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Valproic Acid in Treating Young Patients With Recurrent or Refractory Solid Tumors or CNS Tumors - Article


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Gamma-Linolenic Acid

GLA


Clinical Trial: Valproic Acid in Treating Young Patients With Recurrent or Refractory Solid Tumors or CNS Tumors

This study is not yet open for patient recruitment.

Sponsors and Collaborators: Children's Oncology Group
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)

Purpose

RATIONALE: Drugs used in chemotherapy, such as valproic acid, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Valproic acid may also stop the growth of solid tumors or CNS tumors by blocking blood flow to the tumor.

PURPOSE: This phase I trial is studying the side effects and best dose of valproic acid in treating patients with recurrent or refractory solid tumors or CNS tumors.

Condition Treatment or Intervention Phase
childhood brain tumor
childhood meningioma
childhood solid tumor
childhood spinal cord tumors
 Drug: valproic acid
 Procedure: anti-cytokine therapy
 Procedure: antiangiogenesis therapy
 Procedure: biological response modifier therapy
 Procedure: chemotherapy
 Procedure: growth factor antagonist therapy
Phase I

MedlinePlus related topics:  Brain Cancer

Study Type: Interventional
Study Design: Treatment

Official Title: Phase I Study of Valproic Acid in Young Patients With Recurrent or Refractory Solid Tumors or CNS Tumors

Further Study Details: 

OBJECTIVES: Primary

  • Determine the toxic effects of valproic acid (VPA) administered at doses required to maintain serum trough VPA concentrations of 100-150 mcg/mL or 150-200 mcg/mL in young patients with recurrent or refractory solid tumors or CNS tumors.

Secondary

  • Determine the steady state serum trough concentration of free VPA at the targeted total trough VPA concentration in these patients.
  • Determine the steady state histone acetylation status of peripheral blood monocytes at the targeted trough VPA concentration in these patients.
  • Determine the pharmacokinetic profile of this drug in these patients.
  • Correlate histone acetylation with free or total trough VPA concentration in these patients.
  • Determine, preliminarily, the antitumor activity of this drug in these patients.

OUTLINE: This is a dose-escalation, multicenter study.

For course 1, patients receive escalating doses of oral valproic acid (VPA) twice daily until a target serum trough VPA concentration range is maintained for 28 days (approximately 5-10 weeks). Patients who are unable to achieve the target serum trough VPA concentration range after 6 weeks of dose escalation are removed from the study. Patients who achieve the target serum trough VPA concentration range receive subsequent courses of oral VPA twice daily (at the dose found to maintain the target serum trough VPA concentration range) on days 1-28. Treatment repeats every 28 days for up to 12 courses in the absence of disease progression or unacceptable toxicity.

Cohorts of 6 patients are enrolled at increasing target serum trough VPA concentration ranges until 2 of 6 patients experience dosing-limiting toxicity.

After completion of study treatment, patients are followed annually.

PROJECTED ACCRUAL: A total of 12-18 patients will be accrued for this study.

Eligibility

Ages Eligible for Study:  2 Years   -   21 Years,  Genders Eligible for Study:  Both

Criteria

DISEASE CHARACTERISTICS:

  • Histologically confirmed* solid tumors, including CNS tumors, at original diagnosis or relapse
  • Recurrent or refractory disease NOTE: *Histologic confirmation not required for intrinsic brain stem or optic pathway tumors
  • Measurable or evaluable disease, defined by 1 of the following criteria:
  • Any unidimensionally measurable lesion ≥ 20 mm by standard MRI or CT scan OR ≥ 10 mm by spiral CT scan
  • At least 1 nonmeasurable lesion that is evaluable by nuclear medicine, immunocytochemistry, tumor markers, cerebrospinal fluid cytology, or other reliable measures
  • No known curative therapy exists
  • No documented tumor involvement in the bone marrow

PATIENT CHARACTERISTICS: Age

  • 2 to 21

Performance status*

  • Lansky 50-100% (for patients ≤ 10 years of age)
  • Karnofsky 50-100% (for patients > 10 years of age)

Life expectancy

  • Not specified

Hematopoietic

  • Absolute neutrophil count ≥ 1,000/mm^3
  • Platelet count ≥ 100,000/mm^3 (transfusion independent)
  • Hemoglobin ≥ 8.0 g/dL (transfusions allowed)

Hepatic

  • Bilirubin ≤ 1.5 times upper limit of normal (ULN)
  • ALT ≤ 2.5 ULN
  • Albumin ≥ 2 g/dL

Renal

  • Creatinine clearance or radioisotope glomerular filtration rate ≥ 70 mL/min OR
  • Creatinine based on age as follows:
  • No greater than 0.8 mg/dL (for patients ≤ 5 years of age)
  • No greater than 1.0 mg/dL (for patients 6 to 10 years of age)
  • No greater than 1.2 mg/dL (for patients 11 to 15 years of age)
  • No greater than 1.5 mg/dL (for patients over 15 years of age)

Other

  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • Neurologic deficits in patients with CNS tumors must be stable for ≥ 1 week before study entry
  • No uncontrolled infection
  • No other condition that would preclude study compliance

PRIOR CONCURRENT THERAPY: Biologic therapy

  • Recovered from prior immunotherapy
  • At least 7 days since prior hematopoietic growth factors that support platelet or WBC number or function
  • At least 7 days since prior antineoplastic biologic agents
  • At least 3 months since prior stem cell transplantation or rescue without total body irradiation
  • No evidence of active graft vs host disease
  • No other concurrent anticancer biologic therapy or immunotherapy

Chemotherapy

  • More than 3 weeks since prior myelosuppressive chemotherapy (6 weeks for nitrosoureas) and recovered
  • No other concurrent anticancer chemotherapy

Endocrine therapy

  • Patients with CNS tumors must be on a stable or decreasing dose of dexamethasone for the past 7 days

Radiotherapy

  • See Biologic therapy
  • Recovered from prior radiotherapy
  • At least 6 months since prior total body irradiation, craniospinal radiotherapy, or radiotherapy to ≥ 50% of the pelvis
  • At least 6 weeks since other prior substantial bone marrow radiotherapy
  • At least 2 weeks since prior local palliative small port radiotherapy
  • No concurrent anticancer radiotherapy

Surgery

  • Not specified

Other

  • No other concurrent investigational agents
  • No other concurrent anticancer agents
  • No other concurrent anticonvulsants
  • Patients receiving valproic acid (VPA) before study entry must have a total trough VPA concentration < 100 mcg/mL within the past 7 days

Location Information

Study chairs or principal investigators

Jack M. Su, MD,  Study Chair,  Texas Children's Cancer Center   
Heidi V. Russell, MD,  Texas Children's Cancer Center   

More Information

Clinical trial summary from the National Cancer Institute's PDQ® database

Study ID Numbers:  CDR0000417845; COG-ADVL0419
Record last reviewed:  March 2005
Last Updated:  April 5, 2005
Record first received:  April 5, 2005
ClinicalTrials.gov Identifier:  NCT00107458
Health Authority: United States: Federal Government
ClinicalTrials.gov processed this record on 2005-04-08


Source: ClinicalTrials.gov
Cache Date: April 9, 2005


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September 6, 2008



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