RATIONALE: Drugs used in chemotherapy, such as paclitaxel and ABI-007, work in different
ways to stop tumor cells from dividing so they stop growing or die. Combining paclitaxel
with ABI-007 may kill more tumor cells.
PURPOSE: Randomized phase I trial to study the effectiveness of combining paclitaxel with
ABI-007 in treating patients who have locally advanced or metastatic solid tumors.
- Determine whether a change in the formulation alters the pharmacokinetic profile of
paclitaxel in the plasma of patients with incurable locally advanced or metastatic
solid tumors treated with ABI-007 and paclitaxel.
- Correlate pharmacokinetic data of this regimen with decrease in the neutrophil count at
nadir in these patients.
- Determine the intra- and interindividual pharmacokinetic variability of ABI-007 in
- Determine protein binding of paclitaxel via measurement of α-1-acid glycoprotein and
serum albumin levels in patients treated with this regimen.
OUTLINE: This is a randomized, pilot study.
- Courses 1 and 2: Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients receive paclitaxel IV over 3 hours on day 1 and ABI-007 IV over 30
minutes on day 22.
- Arm II: Patients receive ABI-007 IV over 30 minutes on day 1 and paclitaxel IV
over 3 hours on day 22.
- Courses 3 and beyond: All patients receive ABI-007 IV over 30 minutes on day 1. Courses
repeat every 21 days in the absence of disease progression or unacceptable toxicity.
PROJECTED ACCRUAL: A total of 20 patients will be accrued for this study.
- Histologically confirmed malignant solid tumor
- Considered incurable
- Locally advanced or metastatic disease
- Likely to be responsive to taxane-based therapy
- Patients who are refractory to prior paclitaxel are ineligible
- No symptomatic or untreated brain metastasis or carcinomatous meningitis
- No patients who are unable to remain free of corticosteroid therapy for > 4
weeks due to CNS disease
- No previously untreated locally advanced breast cancer
- No hematologic malignancy
- 18 and over
- ECOG 0-2
- At least 3 months
- Granulocyte count ≥ 1,500/mm^3
- Platelet count ≥ 100,000/mm^3
- Bilirubin normal
- ALT and AST ≤ 1.5 times upper limit of normal
- Creatinine normal OR
- Creatinine clearance ≥ 60 mL/min
- LVEF ≥ 40%
- No clinical signs or symptoms of heart failure
- No symptomatic congestive heart failure
- No unstable angina pectoris
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception during and for 2 months after study
- No history of allergic reaction attributed to compounds of similar chemical or
biologic composition to paclitaxel (e.g., docetaxel, Cremophor^® EL [CrEL],
polysorbate 80 [Tween 80], or CrEL-containing medications [e.g., cyclosporine])
- No history of seizure disorder requiring anticonvulsant therapy
- No active serious infection
- No psychiatric illness or social situation that would preclude study compliance
- No other uncontrolled illness
PRIOR CONCURRENT THERAPY:
- No concurrent immunotherapy
- No concurrent filgrastim (G-CSF) during courses 1 and 2
- See Disease Characteristics
- At least 3 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin)
- No other concurrent chemotherapy
- See Disease Characteristics
- At least 2 weeks since prior hormonal therapy
- Concurrent luteinizing hormone-releasing hormone agonists for prostate cancer allowed
- At least 3 weeks since prior radiotherapy
- No concurrent radiotherapy
- Not specified
- More than 2 weeks since prior drugs, herbal preparations, or dietary supplements
known to influence CYP3A4 (e.g., phenytoin, rifampin, Hypericum perforatum [St.
John's wort], garlic supplements, or grapefruit juice) and/or CYP2C8
- No concurrent substances known or likely to interfere with the pharmacokinetics of
paclitaxel (e.g., verapamil or cyclosporine)
- No other concurrent investigational agents
- No other concurrent anticancer therapy