Unspecified Adult Solid Tumor, Protocol Specific Clinical Trial
Official title:
Phase I/II Study of Irinotecan and Whole Brain Radiation Therapy in Patients With Brain Metastases From Solid Tumors
RATIONALE: Drugs used in chemotherapy, such as irinotecan, work in different ways to stop the
growth of tumor cells, either by killing the cells or by stopping them from dividing.
Radiation therapy uses high-energy x-rays to kill tumor cells. Irinotecan may make tumor
cells more sensitive to radiation therapy. Giving irinotecan together with whole-brain
radiation therapy may kill more tumor cells.
PURPOSE: This phase I/II trial is studying the side effects and best dose of irinotecan when
given together with whole-brain radiation therapy and to see how well they work in treating
patients with brain metastases from solid tumors. (The study of side effects and best dose
has ended as of 4/15/05)
OBJECTIVES:
Primary
- Determine the maximum tolerated dose of irinotecan hydrochloride administered
concurrently with whole-brain radiotherapy in patients with brain metastases from solid
tumors. (Phase I) (Phase I closed to accrual as of 4/15/05)
- Determine the toxicity of this regimen in these patients. (Phase I) (Phase I closed to
accrual as of 4/15/05)
- Determine the overall survival of patients treated with this regimen. (Phase II)
Secondary
- Assess the neurocognitive function of these patients by Mini-Mental Status Examination.
(Phase II)
OUTLINE: This is a phase I, dose-escalation study of irinotecan hydrochloride (phase I closed
to accrual as of 4/15/05) followed by a phase II study. Patients enrolled in phase II are
stratified according to cognitive dysfunction (yes vs no).
- Phase I (closed to accrual as of 4/15/05): Patients undergo whole-brain radiotherapy
(WBRT) once daily, 5 days a week, for 3 weeks (15 fractions). Patients also receive
irinotecan hydrochloride IV over 90 minutes on days 1, 8, and 15.
Cohorts of 3-6 patients receive escalating doses of irinotecan hydrochloride until the
maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at
which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity.
- Phase II (for patients enrolled after 4/15/05): Patients receive irinotecan
hydrochloride at the MTD and undergo concurrent WBRT as in phase I.
Patients complete the Mini-Mental Status Examination to assess neurocognitive function at
baseline, on the last day of radiotherapy, and periodically after completion of study
therapy.
After completion of study therapy, patients are followed monthly for 3 months, at 6 months,
and then every 6 months thereafter.
PROJECTED ACCRUAL: A total of 51 patients will be accrued for this study.
;
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