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CompletedNCT00808184Updated Nov 1, 2012

Pharmacokinetic Study of CPT-11, Raltegravir and Midazolam With Characterisation of UGT1A1 Genotype

A Phase 4 interventional study of CPT-11, Raltegravir (Isentress®), Midazolam in Solid Tumor, sponsored by National University Hospital, Singapore. Completed at 2 sites in Singapore. Open to participants aged 21 Years and older. Per ClinicalTrials.gov, last updated 2012-11-01.

Sponsored by National University Hospital, Singapore · Phase 4, Interventional, and Treatment

Phase
Phase 4
Study type
Interventional
Enrollment
25
Allocation
Non-randomized
Ages
21 Years and older
Sex
All
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Study summary

The objectives of this study are:

To correlate pharmacokinetic parameters of raltegravir and midazolam with irinotecan (CPT-11) and its metabolite SN-38.

To correlate the genotype of UGT1A1 of patients receiving CPT-11 chemotherapy with irinotecan and raltegravir pharmacokinetic parameters.

To model pharmacokinetic and pharmacodynamic behaviour of CPT-11 in the study population.

Read the detailed description

To correlate pharmacokinetic parameters of raltegravir and midazolam with irinotecan (CPT-11) and its metabolite SN-38.

To correlate the genotype of UGT1A1 of patients receiving CPT-11 chemotherapy with irinotecan and raltegravir pharmacokinetic parameters.

To model pharmacokinetic and pharmacodynamic behaviour of CPT-11 in the study population.

VI. Abstract of Research Proposal In no more than 300 words, describe concisely the specific aims, hypotheses, methodology and approach of the application, indicating where appropriate the application's importance to science or medicine. The abstract must be self-contained so that it can serve as a succinct and accurate description of the application when separated from it. Please use lay terms. If this not possible, the technical and medical terms should be explained in simple language. The pharmacokinetic parameters of raltegravir will correlate well with irinotecan (CPT-11) and its metabolite SN-38 and better than midazolam.

Raltegravir pharmacokinetic parameters can be used to predict the genotype of UGT1A1 of patients receiving CPT-11 chemotherapy with irinotecan. Patients who are prescribed the CPT-11 containing regimen FOLFIRI will be selected for the study.

Subjects will then undergo the raltegravir and midazolam test one day before the first dose of their chemotherapy. Pharmacokinetic sampling will occur for these 2 days. The raltegravir and midazolam test will be carried out under fasting conditions (minimum 10 hours). Between 8 to 9 am, one mg of midazolam will be administered intravenously over 30 seconds. At the same time, raltegravir 400 mg will be administered orally with water. Blood samples will be drawn at specified times for pharmacokinetic analysis from a heparinised butterfly needle in the opposite arm.

On the next day, FOLFIRI will be administered as follows:

CPT-11 at 180 mg/m2 in 250 mL Normal Saline over 90 min followed by Leucovorin at 400 mg/m2 in 250 mL Normal Saline over 2 hours followed by 5-Flourouracil 400 mg/m2 IV bolus followed by 5-Flourouracil 2400 mg/m2 over 46 hours. Premedications may be administered as per routine clinical practice. Blood will be taken at specified times for pharmacokinetic analysis. The pharmacokinetic parameters of the raltegravir and midazolam will be compared with the pharmacokinetic parameters of CPT-11 and its metabolite SN-38. Correlation analysis will be performed on the parameters to find the raltegravir or midazolam parameters which correlate best with the CPT-11 and SN-38 parameters. CPT-11 and raltegravir parameters will be correlated with UGT1A1 and other demographic information.

02

Conditions studied

  • Solid Tumor

Keywords

  • Histologically or cytologically proven solid tumour for which CPT-11 given by the Folfiri regimen
03

In context

Lead sponsor

National University Hospital, Singapore is the lead sponsor of 444 studies on the registry; 96 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
21 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Histologically or cytologically proven solid tumour for which CPT-11 given by the Folfiri regimen is indicated and prescribed by the attending physician.
  • Age above 21 years.
  • Measurable or evaluable disease
  • Karnofsky performance status > 70%
  • Life expectancy > 3 months
  • WBC > 3.0 x 103/?l; ANC > 1500/?l
  • Hemoglobin > 9.0 g/dl
  • Platelets > 100000/?l
  • Creatinine \< 1.5 x ULN or calculated creatinine clearance > 40 ml/min
  • Total bilirubin \< 1.5 x ULN
  • SGOT, SGPT \< 5 x ULN unless due to disease

Exclusion criteria

Exclusion Criteria:

  • Biologic therapy or chemotherapy within 4 weeks. (Six weeks for prior nitrosoureas or mitomycin C).
  • Radiation therapy within 4 weeks if > 25% of bone marrow was irradiated.
  • Have not received any medications that are known to be metabolised by UGT1A1 within 30 days of the first dose of CPT-11.
  • Short gut syndrome or other causes of malabsorption.
  • Colony stimulating factors within 2 weeks.
  • Women of childbearing potential not practicing birth control. (Note: by means other than oral contraception)
  • Pregnant women
  • Severe peripheral neuropathy grade 2 or higher.
  • Medical or psychiatric conditions which may impair the patient's ability to provide informed consent.
  • Hypersensitivity to CPT-11, raltegravir or midazolam/other benzodiazepines.
  • Rapidly progressive intracranial or spinal metastatic disease.
05

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Non-randomized
Intervention model
Single group
Masking
None (open label)
Enrollment
25 participants (actual)

Study arms

  • Active comparator
    CPT-11

    Drug: CPT-11, Raltegravir (Isentress®), Midazolam

Interventions

  • DrugCPT-11, Raltegravir (Isentress®), Midazolam
06

What researchers measure

Primary outcomes

  1. Correlate pharmacokinetic parameters of raltegravir and midazolam with irinotecan (CPT-11) and its metabolite SN-38

    Time frame: 1 year

07

Study locations

2 sites
  • National University Hospital
    Singapore, 119074, Singapore
  • Tan Tock Seng Hospital
    Singapore, 308433, Singapore
08

References and documents

Publications

  • Atsumi R, Suzuki W, Hakusui H. Identification of the metabolites of irinotecan, a new derivative of camptothecin, in rat bile and its biliary excretion. Xenobiotica. 1991 Sep;21(9):1159-69. doi: 10.3109/00498259109039556. PubMed 1788984 ↗
  • Gupta E, Mick R, Ramirez J, Wang X, Lestingi TM, Vokes EE, Ratain MJ. Pharmacokinetic and pharmacodynamic evaluation of the topoisomerase inhibitor irinotecan in cancer patients. J Clin Oncol. 1997 Apr;15(4):1502-10. doi: 10.1200/JCO.1997.15.4.1502. PubMed 9193346 ↗
  • Lee LS, Seng KY, Wang LZ, Yong WP, Hee KH, Soh TI, Wong A, Cheong PF, Soong R, Sapari NS, Soo R, Fan L, Lee SC, Goh BC. Phenotyping of UGT1A1 Activity Using Raltegravir Predicts Pharmacokinetics and Toxicity of Irinotecan in FOLFIRI. PLoS One. 2016 Jan 25;11(1):e0147681. doi: 10.1371/journal.pone.0147681. eCollection 2016. PubMed 26808671 ↗
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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Nov 1, 2012, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT00808184
Lead sponsor
National University Hospital, Singapore
Responsible party
Sponsor
First posted
Dec 15, 2008
Start date
Apr 2010
Primary completion
Feb 2012
Completion
Feb 2012
Last update
Nov 1, 2012

Study contacts

Boon Cher Goh, MRCP
principal investigator · National University Hospital, Singapore

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Apr 2010. You cannot join it, but the record below documents what was studied.

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