Patient case: 54-year-old male with Pancreatic cancer. Genetic variant: CDKN2A. Other conditions: Diabetes, Hypertension.

Clinical trial: UCN-01 and Fluorouracil in Treating Patients With Metastatic Pancreatic Cancer

Summary: RATIONALE: UCN-01 may stop the growth of tumor cells by blocking the enzymes necessary for tumor cell growth. Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Combining UCN-01 with chemotherapy may kill more tumor cells.
  PURPOSE: Phase II trial to study the effectiveness of combining UCN-01 with fluorouracil in treating patients who have metastatic pancreatic cancer that has not responded to treatment with gemcitabine.

Detailed description: OBJECTIVES:
  -  Determine the response rate, time to progression, and overall survival of patients with gemcitabine-refractory metastatic pancreatic cancer treated with UCN-01 and fluorouracil.
  -  Determine the toxicity of this regimen in these patients.
  OUTLINE: Patients receive fluorouracil IV over 24 hours on days 1, 8, 15, and 22. Patients also receive UCN-01 IV continuously over 72 hours (course 1 only) beginning on day 2. In subsequent courses, UCN-01 is infused over 36 hours. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
  PROJECTED ACCRUAL: A total of 12-37 patients will be accrued for this study within 3-13 months.

Eligibility: DISEASE CHARACTERISTICS:
  -  Histologically or cytologically confirmed adenocarcinoma of the pancreas
  -  Progressive disease after gemcitabine-based chemotherapy for metastatic disease
  -  At least 1 unidimensionally measurable metastatic lesion
  -  At least 20 mm by conventional techniques OR
  -  At least 10 mm by spiral CT scan
  -  Primary disease site is not considered a measurable lesion
  -  No known brain metastases
  PATIENT CHARACTERISTICS:
  Age
  -  18 and over
  Performance status
  -  ECOG 0-1 OR
  -  Karnofsky 70-100%
  Life expectancy
  -  More than 8 weeks
  Hematopoietic
  -  WBC at least 3,000/mm^3
  -  Absolute neutrophil count at least 1,500/mm^3
  -  Platelet count at least 100,000/mm^3
  Hepatic
  -  Bilirubin normal
  -  AST/ALT no greater than 2.5 times upper limit of normal
  Renal
  -  Creatinine normal OR
  -  Creatinine clearance at least 60 mL/min
  Cardiovascular
  -  No symptomatic congestive heart failure
  -  No unstable angina pectoris
  -  No cardiac tachyarrhythmia
  Pulmonary
  -  No symptomatic chronic obstructive pulmonary disease
  -  No pulmonary embolism within the past 6 months
  Other
  -  No prior allergic reactions to compounds of similar chemical or biological composition to UCN-01 or other agents used in this study
  -  No diabetes mellitus uncontrolled by insulin or oral hypoglycemic agents
  -  No uncontrolled concurrent illness
  -  No ongoing or active infection
  -  No psychiatric illness or social situation that would preclude study
  -  Not pregnant or nursing
  -  Negative pregnancy test
  -  Fertile patients must use effective contraception before, during, and for 3 months after study
  PRIOR CONCURRENT THERAPY:
  Biologic therapy
  -  No concurrent immunotherapy
  Chemotherapy
  -  See Disease Characteristics
  -  More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin) and recovered
  -  No more than 1 prior chemotherapy regimen for metastatic or recurrent disease
  -  No prior fluorouracil in the adjuvant or inoperable, locally advanced setting (except as a radiosensitizer)
  -  No other concurrent chemotherapy
  Endocrine therapy
  -  Not specified
  Radiotherapy
  -  More than 4 weeks since prior radiotherapy and recovered
  -  No prior mediastinal irradiation
  -  No concurrent radiotherapy
  Surgery
  -  Not specified
  Other
  -  No prior UCN-01 or other cyclin-dependent kinase inhibitors
  -  No concurrent combination antiretroviral therapy for HIV-positive patients
  -  No other concurrent investigational or commercial anticancer agents or therapies
  -  No concurrent anticonvulsant medications

Relevance to patient case: not relevant