Ixabepilone in Treating Patients With Recurrent or Persistent Leiomyosarcoma of the Uterus Previously Treated With Chemotherapy
Condition: Recurrent Uterine Corpus Sarcoma; Uterine Corpus Leiomyosarcoma
MeSH terms: Leiomyosarcoma; Recurrence
Intervention: Ixabepilone; Laboratory Biomarker Analysis
Intervention description: Given IV; Correlative studies
Intervention MeSH terms: Epothilones
Phase: Phase 2
Study type: Interventional
Primary purpose: Treatment
Intervention model: Single Group Assignment
Masking: None (Open Label)
Enrollment: 26.0
Sex: Female
Minimum age: 18 Years
Healthy volunteers: No

Summary:

      This phase II trial is studying the side effects and how well ixabepilone works in treating
      patients with recurrent or persistent leiomyosarcoma of the uterus previously treated with
      chemotherapy. Drugs used in chemotherapy, such as ixabepilone, work in different ways to stop
      the growth of tumor cells, either by killing the cells or by stopping them from dividing.
    

Eligibility criteria:

        Inclusion Criteria:

          -  Histologically confirmed uterine leiomyosarcoma

               -  Persistent or recurrent disease that is refractory to curative or established
                  treatments

               -  Histologic confirmation of the original primary tumor is required

          -  Measurable disease defined as ≥ 1 lesion that can be accurately measured in ≥ 1
             dimension (longest diameter to be recorded)

               -  Each lesion must be ≥ 10 mm by CT scan, MRI, or caliper measurement by clinical
                  exam OR ≥ 20 mm by chest x-ray

               -  Lymph nodes must be ≥ 15 mm in short axis by CT scan or MRI

          -  Must have ≥ 1 "target lesion" to assess response

               -  Tumors within a previously irradiated field will be designated as "non-target"
                  lesions unless progression is documented or a biopsy is obtained to confirm
                  persistence ≥ 90 days following completion of radiotherapy

          -  Not eligible for a higher priority GOG protocol, if one exists

          -  Must have had 1 prior cytotoxic regimen that included a taxane regimen for management
             of leiomyosarcoma

               -  Single-agent or multi-agent therapy allowed

               -  Patients who did not receive prior therapy with a taxane (e.g., docetaxel) must
                  receive a second regimen that includes a taxane

          -  No known brain metastases

          -  GOG performance status 0-2

          -  Life expectancy > 6 months

          -  ANC ≥ 1,500/mm³

          -  Platelet count ≥ 100,000/mm³

          -  Creatinine ≤ 1.5 times upper limit of normal (ULN)

          -  Bilirubin ≤ 1.5 times ULN

          -  AST ≤ 3 times ULN

          -  Alkaline phosphatase ≤ 2.5 times ULN

          -  Peripheral neuropathy (sensory or mother) ≤ grade 1

          -  Negative pregnancy test

          -  Not pregnant or nursing

          -  Fertile patients must use effective contraception prior to and for the duration of
             study participation

          -  Free of active infection requiring antibiotics

               -  Uncomplicated urinary tract infection allowed

          -  No other invasive malignancy except non-melanoma skin cancer or curatively treated
             localized cancer of the breast, head and neck, or skin that was completed more than 3
             years ago and the patient remains free of recurrence or metastatic disease

          -  No history of a severe hypersensitivity reaction to agents containing Cremophor EL or
             its derivatives (e.g., polyoxyethylated castor oil)

          -  No uncontrolled intercurrent illness including, but not limited to, any of the
             following:

               -  Ongoing or active infection

               -  Symptomatic congestive heart failure

               -  Unstable angina

               -  Cardiac arrhythmia

               -  Psychiatric illness and/or social situations that would limit compliance with
                  study requirements

          -  No concurrent amifostine or other protective agents

          -  Recovered from effects of recent surgery, radiotherapy, or chemotherapy

          -  At least 1 week since prior hormonal therapy

               -  Hormonal therapy (cytotoxic or non-cytotoxic) not counted as prior regimen

          -  At least 3 weeks since any other prior therapy directed to the malignant tumor,
             including immunologic agents

          -  At least 4 weeks since prior radiation therapy

          -  One prior non-cytotoxic (biologic or cytostatic) regimen, administered as part of the
             previous cytotoxic regimen or in addition to it, allowed

               -  Non-cytotoxic agents include, but are not limited to, the following:

                    -  Monoclonal antibodies

                    -  Cytokines

                    -  Small-molecule inhibitors of signal transduction

          -  More than 3 years since radiotherapy for localized cancer of the breast, head and
             neck, or skin provided patient remains free of recurrence or metastatic disease

          -  No prior ixabepilone

          -  No prior chemotherapy for any abdominal or pelvic tumor other than for the treatment
             of uterine leiomyosarcoma within the past 3 years

          -  Prior chemotherapy for localized breast cancer allowed provided it was completed more
             than 3 years ago and patient remains free of recurrent or metastatic disease

          -  No other concurrent investigational agents

          -  No concurrent strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole,
             clarithromycin, atazanavir, nefazodone, saquinavir, telithromycin, ritonavir,
             amprenavir, indinavir, nelfinavir, delavirdine, voriconazole, or grapefruit juice) or
             CYP3A4 inducers (e.g., dexamethasone, phenytoin, carbamazepine, rifampin, rifampicin,
             rifabutin, phenobarbital, or St. John wort)

          -  No concurrent combination antiretroviral therapy for HIV-positive patients