A Multi-Histology Phase II Study of 5-Fluoro-2'-Deoxycytidine With Tetrahydrouridine (FdCyd + THU)
Background:
5-Fluoro-2'-deoxycytidine (FdCyd), a fluoropyrimidine nucleoside analog, has a short
(10-minute) half-life and is rapidly degraded in vivo by cytidine deaminase. However,
coadministration with tetrahydrouridine (THU), an inhibitor of cytidine/deoxycytidine
deaminase, has been shown to increase the AUC of the parent compound more than 4-fold.
Increased FdCyd exposure allows it to be taken up intracellularly and converted to its
triphosphate, which is incorporated into DNA and inhibits the action of the enzyme DNA
methyltransferase (DNMT). Inhibition of DNMT, and in turn DNA methylation, can result in the
re-expression of tumor suppressor genes.
Objectives:
- Determine progression-free survival (PFS) and/or the response rate (CR + PR) of FdCyd
administered 5 days per week for 2 weeks, in 28-day cycles, by intravenous infusion
over 3 hours along with THU in patients with breast cancer, head and neck cancer,
non-small cell lung cancer, and urothelial transitional cell carcinoma.
- Evaluate whether treatment with FdCyd and THU alters DNA methylation patterns in tumor
biopsy samples before and during treatment by LINE-1 analysis.
- Evaluate the safety and tolerability of FdCyd (100 mg/m(2)) + THU (350 mg/m(2))
administered 5 days per week for 2 weeks, in 28-day cycles, by intravenous infusion
over 3 hours.
- Measure changes in the number of CTCs following treatment with FdCyd plus THU.
Eligibility:
-Patients with histologically documented non-small cell lung cancer, head and neck cancer,
urothelial transitional cell carcinoma, and breast carcinoma.
Design:
- This is a multicenter trial with NCI as the coordinating center and the California
Cancer Consortium and UPMC as participating sites.
- FdCyd will be administered as an IV infusion over 3 hours with 20% of the daily dose of
THU administered as an IV push and the remaining 80% co-administered with FdCyd by
3-hour infusion daily for 5 consecutive days of treatment per week for 2 consecutive
weeks, followed by 2 weeks of no treatment, in a 28-day cycle.
- Blood and optional tumor biopsies for pharmacodynamic and pharmacokinetic studies will
be obtained.
- The study will accrue a maximum of 185 patients including all centers.
Interventional
Allocation: Non-Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
Determine PFS and/or the response rate (CR + PR) of FdCyd administered 5 days/week for 2 weeks, in 28-day cycles, by iv infusion with THU in patients with breast cancer, head and neck cancer, non-small cell lung cancer, and bladder cancer.
James H Doroshow, M.D.
Principal Investigator
National Cancer Institute (NCI)
United States: Federal Government
090214
NCT00978250
August 2009
December 2013
Name | Location |
---|---|
National Institutes of Health Clinical Center, 9000 Rockville Pike | Bethesda, Maryland 20892 |
City of Hope National Medical Center | Los Angeles, California 91010 |
University of Pittsburgh | Pittsburgh, Pennsylvania 15261 |
City of Hope Medical Group | Pasadena, California 91105 |
University of Southern California | Los Angeles, California 90033 |
University of California, Davis | Sacramento, California 95818 |
Milton Hershey Medical Center | Hershey, Pennsylvania 17033-2390 |