Hepatic Arterial Infusion of Oxaliplatin, Fluorouracil, Leucovorin, and Avastin

• Status: Completed
• Trial end date: 2010-01-01
• Target enrollment: 0
• Participant gender: All

Summary

PRIMARY:

• To determine the toxicity and tolerability of intra-arterial hepatic oxaliplatin every three weeks administered in combination with systemic intravenous Fluorouracil, Leucovorin and bevacizumab to patients with advanced solid tumors metastatic to the liver.

SECONDARY:

• To document in a descriptive fashion the antitumor efficacy of this combination regimen.

• To evaluate the feasibility and accuracy of an alternate radiographic assessment tool and compare with available tumor markers and RECIST guidelines.

• To estimate in a descriptive fashion the development of extrahepatic tumor recurrences.

• Phase: Phase 1
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: M.D. Anderson Cancer Center
• Treatments: Bevacizumab; Fluorouracil; Leucovorin; Oxaliplatin

Criteria

Inclusion Criteria:

1. Patients with histologically confirmed metastatic advanced solid tumors involving the liver.

2. Pediatric patients eligible at the discretion of the primary investigator.

3. Performance status ECOG 0-2 (Capable of all self care but unable to to carry out any work activities).

4. Adequate renal function (Serum Creatinineclearance greater than 60 mL/min.

5. Hepatic function as follows: In treatment arm 1: Total Bilirubin5 times upper normal reference value, or ALTvalue). In treatment arm 2: Total bilirubin >3 mg/dL. If bilirubin >/= 5 mg/dL, fluorouracil (5FU) dose will be omitted.

6. Adequate bone marrow function (ANC >/=1500 cells/uL; PLT >/= 100,000 cells/uL).

7. At least three weeks from previous immunotherapy, chemotherapy or radiotherapy before day of HAI infusion and recovery from any associated toxicities to less or equal to Grade 1.

8. All females in childbearing age MUST have a negative serum HCG test unless prior hysterectomy or menopause (defined as age above 55 and six months without menstrual activity). Patients should not become pregnant or breast feed while on this study. Sexually active patients should use effective birth control.

9. Ability to fully read, comprehend, and sign informed consent forms.

Exclusion Criteria:

1. Clinical or radiographic evidence of ascites.

2. Pregnant females.

3. Inability to complete informed consent process and adhere to protocol treatment plan and follow-up requirements.

4. Grade 2 Peripheral Neuropathy (CTC V3.0: Sensory alteration interfering with function but not interfering with ADL)

5. Serious or non-healing wound, ulcer or bone fracture.

6. History of abdominal fistula, gastrointestinal perforation or intra-abdominal abscess within 28 days.

7. Invasive procedures defined as follows; Major surgical procedure, open biopsy or significant traumatic injury within 28 days prior to Day 1 therapy, Anticipation of need for major surgical procedures during the course of the study, Core biopsy within 7 days prior to D1 of therapy.

8. Patients receiving any other investigational agents.

9. Patients with bleeding diathesis (clinical bleeding, prothrombin time =/> 1.5 X upper institutional normal value, INR =/> 1.5, activated partial thromboplastin time aPTT =/> 1.5 X upper institutional normal value), active gastric or duodenal ulcer.

10. Uncontrolled systemic vascular hypertension (Systolic blood pressure > 140 mmHg, Diastolic Blood Pressure > 90 mmHg).

11. Urine protein should be screened by dipstick or urine analysis. For proteinuria > 1+ or urine protein:creatinine ratio > 1.0, a 24-hour urine protein should be obtained and the level should be < 1000 mg for patient enrollment.

12. Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, or psychiatric illness/social situations that would limit compliance with study requirements.

13. Patients with clinically significant cardiovascular disease: History of CVA within 6 months, myocardial infarction or unstable angina within 6 months, New York Heart Association Grade II or greater congestive heart failure, serious cardiac arrhythmia requiring medication, unstable angina pectoris, clinically significant peripheral vascular disease

14. Patients with history of bleeding CNS metastasis will be excluded from the trial.