Unspecified Adult Solid Tumor, Protocol SpecificPhase 1NCT00714181
Hydroxychloroquine and Temozolomide in Treating Patients With Metastatic or Unresectable Solid Tumors
A Phase 1 study testing hydroxychloroquine, temozolomide and TdT-mediated dUTP nick end labeling assay in people with Unspecified Adult Solid Tumor, Protocol Specific, run by Abramson Cancer Center at Penn Medicine at 1 site in United States.
Trial summary
RATIONALE: Drugs used in chemotherapy, such as hydroxychloroquine and temozolomide, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more tumor cells. Read more about this study
- Who is it for?
- Ages 18 to 120 years
- Conditions the study is for
- Unspecified Adult Solid Tumor, Protocol Specific
- What is being tested?
- hydroxychloroquine, temozolomide and TdT-mediated dUTP nick end labeling assay
- How many people
- 38 participants
- Where
- 1 siteUnited States
- Study dates
- Jun 2008to Jun 2013
- 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 18 to 120 years
- All sexes
- No healthy volunteers
- Adult, Older adult
DISEASE CHARACTERISTICS:
- Histologically or cytologically confirmed solid tumor
- Metastatic or unresectable disease
- Refractory to standard therapy or no standard therapy exists
- Measurable disease by RECIST criteria
- Brain metastases allowed provided patient completed radiotherapy (if radiotherapy was clinically indicated at the time of diagnosis) AND discontinued steroids prior to study enrollment
PATIENT CHARACTERISTICS:
- ECOG performance status 0-1
- WBC ≥ 3,000/mm³
- Absolute granulocyte count ≥ 1,500/mm³
- Platelet count ≥ 100,000/mm³
- Serum creatinine ≤ 2.0 times upper limit of normal (ULN)
- Total bilirubin ≤ 1.5 times ULN (< 3.0 times ULN in the presence of Gilbert's disease)
- AST and ALT ≤ 2.5 times ULN (≤ 5.0 times ULN in the presence of liver metastases)
- aPTT normal
- INR ≤ 1.5 (if on anticoagulation, INR must be < 1.5 prior to starting anticoagulation)
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
- HIV negative
- No porphyria
- No psoriasis, unless the disease is well controlled and patient is under the care of a specialist who agrees to monitor the patient for exacerbations
- No previously documented macular degeneration or diabetic retinopathy
- No concurrent serious illness including, but not limited to, any of the following:
- Ongoing or active infection requiring parenteral antibiotics
- Clinically significant cardiovascular disease (e.g., uncontrolled hypertension, myocardial infarction, or unstable angina)
- New York Heart Association class II-IV congestive heart failure
- Serious cardiac arrhythmia requiring medication
- Peripheral vascular disease ≥ grade 2 within the past year
- Psychiatric illness/social situation that would limit compliance with study requirements
- No other concurrent malignancies, other than basal cell skin cancer, squamous cell skin cancer, carcinoma in situ of the cervix, or ductal or lobular carcinoma in situ of the breast
PRIOR CONCURRENT THERAPY:
- See Disease Characteristics
- Recovered from all prior therapy
- The following prior therapy is allowed in the adjuvant or metastatic disease setting:
- Immunotherapy (interferon, aldesleukin, or sargramostim [GM-CSF])
- Chemotherapy, either as a single-agent or as combination therapy
- Vaccine therapy
- Targeted or biological therapy
- Chloroquine derivatives
- At least 4 weeks since prior active immunotherapy (aldesleukin, interferon, or ipilimumab)
- At least 4 weeks since prior chemotherapy
- At least 2 weeks since prior oral targeted therapies
- More than 4 weeks since prior and no other concurrent investigational anticancer therapy (except for vaccines)
- No prior temozolomide
- Prior radiotherapy allowed
- If radiotherapy has been administered to a lesion, there must be radiographic evidence of progression of that lesion in order for that lesion to constitute measurable disease or to be included in the measured target lesions
- No concurrent cytochrome P450 enzyme-inducing antiepileptic drugs (phenytoin, carbamazepine, phenobarbital, primidone, or oxcarbazepine), rifampin, or Hypericum perforatum (St. John's wort)
- No other concurrent anticancer therapy
Trial locations and contacts
1 site in 1 country.
United States1 site
Abramson Cancer Center of the University of Pennsylvania
Philadelphia, Pennsylvania, 19104-4283
About this study
Official title: A Phase I Study of Hydroxychloroquine in Combination With Temozolomide in Patients With Advanced Solid Tumors
RATIONALE: Drugs used in chemotherapy, such as hydroxychloroquine and temozolomide, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more tumor cells.
PURPOSE: This phase I trial is studying the side effects and best dose of hydroxychloroquine when given together with temozolomide in treating patients with metastatic or unresectable solid tumors.
Read the detailed description
OBJECTIVES:
Primary
- To determine the maximum tolerated dose (MTD) of hydroxychloroquine (HCQ) when administered in combination with temozolomide (TMZ) in patients with metastatic or unresectable solid tumors.
Secondary
- To determine the toxicity and toxicity rate of HCQ when administered at the MTD in combination with TMZ in these patients.
Tertiary
- To construct a population pharmacokinetic (PK) model using a limited sampling of whole blood to determine the drug exposure of HCQ and HCQ metabolites in these patients.
- To measure changes in autophagic vesicle accumulation by immunoblotting against the autophagy marker LC3 in protein lysates prepared from peripheral blood mononuclear cells (PBMC) collected from patients treated with HCQ and TMZ.
- To measure changes in median number of autophagic vesicles by electron microscopy in PBMC collected from patients treated with HCQ and TMZ.
- To assess tumor changes in LC3 and caspase 3 cleavage by western blotting.
- To assess tumor cell death characteristics by immunohistochemical methods (Ki67, TUNEL staining, cleaved caspase 3).
- To evaluate autophagy by electron microscopy.
- To define associations between changes in LC3 levels from baseline in PBMC with HCQ exposure.
- To measure the levels of HMGB1 in the serum of patients treated with HCQ and TMZ.
OUTLINE: This is a dose-escalation study of hydroxychloroquine (HCQ).
Patients receive oral HCQ alone once or twice daily for 14 days. Patients then receive oral HCQ once or twice daily on days 1-28 and oral temozolomide once daily on days 1-7 and 15-21. Treatment with HCQ and temozolomide repeats every 28 days in the absence of disease progression or unacceptable toxicity.
Patients undergo blood sample collection periodically for pharmacodynamic and pharmacokinetic correlative studies. Autophagic vesicles in blood samples are quantified by immunoblotting against the autophagy protein LC3 and by electron microscopy. Pharmacokinetics are analyzed by high-performance liquid chromatography with tandem mass spectrometry. Patients with tumors amenable to biopsy also undergo serial biopsies. Tumor tissue samples are assessed for tumor cell apoptosis and proliferation using Ki67 and TUNEL staining and for the number of autophagic vesicles and nuclear changes characteristic of apoptotic, autophagic, or necrotic cell death by western blotting and electron microscopy.
After completion of study treatment, patients are followed periodically.
- Being tested
- hydroxychloroquine, temozolomide, TdT-mediated dUTP nick end labeling assay, western blotting, electron microscopy
- Keywords
- unspecified adult solid tumor, protocol specific
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
temozolomideDrug
TdT-mediated dUTP nick end labeling assayGenetic
western blottingGenetic
electron microscopyOther
high performance liquid chromatographyOther
immunoenzyme techniqueOther
laboratory biomarker analysisOther
mass spectrometryOther
What is being measured
The primary outcome is the main question the study is designed to answer.
Maximum tolerated dose of hydroxychloroquine
Secondary outcomes (2)
Toxicity rates
Pharmacodynamic and pharmacokinetic correlative endpoints
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted14 Jul 2008 (estimated)
- Study startJun 2008
- Primary completionJul 2011
- Study completionJun 2013
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Unspecified Adult Solid Tumor, Protocol SpecificStudies of the same condition, open and under way.
- More trials run by Abramson Cancer Center at Penn MedicineThe sponsor's other registered studies.
- 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
- Masking
- None (open label)
- Enrolment
- 38 participants (actual)
Sponsor and investigators
- Lead sponsor
- Abramson Cancer Center at Penn Medicine
- Sponsor type
- University, hospital or other
- Collaborators
- National Cancer Institute (NCI)
- Responsible party
- Sponsor
- Investigators
- Ravi Amaravadi, MD, Principal investigator, Abramson Cancer Center at Penn Medicine
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00714181
- Sponsor's protocol ID
- CDR0000600329
- Other IDs
- UPCC-12907
- Status last verified
- Feb 2016
- First submitted
- 11 Jul 2008
- Last updated
- 18 Feb 2016
- Results posted
- No
- Data monitoring committee
- Yes
Study at a glance
From the registry record, last updated by the sponsor on 18 Feb 2016. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase I Study of Hydroxychloroquine in Combination With Temozolomide in Patients With Advanced Solid Tumors
- ClinicalTrials.gov ID
- NCT00714181
- Acronym / sponsor ID
- CDR0000600329
- Keywords
- unspecified adult solid tumor, protocol specific
- Phase
- Phase 1
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 38 participants (actual)
- Lead sponsor
- Abramson Cancer Center at Penn MedicineUniversity, hospital or other
- Collaborators
- National Cancer Institute (NCI)
- Study start
- Jun 2008
- Primary completion
- Jul 2011 (actual)
- Study completion
- Jun 2013 (actual)
- First posted
- 14 Jul 2008 (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, such as hydroxychloroquine and temozolomide, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more tumor cells.
PURPOSE: This phase I trial is studying the side effects and best dose of hydroxychloroquine when given together with temozolomide in treating patients with metastatic or unresectable solid tumors.
Detailed description
OBJECTIVES:
Primary
- To determine the maximum tolerated dose (MTD) of hydroxychloroquine (HCQ) when administered in combination with temozolomide (TMZ) in patients with metastatic or unresectable solid tumors.
Secondary
- To determine the toxicity and toxicity rate of HCQ when administered at the MTD in combination with TMZ in these patients.
Tertiary
- To construct a population pharmacokinetic (PK) model using a limited sampling of whole blood to determine the drug exposure of HCQ and HCQ metabolites in these patients.
- To measure changes in autophagic vesicle accumulation by immunoblotting against the autophagy marker LC3 in protein lysates prepared from peripheral blood mononuclear cells (PBMC) collected from patients treated with HCQ and TMZ.
- To measure changes in median number of autophagic vesicles by electron microscopy in PBMC collected from patients treated with HCQ and TMZ.
- To assess tumor changes in LC3 and caspase 3 cleavage by western blotting.
- To assess tumor cell death characteristics by immunohistochemical methods (Ki67, TUNEL staining, cleaved caspase 3).
- To evaluate autophagy by electron microscopy.
- To define associations between changes in LC3 levels from baseline in PBMC with HCQ exposure.
- To measure the levels of HMGB1 in the serum of patients treated with HCQ and TMZ.
OUTLINE: This is a dose-escalation study of hydroxychloroquine (HCQ).
Patients receive oral HCQ alone once or twice daily for 14 days. Patients then receive oral HCQ once or twice daily on days 1-28 and oral temozolomide once daily on days 1-7 and 15-21. Treatment with HCQ and temozolomide repeats every 28 days in the absence of disease progression or unacceptable toxicity.
Patients undergo blood sample collection periodically for pharmacodynamic and pharmacokinetic correlative studies. Autophagic vesicles in blood samples are quantified by immunoblotting against the autophagy protein LC3 and by electron microscopy. Pharmacokinetics are analyzed by high-performance liquid chromatography with tandem mass spectrometry. Patients with tumors amenable to biopsy also undergo serial biopsies. Tumor tissue samples are assessed for tumor cell apoptosis and proliferation using Ki67 and TUNEL staining and for the number of autophagic vesicles and nuclear changes characteristic of apoptotic, autophagic, or necrotic cell death by western blotting and electron microscopy.
After completion of study treatment, patients are followed periodically.
Study design
- Primary purpose
- Treatment
- Masking
- None (open label)
Who may qualify
- Ages
- 18 to 120 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older 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 |
|---|---|---|
| hydroxychloroquine | Drug | – |
| temozolomide | Drug | – |
| TdT-mediated dUTP nick end labeling assay | Genetic | – |
| western blotting | Genetic | – |
| electron microscopy | Other | – |
| high performance liquid chromatography | Other | – |
| immunoenzyme technique | Other | – |
| immunohistochemistry staining method | Other | – |
| laboratory biomarker analysis | Other | – |
| mass spectrometry | Other | – |
| pharmacological study | Other | – |
Primary outcome
Maximum tolerated dose of hydroxychloroquine
2 secondary outcomes
Toxicity rates
Pharmacodynamic and pharmacokinetic correlative endpoints
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 18 Feb 2016.
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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.
Ravi Amaravadi, MD principal investigator
Abramson Cancer Center at Penn Medicine
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 1 study testing hydroxychloroquine, temozolomide and TdT-mediated dUTP nick end labeling assay in people with Unspecified Adult Solid Tumor, Protocol Specific, run by Abramson Cancer Center at Penn Medicine at 1 site 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 18 Feb 2016. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site 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 of hydroxychloroquine. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 18 Feb 2016.