Lung Neoplasms Clinical Trial
Official title:
A Clinical Trial of the P-Glycoprotein Antagonist, Tariquidar (XR9576), in Combination With Docetaxel in Patients With Lung, Ovarian, Renal and Cervical Cancer: Analysis of the Interaction Between Tariquidar and Docetaxel
The purpose of this study is three-fold: 1) to examine the ability of the experimental drug
tariquidar to improve chemotherapy results by blocking a protein (P-glycoprotein) on some
cancer cells that acts to pump out cancer drugs; 2) examine how tariquidar interacts with
the cancer drug docetaxel; and 3) evaluate the effectiveness of combination treatment with
tariquidar and docetaxel in treating patients with lung, ovarian, or cervical cancer.
Patients 18 years of age and older with recurrent or metastatic (spreading) lung, cervical,
or ovarian cancer who cannot benefit from any standard treatment may be eligible for this
study. Candidates will be screened with a medical history and physical examination; review
of pathology slides; blood and urine tests; imaging tests, including computed tomography
(CT) or magnetic resonance imaging (MRI) scans; chest x-ray, electrocardiogram (EKG); and
possibly echocardiogram.
Participants will undergo the following tests and procedures:
Blood draw. Blood is drawn before treatment begins to establish baseline levels for future
blood tests. Blood counts are done twice weekly after chemotherapy begins.
Central venous catheter placement. A plastic tube is put into a major vein in the chest. It
is used to give the study drugs or other medications, including antibiotics and blood
transfusions, if needed, and to withdraw blood samples. The line is usually placed under
local anesthesia in the radiology department or the operating room. It can stay in the body
for months or be removed after each treatment is completed.
Chemotherapy. Treatment cycles are 21 days. Both drugs are given on day 1 of each cycle.
First, tariquidar is given as a 30-minute infusion. One hour after the tariquidar infusion,
docetaxel is infused over 1 hour. (For the first cycle only, docetaxel is given in divided
doses one week apart and tariquidar is administered on either day 1 or day 8. The order of
tariquidar administration is randomized to generate optimal pharmacokinetic data. Patients
will be hospitalized for several days during this cycle to gather research data). The
tariquidar dose remains the same throughout the study. Docetaxel may be increased or
decreased from cycle to cycle, based on side effects.
Intrinsic and acquired drug resistance remain major obstacles in the treatment of cancer. Accumulating evidence indicates that in some malignancies P-glycoprotein (Pgp) can confer resistance, and that its reversal can improve therapeutic outcome. Clinical trials investigating Pgp antagonists have been hampered by the occurrence of unpredictable pharmacokinetic interactions, which have required dose reductions of the chemotherapeutic agents to avert excessive toxicity. Tariquidar (XR9576) is a new Pgp antagonist that is more potent and has prolonged activity. Phase I trials with paclitaxel, vinorelbine, and docetaxel have demonstrated that tariquidar (XR9576) has minimal pharmacokinetic interactions while surrogate studies have confirmed in vivo inhibition of Pgp-mediated drug transport.This study seeks to determine the pharmacokinetic interaction, if any between docetaxel and tariquidar and to evaluate the potential for activity in lung, ovarian, primary peritoneal, fallopian tube and cervical cancers. Renal cell cancer has been added in a 3/1/06 amendment. The secondary goal is to evaluate the impact of tariquidar on uptake of (99m)Tc-sestamibi in recurrent or metastatic tumors of patients with lung, ovarian, renal or cervical cancer. ;
Allocation: Randomized, Endpoint Classification: Pharmacokinetics Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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