The purpose of this study is to evaluate the tolerability and safety of escalating doses of metformin on a backbone of vincristine, irinotecan and temozolomide (VIT) in children with recurrent and refractory solid tumors.
Metformin is an oral anti-diabetes medication that activates AMP-activated protein kinase (AMPK). Recent data from in vitro and in vivo experiments, as well as epidemiologic retrospective analyses, suggest that metformin has anti-cancer activity. Vincristine, irinotecan, and temozolomide (VIT) is a combination of chemotherapeutic agents that have different mechanisms of action as well as disparate side effect profiles. Two recent phase 1 trials have demonstrated that this regimen is safe and well-tolerated in children with relapsed and refractory solid tumors.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
26
Vincristine (VCR) = 1.5 mg/m\^2/day (maximum dose 2 mg), days 1 and 8, administered as intravenous (IV) bolus over 1-5 minutes
Irinotecan (IRN) = 50 mg/m\^2/day, days 1-5, IV over 60 minutes
Temozolomide (TEM) = 50 mg/m\^2/day by mouth (PO) Days 1-5
Connecticut Children's Medical Center
Hartford, Connecticut, United States
Nemours/Alfred I. duPont Hospital for Children, Delaware
Wilmington, Delaware, United States
Maximum Tolerated Dose (MTD)
To determine the maximum tolerated dose (MTD) of metformin when given in conjunction with VIT in children with refractory and relapsed solid tumors.
Time frame: Average of 3 Months
Number of Participants with Antitumor Activity
To evaluate the antitumor activity of the addition of metformin to VIT.
Time frame: Average of 3 Months
Pharmacokinetics
To describe the pharmacokinetics of metformin in children with relapsed malignancies receiving VIT combination chemotherapy.
Time frame: Average of 3 Months
Pharmacodynamics
To define the pharmacodynamics of metformin.
Time frame: Average of 3 Months
Metformin Concentrations
To determine tissue and tumor metformin concentrations in patients undergoing resection.
Time frame: Average of 3 Months
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Metformin (MET) = dose as per dose escalation, divided twice a day (BID), PO continuously for the 21 day cycle.
University of Florida
Gainesville, Florida, United States
Nemours Children's Clinic
Jacksonville, Florida, United States
University of Miami Sylvester Comprehensive Cancer Center
Miami, Florida, United States
Johns Hopkins All Children's Hospital
St. Petersburg, Florida, United States
Tampa General Hospital
Tampa, Florida, United States
H. Lee Moffitt Cancer Center and Research Institute
Tampa, Florida, United States
University of Kentucky
Lexington, Kentucky, United States
Johns Hopkins Sidney Kimmel Comprehensive Cancer Center
Baltimore, Maryland, United States
...and 4 more locations