Ixabepilone and Liposomal Doxorubicin in Advanced Ovarian Cancer

Fallopian Tube Cancer Clinical Trial

Official title:

A Phase I/II Study of BMS-247550 and Pegylated Liposomal Doxorubicin (Doxil®) in Patients With Advanced Epithelial Ovarian Cancer or Primary Peritoneal Cancer Who Have Been Previously Treated With a Platinum and a Taxane

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00182767
• Other study ID #: NCI-2009-00140
• Secondary ID: NCI-2009-0014005
• Status: Completed
• Phase: Phase 1/Phase 2
• First received: September 15, 2005
• Last updated: February 11, 2016
• Start date: January 2006
• Est. completion date: May 2014

Study information

• Verified date: February 2014
• Source: National Cancer Institute (NCI)
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Food and Drug Administration
• Study type: Interventional

Clinical Trial Summary

This trial is studying the side effects and best dose of ixabepilone when given together with pegylated liposomal doxorubicin hydrochloride and to see how well they work in treating women with advanced ovarian epithelial, primary peritoneal cavity, or fallopian tube cancer or metastatic breast cancer. Drugs used in chemotherapy, such as ixabepilone and pegylated liposomal doxorubicin hydrochloride, 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.

Description:

PRIMARY OBJECTIVES:

I. To determine the maximum tolerated dose and recommended phase II dose of ixabepilone when combined with pegylated doxorubicin hydrochloride (HCl) liposome (pegylated liposomal doxorubicin hydrochloride) in women with previously treated advanced ovarian epithelial, primary peritoneal cavity, or fallopian tube cancer or metastatic breast cancer.

II. To determine the safety profile of this regimen in these patients. III. To determine the clinical efficacy of this regimen in patients with platinum- and taxane-resistant advanced ovarian epithelial, primary peritoneal cavity, or fallopian tube cancer.

OUTLINE: This is a phase I, multicenter, open-label, dose-escalation study of ixabepilone followed by a phase II study.

Patients receive ixabepilone intravenously (IV) over 3 hours and pegylated liposomal doxorubicin hydrochloride IV over 30-60 minutes on day 1. Courses repeat every 21-28 days in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed for up to 2 years.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 45
• Est. completion date: May 2014
• Est. primary completion date: April 2012
• Accepts healthy volunteers: No
• Gender: Female
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Histologically or cytologically confirmed diagnosis of 1 of the following: advanced ovarian epithelial, primary peritoneal cavity, or fallopian tube cancer (phase I and II) or metastatic breast cancer (phase I only).

• Platinum- and taxane-resistant disease, defined as a disease-free interval of < 6 months after completion of platinum- and taxane-based chemotherapy. Disease progression during the regimen (phase II) or previously treated with >= 2 prior regimens for metastatic breast cancer, including 1 taxane-based regimen in the adjuvant or metastatic setting (phase I).

• Meets 1 of the following criteria: Previously treated with a standard course of taxane- and platinum-based chemotherapy for ovarian epithelial, primary peritoneal cavity, or fallopian tube cancer, that is platinum-refractory or -sensitive disease (phase I );

• Measurable or evaluable disease, meeting 1 of the following criteria:

unidimensionally measurable lesion, known disease and CA 125 > 50 U/mL on 2 occasions >= 1 week apart or known disease and CA 27-29, CA 15-3, or CA 125 > 50 U/mL on 2 occasions >= 1 week apart (for breast cancer patients)

• ECOG 0-2 or Karnofsky 60-100%

• At least 3 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin) and recovered.

• At least 1 week since prior chemotherapy if given on a daily or weekly schedule and recovered.

• At least 3 weeks since prior radiotherapy and recovered.

• Recovered for more than 4 weeks from all adverse events related to prior agents.

• Normal organ function including:

• Normal bilirubin

• WBC >= 3,000/mm3

• Absolute neutrophil count >= 1,500/mm3

• Platelet count >= 100,000/mm3

• AST and ALT =< 2.5 times upper limit of normal (ULN)

• Creatinine =< 1.5 times ULN or Creatinine clearance = 60 mL/min

Exclusion criteria:

• No other concurrent investigational agents.

• No concurrent combination antiretroviral therapy for HIV-positive patients.

• No other concurrent anticancer therapy.

• Has received a previous chemotherapy regimen for this cancer that included drugs such as docetaxel or paclitaxel.

• Life expectancy of more than 3 months

• No symptomatic congestive heart failure

• No unstable angina pectoris

• No cardiac arrhythmia

• Not pregnant or nursing

• Fertile patients must use effective contraception

• No history of allergic reaction attributed to compounds of similar chemical or biological composition to Cremophor® or study drugs

• No neuropathy >= grade 2

• No ongoing or active infection

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

• No other uncontrolled illness.

• No active brain metastases, including any of the following: evidence of cerebral edema by CT scan or MRI, evidence of disease progression on prior imaging studies, requirement for steroids or clinical symptoms of brain metastasis.

Study Design

Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Related Conditions & MeSH terms

• Breast Neoplasms
• Fallopian Tube Cancer
• Female Reproductive Cancer
• Neoplasms, Glandular and Epithelial
• Ovarian Neoplasms
• Recurrent Breast Cancer
• Recurrent Ovarian Epithelial Cancer
• Stage III Ovarian Epithelial Cancer
• Stage IV Breast Cancer
• Stage IV Ovarian Epithelial Cancer

Intervention

Drug:
• ixabepilone
Given IV
• pegylated liposomal doxorubicin hydrochloride
Given IV

Locations

Country	Name	City	State
United States	Women's Cancer Care Associates LLC	Albany	New York
United States	Albert Einstein College of Medicine	Bronx	New York
United States	Montefiore Medical Center - Moses Campus	Bronx	New York
United States	University of Connecticut	Farmington	Connecticut
United States	Weill Medical College of Cornell University	New York	New York

Sponsors (1)

Lead Sponsor	Collaborator
National Cancer Institute (NCI)

Country where clinical trial is conducted

United States, 

References & Publications (1)

Chuang E, Wiener N, Christos P, Kessler R, Cobham M, Donovan D, Goldberg GL, Caputo T, Doyle A, Vahdat L, Sparano JA. Phase I trial of ixabepilone plus pegylated liposomal doxorubicin in patients with adenocarcinoma of breast or ovary. Ann Oncol. 2010 Oct — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Incidence of Dose-limiting Toxicity (DLT), Graded Using the National Cancer Institute (NCI) Common Toxicity Criteria (CTC) Version 4.0 (Phase I)	Dose-Limiting Toxicities are assessed according to the National Cancer Institute's Common Terminology Criteria for Adverse Events classification and usually encompasses all grade 3 or higher toxicities	28 days	Yes
Primary	Maximum Tolerated Dose	The phase I component of the study included 30 patients with breast and ovarian cancer. A protocol amendment was made during phase I trial from a treatment regimen of Schedule A (ixabepilone every 3-4 weeks) to Schedule B (ixabepilone every week). The maximum tolerated dose was determined to be the preceding dose of any dose that resulted in 2 DLT events. Schedule B was carried forward to the phase II trial. The Maximum Tolerated Dose for Schedule B is reported. Please see (Chuang et al., 2010) for additional details	Once 2 DLT events occur in patients during the first 28 days of treatment (cycle 1), the preceding dose will be designated the maximum tolerated dose (MTD).	Yes
Secondary	Proportion of Patients Responding to Therapy (Complete Response [CR], Partial Response [PR], or Stable Disease [SD]), Assessed According to Response Evaluation Criteria in Solid Tumors (RECIST) and Cancer Antigen-125 (CA-125) Response Criteria (Phase II)		Up to 2 years	No
Secondary	Progression-free Survival	We will summarize progression-free survival by Kaplan-Meier survival analysis.	The time from start of treatment to time of progression or death, assessed up to 2 years	No