Overview

Phase I Study of Intravenous Triapine (IND # 68338) in Combination With Pelvic Radiation Therapy With or Without Weekly Intravenous Cisplatin Chemotherapy for Locally Advanced Cervical, Vaginal, or Pelvic Gynecologic Malignancies

Status:
Completed
Trial end date:
1969-12-31
Target enrollment:
0
Participant gender:
All
Summary
Drugs used in chemotherapy, such as 3-AP and cisplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. 3-AP may also stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Radiation therapy uses high-energy x-rays to kill tumor cells. 3-AP and cisplatin may make tumor cells more sensitive to radiation therapy. Giving 3-AP and external-beam radiation therapy together with cisplatin may kill more tumor cells. This phase I trial is studying the side effects and best dose of 3-AP when given together with external-beam radiation therapy with or without cisplatin in treating patients with gynecologic cancer
Phase:
Phase 1
Accepts Healthy Volunteers?
No
Details
Lead Sponsor:
National Cancer Institute (NCI)
Treatments:
Cisplatin
Criteria
Inclusion Criteria:

- Patients with pathologically-proven primary or recurrent locally advanced cervical,
vaginal, or vulvar cancers not amenable to curative surgical resection alone are
eligible

- Patients with pathologically-proven recurrent or persistent epithelial ovarian or
endometrial cancer a) not amenable to curative surgical resection alone, b) are
planned for pelvic radiotherapy, and c) are amenable to tumor biopsy through the
vaginal canal are eligible

- Patients with other active invasive malignancies are excluded; patients with prior
malignancies in remission for at least six months and not being currently treated are
eligible; patients are excluded if their previous cancer treatment as determined by
their treating physicians contraindicates this protocol therapy or if they have
received prior low abdominal or pelvic radiotherapy that would contribute radiation
dose that would exceed tolerance of normal tissues (as determined by the principal
investigator or co-investigators); for patients relapsing at least four weeks after
initial surgery or chemotherapy, they must have fully recovered from side effects of
prior treatment, have measurable disease in the pelvis; measurable lesions are defined
as those that can be accurately measured in at least one dimension (longest diameter
to be recorded) as >= 20 mm with conventional techniques (CT, MRI, x-ray or as >= 10
mm with spiral CT scan; patients with metastatic disease to extra-pelvic sites are
eligible if pelvic radiotherapy is planned as primary management of the site of pelvic
disease. There is no numerical limit on prior chemotherapy regimens previously
received

- ECOG performance status 0-2; (Karnofsky >= 50%)

- Life expectancy of greater than 3 months

- Leukocytes >= 3,000/uL

- Absolute neutrophil count >= 1,500/uL

- Platelets >= 100,000/uL

- Hemoglobin >= 10 g/dL

- Total bilirubin =< 2.0 mg/dL

- AST(SGOT)/ALT(SGPT) =< 2.5 X institutional upper limit of normal

- PT/aPTT =< 1.5 X institutional upper limit of normal

- Patients should have a serum creatinine =< 1.5mg/dL to receive weekly intravenous
cisplatin chemotherapy; patients whose serum creatinine is between 1.5 and 1.9 mg/dL
are eligible for cisplatin chemotherapy if the estimated creatinine clearance is >= 30
ml/min; for the purpose of estimating the creatinine clearance, the formula of
Jelliffe should be used: CCr = 0.9{98-[0.8(age-20)]}/Scr where CCr is the estimated
creatinine clearance, age is patient's age in years (from 20-80), and Scr is the serum
creatinine in mg/dL; patients eligible for cisplatin chemotherapy will also receive
intravenous Triapine®; patients who have refused or are not candidates for cisplatin
chemotherapy as defined above, have prior platinum adverse sensitivity, have active
neuropathy, or have intercurrent co-morbid illness as determined by treating
physicians will receive intravenous Triapine® alone with pelvic radiation; to receive
Triapine® alone with pelvic radiotherapy, patients must have a serum creatinine =<
2.0mg/dL

- The effects of Triapine® on the developing human fetus are unknown; for this reason
and because heterocyclic carboxaldehyde thiosemicarbazones as well as other
therapeutic agents used in this trial are known to be teratogenic, 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; should a woman become pregnant or suspect she is pregnant
while participating in this study, she should inform her treating physician
immediately

- Eligibility of patients receiving any medications or substances known to affect or
with the potential to affect the activity or pharmacokinetics of Triapine® will be
determined following review of their case by the Principal Investigator

- Ability to undergo and the willingness to sign a written informed consent for
placement of a PICC line or a central venous catheter

- Ability to understand and willingness to sign a written informed consent document

Exclusion Criteria:

- Patients who have had chemotherapy or radiotherapy within 4 weeks (6 weeks for
nitrosoureas or mitomycin C) prior to entering the study or those who have not
recovered from adverse events due to agents administered more than 4 weeks earlier are
excluded

- Patients may not be receiving any other investigational agents

- Patients with known brain metastases should be excluded from this clinical trial
because of their poor prognosis and because they often develop progressive neurologic
dysfunction that would confound the evaluation of neurologic and other adverse events

- History of allergic reactions attributed to compounds of similar chemical or biologic
composition to Triapine® or other agents used in study

- Patients unable to receive intravenous chemotherapies as a consequence of poor
vascular access (for example, patient receiving hemodialysis) are ineligible

- Uncontrolled intercurrent illness including, but not limited to, ongoing or active
infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac
arrhythmia, known inadequately controlled hypertension, significant pulmonary disease
including dyspnea at rest, patients requiring supplemental oxygen, or poor pulmonary
reserve; proteinuria or clinically significant renal function impairment (baseline
serum creatinine > 2mg/dL), or psychiatric illness/social situations that would limit
compliance with study requirements are excluded

- Patients with known glucose-6-phosphate dehydrogenase deficiency (G6PD) are excluded

- Pregnant women are excluded from this study because Triapine® is a heterocyclic
carboxaldehyde thiosemicarbazone with the potential for teratogenic or abortifacient
effects; screening b-hcg levels and diagnostic tests will be used to determine
eligibility; because there is an unknown but potential risk for adverse events in
nursing infants secondary to treatment of the mother with Triapine®, breastfeeding
should be discontinued if the mother is treated with Triapine®; these potential risks
may also apply to other agents used in this study

- HIV-positive patients on combination antiretroviral therapy are ineligible because of
the potential for pharmacokinetic interactions with Triapine®; in addition, these
patients are at increased risk of lethal infections when treated with
marrow-suppressive therapy; appropriate studies will be undertaken in patients
receiving combination antiretroviral therapy when indicated