Erlotinib and Temozolomide in Treating Young Patients With Recurrent or Refractory Solid Tumors

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
National Cancer Institute (NCI)
ClinicalTrials.gov Identifier:
NCT00077454
First received: February 10, 2004
Last updated: June 4, 2013
Last verified: June 2013
  Purpose

This phase I trial is studying the side effects and best dose of erlotinib when given with temozolomide in treating young patients with recurrent or refractory solid tumors. Erlotinib may stop the growth of tumor cells by blocking the enzymes necessary for their growth. Drugs used in chemotherapy, such as temozolomide, work in different ways to stop tumor cells from dividing so they stop growing or die. Giving erlotinib with temozolomide may kill more tumor cells.


Condition Intervention Phase
Previously Treated Childhood Rhabdomyosarcoma
Recurrent Childhood Brain Tumor
Recurrent Childhood Cerebellar Astrocytoma
Recurrent Childhood Cerebral Astrocytoma
Recurrent Childhood Ependymoma
Recurrent Childhood Malignant Germ Cell Tumor
Recurrent Childhood Medulloblastoma
Recurrent Childhood Rhabdomyosarcoma
Recurrent Childhood Soft Tissue Sarcoma
Recurrent Childhood Supratentorial Primitive Neuroectodermal Tumor
Recurrent Neuroblastoma
Recurrent Osteosarcoma
Drug: erlotinib hydrochloride
Drug: temozolomide
Other: pharmacological study
Other: laboratory biomarker analysis
Phase 1

Study Type: Interventional
Study Design: Endpoint Classification: Safety Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Phase I Study of Single Agent OSI-774 (Tarceva) (NSC# 718781, IND# 63383) Followed by OSI-774 With Temozolomide for Patients With Selected Recurrent/Refractory Solid Tumors, Including Brain Tumors

Resource links provided by NLM:


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

Primary Outcome Measures:
  • Dose-limiting toxicity (DLT) as assessed by the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 3.0 [ Time Frame: 56 days (2 courses) ] [ Designated as safety issue: Yes ]
  • Maximum-tolerated dose (MTD) based on the incidence of DLT as assessed by NCI CTCAE version 3.0 [ Time Frame: 56 days (2 courses) ] [ Designated as safety issue: Yes ]
  • Pharmacokinetics of erlotinib hydrochloride [ Time Frame: At baseline and at 0.5, 1, 2, 4, 6, 8, and 24 hours of course 1 ] [ Designated as safety issue: No ]

Enrollment: 95
Study Start Date: February 2004
Primary Completion Date: September 2007 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Treatment (erlotinib hydrochloride, temozolomide)
Patients receive oral erlotinib once daily on days 1-28. Beginning with course 2, patients also receive oral temozolomide once daily on days 1-5. Treatment repeats every 28 days for up to 23 courses in the absence of disease progression or unacceptable toxicity.
Drug: erlotinib hydrochloride
Given orally (PO)
Other Names:
  • CP-358,774
  • erlotinib
  • OSI-774
Drug: temozolomide
Given PO
Other Names:
  • SCH 52365
  • Temodal
  • Temodar
  • TMZ
Other: pharmacological study
Correlative studies
Other Name: pharmacological studies
Other: laboratory biomarker analysis
Correlative studies

Detailed Description:

PRIMARY OBJECTIVES:

I. Determine the maximum tolerated dose of erlotinib in children with recurrent or refractory solid tumors.

II. Determine the dose-limiting toxic effects of this drug alone and with temozolomide in these patients.

III. Determine the tolerability of this regimen in these patients. IV. Determine the pharmacokinetics of this regimen in these patients.

SECONDARY OBJECTIVES:

I. Determine, preliminarily, the antitumor activity of this regimen in these patients.

OUTLINE: This is a 2-part, multicenter, dose-escalation study of erlotinib. Patients are stratified according to pretreatment (heavily pretreated [received more than 2 prior multiagent myelosuppressive chemotherapy regimens OR received prior craniospinal or pelvic radiotherapy or bone marrow transplantation OR has bone marrow involvement] vs less heavily pretreated).Part 1:

Patients receive oral erlotinib once daily on days 1-28. Beginning with course 2, patients also receive oral temozolomide once daily on days 1-5. Treatment repeats every 28 days for up to 23 courses in the absence of disease progression or unacceptable toxicity.

Cohorts of 3-6 patients receive escalating doses of erlotinib during course 1 only 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.

Part 2: Patients receive erlotinib (at the MTD) and temozolomide as in part 1.

PROJECTED ACCRUAL: A total of 9-45 patients (9-24 for part 1 and up to 21 for part 2) will be accrued for this study.

  Eligibility

Ages Eligible for Study:   up to 21 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • One of the following histologically confirmed solid tumors:

    • Brain tumors
    • Osteogenic sarcoma
    • Rhabdomyosarcoma
    • Soft tissue sarcoma (excluding Ewing's sarcoma)
    • Neuroblastoma
    • Germ cell tumors
  • Recurrent or refractory disease
  • No known curative therapy exists
  • Performance status - Karnofsky 50-100% (for patients age 11 to 21)
  • Performance status - Lansky 50-100% (for patients age 10 and under)
  • At least 8 weeks
  • Absolute neutrophil count > 1,000/mm^3
  • Platelet count > 100,000/mm^3 (transfusion independent*)
  • Hemoglobin > 8.0 g/dL (transfusion allowed)
  • Bilirubin < 1.5 times upper limit of normal (ULN)
  • ALT < 2.5 times ULN
  • Albumin ≥ 2 g/dL
  • Creatinine clearance or radioisotope glomerular filtration rate at least 70 mL/min
  • Creatinine based on age as follows:

    • ≤ 0.8 mg/dL for patients age 5 and under
    • ≤ 1.0 mg/dL for patients 6 to 10
    • ≤ 1.2 mg/dL for patients 11 to 15
    • ≤ 1.5 mg/dL for patients age 15 to 21
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • Able to swallow tablets (for patients in part 2 only)
  • No uncontrolled infection
  • Recovered from all prior immunotherapy
  • At least 7 days since prior biologic therapy
  • At least 3 months since prior stem cell transplantation and no evidence of active graft-versus-host disease
  • More than 1 week since prior growth factors
  • No concurrent prophylactic growth factor therapy
  • No concurrent immunotherapy
  • No concurrent biologic therapy
  • More than 2 weeks since prior myelosuppressive chemotherapy (4 weeks for nitrosoureas) and recovered
  • No other concurrent chemotherapy
  • No concurrent systemic corticosteroids except for treatment of increased intracranial pressure or symptomatic tumor edema in patients with CNS tumors

    • No concurrent steroids as an antiemetic
  • Concurrent dexamethasone for patients with CNS tumors allowed provided patient has been on a stable or decreasing dose for at least 1 week before study entry
  • Recovered from all prior radiotherapy
  • At least 2 weeks since prior local palliative radiotherapy (small port)
  • At least 6 weeks since prior substantial bone marrow irradiation
  • At least 6 months since prior craniospinal radiotherapy
  • At least 6 months since prior radiotherapy to 50% or more of the pelvis
  • At least 8 weeks since prior standard-fraction radiotherapy for patients with recurrent brain tumors unless there is biopsy proof of recurrent tumor
  • Prior radiosurgery within the past 9 months allowed provided there is documentation of progressive disease by biopsy, positron-emission tomography (PET) scan, or MR spectroscopy
  • No concurrent radiotherapy
  • More than 1 week since prior CYP3A4 inhibitors
  • More than 4 weeks since prior CYP3A4 inducers
  • More than 5 days since prior proton-pump inhibitors
  • More than 2 days since prior H_2 blockers
  • No prior erlotinib
  • No concurrent enzyme-inducing anticonvulsants
  • No concurrent proton-pump inhibitors
  • No concurrent H2 blockers
  • No other concurrent investigational agents
  • Concurrent antacids allowed provided the antacid is not administered 2 hours before, during, and 2 hours after erlotinib administration
  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: NCT00077454

Locations
United States, California
COG Phase I Consortium
Arcadia, California, United States, 91006-3776
Sponsors and Collaborators
Investigators
Principal Investigator: Regina Jakacki COG Phase I Consortium
  More Information

No publications provided

Responsible Party: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00077454     History of Changes
Obsolete Identifiers: NCT00089934
Other Study ID Numbers: NCI-2012-01808, ADVL0214, CDR0000350336, COG-ADVL0214, NCI-04-C-0256, U01CA097452
Study First Received: February 10, 2004
Last Updated: June 4, 2013
Health Authority: United States: Food and Drug Administration

Additional relevant MeSH terms:
Astrocytoma
Brain Neoplasms
Ependymoma
Medulloblastoma
Neuroblastoma
Osteosarcoma
Rhabdomyosarcoma
Neoplasms, Germ Cell and Embryonal
Neuroectodermal Tumors
Neuroectodermal Tumors, Primitive
Rhabdomyosarcoma, Embryonal
Sarcoma
Glioma
Neoplasms, Neuroepithelial
Neoplasms by Histologic Type
Neoplasms
Neoplasms, Glandular and Epithelial
Neoplasms, Nerve Tissue
Central Nervous System Neoplasms
Nervous System Neoplasms
Neoplasms by Site
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases
Neuroectodermal Tumors, Primitive, Peripheral
Neoplasms, Bone Tissue
Neoplasms, Connective Tissue
Neoplasms, Connective and Soft Tissue
Myosarcoma
Neoplasms, Muscle Tissue

ClinicalTrials.gov processed this record on August 01, 2014