Phase I trial to study the effectiveness of KRN5500 in treating patients who have solid
tumors. Drugs used in chemotherapy, such as KRN5500, work in different ways to stop cancer
cells from dividing so they stop growing or die
I. To establish the MTD and identify the DLTs of the investigational agent KRN5500 when
administered by a 72-hr continuous i.v. infusion to patients with solid tumors who have
failed standard therapy or for whom no standard therapy exists.
II. To establish and assess the safety of an appropriate dose for phase II studies.
III. To characterize the pharmacokinetics of KRN5500 in patients when administered by a 72
hr continuous IV infusion.
IV. To characterize the response to KRN5500 by FLT-PET scanning at the MTD.
I. To describe any preliminary evidence of antitumor activity. II. Establish pharmacodynamic
relationships for the pharmacological effect of the drug upon surrogate markers of activity
and host toxicity.
III. To compare the toxicity profiles for the 1 hr i.v. infusion and 72 hr continuous i.v.
infusion administration schedules.
OUTLINE: This is a dose-escalation, multicenter study.
Patients receive KRN5500 IV over 24-72 hours on day 1. Treatment repeats every 21 days in
the absence of disease progression or unacceptable toxicity.
Cohorts of 1-3 patients receive KRN5500 at the starting dose over escalating infusion
durations. After the longest duration of infusion time is safely reached, cohorts of 3-6
patients receive escalating doses of KRN5500 until the maximum tolerated dose (MTD) is
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 to receive treatment with KRN5500 at the recommended phase II dose.
Patients are followed every 4 weeks until resolution of all toxicity.
PROJECTED ACCRUAL: A total of 20-40 patients will be accrued for this study within 9-12
- Metastatic or inoperable malignancy, other than leukemia or a primary CNS tumor, for
which there is no known curative or survival prolonging palliative therapy, or all
such therapies have failed
- Life expectancy >= 2 months
- ECOG performance status =< 2
- WBC >= 3,000/mm^3
- ANC >= 1,500/mm^3
- Platelets >= 100,000/mm^3
- SGOT ≤ 2.5-times the upper limit of normal (ULN)
- SGPT ≤ 2.5-times the ULN
- Total bilirubin ≤ 1.5 mg/dl
- Serum creatinine ≤ 1.5 mg/dl
- ECG showing no evidence of acute ischemia or serious conduction abnormality
- >= 2 weeks since major surgery
- >= 3 weeks since chemotherapy or radiation therapy, except for nitrosoureas and
mitomycin-C, in which case the interval shall be 6 weeks
- Women of childbearing potential must not be pregnant or lactating; all women of
childbearing potential must have a negative serum or urine pregnancy test (minimum
sensitivity 25 IU/L of β-HCG) within 72 hr prior to receiving the study medication;
KRN5500 has antiproliferative effects which may be harmful to the developing fetus or
- Fertile males and females must use adequate contraception
- Central venous catheter placed at least one day prior to treatment
- Signed informed consent
- A serious uncontrolled medical disorder or active infection that would impair the
ability of the patient to receive study treatment
- Uncontrolled or significant pulmonary or cardiovascular disease, including a recent
(6 months or less) myocardial infarction, any significant degree of congestive heart
failure with or without medical treatment, any history of clinically significant
atrial or ventricular arrhythmias, any history of second or third degree heart block,
or prolonged QTc interval (greater than 450 ms) on electrocardiogram
- Active brain metastases including evidence of cerebral edema by CT scan or MRI, or
progression from prior imaging study, any requirement for steroids, or clinical
symptoms related to brain metastases
- A psychiatric illness that precludes the ability to provide informed consent