Brain and Central Nervous System TumorsPhase 1NCT00030108
Ixabepilone in Treating Young Patients With Solid Tumors or Leukemia That Haven't Responded to Therapy
A Phase 1 study testing ixabepilone in people with Brain and Central Nervous System Tumors and Childhood Germ Cell Tumor, run by National Institutes of Health Clinical Center (CC) at 2 sites in United States.
Trial summary
RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. PURPOSE: This phase I trial is studying the side effects and best dose of ixabepilone in treating young patients with relapsed or refractory solid tumors or leukemia. Read more about this study
- Who is it for?
- Ages 2 to 21 years
- Conditions the study is for
- Brain and Central Nervous System Tumors, Childhood Germ Cell Tumor, Extragonadal Germ Cell Tumor
- What is being tested?
- ixabepilone
- How many people
- 30 participants
- Where
- 2 sitesUnited States
- Study dates
- Nov 2001to Apr 2010
- Phase
- Phase 1
- 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 2 to 21 years
- All sexes
- No healthy volunteers
- Child, Adult
DISEASE CHARACTERISTICS:
- Meets 1 of the following criteria:
- Histologically confirmed solid tumor (closed to accrual as of 10/4/2007) that relapsed after or failed to respond to front-line curative therapy and for which no other potentially curative treatment options exist
- Curative therapy may include surgery, radiotherapy, chemotherapy, or any combination of these modalities
- Eligible tumor types include, but are not limited to, the following:
- Rhabdomyosarcoma
- Other soft tissue sarcomas
- Ewing's sarcoma family of tumors
- Osteosarcoma
- Neuroblastoma
- Wilms' tumor
- Hepatic tumors
- Germ cell tumors
- Primary brain tumors
- Histologic confirmation may be waived for brain stem or optic glioma
- Diagnosis of relapsed or refractory leukemia
- Patients with refractory or second or greater relapsed leukemia must have > 25% blasts in the bone marrow (M3 bone marrow) with or without active extramedullary disease (except for leptomeningeal disease)
- Relapsed after or failed to respond to frontline curative therapy and no other potentially curative therapy (e.g., radiotherapy, chemotherapy, or any combination of these modalities) exists
- Patients with acute promyelocytic leukemia must be refractory to treatment with retinoic acid and arsenic trioxide
- Patients with Philadelphia chromosome positive chronic myelogenous leukemia must be refractory to imatinib
- No active CNS leukemia (CNS3)
PATIENT CHARACTERISTICS:
Age:
- 2 to 18 (solid tumor patients [closed to accrual as of 10/4/2007])
- 1 to 21 (leukemia patients)
Performance status:
- For patients age 11 to 21:
- Karnofsky 50-100%
- For patients age 1 to 10:
- Lansky 50-100%
Life expectancy:
- Not specified
Hematopoietic:
- Platelet count at least 100,000/mm^3 (20,000/mm^3 for leukemia patients)
- Hemoglobin ≥ 8.0 g/dL
Hepatic:
- Bilirubin less than 1.5 times upper limit of normal (ULN)
- SGOT and SGPT less than 2.5 times ULN
- No hepatic dysfunction that would preclude study
Renal:
- Creatinine normal for age OR
- Creatinine clearance at least 60 mL/min
- No renal dysfunction that would preclude study
Other:
- No known severe prior hypersensitivity reaction to agents containing Cremophor EL
- No clinically significant unrelated systemic illness (e.g., serious infections or other organ dysfunction) that would preclude study
- No grade 2 or greater preexisting sensory neuropathy
- More than 2 month since prior and no concurrent evidence of graft vs host disease
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
PRIOR CONCURRENT THERAPY:
Biologic therapy:
- Recovered from all therapy-related acute toxic effects (leukemia patients only)
- Prior epoetin alfa allowed
- At least 3 days since other prior colony-stimulating factors (e.g., filgrastim (G-CSF), sargramostim (GM-CSF), or interleukin-11 (IL-11))
- At least 6 months since prior bone marrow transplantation
- At least 2 months since prior stem cell transplantation or rescue (leukemia patients)
- At least 7 days since prior therapy with a biological agent and hematopoietic growth factor with the exception of erythropoietin
- More than 3 weeks since prior monoclonal antibody therapy (leukemia patients only)
- No concurrent GM-CSF or IL-11
- No concurrent immunotherapy
Chemotherapy:
- See Disease Characteristics
- Recovered from all therapy-related acute toxic effects (leukemia patients only)
- At least 4 weeks since prior chemotherapy (6 weeks for nitrosoureas)
- No other concurrent anticancer chemotherapy
Endocrine therapy:
- Concurrent corticosteroids allowed for the control of symptoms related to tumor-associated edema in patients with brain tumors
- Patients with brain tumors must be on a stable or tapering dose of corticosteroids for 7 days before baseline scan is performed for the purpose of assessing response to study therapy
- Must be on a stable or tapering dose of corticosteroids for 7 days prior to study entry (leukemia patients only)
Radiotherapy:
- See Disease Characteristics
- Recovered from all therapy-related acute toxic effects (leukemia patients only)
- At least 4 weeks since prior radiotherapy
- More than 2 weeks since prior local palliative radiotherapy (leukemia patients only)
- More than 3 months since prior total-body irradiation, craniospinal radiotherapy, or radiotherapy to ≥50% of the pelvis (leukemia patients only)
- More than 6 weeks since prior other substantial bone marrow radiotherapy (leukemia patients only)
- No prior extensive radiotherapy (e.g., craniospinal irradiation, total body irradiation, or radiotherapy to more than half of the pelvis)
- No concurrent anticancer radiotherapy
Surgery:
- See Disease Characteristics
Other:
- Recovered from prior therapy
- At least 30 days since any prior investigational anticancer therapy
- At least 1 week since prior known inhibitors of CYP3A4, including any of the following:
- Antibiotics (i.e., clarithromycin, erythromycin, or troleandomycin)
- Anti-HIV agents (i.e, delaviridine, nelfinavir, amprenavir, ritonavir, idinavir, saquinavir, or lopinavir)
- Anti-fungals (i.e., itraconazole, ketoconazole, fluconazole [doses > 3mg/kg/day], or voriconazole)
- Anti-depressants (i.e., nefaxodone or fluovoxamine)
- Calcium channel blockers (i.e., verapamil or diltiazem)
- Anti-emetics (i.e., aprepitant [Emend®])
- Miscellaneous agents (i.e., amiodarone)
- Grapefruit juice
- No other concurrent investigational agents
- No concurrent St. John's Wort
- No concurrent known inhibitors of CYP3A4, including grapefruit juice
- Concurrent other agents inducing CYP3A4 allowed
Trial locations and contacts
2 sites in 1 country.
United States2 sites
Warren Grant Magnuson Clinical Center - NCI Clinical Trials Referral Office
Bethesda, Maryland, 20892-1182
Children's National Medical Center
Washington D.C., District of Columbia, 20010-2970
About this study
Official title: Phase I Trial and Pharmacokinetic Study of BMS-247550 (NSC 710428, Ixabepilone), an Epothilone B Analog, in Pediatric Patients With Refractory Solid Tumors and Leukemias
RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die.
PURPOSE: This phase I trial is studying the side effects and best dose of ixabepilone in treating young patients with relapsed or refractory solid tumors or leukemia.
Read the detailed description
OBJECTIVES:
Primary
- Determine the maximum tolerated dose (MTD) and dose-limiting toxicity (DLT) of ixabepilone in young patients with refractory solid tumors (closed to accrual as of 10/4/2007) or relapsed or refractory leukemia.
- Determine the toxicity spectrum of this drug in these patients.
- Determine the plasma pharmacokinetics of this drug in these patients.
- Determine the pharmacodynamics of this drug in these patients.
- Assess the nerve growth factor levels, before and after the initiation of this drug, as a potential surrogate marker for the development of peripheral neuropathy in these patients.
Secondary
- Determine the response of patients treated with this drug.
- Compare the tolerability, toxicity profile, MTD, DLT, pharmacokinetics, and pharmacodynamics of this drug in young patients treated on this study vs adults with solid tumors (closed to accrual as of 10/4/2007) treated on the ongoing Medicine Branch, NCI, phase I study.
- Assess the safety and tolerability of ixabepilone at the solid tumor MTD (expanded leukemia cohort).
- Evaluate the plasma pharmacokinetics of in young patients with refractory or relapsed leukemia.
- Evaluate the extent of tubulin polymerization in leukemic blasts at baseline after treatment with ixabepilone ex-vivo.
- Compare the effects of tubulin polymerization in leukemic blasts with ixabepilone versus paclitaxel ex-vivo with an without the presence of a potent P-glycoprotein inhibitor.
- Evaluate the activity known drug transporters in drug-resistant leukemias in leukemic blasts.
OUTLINE: This is a multicenter, dose-escalation study.
Patients receive ixabepilone IV over 1 hour on days 1-5. Treatment repeats every 21 days in the absence of disease progression or unacceptable toxicity.
Cohorts of 3-6 patients receive escalating doses of ixabepilone until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 or more of 6 patients experience dose-limiting toxicity. Intrapatient dose escalation to one dose level above the enrollment dose level is allowed in patients who have stable or responding disease or are experiencing other benefits from therapy (e.g., decrease in tumor-related pain symptoms) and who have no grade 2 or greater non-hematologic toxicity and no grade 3 or greater hematologic toxicity. Additional patients are treated at the MTD. Patients treated at the MTD may not undergo intrapatient dose escalation.
PROJECTED ACCRUAL: A maximum of 30 patients will be accrued for this study within 1-2 years.
- Conditions
- Brain and Central Nervous System Tumors, Childhood Germ Cell Tumor, Extragonadal Germ Cell Tumor, Kidney Cancer, Leukemia, Liver Cancer
- Being tested
- ixabepilone
- Keywords
- recurrent childhood rhabdomyosarcoma, childhood craniopharyngioma, recurrent neuroblastoma, recurrent childhood liver cancer, recurrent Wilms tumor and other childhood kidney tumors, childhood central nervous system germ cell tumor, recurrent osteosarcoma, unspecified childhood solid tumor, protocol specific, childhood germ cell tumor, recurrent childhood soft tissue sarcoma, childhood oligodendroglioma, childhood choroid plexus tumor, childhood grade I meningioma, childhood grade II meningioma, childhood grade III meningioma, recurrent childhood cerebellar astrocytoma, recurrent childhood cerebral astrocytoma, recurrent childhood medulloblastoma, recurrent childhood visual pathway and hypothalamic glioma, previously treated childhood rhabdomyosarcoma
- Medical subject headings
- Central Nervous System Neoplasms, Kidney Neoplasms, Leukemia, Liver Neoplasms, Neuroblastoma, Ovarian Neoplasms, Sarcoma, Wilms Tumor
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
ixabepiloneDrug
What is being measured
The primary outcome is the main question the study is designed to answer.
Maximum tolerated dose and dose-limiting toxicity of ixabepilone
Toxicity spectrum
Plasma pharmacokinetics
Pharmacodynamics
Nerve growth factor levels before and after drug administration
Secondary outcomes (2)
Objective tumor response
Tubulin polymerization in PBMCs prior to the start of the infusion, just before the end of the infusion, 5 hours after the end of the infusion and before the start of the infusion on day 2 of the ixabepilone on course 1
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted27 Jan 2003 (estimated)
- Study startNov 2001
- Primary completionMar 2010
- Study completionApr 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 Brain and Central Nervous System TumorsStudies of the same condition, open and under way.
- 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
- Primary purpose
- Treatment
- Enrolment
- 30 participants (estimated)
Sponsor and investigators
- Lead sponsor
- National Institutes of Health Clinical Center (CC)
- Sponsor type
- US National Institutes of Health
- Collaborators
- National Cancer Institute (NCI)
- Investigators
- AeRang Kim, MD, Study chair, National Cancer Institute (NCI)
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00030108
- Sponsor's protocol ID
- 020031
- Other IDs
- 02-C-0031, NCI-5425, CDR0000069133
- Status last verified
- Mar 2012
- First submitted
- 30 Jan 2002
- Last updated
- 15 Mar 2012
- Results posted
- No
Publications
Widemann BC, Goodspeed W, Goodwin A, Fojo T, Balis FM, Fox E. Phase I trial and pharmacokinetic study of ixabepilone administered daily for 5 days in children and adolescents with refractory solid tumors. J Clin Oncol. 2009 Feb 1;27(4):550-6. doi: 10.1200/JCO.2008.17.6644. Epub 2008 Dec 15.
PubMed 19075272
Study at a glance
From the registry record, last updated by the sponsor on 15 Mar 2012. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Phase I Trial and Pharmacokinetic Study of BMS-247550 (NSC 710428, Ixabepilone), an Epothilone B Analog, in Pediatric Patients With Refractory Solid Tumors and Leukemias
- ClinicalTrials.gov ID
- NCT00030108
- Acronym / sponsor ID
- 020031
- Conditions
- Brain and Central Nervous System Tumors, Childhood Germ Cell Tumor, Extragonadal Germ Cell Tumor, Kidney Cancer, Leukemia, Liver Cancer
- Keywords
- recurrent childhood rhabdomyosarcoma, childhood craniopharyngioma, recurrent neuroblastoma, recurrent childhood liver cancer, recurrent Wilms tumor and other childhood kidney tumors, childhood central nervous system germ cell tumor, recurrent osteosarcoma, unspecified childhood solid tumor, protocol specific
- Phase
- Phase 1
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 30 participants (estimated)
- Lead sponsor
- National Institutes of Health Clinical Center (CC)US National Institutes of Health
- Collaborators
- National Cancer Institute (NCI)
- Study start
- Nov 2001
- Primary completion
- Mar 2010 (actual)
- Study completion
- Apr 2010 (actual)
- First posted
- 27 Jan 2003 (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 use different ways to stop tumor cells from dividing so they stop growing or die.
PURPOSE: This phase I trial is studying the side effects and best dose of ixabepilone in treating young patients with relapsed or refractory solid tumors or leukemia.
Detailed description
OBJECTIVES:
Primary
- Determine the maximum tolerated dose (MTD) and dose-limiting toxicity (DLT) of ixabepilone in young patients with refractory solid tumors (closed to accrual as of 10/4/2007) or relapsed or refractory leukemia.
- Determine the toxicity spectrum of this drug in these patients.
- Determine the plasma pharmacokinetics of this drug in these patients.
- Determine the pharmacodynamics of this drug in these patients.
- Assess the nerve growth factor levels, before and after the initiation of this drug, as a potential surrogate marker for the development of peripheral neuropathy in these patients.
Secondary
- Determine the response of patients treated with this drug.
- Compare the tolerability, toxicity profile, MTD, DLT, pharmacokinetics, and pharmacodynamics of this drug in young patients treated on this study vs adults with solid tumors (closed to accrual as of 10/4/2007) treated on the ongoing Medicine Branch, NCI, phase I study.
- Assess the safety and tolerability of ixabepilone at the solid tumor MTD (expanded leukemia cohort).
- Evaluate the plasma pharmacokinetics of in young patients with refractory or relapsed leukemia.
- Evaluate the extent of tubulin polymerization in leukemic blasts at baseline after treatment with ixabepilone ex-vivo.
- Compare the effects of tubulin polymerization in leukemic blasts with ixabepilone versus paclitaxel ex-vivo with an without the presence of a potent P-glycoprotein inhibitor.
- Evaluate the activity known drug transporters in drug-resistant leukemias in leukemic blasts.
OUTLINE: This is a multicenter, dose-escalation study.
Patients receive ixabepilone IV over 1 hour on days 1-5. Treatment repeats every 21 days in the absence of disease progression or unacceptable toxicity.
Cohorts of 3-6 patients receive escalating doses of ixabepilone until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 or more of 6 patients experience dose-limiting toxicity. Intrapatient dose escalation to one dose level above the enrollment dose level is allowed in patients who have stable or responding disease or are experiencing other benefits from therapy (e.g., decrease in tumor-related pain symptoms) and who have no grade 2 or greater non-hematologic toxicity and no grade 3 or greater hematologic toxicity. Additional patients are treated at the MTD. Patients treated at the MTD may not undergo intrapatient dose escalation.
PROJECTED ACCRUAL: A maximum of 30 patients will be accrued for this study within 1-2 years.
Study design
- Primary purpose
- Treatment
Who may qualify
- Ages
- 2 to 21 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, 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 |
|---|---|---|
| ixabepilone | Drug | – |
Primary outcome
Maximum tolerated dose and dose-limiting toxicity of ixabepilone
Toxicity spectrum
Plasma pharmacokinetics
Pharmacodynamics
Nerve growth factor levels before and after drug administration
2 secondary outcomes
Objective tumor response
Tubulin polymerization in PBMCs prior to the start of the infusion, just before the end of the infusion, 5 hours after the end of the infusion and before the start of the infusion on day 2 of the ixabepilone on course 1
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 15 Mar 2012.
- Results publication: PubMed 19075272Widemann BC, Goodspeed W, Goodwin A, Fojo T, Balis FM, Fox E. Phase I trial and pharmacokinetic study of ixabepilone administered daily for 5 days in children and adolescents with refractory solid tumors. J Clin Oncol. 2009 Feb 1;27(4):550-6. doi: 10.1200/JCO.2008.17.6644. Epub 2008 Dec 15.
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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.
AeRang Kim, MD study chair
National Cancer Institute (NCI)
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 1 study testing ixabepilone in people with Brain and Central Nervous System Tumors and Childhood Germ Cell Tumor, run by National Institutes of Health Clinical Center (CC) at 2 sites 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 15 Mar 2012. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 sites 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 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.
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 and dose-limiting toxicity of ixabepilone. The study lists 5 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 NCT00030108, 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 15 Mar 2012.