Non Hodgkin Lymphoma Clinical Trial
AMG 706 and Gemcitabine in Treating Patients With Advanced Solid Tumors or Lymphoma
Summary
RATIONALE: AMG 706 may stop the growth of cancer cells by blocking blood flow to the cancer or by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as gemcitabine, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Giving AMG 706 together with gemcitabine may kill more cancer cells.
PURPOSE: This phase I trial is studying the side effects and best dose of AMG 706 when given together with gemcitabine in treating patients with advanced solid tumors or lymphoma.
Full Description
OBJECTIVES:
Primary
Determine the maximum tolerated dose and safety of AMG 706 when given in combination with gemcitabine hydrochloride in patients with advanced solid tumors or lymphoma.
Secondary
Determine the pharmacokinetic profiles of this regimen in these patients.
OUTLINE: This is a multicenter, open-label, dose-escalation study of AMG 706.
Patients receive oral AMG 706 once daily on days 2-56 and gemcitabine hydrochloride IV over 30 minutes on days 1, 8, 15, 22, 29, 36, and 43 of course 1. For all subsequent courses, patients receive oral AMG 706 on days 1-28 and gemcitabine hydrochloride IV over 30 minutes on days 1, 8, and 15. Treatment repeats every 4 weeks for up to 10 courses in the absence of disease progression or unacceptable toxicity.
Cohorts of 3-6 patients receive escalating doses of AMG 706 until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 3 of 6 patients experience dose-limiting toxicity.
During the first course of study treatment, patients undergo blood collection periodically for pharmacokinetic analysis.
After completion of study treatment, patients are followed periodically for up to 5 years.
PROJECTED ACCRUAL: Approximately 18 patients will be accrued for this study.
Eligibility Criteria
DISEASE CHARACTERISTICS:
Histologically or cytologically confirmed advanced solid tumors or lymphoma
Must have measurable disease outside a previously irradiated field OR regrowth of tumor within a previously irradiated field
Must be a candidate for gemcitabine hydrochloride treatment, in the opinion of the investigator
No untreated or symptomatic brain metastases
No tumors with direct bowel invasion
No other hematological malignancies
No non-small cell lung cancer of squamous cell histology or large central tumor (lesions ≥ 3 cm and located adjacent to or within the hilum or mediastinum)
PATIENT CHARACTERISTICS:
ECOG performance status 0-2
Not pregnant
No nursing during and for 6 months after completion of study treatment
Fertile patients must use effective contraception during and for 6 months after completion of study treatment
Negative pregnancy test
Able to swallow oral medication
Absolute neutrophil count ≥ 1,500/mm^3
Platelet count ≥ 100,000/mm^3
Hemoglobin ≥ 9 g/dL
Creatinine ≤ 2.0 mg/dL OR creatinine clearance ≥ 40 mL/min
Albumin-adjusted calcium ≥ 8 mg/dL
Urine protein < 30 mg/dL by urinalysis or < 1+ by dipstick OR < 500 mg by 24-hour urine collection
AST or ALT ≤ 2.5 times upper limit of normal (ULN) (5.0 times ULN in the presence of liver metastasis or primary hepatic neoplasm)
Bilirubin ≤ 2 times ULN
PT ≤ 2.0
INR or PTT ≤ 1.5 times ULN
Systolic blood pressure (BP) ≤ 145 mm Hg and diastolic BP ≤ 85 mm Hg (stable antihypertensive medication allowed)
No myocardial infraction within the past year
No arterial thrombosis or deep vein thrombosis within the past year
No unstable angina
No congestive heart failure
No New York Heart Association class III-IV cardiac disease
No other unstable or uncontrolled disease or condition relating to or impacting cardiac function
No HIV positivity
No other condition that would preclude study participation, compliance, or follow-up assessments
PRIOR CONCURRENT THERAPY:
See Disease Characteristics
No prior enrollment into this study
At least 1 month since prior investigational device or drug trial
At least 1 month since prior major surgical procedure
At least 3 weeks since prior systemic chemotherapy
At least 2 weeks since prior radiotherapy
At least 2 weeks since prior rifampin or phenobarbital
At least 1 week since prior treatment with any of the following:
Ketoconazole
Itraconazole
Clarithromycin
Erythromycin
Cyclosporine or tacrolimus
Nefazodone
Herbal medications containing Hypericum perforatum (St. John's wort)
At least 1 week since prior and no concurrent warfarin
Concurrent prophylactic anticoagulation therapy (e.g., low-dose warfarin [≤ 2 mg/day] or low molecular weight heparin) for venous or arterial access devices allowed
No prior or concurrent kinase insert domain-receptor inhibitors
No concurrent chemotherapy, radiotherapy, hormone-directed cancer therapy, or tumor-directed antibody therapy
Gonadotropin releasing-hormone agonist therapy allowed
No concurrent interferon
No concurrent grapefruit juice or whole grapefruit
No other concurrent standard or investigational drugs or antitumor treatment, including c-kit, platelet-derived growth factor, vascular endothelial growth factor, or epidermal growth factor inhibitors
No elective surgery during or for 2 weeks after completion of the last dose of AMG 706
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There is 1 Location for this study
Los Angeles California, 90095, United States
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