- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01226056
Sorafenib in Combination With RAD001 in Advanced Solid Tumors Selected on Molecular Targets
Phase I/II Trial With Sorafenib in Combination With RAD001 Administered Orally in Patients With Advanced Solid Tumors, Selected on the Base of Molecular Targets
Sorafenib is an oral multikinase inhibitor and among its targets are several RTKs involved in tumor genesis (Raf, Flt-3, c-Kit and RET) and angiogenesis (VEGFR1, 2 and 3 and PDGFRß). Therefore sorafenib inhibits tumor growth by a dual mechanism, acting either directly on the tumor (through inhibition of Raf and Kit signaling) and/or on tumor angiogenesis (through inhibition of VEGFR and PDGFR signaling.
RAD001 is a novel derivative of rapamycin. It selectively inhibits mTOR directly blocking tumor cells by preventing tumor cell growth and proliferation and indirectly by inhibiting angiogenesis (via potent inhibition of the HIF-1 and consequently VEGF production).
Targeting mTOR in combination with sorafenib might lead to more profound effects on tumor cell biology than could be achieved through individual targeting of some proteins.
New drugs have often met only limited success since not always target pathways responsible for tumor development and growth are targeted. To overcome this problem, the specific pathways targeted by the investigators two drugs will be analyzed in each single patient before the inclusion.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Anticipated)
Phase
- Phase 2
- Phase 1
Contacts and Locations
Study Locations
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Milano, Italy, 20141
- Istituto Europeo di Oncologia,
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients with progressive disease of advanced solid tumours judged non suitable for standard treatment
Biopsiable lesion or archive tissue not older than 1 year to assess the expression of:
- phosphorylated AKT
- phosphorylated p70S6
- RKIP (Raf Kinase Inhibitor Protein)
- phosphorylated ERK1/2 The presence of at least one of the previous targets will be mandatory for patient enrolment
- At least 1 uni-dimensional measurable lesion according to modified RECIST
- Life expectancy of at least 12 weeks
- Age ≥ 18 years old
- ECOG Performance Status of 0 or 1
Adequate bone marrow, liver, and renal function as assessed by the following laboratory requirements to be conducted within 7 days prior to start of first dose:
- Haemoglobin ≥9.0 g/dL (5.6 mmol/L)
- Absolute neutrophil count (ANC)≥1.5 x 109/L
- Platelet count ≥100 x 109/L
- Total bilirubin ≤1.5 x upper limit of normal (ULN)
- ALT and AST ≤2.5 x ULN (≤5 x ULN for patients with liver involvement of their cancer)
- Alkaline phosphatase ≤4 x ULN
- PT-INR/PTT <1.5 x ULN
- Serum albumin levels ≥2.5 mg/dl
- Serum creatinine ≤1.5 x ULN
- HBV/HCV testing in the 2 weeks before treatment start in specific categories of patient with hepatitis B and C risk factors and in additional patients at the discretion of the investigators according to guidelines in Appendix 6.
- All fertile patients must use adequate contraception while on study and for three subsequent months
- Ability to understand and the willingness to sign a written informed consent. A signed informed consent must be obtained prior to performing any study specific procedures
Exclusion Criteria:
- History of cardiac disease: congestive heart failure (NYHA II-IV), active coronary artery disease - CAD (MI more than 6 months prior to study entry is allowed), cardiac arrhythmias requiring antiarrhythmic therapy (betablockers or digoxin are permitted) or uncontrolled hypertension
- History of HIV infection or chronic hepatitis B or C
- Patients with NSCLC squamous histotype
- Recurrent hemoptysis or cerebrovascular accident within 12 months, or peripheral vascular disease with claudication on less than 1 block (about 150 metres), or history of clinically significant bleeding non-traumatic
- Deep venous thrombosis or pulmonary embolus within 1 year or ongoing need for full-dose oral or parenteral anticoagulation
- Clinically active infections (> Grade 2 NCI-CTC AE version 3.0)
- Evidence of CNS tumor metastases
- History of organ allograft
- Pre-existing thyroid abnormality where thyroid function cannot be maintained in the normal range by medication
- Serious, non-healing wound, ulcer, or bone fracture
- Second malignancies within the past 5 years (except for non - melanoma skin cancer and cervical carcinoma in situ)
- Pregnant or breast-feeding patients
- Substance abuse, medical, psychological, or social conditions that may interfere with the patient's participation in the study or evaluation of the study results
- Any condition that is unstable or could jeopardize the safety of the patient and his/her compliance in the study
- Patients unable to swallow oral medications
- Any malabsorption condition
- Prior treatment with sorafenib or m-TOR inhibitors
- Ongoing requirement for systemic corticosteroid medication or other immunosuppressants
- Radiotherapy within 3 weeks of start of study drug. Palliative radiotherapy is allowed. Major surgery within 4 weeks of study entry
- Radiotherapy involving > 30% of the active bone marrow
- Autologous bone marrow transplant or stem cell rescue within 4 months of study entry
- Use of biologic response modifiers, such as G-CSF, within 3 week of study entry. Patients taking chronic erythropoietin are permitted provided no dose adjustment is undertaken within 2 months prior to the study or planned during the study period
- Investigational drug therapy outside of this trial during or within 4 weeks of study entry
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: RAD001 in combination with sorafenib
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Phase I / Dose escalation: during the first cycle RAD001 (2.5-10 mg/day) will be administered alone, once a day, on days 1-14 to allow PK-profiling of the drug. From day 15 sorafenib administration (400-800 mg/day) twice a day will be added. The cycle 1 will last 6 weeks, subsequent cycles will last 4 weeks (the 2 drugs administered in combination from day 1 to day 28). Phase II: The drugs will be administered at the Recommended Dose and each treatment cycle will last 4 weeks.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Phase I: Maximum Tolerated Dose (MTD)
Time Frame: 6 weeks
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The maximum tolerated dose (MTD) is defined as the dose in which 2 of 3 or 2 of 6 patients experience a DLT.
The Recommended Dose is identified as one dose level below the MTD.
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6 weeks
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Phase II: PFS (Progression Free survival) rate
Time Frame: 3 months
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3 months
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Phase I: Pharmacokinetics profile of both drugs
Time Frame: 6 weeks
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6 weeks
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Phase II: overall survival
Time Frame: 15 months
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15 months
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Tumor response
Time Frame: every 8 weeks
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Evaluated according to RECIST criteria
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every 8 weeks
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Objective Response Rate (ORR)
Time Frame: 15 months
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15 months
|
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Incidence and severity of AEs
Time Frame: 36 months
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graded according to CTCAE criteria v3.0
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36 months
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Collaborators and Investigators
Investigators
- Study Chair: filippo De Braud, MD, IEO, Milano (Italy)
Study record dates
Study Major Dates
Study Start
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- S075SORD01
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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