Tretinoin Plus Interferon Alfa in Treating Patients With Metastatic Kidney Cancer

Weill Medical College of Cornell University26 enrolled

Overview

RATIONALE: Tretinoin may help kidney cancer cells develop into normal cells. Interferon alfa may interfere with the growth of cancer cells. PURPOSE: Phase II trial to study the effectiveness of liposomal tretinoin plus interferon alfa in treating patients who have metastatic kidney cancer.

OBJECTIVES: * Determine the response in patients with metastatic renal cell carcinoma treated with tretinoin liposome and interferon alfa-2b. * Determine the toxicity of this regimen in these patients. * Study retinoic acid receptor expression on tissue obtained from selected patients who have tumor biopsies. OUTLINE: This is a dose-escalation study of tretinoin liposome with concurrent individual dose escalation of interferon alfa-2b. (Phase I closed to accrual as of 9/24/03.) Patients receive tretinoin liposome IV over 30 minutes once weekly and interferon alfa-2b subcutaneously on five consecutive days (M-F) for 8 weeks. Courses repeat every 8 weeks in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of tretinoin liposome until the maximum tolerated dose (MTD) has been determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. Once the MTD is determined additional patients are accrued and treated at that dose. (Phase I closed to accrual as of 9/24/03.) During the first 3 weeks of the study, patients receive interferon alfa-2b at weekly dose escalations. After week 3, patients continue at the highest acceptable dose level of interferon alfa-2b for the remainder of the study. (Phase I closed to accrual as of 9/24/03.) Patients are followed at 30 days after the last treatment. PROJECTED ACCRUAL: A total of 3-18 patients will be accrued into the phase I portion of this study (Phase I closed to accrual as of 9/24/03). A total of 14-25 patients will be accrued into the phase II portion of this study.

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Kidney Cancer

Interventions

recombinant interferon alfaBIOLOGICAL

tretinoin liposomeDRUG

Eligibility

Sex: ALLMin age: 18 YearsMax age: 120 Years

Medical Language ↔ Plain English

DISEASE CHARACTERISTICS: * Histologically confirmed metastatic renal cell carcinoma * Bidimensionally measurable disease * No active brain metastases PATIENT CHARACTERISTICS: Age: * 18 and over Performance status: * Karnofsky 60-100% Life expectancy: * More than 3 months Hematopoietic: * WBC at least 3,000/mm\^3 * Platelet count at least 100,000/mm\^3 * No coagulation disorders Hepatic: * Bilirubin less than 1.5 mg/dL * SGOT and SGPT less than 112.5 IU/L each or less than 2.5 times upper limit of normal * No clinically significant hepatic disease, including autoimmune hepatitis Renal: * Creatinine less than 2 mg/dL OR * Creatinine clearance greater than 50 mL/min * No clinically significant renal disease Cardiovascular: * No clinically significant cardiac disease * No thrombophlebitis Pulmonary: * No severe debilitating pulmonary disease * No pulmonary embolism Other: * No history of diabetes mellitus prone to ketoacidosis * No known hypersensitivity to retinoids or retinoic acid derivatives or to interferon or any component of the injection for this study * No thyroid abnormalities that hinder maintaining thyroid function at the normal range * No severe infection * No severe malnutrition * No clinically significant retinal abnormalities * No pre-existing psychiatric condition, especially depression or a history of severe psychiatric disorder * No other concurrent malignancy except nonmelanoma skin cancer or curatively treated carcinoma in situ of the cervix * Not pregnant or nursing * Negative pregnancy test * Fertile patients must use 2 effective methods of contraception during and for 1 month after study participation PRIOR CONCURRENT THERAPY: Biologic therapy: * No more than 1 prior biological response modifier therapy or immunotherapy Chemotherapy: * No more than 1 prior chemotherapy regimen Endocrine therapy: * No concurrent steroids Radiotherapy: * At least 4 weeks since prior radiotherapy Surgery: * At least 4 weeks since prior major surgery Other: * No prior retinoid therapy

Locations (2)

New York Weill Cornell Cancer Center at Cornell University

New York, New York, United States

Herbert Irving Comprehensive Cancer Center at Columbia University

New York, New York, United States

Outcomes

Primary Outcomes

Best Response as Measured by CT, Bone Scans, and Clinical Progression

Time frame: After 8 weeks

Number of Subjects With Toxicity by Clinical Evaluation From First Dose to 30 Days After Last Dose

Time frame: In 30 days after the last dose, an average of 1 year.

Secondary Outcomes

Change in Retinoic Acid Receptor Expression on Tissue as Measured by Number of Subjects With the Presence of Peripheral Blood Lymphocytes During the First and Fifth Dose

Time frame: At baseline and 5th week

Duration of Response (Progression-free Survival) as Measured by CT, Bone Scans, and Clinical Progression From Initiation of Therapy Until an Increase of ≥ 25% From the Smallest Sum of All Tumor Measurements Obtained During the Best Response

Time frame: At 6 months and 12 months

Data from ClinicalTrials.gov

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