NCT01485731

Brief Summary

Nelfinavir will increase the efficacy of Cisplatin based chemo- radiation therapy for locally advanced cervical cancer.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
8

participants targeted

Target at below P25 for phase_1

Timeline
Completed

Started Jan 2012

Typical duration for phase_1

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

November 29, 2011

Completed
6 days until next milestone

First Posted

Study publicly available on registry

December 5, 2011

Completed
27 days until next milestone

Study Start

First participant enrolled

January 1, 2012

Completed
3.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

February 1, 2015

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

February 1, 2015

Completed
Last Updated

June 3, 2015

Status Verified

June 1, 2015

Enrollment Period

3.1 years

First QC Date

November 29, 2011

Last Update Submit

June 1, 2015

Conditions

Keywords

CervicalCancerUterine CervixSquamous CellAdenocarcinoma

Outcome Measures

Primary Outcomes (2)

  • Number of Patients with Adverse Events in Phase 1 Study of Nelfinavir + Cisplatin + Pelvic Radiation Therapy

    Number of Patients with Adverse Events in Phase 1 Study of Nelfinavir + Cisplatin + Pelvic Radiation Therapy

    3 Years

  • The proportion of enrolled patients for whom Nelfinavir dose can be successfully administered in combination with Cisplatin and Pelvic Radiation Therapy.

    Maximum tolerable Phase II dose of Nelfinavir in combination with Cisplatin and Pelvic Radiation Therapy.

    3 Years

Secondary Outcomes (4)

  • Serum Levels of Nelfinavir and other Biomarker Activity

    3 Years

  • Response to protocol therapy

    3 years

  • Progression-free Survival

    3 years

  • Overall Survival

    3 years

Study Arms (1)

Nelfinavir + Cisplatin + Pelvic Radiation Therapy

EXPERIMENTAL

Nelfinavir in combination with Cisplatin and Pelvic Radiation Therapy

Drug: NelfinavirDrug: CisplatinRadiation: Pelvic External Beam Radiation TherapyRadiation: BrachytherapyProcedure: Pharmacokinetic SamplingProcedure: Cervical BiopsyProcedure: Pelvic ExaminationProcedure: Pap SmearProcedure: AudiogramProcedure: ProctoscopyProcedure: CytoscopyProcedure: Renal UltrasoundProcedure: CT ScanProcedure: Whole Body PET/CT Scan

Interventions

Nelfinavir (NFV) will be prescribed orally twice daily for 7 days prior to initiation of cisplatin and pelvic radiation at the starting dose level, 875 mg BID

Also known as: NFV
Nelfinavir + Cisplatin + Pelvic Radiation Therapy

Cisplatin at 40 mg/m2 (maximum total dose of 70 mg per week), will be infused intravenously once per week on either Day 1, 2, 3, 4, or 5 of weeks 2 to 6, preferably approximately four hours prior to radiation therapy. One additional cycle of cisplatin will be given either week 7 or 8 for a total of 6 cycles of cisplatin. Patients are not to be dosed more than 70 mg/week.

Nelfinavir + Cisplatin + Pelvic Radiation Therapy

Pelvic external beam radiation therapy (PEBRT) will be delivered in combination with weekly IV cisplatin (40mg/mg2) and twice daily oral NFV.PEBRT should be delivered once each day during the business week (Monday to Friday) according to the acceptable standards of care as prescribed by the treating radiation oncologist(s). The radiation therapy should consist of whole pelvic external beam radiation therapy (WPEBRT) with or without a parametrial boost (PB). PEBRT will be interdigitated with one administration of intrauterine brachytherapy (BT) given on any business day of week 7 or 8.

Also known as: PEBRT
Nelfinavir + Cisplatin + Pelvic Radiation Therapy
BrachytherapyRADIATION

PEBRT will be interdigitated with one administration of intrauterine brachytherapy (BT) given on any business day of week 7 or 8.

Also known as: BT
Nelfinavir + Cisplatin + Pelvic Radiation Therapy

Serum levels of Nelfinavir will be assayed at the following 3 time points: 5-8 days after initiation of NFV single agent (on Day 5, 6, or 7 of week 1 or day 1 of week 2), 1 week after combined NFV and cisplatin pelvic radiation (on day 15, 16, or 17 if start on Monday) for measurement of steady state, and at the completion of treatment (within the last 3 days of radiation in week 6). Blood samples will be taken before drug administration on the day of the sample to make sure the concentrations are actually at a minimum and before tumor biopsies.

Nelfinavir + Cisplatin + Pelvic Radiation Therapy

Three punch biopsies of cervical tumor will be obtained during office visit at each time point (for PCR, IHC, and banked for future research). NFV serum levels will be obtained once NFV has been started (day 5-8 pre chemoradiation and at completion of chemoradiation) before each cervical biopsy

Nelfinavir + Cisplatin + Pelvic Radiation Therapy

Pre-Treatment, at the end of treatment +/- 1 week, every 3 months +/- 2 weeks after therapy (x 1 year)

Nelfinavir + Cisplatin + Pelvic Radiation Therapy
Pap SmearPROCEDURE

Recommended. Every 3 months +/- 2 weeks after therapy (x 1 year)

Nelfinavir + Cisplatin + Pelvic Radiation Therapy
AudiogramPROCEDURE

Required in patients with history of hearing loss; 28 days within starting treatment and every other cycle.

Nelfinavir + Cisplatin + Pelvic Radiation Therapy
ProctoscopyPROCEDURE

Optional. Pre-Treatment

Nelfinavir + Cisplatin + Pelvic Radiation Therapy
CytoscopyPROCEDURE

Optional. Pre-Treatment

Nelfinavir + Cisplatin + Pelvic Radiation Therapy

Optional. Pre-Treatment

Nelfinavir + Cisplatin + Pelvic Radiation Therapy
CT ScanPROCEDURE

CT Scan of Chest/Abdomen/Pelvis, pre-treatment,Immediately at end of trial +/- 1 week, Every 3 months +/- 2 weeks after therapy (x 1 year)

Nelfinavir + Cisplatin + Pelvic Radiation Therapy

In lieu of CT Scan, pre-treatment,Immediately at end of trial +/- 1 week, Every 3 months +/- 2 weeks after therapy (x 1 year)

Nelfinavir + Cisplatin + Pelvic Radiation Therapy

Eligibility Criteria

Age18 Years+
Sexfemale
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • All patients with primary, previously untreated, histologically confirmed invasive carcinoma of the uterine cervix (any cell type). Clinical stages IIA, IIB, IIIA, IIIB, IVA.
  • Patients must have adequate bone marrow, renal and hepatic function:
  • ANC ≥ 1,500/μL;
  • Platelet count ≥ 100,000/μL;
  • Creatinine \< 2.0 mg/dL;
  • Total Bilirubin ≤ 1.5 times normal;
  • SGOT ≤ 3 times normal.
  • Patients with a GOG Performance Status of 0, 1, or 2.
  • Patients with ureteral obstruction must be treated with stent or nephrostomy tube.
  • Patients must be entered within eight weeks of diagnosis.
  • Patients of childbearing potential must use an effective form of birth control."Patients receiving oral contraceptives should be instructed that alternate or additional contraceptive measures should be used during therapy with VIRACEPT. "
  • Seronegative HIV status.
  • Patients must be at least 18 years of age.
  • Patients must have signed an approved informed consent and authorization permitting release of personal health information.

You may not qualify if:

  • Patients with Stage IA, IB or IVB disease.
  • Patients who have known metastases to other organs outside the radiation field at the time of the original clinical and surgical staging.
  • Patients who have received previous pelvic or abdominal radiation, cytotoxic chemotherapy, or previous therapy of any kind for this malignancy.
  • Patients with septicemia or severe infection.
  • Patients who have circumstances that will not permit completion of this study or the required follow-up.
  • Patients who are pregnant at the time of diagnosis and do not wish pregnancy termination prior to initiation of treatment.
  • Patients with renal abnormalities, such as pelvic kidney, horseshoe kidney, or renal transplantation, that would require modification of radiation fields.
  • Patients with other concomitant malignancies (with the exception of non-melanoma skin cancer), who had (or have) any evidence of other cancer present within the last 5 years.
  • Patients with GI tract disease resulting in an inability to take oral medication, malabsorption syndrome, a requirement for IV alimentation, prior surgical procedures affecting absorption, uncontrolled inflammatory GI disease (e.g., Crohn's, ulcerative colitis).
  • Patients with poorly controlled diabetes mellitus despite medication.
  • Patients taking anti-arrhythmic agents such as amiodarone, quinidine, rifampin, ergot derivatives such as ergotamine, St Johs Wort, HMG-CoA reductase inhibitors such as lovastatin, neuroleptic such as pimozide, sedatives such as midazolam and triazolam among other CYP3A4 and CYP2C19 substrates.
  • Patients with Phenylketonuria.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

University of Miami

Miami, Florida, 33136, United States

Location

MeSH Terms

Conditions

Uterine Cervical NeoplasmsNeoplasmsAdenocarcinoma

Interventions

NelfinavirCisplatinBrachytherapyPapanicolaou TestHearingProctoscopy

Condition Hierarchy (Ancestors)

Uterine NeoplasmsGenital Neoplasms, FemaleUrogenital NeoplasmsNeoplasms by SiteUterine Cervical DiseasesUterine DiseasesGenital Diseases, FemaleFemale Urogenital DiseasesFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesGenital DiseasesCarcinomaNeoplasms, Glandular and EpithelialNeoplasms by Histologic Type

Intervention Hierarchy (Ancestors)

IsoquinolinesHeterocyclic Compounds, 2-RingHeterocyclic Compounds, Fused-RingHeterocyclic CompoundsChlorine CompoundsInorganic ChemicalsNitrogen CompoundsPlatinum CompoundsRadiotherapyTherapeuticsBiopsyCytodiagnosisCytological TechniquesClinical Laboratory TechniquesDiagnostic Techniques and ProceduresDiagnosisSpecimen HandlingSurgical Procedures, OperativeInvestigative TechniquesVestibulocochlear Physiological PhenomenaPhysiological PhenomenaSensationNervous System Physiological PhenomenaMusculoskeletal and Neural Physiological PhenomenaEndoscopy, GastrointestinalEndoscopy, Digestive SystemDiagnostic Techniques, Digestive SystemEndoscopyDiagnostic Techniques, SurgicalDigestive System Surgical ProceduresMinimally Invasive Surgical Procedures

Study Officials

  • J. Matthew Pearson, MD

    University of Miami

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
phase 1
Allocation
NA
Masking
NONE
Purpose
TREATMENT
Intervention Model
SINGLE GROUP
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Assistant Professor of Clinical

Study Record Dates

First Submitted

November 29, 2011

First Posted

December 5, 2011

Study Start

January 1, 2012

Primary Completion

February 1, 2015

Study Completion

February 1, 2015

Last Updated

June 3, 2015

Record last verified: 2015-06

Locations