Propranolol Hydrochloride in Treating Patients With Locally Recurrent or Metastatic Solid Tumors That Cannot Be Removed By Surgery

NCT02013492 | Completed Early Phase 1 DMC FDA Drug

• 2 other identifiers: OSU 13023NCI-2013-01958
• Study Type: interventional
• Target: 1
• Locations: 1 country
• Sites: 1

Brief Summary

This pilot trial studies propranolol hydrochloride in treating patients with locally recurrent or metastatic solid tumors that cannot be removed by surgery. Propranolol hydrochloride may slow the growth of tumor cells by blocking the use of hormones by the tumor cells.

Conditions

Male Breast Cancer; Recurrent Melanoma; Stage IV Breast Cancer; Stage IV Melanoma; Stage IV Ovarian Epithelial Cancer; Stage IV Ovarian Germ Cell Tumor; Unspecified Adult Solid Tumor, Protocol Specific; Hepatocellular Carcinoma

Keywords

Beta-Blocker; metastatic melanoma; hepatocellular carcinoma

Outcome Measures

Primary Outcomes (4)

• Incidence of toxicity graded according to Common Terminology Criteria for Adverse Events (CTCAE) V. 4.0

  A dose-limiting toxicity (DLT) will be considered as any grade 3 or higher hematologic or non- hematologic toxicity that is probably or definitely related to treatment.

  Up to 4 months

• Change in vascular endothelial growth factor (VEGF)

  Baseline to 4 months

• Effect of beta-adrenergic blockade on the tumor microenvironment

  Measured via a series of correlative laboratory studies using cancer tumor tissue and peripheral blood mononuclear cells.

  Up to 4 months

• Effect of beta-adrenergic blockade on the host immune system

  Measured via a series of correlative laboratory studies using cancer tumor tissue and peripheral blood mononuclear cells.

  Up to 4 months

Secondary Outcomes (2)

• Progression-free survival

  Up to 1 year

• Overall survival

  Up to 1 year

Study Arms (1)

Treatment (propranolol hydrochloride)

EXPERIMENTAL

Patients receive propranolol hydrochloride PO BID for 4 months in the absence of disease progression or unacceptable toxicity. Propranolol will be administered on an out-patient basis. Blood for correlative studies (30 ml - green top tube) will be drawn at baseline and at each clinic visit. Tumor tissue for analysis will be obtained via core needle biopsy (or other appropriate modality) pre-study and at approximately the two month time point.

Drug: propranolol hydrochloride; Other: Correlative Studies

Interventions

propranolol hydrochloride DRUG

Given PO

Also known as: Inderal

Treatment (propranolol hydrochloride)

Correlative Studies OTHER

Correlative studies will be conducted using the following materials: * Plasma derived from peripheral blood. * Peripheral blood mononuclear cells (PBMC) derived from patient blood * Tumor tissue obtained at the time of core needle biopsy at the 2 month time point. * Paraffin-embedded tumor tissue obtained pre-therapy to make the diagnosis of metastatic disease.

Treatment (propranolol hydrochloride)

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients must have histologically-proven locally-recurrent or metastatic solid tumor; the first 10 patients may have cancer of any histology; preference will be given to patients with metastatic ovarian cancer, breast cancer, and malignant melanoma, as these malignancies have been shown to be sensitive to manipulation of the beta-adrenergic receptor; the final twenty-five patients to be accrued must have locally-recurrent or metastatic malignant melanoma that is not surgically resectable. An additional cohort of 10 patients with BCLC stages A to C locally advanced or metastatic hepatocellular carcinoma (HCC) that is not surgically resectable will also be enrolled (See appendix for BCLC staging system). Patients with liver transplantation will not be eligible.
• The diagnosis of hepatocellular carcinoma may be made by one of the following methods:
• Pathologically (histologically or cytologically) proven diagnosis of HCC.
• At least one solid liver lesion or vascular tumor thrombosis (involving portal vein, IVC and/or hepatic vein) \> 1 cm with arterial enhancement and delayed washout on multiphasic computerized tomography (CT) or magnetic resonance imaging (MRI) in the setting of cirrhosis or chronic hepatitis B or C without cirrhosis.
• For patients whose CURRENT disease is vascular only: Enhancing vascular thrombosis (involving portal vein, IVC and/or hepatic vein) demonstrating early arterial enhancement and delayed washout on multi-phasic CT or MRI, in a patient with known HCC (diagnosed according to criteria in (a) or (b).
• Patients may have had any number of prior systemic therapies; patients need not have exhausted standard therapy for their disease, but must be stable and must not have actively progressing
• Eastern Cooperative Oncology Group (ECOG) performance status =\< 2
• Karnofsky \>= 60%
• Life expectancy of greater than 6 months
• Patients (except for the HCC cohort) must have normal organ and marrow function as defined below:
• Leukocytes \>= 3,000/mcL
• Absolute neutrophil count \>= 1,500/mcL
• Platelets \>= 100,000/mcL
• Total bilirubin within normal institutional limits
• Aspartate aminotransferase (AST)(serum glutamic oxaloacetic transaminase \[SGOT\])/alanine aminotransferase (ALT)(serum glutamate pyruvate transaminase \[SGPT\]) =\< 2.5 X institutional upper limit of normal

You may not qualify if:

• Patients who have had chemotherapy or radiotherapy within 4 weeks (6 weeks for nitrosoureas or mitomycin C) prior to entering the study or those who have not recovered from adverse events due to agents administered more than 4 weeks earlier
• Patients may not be receiving any other investigational agents
• History of allergic reactions attributed to compounds of similar chemical or biologic composition to propranolol
• Uncontrolled hypertension
• 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
• Patients with significant lung disease, an ejection fraction less than 40%, or a resting heart rate less than 60/min will not be enrolled
• Pregnant women are excluded from this study because propranolol is an agent with the potential for teratogenic or abortifacient effects
• Patients who are currently receiving a beta-blocker for another medical condition will be excluded from this study; patients with extremes of blood pressure (e.g., systolic blood pressure \[SBP\] \> 150 or \< 100) may be excluded from participation if the treating physician feels that this medical condition has not been adequately addressed by the patient's primary care physician
• Patients with worsening depression that has not been addressed clinically will be excluded from this study

Sponsors & Collaborators

• William Carson: lead

Study Sites (1)

Ohio State University Comprehensive Cancer Center

Columbus, Ohio, 43210, United States

Location

Related Links

• The Jamesline

MeSH Terms

Conditions

Breast Neoplasms, Male; Melanoma; Breast Neoplasms; Carcinoma, Ovarian Epithelial; Carcinoma, Hepatocellular

Interventions

Propranolol

Condition Hierarchy (Ancestors)

Neoplasms by Site; Neoplasms; Breast Diseases; Skin Diseases; Skin and Connective Tissue Diseases; Neuroendocrine Tumors; Neuroectodermal Tumors; Neoplasms, Germ Cell and Embryonal; Neoplasms by Histologic Type; Neoplasms, Nerve Tissue; Nevi and Melanomas; Skin Neoplasms; Carcinoma; Neoplasms, Glandular and Epithelial; Ovarian Neoplasms; Endocrine Gland Neoplasms; Ovarian Diseases; Adnexal Diseases; Genital Diseases, Female; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Genital Neoplasms, Female; Urogenital Neoplasms; Genital Diseases; Endocrine System Diseases; Gonadal Disorders; Adenocarcinoma; Liver Neoplasms; Digestive System Neoplasms; Digestive System Diseases; Liver Diseases

Intervention Hierarchy (Ancestors)

Phenoxypropanolamines; Propanolamines; Amino Alcohols; Alcohols; Organic Chemicals; Propanols; Amines; Naphthalenes; Polycyclic Aromatic Hydrocarbons; Hydrocarbons, Aromatic; Hydrocarbons, Cyclic; Hydrocarbons; Polycyclic Compounds

Study Officials

• William Carson, MD

  Ohio State University Comprehensive Cancer Center

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: early phase 1
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: December 11, 2013
• First Posted: December 17, 2013
• Study Start: January 21, 2014
• Primary Completion: June 12, 2015
• Study Completion: June 12, 2015
• Last Updated: December 6, 2022

Record last verified: 2022-12

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)