Therapeutic solutions to treat solid tumors that are resistant to conventional treatments are now limited. Laboratory data in animals (on pediatric tumors such as brain tumors, sarcomas and neuroblastomas) have shown that the combination of irinotecan (HIF1alpha inhibitor) and rapamycin (mTOR inhibitor) allowed to block development of blood vessels in the tumor and could, in some cases, stop its progression. This drug combination has already been tested in adult patients with refractory tumors and seems to give encouraging results with stabilization of the tumor. The dose and toxicity of irinotecan and rapamycin are known when these drugs are administered separately and in a context different from that of refractory tumors. RAPIRI is a phase I clinical trial whose principal objectives are to determine the maximum dose at which these two molecules may be administered and to assess the safety of this new combination of drugs.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
42
This phase I trial is a dose escalation study of irinotecan + rapamycin with a 3+3 statistical design.
Hôpital des Enfants - Groupe Hospitalier Pellegrin
Bordeaux, France
Centre Oscar Lambret
Lille, France
Institut Hémato-Oncologie Pédiatrique (IHOP)
Lyon, France
CHU La Timone
Marseille, France
CHU Mère-Enfants
Nantes, France
Institut Curie
Paris, France
Hôpitaux Universitaires de Strasbourg
Strasbourg, France
Hôpital des Enfants
Toulouse, France
Institut Gustave Roussy
Villejuif, France
Determine the maximum tolerated dose (MTD) of irinotecan and rapamycin combination in children with refractory solid tumors.
The Dose-Limiting Toxicity (DLT) of the drug combination is determined during the first cycle (J1 to J28) of treatment. MTD will be defined as the dose level immediately below the dose level at which 2 patients in a cohort of 3 to 6 patients will have experienced a DLT.
Time frame: 28 days
Characterize the pharmacokinetics of rapamycin and irinotecan during the first cycle of treatment.
Pharmacokinetic parameters for rapamycin will be evaluated at days 1 and 8 of the first cycle of treatment. Pharmacokinetic parameters for irinotecan will be evaluated at day 1 of the first cycle of treatment. Pharmacokinetic profile will be modelized for each patient.
Time frame: Day1 + day8
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