This study will examine whether the experimental drug BMS 247550 is an effective treatment
for kidney cancer. BMS 247550 belongs to a class of drugs called epothilones that interfere
with the ability of cancer cells to divide. In the way they kill cells, they are very
similar to a class of compounds known as the taxanes, which include the drug Taxol. Other
characteristics of the epothilones, however, enable them to work in cells that are resistant
Patients 18 years of age or older with kidney cancer that has not spread to the central
nervous system (unless the brain tumor has remained stable for at least six months after
surgical or radiation treatment) may be eligible for this study. Pregnant or nursing women
may not participate. Candidates are screened with various tests that may include blood and
urine tests, electrocardiogram (EKG), and chest x-ray. Computerized tomography (CT) scans or
X-rays, and possibly nuclear medicine studies may be done to determine the extent of
Participants receive BMS 247550 by a 1-hour infusion into a vein for 5 consecutive days
(days 1, 2, 3, 4 and 5) of each 21-day treatment cycle. Patients must stay in the NIH area
near Bethesda, Maryland, for 7 to 8 days during the first treatment cycle and for the 5 days
of treatment in subsequent cycles. The total number of cycles will vary among patients,
depending on their individual clinical situation. The drug dose may be increased gradually
in subsequent cycles in patients who can tolerate such increases. In addition, participants
undergo the following tests and procedures:
- Periodic physical examinations and frequent blood tests
- X-ray and other imaging studies to determine if the tumor is responding to the
- Tumor biopsies to confirm the diagnosis or spread of tumor and to examine the reaction
of certain proteins in cancer cells to BMS 247550. Two biopsies will be done. For this
procedure, a small piece of tumor tissue is withdrawn through a needle under local
Treatment will be stopped in patients whose tumor grows while receiving BMS 247550. Patients
whose tumor disappears completely will be followed at NIH periodically for examinations and
tests. Patients whose disease does not completely resolve or whose disease recurs may be
advised of other appropriate research protocols at NIH or, if none are available, will be
returned to the care of their local doctor.
BMS-247550 (NSC 710428), (ixabepilone) is a semi-synthetic analog of the natural product
The epothilones are a novel class of non-taxane microtubule-stabilizing agents obtained from
the fermentation of the cellulose degrading myxobacteria, Sorangium cellulosum.
BMS-247550 is active against cancer models that are naturally insensitive to paclitaxel or
have developed resistance to paclitaxel, both in-vitro and in-vivo.
Establish the efficacy of the investigational agent BMS-247550 in patients with renal cell
carcinoma when administered as a one hour infusion on day 1 to 5 every 21 days.
Evaluate the plasma pharmacokinetics of BMS-247550.
Explore the pharmacodynamics of BMS-247550 using an assay that measures the amount of
endogenous tubulin in peripheral blood mononuclear cells (PBMC) that exists in the
polymerized versus the unpolymerized state.
Determine the extent to which pharmacodynamic changes are observed over a range of doses of
Determine if cross-resistance to BMS-247550 exists in patients who have previously received
sorafenib or sunitinib.
Age greater than18.
Pathological confirmation of renal cell carcinoma.
Prior chemotherapy including sorafenib and sunitinib is allowed.
Phase II study.
BMS-247550 will be administered on days 1 through 5, every 21 days.
Restaging will be done every two cycles.
- INCLUSION CRITERIA:
Patients must fulfill all of the following criteria to be eligible for study admission:
1. Age greater than or equal to 18 years.
2. Histologic or cytologic confirmation of renal cell carcinoma (clear cell, type I and
type II papillary, chromophobe, collecting duct and medullary). Patients should
either: (a) have received IL-2; (b) have been evaluated for therapy with IL-2 and
deemed to be ineligible; or (c) have been evaluated for therapy with IL-2 and refused
3. Measurable extent of disease.
4. Performance Status ECOG 0-2.
5. Life expectancy of 3 months or greater.
6. Suitable candidate for receiving planned therapy as evidenced by screening laboratory
assessments of hematologic, renal, hepatic, and metabolic functions: platelet count
greater than or equal to 100,000/mL, absolute granulocyte count (AGC) greater than or
equal to 1,500/mL, serum creatinine less than or equal to 1.6 or a measured
creatinine clearance greater than or equal to 40 ml/min, SGPT and SGOT less than or
equal to 2.5 x NL, and total bilirubin less than or equal to 1.5 x NL (in patients
with clinical evidence of Gilberts' disease, less than or equal to 3 x NL).
7. Greater than or equal to 4 weeks from prior cytotoxic chemothrapy, radiation or
immunotherapy; greater than or equal to 2 weeks from prior targeted-therapy
(cytostatic agents); such patients should have recovered from toxicity from the prior
8. No serious intercurrent medical illness.
9. The ability to understand and willingness to sign a written informed consent form,
and to comply with the protocol.
10. Patients should either: (a) have received sorafenib and or sunitinib and had
progressive disease while receiving the drug(s) or (b) been intolerant to the
drugs(s), or (c) been evaluated for therapy with sorafenib and or sunitinib and
deemed to be ineligible; or (d) have been evaluated for therapy with sorafenib and or
sunitinib and refused treatment.
Patients with any of the following will be excluded from study entry:
1. Pregnant or nursing women are not eligible; neither are women or men of childbearing
potential unless using effective contraception as determined by the patient's
2. Patients with a history of CNS metastases, because symptoms/signs of progressive
disease may be confused with drug-related toxicities, unless control has been
achieved with either radiation or surgical resection at least six months prior to
enrollment on study.
3. Patients who are poor medical risk because of other non-malignant systemic disease or
active, uncontrolled infection.
4. HIV seropositive patients. Patients infected with the HIV virus will be excluded
from this trial because the effect of BMS-247550 on HIV replication and/or the immune
system is unknown and may be potentially harmful.
5. Prior craniospinal radiation, or total body irradiation (TBI).
6. Patients receiving other investigational drugs, or St. John's Wort (St. John's Wort
can induce P450 and alter drug metabolism).
7. CTC Grade 2 or greater motor or sensory neuropathy.
8. Known prior severe hypersensitivity reactions to agents containing Cremophor EL.