Phase 1 Study of 17-dimethylaminoethylamino-17-demethoxygeldanamycin (17-DMAG, NSC #707545) in Patients With Solid Tumors.
Inclusion Criteria:
- Histologically confirmed solid tumor, including, but not limited to, the following:
- Prostate
- Breast
- Ovary
- Colon
- Kidney
- Head and neck
- Stomach
- Melanoma
- Metastatic or unresectable disease
- No standard curative or palliative therapy exists or is no longer effective
- Progressive disease as indicated by the following:
- Non-prostate cancer
- New lesions or increase in pre-existing lesions on bone scintigraphy, CT
scan, MRI, or by physical examination
- No increase in biochemical markers (e.g., carcinoembryonic antigen or
CA-15-3) or symptoms as sole evidence of disease progression
- Prostate cancer
- Must have castrate metastatic disease (i.e., disease progression after
castration or treatment with a gonadotropin-releasing hormone [GnRH]
analog)
- Patients who have not undergone surgical orchiectomy must continue
with medical therapy (i.e., GnRH analogs) to maintain castrate levels
of serum testosterone < 50 ng/dL
- Patients who received an antiandrogen as part of first-line hormonal
therapy must show disease progression after discontinuing treatment
- Progressive metastatic disease on imaging studies (e.g., bone scan, CT
scan, or MRI) OR metastatic disease and a rising prostate-specific antigen
(PSA) allowed
- Biochemical progression is defined as a minimum of 3 rising PSA values
from baseline obtained at least 1 week apart OR 2 rising PSA values
obtained more than 1 month apart, with >= 25% increase in value
- No active brain metastases
- Hormone receptor status:
- Not specified
- Male or female
- Performance status - Karnofsky 70-100%
- Performance status - ECOG 0-1
- More than 6 months
- WBC >= 3, 000/mm^3
- Absolute neutrophil count >= 1, 500/mm^3
- Platelet count >= 100,000/mm^3
- Bilirubin =< 1.5 times upper limit of normal (ULN)
- AST and ALT < 1.5 times ULN
- PT normal
- Creatinine =< 1.4 mg/dL
- Creatinine clearance > 55 mL/min
- QTc < 450 msec for male patients (470 msec for female patients)
- LVEF > 40% by MUGA
- No history of serious ventricular arrhythmia (i.e., ventricular tachycardia or
ventricular fibrillation >= 3 beats in a row)
- No myocardial infarction within the past year
- No active ischemic heart disease within the past year
- No New York Heart Association class III or IV congestive heart failure
- No congenital long QT syndrome
- No left bundle branch block
- No poorly controlled angina
- No history of uncontrolled dysrhythmias or requiring antiarrhythmic drugs
- Calcium blockers and beta blockers allowed
- No other significant cardiac disease
- Oxygen saturation > 88%
- Dyspnea < grade 2 at rest on room air
- No clinically significant pulmonary comorbidity (e.g., severe chronic obstructive
pulmonary disease)
- No requirement for supplemental oxygen
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
- No active or ongoing infection
- No symptomatic peripheral neuropathy >= grade 2
- No psychiatric illness or social situation that would preclude study compliance
- No other uncontrolled illness
- More than 4 weeks since prior chemotherapy (6 weeks for mitomycin and nitrosoureas)
- At least 1 week since prior ketoconazole
- More than 4 weeks since prior radiotherapy
- Recovered from all prior therapy
- More than 4 weeks since prior investigational anticancer therapeutic drugs
- No concurrent combination antiretroviral therapy for HIV-positive patients
- No concurrent administration of any of the following herbal remedies:
- Hydrastis canadensis (goldenseal)
- Hypericum perforatum (St. John's wort)
- Uncaria tomentosa (cat's claw)
- Echinacea angustifolia roots
- Trifolium pratense (wild cherry)
- Matricaria chamomilla (chamomile)
- Glycyrrhiza glabra (licorice)
- Dillapiol
- Hypericin
- Naringenin
- No other concurrent investigational agents
- No other concurrent anticancer agents or therapies