Phenylbutyrate in Treating Patients With Refractory Solid Tumors or Lymphoma

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
National Cancer Institute (NCI)
ClinicalTrials.gov Identifier:
NCT00002909
First received: November 1, 1999
Last updated: February 4, 2013
Last verified: February 2001
  Purpose

Phase I trial to study the effectivenes of phenylbutyrate in treating adults with refractory solid tumor or lymphoma. Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die.


Condition Intervention Phase
Lymphoma
Unspecified Adult Solid Tumor, Protocol Specific
Drug: chemotherapy
Drug: oral sodium phenylbutyrate
Phase 1

Study Type: Interventional
Study Design: Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A PHASE I CLINICAL AND PHARMACOLOGIC EVALUATION OF PHENYLBUTYRATE IN PATIENTS WITH REFRACTORY SOLID TUMORS: STUDY OF CONTINUOUS EXPOSURE ORAL PHENYLBUTYRATE ON A THREE TIMES DAILY SCHEDULE

Resource links provided by NLM:


Further study details as provided by National Cancer Institute (NCI):

Enrollment: 24
Study Start Date: February 1997
Primary Completion Date: October 2000 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Arm I
All patients receive oral phenylbutyrate three times daily. Groups of 4 or more patients receive escalating doses of phenylbutyrate until the maximum tolerated dose (MTD) is determined. Treatment continues until disease progression or unacceptable toxicity intervenes.
Drug: chemotherapy Drug: oral sodium phenylbutyrate

Detailed Description:

OBJECTIVES:

I. Determine the maximum tolerated dose of oral phenylbutyrate that can be given three times daily in patients with refractory solid tumors or lymphoma until disease progression or a trough plasma concentration of 2-6 micromoles per liter is achieved.

II. Characterize the pharmacokinetics of oral phenylbutyrate absorption, and determine whether there is time dependence in the systemic clearance rate during multiple dosing.

III. Seek preliminary evidence of therapeutic activity of phenylbutyrate when administered on this schedule in these patients.

IV. Correlate any observed responses and toxic effects with results of bioassays and tissue sampling for phenylbutyrate activity.

OUTLINE: This is a dose-seeking study.

All patients receive oral phenylbutyrate three times daily. Groups of 4 or more patients receive escalating doses of phenylbutyrate until the maximum tolerated dose (MTD) is determined. Treatment continues until disease progression or unacceptable toxicity intervenes.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Histologically or cytologically confirmed solid tumor or lymphoma that is progressive or refractory to conventional therapy or for which no effective therapy is known
  • Priority given to hormone-refractory prostate cancer and melanoma
  • No untreated CNS metastases
  • Head CT not required in the absence of clinical signs or symptoms but recommended for metastatic melanoma

PATIENT CHARACTERISTICS:

  • Age: 18 and over
  • Performance status: ECOG 0-2
  • Life expectancy: At least 3 months
  • WBC greater than 2,000/mm3 OR absolute neutrophil count greater than 1,500/mm3
  • Platelet count greater than 100,000/mm3
  • Hemoglobin greater than 9 g/dL
  • Bilirubin less than 1.5 mg/dL
  • AST/ALT less than 1.5 times normal
  • Creatinine less than 2.0 mg/dL
  • Obstructive uropathy allowed if relieved by nephrostomy or other appropriate device
  • Left ventricular ejection fraction greater than 40% by MUGA or normal by echocardiogram
  • No history of congestive heart failure
  • No uncontrolled hypertension (diastolic greater than 110 mm Hg)
  • Forced expiratory volume (1 second) greater than 1.5 L/min
  • No active infection, including HIV or viral hepatitis
  • No active seizure disorder
  • No clinical evidence of increased intracranial pressure
  • No baseline dementia (mini-mental exam less than 23)
  • No autoimmune disease, including systemic lupus erythematosus, scleroderma, or other connective tissue illness
  • No nonmalignant medical or psychiatric problem of sufficient severity to limit full compliance with study or to pose undue risk
  • Not pregnant or nursing
  • Adequate contraception required of fertile patients for 2 weeks prior to, during, and for 3 months after study
  • Normal gastrointestinal function with ability to tolerate large intake of oral volume required for phenylbutyrate administration
  • Patients with persistent nausea or moderate to severe anorexia may not be good candidates for study

PRIOR CONCURRENT THERAPY:

  • Fully recovered from all prior therapy
  • Prior suramin allowed if serum suramin level less than 50 micrograms/mL at entry
  • At least 28 days since chemotherapy
  • No prior phenylacetate, phenylbutyrate, or antineoplaston therapy
  • The following may be continued during study:
  • Luteinizing hormone-releasing hormone agonist with evidence of tumor progression (e.g., rising prostate-specific antigen, new lesions on bone scan) despite therapy
  • Adrenal steroid replacement (if needed)
  • Dexamethasone or other steroids
  • At least 4-6 weeks since flutamide with evidence of PSA progression required (if possible)
  • At least 28 days since radiotherapy
  • At least 28 days since major surgery
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00002909

Locations
United States, Maryland
Johns Hopkins Oncology Center
Baltimore, Maryland, United States, 21287
Sponsors and Collaborators
Investigators
Study Chair: Michael A. Carducci, MD Sidney Kimmel Comprehensive Cancer Center
  More Information

Additional Information:
Publications:
Carducci M, Bowling MK, Eisenberger M, et al.: Phenylbytyrate (PB) for refractory solid tumors: Phase I evaluation of continuous oral PB exposure. [Abstract] Proc Am Assoc Cancer Res 39: A507, 1998.

Responsible Party: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00002909     History of Changes
Other Study ID Numbers: NCI-2012-02250, J-9616, JHOC-9616, NCI-T95-0017H, CDR0000065274
Study First Received: November 1, 1999
Last Updated: February 4, 2013
Health Authority: United States: Food and Drug Administration

Keywords provided by National Cancer Institute (NCI):
stage III adult Hodgkin lymphoma
stage IV adult Hodgkin lymphoma
recurrent adult Hodgkin lymphoma
unspecified adult solid tumor, protocol specific
stage III grade 1 follicular lymphoma
stage III grade 2 follicular lymphoma
stage III grade 3 follicular lymphoma
stage III adult diffuse small cleaved cell lymphoma
stage III adult diffuse mixed cell lymphoma
stage III adult diffuse large cell lymphoma
stage III adult immunoblastic large cell lymphoma
stage III adult lymphoblastic lymphoma
stage III adult Burkitt lymphoma
stage IV grade 1 follicular lymphoma
stage IV grade 2 follicular lymphoma
stage IV grade 3 follicular lymphoma
stage IV adult diffuse small cleaved cell lymphoma
stage IV adult diffuse mixed cell lymphoma
stage IV adult diffuse large cell lymphoma
stage IV adult immunoblastic large cell lymphoma
stage IV adult lymphoblastic lymphoma
stage IV adult Burkitt lymphoma
recurrent grade 1 follicular lymphoma
recurrent grade 2 follicular lymphoma
recurrent grade 3 follicular lymphoma
recurrent adult diffuse small cleaved cell lymphoma
recurrent adult diffuse mixed cell lymphoma
recurrent adult diffuse large cell lymphoma
recurrent adult immunoblastic large cell lymphoma
recurrent adult lymphoblastic lymphoma

Additional relevant MeSH terms:
Lymphoma
Neoplasms
Immune System Diseases
Immunoproliferative Disorders
Lymphatic Diseases
Lymphoproliferative Disorders
Neoplasms by Histologic Type
4-phenylbutyric acid
Antineoplastic Agents
Pharmacologic Actions
Therapeutic Uses

ClinicalTrials.gov processed this record on October 20, 2014