Lymphoma Clinical Trial
Official title:
Phase I Study of the Hsp90 Inhibitor, PU-H71, in Patients With Refractory Solid Tumors and Low-Grade Non-Hodgkin's Lymphoma
Background:
- PU-H71 is an experimental drug used to treat cancer. It works by blocking a protein in
tumors. When this protein is blocked, it affects other proteins inside the cell that cancers
need to grow. Researchers want to study whether PU-H71 is a safe and effective way to treat
solid tumors and non-Hodgkin's lymphoma.
Objectives:
- To evaluate the safety and effectiveness of PU-H71 in solid tumors and non-Hodgkin's
lymphoma that have not responded to standard treatments.
Eligibility:
- Individuals at least 18 years of age who have solid tumors or non-Hodgkin's lymphoma that
have not responded to standard treatments.
Design:
- Patients will be screened with a physical exam, medical history, blood tests, and
imaging studies.
- Patients will receive PU-H71 as a 1-hour dose on days 1 and 8 of a 21-day cycle of
treatment. The first treatment cycle will be done in the hospital so that patients can
be monitored. The next treatment cycles will be done on an outpatient basis.
- Patients will have blood and urine tests and eye exams.
- Patients will provide tumor samples for study.
- Patients will have imaging studies to monitor tumor response to treatment.
- Patients will continue to take PU-H71 for as long as side effects remain tolerable and
their tumor or lymphoma does not worsen. Study researchers may adjust the dose if
needed.
Background:
-PU-H71 is a synthetic HSP90 inhibitor which can bind both open and closed conformations of
HSP90. It demonstrates extended tumor retention and client protein degradation, while being
rapidly cleared from normal tissues. It has shown complete tumor responses and retained
sensitivity to retreatment in vivo.
Primary Objectives:
- To establish the safety and tolerability of PU-H71 administered on a once weekly, 2
weeks out of 3 schedule, in patients with refractory solid tumors and lowgrade
non-Hodgkin's lymphoma (NHL).
- To establish the maximum tolerated dose (MTD) and the recommended phase 2 dose (RP2D) of
PU-H71 administered on a once weekly, 2 weeks out of 3 schedule, in patients with
refractory solid tumors and low-grade NHL.
- To determine the pharmacokinetics of PU-H71 administered on a once weekly, 2 weeks out
of 3 schedule, in patients with refractory solid tumors and low-grade NHL.
Secondary Objectives:
- To perform pharmacodynamic studies to ascertain PU-H71 effect on HSP70 in tumor tissue,
serum, and peripheral blood mononuclear cells (PBMCs) at the MTD.
- To perform pharmacodynamic studies to ascertain PU-H71 effect on HSP90 client proteins
in tumor tissue at the MTD.
Eligibility:
-Study participants must have histologically confirmed solid tumor malignancy or low-grade
non-Hodgkin s lymphoma that has progressed or recurred after at least one line of
chemotherapy or for which no standard treatment option exists; no therapy within 4 weeks
prior to entering the study; age greater than or equal to 18 years; Eastern Cooperative
Oncology Group (ECOG) less than or equal to 2; life expectancy > 3 months; and adequate organ
and marrow function. Patients entering on the expansion cohort at the MTD must have disease
amenable to biopsy with willingness to undergo pre- and post-treatment biopsies.
Study Design:
- This study will follow a modified accelerated titration design (Simon et al., 1997).
- The accelerated phase ends when 1 patient experiences a dose-limiting toxicity or 2
patients experience Grade 2 drug-related toxicity during the first cycle; after which
the study will follow the standard 3 + 3 design.
- PU-H71 will be administered intravenously over one hour, once weekly, 2 weeks out of 3,
(i.e., on days 1 and 8) every 21 days.
- Pharmacokinetics (PK) and pharmacodynamics (PD) studies will be conducted during cycle
1. Up to 10 additional patients will be entered at the MTD to further define toxicity
and perform PD studies at this dose; pre- and post-treatment tumor biopsies will be
mandatory for these patients.
- Computed tomography (CT) scans will be performed at baseline and every 2 cycles (6
weeks) for restaging.
- Up to 100 patients may be treated.
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