I. To determine the maximally tolerated dose (MTD) of cilengitide and paclitaxel at weekly dose schedule.
II. To describe the toxicities associated with cilengitide and paclitaxel. III. To describe any antitumor activity of cilengitide and paclitaxel at weekly dose schedule.
IV. To characterize pharmacokinetics (PK) of cilengitide and paclitaxel with the proposed schedule and correlate PK parameters to clinical outcome.
V. To evaluate the effect of cilengitide and paclitaxel on circulating Cyr61 using a novel "sandwich ELISA" assay and to correlate this effect with clinical response.
VI. To evaluate the information obtained through use of items from the Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) in Phase I studies.
OUTLINE: This is a dose-escalation study of cilengitide.
Patients receive cilengitide intravenously (IV) over 1 hour on days* 1, 8, and 15 and paclitaxel IV over 1 hour on days 1, 8, and 15. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.
NOTE: *Some patients receive cilengitide IV over 1 hour on days 1, 2, 8, 9, 15, and 16.
After completion of study treatment, patients are followed up for 3 months.
- Histologic proof of cancer that is now unresectable (solid tumors, excluding lymphoma)
- For Cohort II only: breast cancer patients who have progressed on taxanes are eligible ("progression on taxanes" is defined as any type of prior taxane exposure, that is, patients that progress during taxane treatment, immediately after taxane treatment)
- ANC ≥ 1500/μL
- Hgb ≥ 9 g/dL
- PLT ≥ 100,000/μL
- Total bilirubin ≤ 1.5 x upper limit of normal (ULN)
- AST ≤ 3 x ULN or AST ≤ 5 x ULN if liver involvement
- Creatinine ≤ 1.5 x ULN
- ECOG performance status (PS) 0, or 1 (or KPS > 70)
- Ability to provide informed consent
- Willingness to return to the enrolling Mayo Clinic institution for follow-up
- Life expectancy ≥ 12 weeks
- Willingness to provide blood samples for the mandatory correlative research component
- For Cohort II, available tissue is mandatory (tissue has to be enough to allow testing for the proposed biomarkers; otherwise, a biopsy to obtain new tissue is mandated)
- Women of childbearing potential only: Negative serum pregnancy test done ≤ 7 days prior to registration, for women of childbearing potential including women within 2 years of postmenopause
- Patients on hormonal therapy for breast cancer are allowed to continue their hormonal therapy
- Known standard therapy for the patient's disease that is potentially curative or definitely capable of extending life expectancy
- Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
- Any of the following prior therapies:
- Chemotherapy ≤ 21 days prior to registration
- Mitomycin C/nitrosoureas ≤ 42 days prior to registration
- Immunotherapy ≤ 14 days prior to registration
- Biologic therapy ≤ 14 days prior to registration
- Prior investigational therapy ≤ 28 days prior to registration
- Full* field radiation therapy ≤ 28 days prior to registration or limited** field radiation therapy < 14 days prior to registration
- Full field radiation encompasses the entire area of known disease involvement and surrounding uninvolved but at-risk areas, e.g. subtotal nodal (mantle and upper abdomen) or total nodal irradiation
- Limited field radiation is restricted to treating only the known areas of clinical disease, e.g. involved-field therapy for lymphoma
- Major surgery (i.e., laparotomy) ≤ 4 weeks prior to registration; minor surgery ≤ 2 weeks prior to registration; NOTE: Insertion of a vascular access device is not considered major or minor surgery in this regard
- Failure to fully recover from acute, reversible effects of prior chemotherapy regardless of interval since last treatment
- New York Heart Association classification III or IV
- CNS metastases or seizure disorder; Note: CNS metastases are allowed if previously treated and stable for at least 4 weeks
- Any of the following:
- Pregnant women
- Nursing women
- Men or women of childbearing potential who are unwilling to employ adequate contraception (condoms, diaphragm, injections, intrauterine device [IUD], or abstinence, etc.); oral, implantable, or injectable contraceptives may be affected by cytochrome P450 interactions, and are therefore not considered effective for this study
- NOTE: This study involves an investigational agent whose genotoxic, mutagenic and teratogenic effects on the developing fetus and newborn are unknown
- Other concurrent chemotherapy, immunotherapy, radiotherapy, or any ancillary therapy considered investigational (utilized for a non-FDA-approved indication and in the context of a research investigation)
- Co-morbid systemic illnesses or other severe concurrent disease which, in the judgment of the investigator, would make the patient inappropriate for entry into this study or interfere significantly with the proper assessment of safety and toxicity of the prescribed regimens
- Immunocompromised patients (other than that related to the use of corticosteroids) including patients known to be HIV positive on HAART therapy as there is a risk for drug interaction with antiretroviral treatment
- Receiving any other investigational agent which would be considered as a treatment for the primary neoplasm
- Other active malignancy =< 3 years prior to registration; EXCEPTIONS: Nonmelanotic skin cancer or carcinoma-in-situ of the cervix; NOTE: If there is a history of prior malignancy, they must not be receiving other specific treatment for their cancer
- History of myocardial infarction ≤ 6 months prior to registration, or congestive heart failure requiring use of ongoing maintenance therapy for life-threatening ventricular arrhythmias
- Uncontrolled hypertension, labile hypertension of history of poor compliance with antihypertensive medication
- Patients with active, bleeding diathesis
- Non-disease related- major surgery, =< 28 days or minor surgery =< 7 days prior to registration
Last updated: 03/15/2013
NCT ID: NCT01276496