Clinical Study of Microdosing Carboplatin in Lung or Bladder Cancer
Sponsored by University of California, Davis
Carboplatin kills cancer cells mainly through induction of DNA damage (drug-DNA adducts).
The goal of this clinical trial is to determine if chemoresistance to carboplatin can be
identified by measuring carboplatin-induced DNA monoadducts, the precursor of Pt-DNA
diadducts or crosslinks, from subtherapeutic drug doses given prior to the initiation of
chemotherapy. We hypothesize that low levels of carboplatin-DNA monoadducts and rapid
drug-DNA adduct repair correlate with chemoresistance. A highly sensitive technology,
called accelerator mass spectrometry (AMS), will be used to measure carboplatin-DNA
monoadducts from patient samples. AMS can measure C-14 at the attomole level in specimens of
milligram size. In this study, patients will receive one non-toxic "microdose" (defined as
1/100th the therapeutic dose) of C-14-labeled carboplatin. Blood specimens will be drawn
for determination of carboplatin-DNA monoadduct formation and repair in peripheral blood
mononuclear cells (PBMC), and pharmacokinetics (PK) will be determined from serum
ultrafiltrate. In patients microdosed prior to providing tumor samples, a few milligrams of
leftover tumor biopsy/resection specimens will be analyzed for formation of carboplatin-DNA
monoadducts. Patients will subsequently receive carboplatin-based chemotherapy. The levels
of microdose-induced carboplatin-DNA monoadducts will be correlated with response to
chemotherapy. Some blood and biopsy samples will be assayed by RT-PCR for several putative
resistance markers at the mRNA level. Side effects will also be monitored and compared to
the AMS data. This trial will also utilize PK, DNA repair and pharmacogenomics data in
order to determine some of the underlying chemoresistance mechanisms.
Participants must have clinical diagnosis of lung or bladder cancer. Platinum-based chemotherapy must be planned either for neoadjuvant chemotherapy for Stage II or above bladder cancer, or palliative therapy for stage IV lung or bladder cancer no matter whether patients participate in this study or not. Patients with Stage IV lung or bladder cancer must have measurable lesion(s)
Prior radiation or surgery is allowed, but should be finished at least 2 weeks prior to study enrollment. If a participant has prior radiation therapy, at least one measurable lesion outside of the radiation field should be available for the evaluation of response to chemotherapy
Participants must be 18 years or older. We do not see any patients with NSCLC or bladder TCC are diagnosed under the age of 18 years
ECOG performance status equal or less than to 2 (Karnofsky equal to or greater than 50%)
Life expectancy of at least 3 months
Participants must have normal organ and marrow function as defined below: Absolute neutrophil count greater than/equal to 1,500/microL; Platelet count greater than/equal to 100,000/microL; Total bilirubin less than 1.5 X ULN; AST (SGOT) less than/equal to 2.5 X ULN; Creatinine less than 1.5 X ULN
Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for 30 days after study participation
Ability to understand and willing to sign a written informed consent document.
Participants may not be receiving any other investigational agents
Patients must not receive concomitant radiation with chemotherapy if they do not have any measurable lesions outside of the radiation field
Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
Participants who are pregnant or nursing
Participants who are allergic to platinum agents
Participants who receive chemotherapy before that includes cisplatin, carboplatin or oxaliplatin
Study Locations And Contact Information
University of California Davis, Sacramento California
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