Unspecified Adult Solid Tumor, Protocol Specific Clinical Trial
Official title:
A Phase I Clinical Trial to Investigate the Correlation Between UGT1A1 Genotype and Irinotecan (CPT-11) Pharmacokinetics and Toxicity in Cancer Patients
Phase I trial to study genetic testing and the effectiveness of irinotecan in treating patients who have solid tumors and lymphoma. Drugs used in chemotherapy use different ways to stop cancer cells from dividing so they stop growing or die. Genetic testing for a specific enzyme may help doctors determine whether side effects from or response to chemotherapy are related to a person's genetic makeup
OBJECTIVES:
I. Classify patients with solid tumors or lymphoma according to UGT1A1 promoter (TATA box)
and coding region (Gly71Arg) mutation, and CYP3A4 promoter (G to A) polymorphisms.
II. Identify UGT1A1 enzyme glucuronidator and irinotecan oxidizer phenotypes in these
patients and determine the correlation between the two metabolic reactions in vivo.
III. Determine the relationship between UGT1A1 genotype (promoter and/or coding region
mutation) and CYP3A4 promoter genotype vs gastrointestinal or bone marrow toxicity, and
pharmacokinetics of irinotecan in these patients.
IV. Determine the pharmacokinetics of irinotecan in these patients.
OUTLINE: Patients are genotyped for UGT1A1 enzyme and classified as "Gilbert's" (7/7),
"heterozygotes" (6/7), and "homozygotes for allele 6" (6/6). The DNA is analyzed for the
UGT1A1 coding region mutation (Gly71Arg) and CYP3A4 promoter polymorphism. Patients are also
examined for glucuronidator ratio of SN-38, the active metabolite of irinotecan, and
classified as "low/slow" (very low or zero SN-38G/SN-38 ratio), "intermediate" (less than
50% normal ratio), or "normal".
Patients receive irinotecan IV over 90 minutes once every 3 weeks. Treatment continues for
at least 2 courses in the absence of disease progression or unacceptable toxicity.
;
Endpoint Classification: Safety Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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