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Talabostat Combined With Temozolomide or Carboplatin in Treating Young Patients With Relapsed or Refractory Brain Tumors or Other Solid Tumors

This study has been completed.
Sponsor:
Collaborator:
Information provided by:
National Institutes of Health Clinical Center (CC)
ClinicalTrials.gov Identifier:
NCT00303940
First received: March 15, 2006
Last updated: March 14, 2012
Last verified: March 2012
  Purpose

RATIONALE: Talabostat may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as temozolomide and carboplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving talabostat together with temozolomide or carboplatin may kill more tumor cells.

PURPOSE: This phase I trial is studying the side effects and best dose of talabostat when given together with temozolomide or carboplatin in treating young patients with relapsed or refractory brain tumors or other solid tumors.


Condition Intervention Phase
Brain and Central Nervous System Tumors
Childhood Germ Cell Tumor
Kidney Cancer
Liver Cancer
Neuroblastoma
Ovarian Cancer
Sarcoma
Unspecified Childhood Solid Tumor, Protocol Specific
Drug: carboplatin
Drug: talabostat mesylate
Drug: temozolomide
Other: pharmacological study
Phase 1

Study Type: Interventional
Study Design: Primary Purpose: Treatment
Official Title: A Phase I Trial and Pharmacokinetic Study of Talabostat (PT-100, Val-Boro-Pro) in Combination With Temozolomide or Carboplatin in Pediatric Patients With Relapsed or Refractory Solid Tumors Including Brain Tumors

Resource links provided by NLM:


Further study details as provided by National Institutes of Health Clinical Center (CC):

Estimated Enrollment: 26
Study Start Date: December 2005
Study Completion Date: February 2010
Detailed Description:

OBJECTIVES:

Primary

  • Determine the dose of talabostat, when used in combination with either temozolomide or carboplatin, at which maximum plasma dipeptidyl peptidase IV enzyme inhibition is achieved (in the absence of talabostat-related dose-limiting toxicity) in pediatric patients with refractory or relapsed solid tumors, including brain tumors.
  • Determine the maximum tolerated dose of talabostat, when used in combination with temozolomide or carboplatin in pediatric patients, if dose-limiting toxicity attributed to talabostat is observed.
  • Define the toxicity profile of talabostat when used in combination with temozolomide or carboplatin.
  • Describe the pharmacokinetic profile of talabostat in pediatric patients.

Secondary

  • Study levels, at baseline and after drug administration, of serum cytokines (interleukin [IL]-2, IL-6, IL-10, filgrastim [G-CSF], tumor necrosis factor-α, IL-1β, IL-8, IP10, and thrombospondin) that may be important in the immune-mediated antitumor effect of talabostat.
  • Evaluate the antitumor effect of talabostat in combination with temozolomide or carboplatin on pediatric solid tumors by direct assessment of tumor response.
  • Study the effect of talabostat on neutrophil function.
  • Evaluate the expression of fibroblast activation protein (FAP) in pediatric tumors using immunohistochemistry to detect FAP in paraffin-embedded tissue sections from existing tumor specimens, when available.

OUTLINE: This is a dose-escalation study of talabostat. Patients are stratified according to tumor histology and prior therapy.

Based on stratification, patients receive either oral temozolomide on days 1-5 or carboplatin IV over 30 minutes on days 1-2. Patients also receive oral talabostat on days 7-20. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity. (Closed to accrual as of 5/25/2009)

Cohorts of 2-6 patients receive escalating doses of talabostat until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 6 or < 4 of 12 patients experience dose-limiting toxicity during the first course of therapy.

PROJECTED ACCRUAL: A total of 26 patients will be accrued for this study.

  Eligibility

Ages Eligible for Study:   2 Years to 18 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Histologically confirmed solid tumors, including, but not limited to, any of the following:

    • Rhabdomyosarcoma and other soft tissue sarcomas
    • Ewing's sarcoma family of tumors
    • Osteosarcoma
    • Neuroblastoma
    • Wilms' tumor
    • Hepatic tumors
    • Germ cell tumors
    • Primary brain tumors

      • In patients with brainstem or optic gliomas, requirement for histological confirmation can be waived if biopsy was not performed

        • Patients with brainstem gliomas that did not respond to therapy but that are without radiographic evidence of disease progression must have clinical evidence of progression
      • Patients with brain tumors must be on stable or tapering dose of corticosteroids for 7 days prior to study entry
  • Measurable or evaluable disease
  • Relapsed or failed to respond to frontline curative therapy, including any of the following:

    • Surgery
    • Radiotherapy
    • Chemotherapy
    • Combination of modalities
  • No other potentially curative treatment options available

PATIENT CHARACTERISTICS:

  • ECOG performance status 0-2
  • Absolute neutrophil count ≥ 1,500/mm^3
  • Hemoglobin ≥ 8 mg/dL
  • Platelet count ≥ 100,000/mm^3 (platelet transfusion independent)
  • Bilirubin ≤ 1.5 times upper limit of normal (ULN)
  • SGPT ≤ 2.5 times ULN
  • Creatinine clearance ≥ 60 mL/min OR age-adjusted creatinine* as follows:

    • No more than 0.8 mg/dL (for patients ≤ 5 years of age)
    • No more than 1.0 mg/dL (for patients 6 to 10 years of age)
    • No more than 1.2 mg/dL (for patients 11 to 15 years of age)
    • No more than 1.5 mg/dL (for patients > 15 years of age) NOTE: *For patients receiving carboplatin a nuclear glomerular filtration rate study, 24-hour urine collection, and serum creatinine for estimation of creatinine clearance is required if under 15 years of age OR serum creatinine and weight for estimation of creatinine clearance is required if 15-18 years of age
  • Patients with history of seizures eligible if seizures controlled by anticonvulsants
  • No clinically significant, unrelated systemic illness, including either of the following:

    • Serious infections
    • Hepatic, renal, or other organ dysfunction that would preclude study treatment
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No generalized pitting peripheral edema
  • No sensitivity to valine-proline boronic acid

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • Recovered to ≤ grade 1 from the acute toxic effects of all prior chemotherapy, immunotherapy, or radiotherapy prior to study entry
  • Any number of prior chemotherapy regimens allowed
  • Prior temozolomide or carboplatin as frontline therapy or in the adjuvant setting allowed provided patient did not experience severe toxicities related to the drug and tumor progressed during this therapy
  • At least 3 weeks since last dose of all myelosuppressive chemotherapy
  • At least 7 days since last dose of anticancer biologic agents (e.g., retinoids)
  • At least 30 days since prior investigational agents
  • At least 4 weeks since prior radiotherapy to > 25% of marrow-containing bones (pelvis, spine, or skull) (2 weeks for palliative [limited-port] radiotherapy)
  • At least 2 months since prior autologous stem cell transplantation and recovered
  • At least 1 week since prior filgrastim (G-CSF), sargramostim (GM-CSF), or epoetin alfa
  • At least 2 weeks since prior pegfilgrastim
  • No history of allogeneic stem cell transplantation
  • No other concurrent anticancer chemotherapy, radiation therapy, or immunotherapy
  • No other concurrent investigational agents
  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: NCT00303940

Locations
United States, Maryland
Warren Grant Magnuson Clinical Center - NCI Clinical Trials Referral Office
Bethesda, Maryland, United States, 20892-1182
Sponsors and Collaborators
Investigators
Study Chair: Holly Meany, MD National Cancer Institute (NCI)
Principal Investigator: Elizabeth Fox, MD National Cancer Institute (NCI)
  More Information

Additional Information:
Publications:
ClinicalTrials.gov Identifier: NCT00303940     History of Changes
Obsolete Identifiers: NCT00261885
Other Study ID Numbers: 050239, 05-C-0239, NCI-P6672, CDR0000462620
Study First Received: March 15, 2006
Last Updated: March 14, 2012
Health Authority: United States: Food and Drug Administration

Keywords provided by National Institutes of Health Clinical Center (CC):
unspecified childhood solid tumor, protocol specific
recurrent childhood rhabdomyosarcoma
recurrent childhood soft tissue sarcoma
recurrent Ewing sarcoma/peripheral primitive neuroectodermal tumor
recurrent osteosarcoma
recurrent neuroblastoma
recurrent Wilms tumor and other childhood kidney tumors
recurrent childhood malignant germ cell tumor
recurrent childhood liver cancer
recurrent childhood brain stem glioma
recurrent childhood cerebellar astrocytoma
recurrent childhood cerebral astrocytoma
recurrent childhood ependymoma
recurrent childhood medulloblastoma
recurrent childhood supratentorial primitive neuroectodermal tumor
childhood atypical teratoid/rhabdoid tumor
childhood low-grade cerebral astrocytoma
childhood high-grade cerebral astrocytoma
childhood choroid plexus tumor
childhood craniopharyngioma
childhood infratentorial ependymoma
childhood supratentorial ependymoma
childhood oligodendroglioma
recurrent childhood visual pathway and hypothalamic glioma
recurrent childhood brain tumor
childhood central nervous system germ cell tumor
childhood grade I meningioma
childhood grade II meningioma
childhood grade III meningioma
childhood malignant ovarian germ cell tumor

Additional relevant MeSH terms:
Brain Neoplasms
Carcinoma, Renal Cell
Central Nervous System Neoplasms
Kidney Neoplasms
Liver Neoplasms
Neoplasms
Neoplasms, Germ Cell and Embryonal
Nervous System Neoplasms
Neuroblastoma
Ovarian Neoplasms
Sarcoma
Adenocarcinoma
Adnexal Diseases
Brain Diseases
Carcinoma
Central Nervous System Diseases
Digestive System Diseases
Digestive System Neoplasms
Endocrine Gland Neoplasms
Endocrine System Diseases
Genital Diseases, Female
Genital Neoplasms, Female
Gonadal Disorders
Kidney Diseases
Liver Diseases
Neoplasms by Histologic Type
Neoplasms by Site
Neoplasms, Connective and Soft Tissue
Neoplasms, Glandular and Epithelial
Neoplasms, Nerve Tissue

ClinicalTrials.gov processed this record on November 25, 2014