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Protocol Details

Phase I Trial of the Combination of Nilotinib and Paclitaxel in Adults and Pediatric Patients with Refractory Solid Tumors

This study is currently recruiting participants.

Summary | Eligibility | Citations | Contacts

Summary

Number

15-C-0086

Sponsoring Institute

National Cancer Institute (NCI)

Recruitment Detail

Type: Participants currently recruited/enrolled
Gender: Male & Female
Min Age: 12 Years
Max Age: 120 Years

Referral Letter Required

No

Population Exclusion(s)

None

Keywords

Drug Efflux;
Taxanes;
Combination;
Bcr-Abl Kinase Inhibitors;
Neoplasms

Recruitment Keyword(s)

None

Condition(s)

Solid Tumors

Investigational Drug(s)

None

Investigational Device(s)

None

Intervention(s)

Drug: Nilotinib + Paclitaxel

Supporting Site

National Cancer Institute

Background:

- Researchers want to find better ways to treat cancer. One drug that treats cancer is paclitaxel. Sometimes proteins block that drug from working. Researchers want to see if another drug, nilotinib, helps paclitaxel work better.

Objective:

- To test the safety of nilotinib plus paclitaxel and find out what doses of the drugs can be given safely to people.

Eligibility:

- Adults at least 18 years old with advanced cancer that has progressed after receiving standard treatment, or for which no effective therapy exists.

Design:

- Participants will be screened with tests they usually get in their cancer care: medical history, physical exam, blood and urine tests, heart test, and scans.

- Participants will take the two study drugs in 28-day cycles. They will keep a medicine diary.

- Nilotinib will be taken by mouth twice every day except day 1 of the first cycle.

- Paclitaxel will be given by IV once a week for the first 3 weeks of a cycle. This will usually be done at the clinic.

- Most participants will have a weekly study visit every week for cycle 1, then the first 3 weeks of other cycles. They will have:

- Physical exam at every visit.

- Blood tests multiple times for cycle 1, then the first 3 weeks of other cycles.

- Scans every 8 weeks. These may be CT or MRI scans, in a machine that takes pictures. Or they may be ultrasounds, where a wand is pressed on the skin with gel on it.

- Around 30 days after stopping the study drugs, participants will be called to discuss any side effects.

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Eligibility

INCLUSION CRITERIA:

-Patients must have histologically confirmed solid tumors that have progressed on standard therapy known to prolong survival or for which no standard treatment options exist.

-Age greater than or equal to 12 years.

-ECOG performance status less than or equal to 2.

-Life expectancy of greater than 3 months

-Patients must have normal organ and marrow function as defined below:

--Absolute neutrophil count greater than or equal to 1,500/mcL

--Platelets greater than or equal to 100,000/mcL

--Total bilirubin less than or equal to 1.5 X institutional ULN (with the exception of those with Gilbert syndrome, who must have total bilirubin <=3 X institutional ULN)

--AST(SGOT)/ALT(SGPT) less than or equal to 3 X institutional upper limit of normal; 5.0 x ULN in patients with liver metastases

--creatinine less than or equal to 1.5 X institutional ULN OR

--creatinine clearance greater than or equal to 60 mL/min/1.73 m2 for patients with creatinine levels greater than 1.5 mg/dL

-Nilotinib and paclitaxel have both been assigned to pregnancy category D by the FDA. For this reason, women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation and for at least 3 months after dosing with study drugs ceases. Should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately. Men treated or enrolled on this protocol must also agree to use adequate contraception prior to the study, for the duration of study participation, and 3 months after completion of study drug administration.

-Patients must have completed radiation therapy, or major surgery greater than or equal to 3 weeks, or biologic therapy or chemotherapy greater than or equal to 5 half-lives or 3 weeks, whichever is shorter (6 weeks for nitrosoureas and mitomycin C) prior to entering the study. Patients must be greater than or equal to 2 weeks since any prior administration of a study drug in a Phase 0 or equivalent study and be greater than or equal to1 week from palliative radiation therapy. Patients must have recovered to eligibility levels from prior toxicity or adverse events. Treatment with bisphosphonates is permitted.

-For the PD-expansion cohort, patients must be willing to give biopsies for research and have tumors amenable for the acceptable biopsy procedures- or in lieu of baseline biopsies, patient must have and be willing to submit at registration archival tumor biopsy tissue from a previous research study or medical care. Criteria for the submission of archival tissue are:

-Tissue must have been collected within 3 months prior to registration.

-Patient must not have received any intervening therapy for their cancer since the collection of the tumor sample.

-Tumor tissue must meet the minimum requirements

EXCLUSION CRITERIA:

-QTcF interval of less than 450 msec at study entry; congenital long QT syndrome

-Sensory/motor neuropathy less than or equal to Grade 2

-Patients who are receiving any other investigational agents.

-Patients with active brain metastases or carcinomatous meningitis are excluded from this clinical trial. Patients with treated brain metastases, whose brain metastatic disease has remained stable for less than or equal to 4 weeks without requiring steroid and anti-seizure medication are eligible to participate.

-History of allergic reactions attributed to compounds of similar chemical or biologic composition to study drugs.

-Uncontrolled intercurrent illness including, but not limited to, serious untreated infection, symptomatic respiratory failure/congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.

-Pregnant women are excluded from this study because nilotinib and paclitaxel have been assigned to pregnancy category D by the FDA. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with the study drugs, breastfeeding should be discontinued prior to the first dose of study drug and women should refrain from nursing throughout the treatment period and for 3 months following the last dose of study drug.

-HIV-positive patients on combination antiretroviral therapy are ineligible because of possible PK interactions with study drugs.

-Both men and women of all races and ethnic groups are eligible for this trial.


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Citations:

Kummar S, Chen HX, Wright J, Holbeck S, Millin MD, Tomaszewski J, Zweibel J, Collins J, Doroshow JH. Utilizing targeted cancer therapeutic agents in combination: novel approaches and urgent requirements. Nat Rev Drug Discov. 2010 Nov;9(11):843-56. doi: 10.1038/nrd3216. Epub 2010 Oct 29.

Tiwari AK, Sodani K, Dai CL, Abuznait AH, Singh S, Xiao ZJ, Patel A, Talele TT, Fu L, Kaddoumi A, Gallo JM, Chen ZS. Nilotinib potentiates anticancer drug sensitivity in murine ABCB1-, ABCG2-, and ABCC10-multidrug resistance xenograft models. Cancer Lett. 2013 Jan 28;328(2):307-17. doi: 10.1016/j.canlet.2012.10.001. Epub 2012 Oct 9.

Shen T, Kuang YH, Ashby CR, Lei Y, Chen A, Zhou Y, Chen X, Tiwari AK, Hopper-Borge E, Ouyang J, Chen ZS. Imatinib and nilotinib reverse multidrug resistance in cancer cells by inhibiting the efflux activity of the MRP7 (ABCC10). PLoS One. 2009 Oct 20;4(10):e7520. doi: 10.1371/journal.pone.0007520. Erratum in: PLoS One. 2009;4(11). doi: 10.1371/annotation/e57b4610-9029-48db-9d57-5cc0fa35b8ac.

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Contacts:

Principal Investigator

Referral Contact

For more information:

Alice P. Chen, M.D.
National Cancer Institute (NCI)
NIHBC 10 - CLINICAL CENTER BG RM 8D53
10 CENTER DR
BETHESDA MD 20892
(240) 781-3320
chenali@mail.nih.gov

DTC Referral Coordinators
National Cancer Institute (NCI)

(240) 781-3499
dtcreferralcoordinators@nih.gov

NCI Referral Office
National Institute of Health Clinical Center (CC), 9000 Rockville Pike, Bethesda, Maryland 20892, United States: NCI Clinical Trials Referral Office
1-888-NCI-1937

Clinical Trials Number:

NCT02379416

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