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Translational Phase I Trial of Escalating Doses of 5-Chloro-2'-Deoxycytidine (CldC) With a Fixed Dose of Tetrahydrouridine Combined With External Brain Radiation for Metastatic Carcinoma to the Brain

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City:   Miami
State:   Florida
Zip Code:   33136
Conditions:   Brain and Central Nervous System Tumors
Purpose:   RATIONALE: Radiation therapy uses high-energy x-rays to kill tumor cells. Drugs, such as cytochlor and tetrahydrouridine, may make tumor cells more sensitive to radiation therapy. PURPOSE: This phase I trial is studying the side effects and best dose of cytochlor when given together with tetrahydrouridine and external-beam radiation therapy in treating patients with cancer that has spread to the brain.
Study Summary:   OBJECTIVES: Primary - Establish the safety and toxicity profile of cytochlor and H4U when given in combination with external-beam radiotherapy for 2 weeks after treatment with the drugs alone in the previous week. Secondary - Determine the effectiveness of H4U to inhibit systemic cytidine deaminase (CD) during the course of treatment with cytochlor and H4U. - Perform detailed pharmacokinetic studies to determine the levels of cytochlor and its metabolites in serum and in urine in weeks 1, 2, and 3 during treatment. OUTLINE: This is a dose-escalation study of cytochlor. Patients receive cytochlor IV and tetrahydrouridine (H4U) IV over 5 minutes on 3 days in week 1 and on days 1-5 in weeks 2 and 3. Patients also undergo external-beam radiotherapy 5 days a week in weeks 2 and 3 initiated 3-4 hours after infusions of cytochlor and H4U. Treatment may repeat in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed monthly for 3 months, every 3 months for 1 year, every 4 months for 1 year, every 6 months for 1 year, and then yearly thereafter.
Criteria:   DISEASE CHARACTERISTICS: - Diagnosis of metastatic cancer to the brain by contrast-enhanced MRI or CT scan - Eligible for whole-brain radiotherapy (WBRT) - Patients treated with prior surgery are eligible if WBRT is to be used post operatively - Not planning to be treated with stereotactic radiosurgery - No leptomeningeal metastasis documented by contrast-enhanced MRI/CT scan or cerebrospinal fluid evaluation PATIENT CHARACTERISTICS: Inclusion criteria: - Karnofsky performance status (PS) 70-100% or ECOG PS 0-1 - Leukocytes ≥ 3,000/µL - Absolute neutrophil count > 1,500/µL - Platelet count > 100,000/µL - Total bilirubin normal - AST and ALT < 2.5 times upper limit of normal - Creatinine normal OR creatinine clearance > 60 mL/min - Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control) prior to study entry and for the duration of study participation Exclusion criteria: - Uncontrolled intercurrent illness including, but not limited to, any of the following: - Ongoing or active infection - Symptomatic congestive heart failure - Unstable angina pectoris - Cardiac arrhythmia - Psychiatric illness/social situations that would limit compliance with study requirements - Pregnant or lactating - Alcohol dependence PRIOR CONCURRENT THERAPY: - No prior radiotherapy to the brain - No concurrent combination antiretroviral therapy for HIV-positive patients - No other concurrent chemotherapy, immunotherapy, hormonal therapy (excluding contraceptives and replacement steroids), or other experimental medication - No other concurrent anticancer therapy outside the protocol - Systemic therapy one month before or after brain radiotherapy is allowed - No concurrent heparin or coumadin
NCT ID:   NCT00521183
Primary Contact:   Study Chair
Brian Lally, MD
University of Miami Sylvester Comprehensive Cancer Center

Backup Contact:   N/A
Location Contact:   Miami, Florida 33136
United States

University of Miami Sylvester Comprehensive Cancer Center Clin
Phone: 866-574-5124
Email: Sylvester@emergingmed.com

Site Status: Recruiting

Data Source:   ClinicalTrials.gov
Date Processed:   May 20, 2013
Modifications to this listing:   Only selected fields are shown, please use the link below to view all information about this clinical trial.
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