate and sunitinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth.

PURPOSE: This phase I trial is studying the side effects and best dose of imatinib mesylate given together with sunitinib in treating patients with gastrointestinal stromal tumors.

Full description

OBJECTIVES:

To determine the maximum tolerated dose of imatinib mesylate in combination with sunitinib malate in patients with gastrointestinal stromal tumors.
To determine the toxicity of this regimen in these patients.
To determine the antitumor activity in patients treated with this regimen.

OUTLINE: This is a dose-escalation study of imatinib mesylate.

Patients receive oral sunitinib malate once daily on days 1-14 in course 1 and on days 1-42 in all subsequent courses. Beginning in course 2, patients also receive oral imatinib mesylate once or twice daily on days 1-42. Courses repeat every 6 weeks in the absence of unacceptable toxicity.

Blood samples are collected on day 15 and day 43 for pharmacokinetics.

After completion of study treatment, patients are followed every 6 months.

Enrollment

6 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion and exclusion criteria

DISEASE CHARACTERISTICS:

Biopsy proven gastrointestinal stromal tumor
Patients previously treated with imatinib mesylate must have documented progression of disease
- Untreated disease allowed
Must have ≥ 1 measurable lesion by RECIST
No history of or known brain metastases, spinal cord compression,carcinomatous meningitis, or evidence of symptomatic brain or leptomeningeal disease on screening CT or MRI scan

PATIENT CHARACTERISTICS:

ECOG performance status 0-2
ANC ≥ 1,500/μL
Hemoglobin ≥ 9.0 g/dL
Platelet count ≥ 150,000/μL
Total serum bilirubin ≤ 2.0 mg/dL
Serum calcium ≤ 12.0 mg/dL
Serum creatinine ≤ 1.8 mg/dL
AST and ALT ≤ 3 times upper limit of normal (ULN) (5 times ULN if liver function abnormalities are due to underlying malignancy)
Able to take oral medications
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception
No grade 3 hemorrhage within the past 4 weeks
No myocardial infarction, severe or unstable angina, coronary or peripheral artery bypass graft, symptomatic congestive heart failure, cerebrovascular accident or transient ischemic attack, or pulmonary embolism within the past 6 months
No ongoing cardiac dysrhythmias ≥ grade 2
No prolonged QTc interval on baseline EKG
No hypertension that cannot be controlled by medications (BP > 150/100 mm Hg, despite medical therapy)
No pre-existing thyroid abnormality with thyroid function that cannot be maintained in the normal range with medication
No known HIV or AIDS-related illness or other active infection
No other severe, acute, or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or study drug administration, or may interfere with the interpretation of study results, and in the judgment of the investigator, preclude study entry
No malabsorption syndrome
No prior intolerance of imatinib mesylate or toxicity necessitating dose modification
No prior intolerance of sunitinib malate or toxicity necessitating dose modification

PRIOR CONCURRENT THERAPY:

Recovered from all acute toxic effects of prior chemotherapy, radiotherapy, or surgical procedures
No major surgery or radiotherapy within the past 4 weeks
No concurrent treatment on another clinical trial, except supportive care trials or non-treatment trials (e.g., quality of life)
No concurrent ketoconazole and other agents known to induce CYP3A4
No concurrent theophylline or phenobarbital and/or other agents metabolized by the cytochrome P450 system
No ongoing therapeutic doses of coumadin, except low-dose oral coumadin up to 2 mg once daily for thrombosis prophylaxis
No concurrent Hypericum perforatum (St. John's wort) or other herbal medications