Azacitidine and Entinostat in Treating Patients With Metastatic Colorectal Cancer
30. juli 2014 opdateret af: National Cancer Institute (NCI)
Phase II Study of Azacitadine and Entinostat in Patients With Metastatic Colorectal Cancer
This phase II trial is studying how well giving azacitidine together with entinostat works in treating patients with metastatic colorectal cancer.
Drugs used in chemotherapy, such as azacitidine, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing.
Entinostat may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth.
Giving azacitidine together with entinostat may kill more tumor cells.
Studieoversigt
Status
Afsluttet
Betingelser
Intervention / Behandling
Detaljeret beskrivelse
PRIMARY OBJECTIVES:
I. To determine the preliminary efficacy via Response Evaluation Criteria In Solid Tumors (RECIST) response rate of the combination of azacitidine and entinostat in patients with metastatic colorectal cancer.
SECONDARY OBJECTIVES:
I. Explore the effects of azacitidine and entinostat on time to progression in patients with metastatic colorectal cancer.
II. To assess the toxicity for combination azacitidine and entinostat therapy.
TERTIARY OBJECTIVES:
I. Evaluate changes in promoter methylation of selected genes from DNA in circulating serum samples.
II. To determine changes in histone deacetylase activity and acetylation of H3 and H4 histones in pre- and post-treatment tumor biopsies.
III. To evaluate correlations between these molecular effects and clinical outcomes (response, time to progression).
IV. To correlate response rates by RECIST criteria versus response rates determined be EASL (change in tumor enhancement).
OUTLINE: This is a multicenter study.
Patients receive azacitidine subcutaneously on days 1-5 and 8-10 and oral entinostat on days 3 and 10. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
Blood and tumor tissue samples are collected at baseline and periodically during courses 1-3 for DNA methylation, histone deacetylation activity, and acetylation of H3 and H4 histones analysis by PCR, western blot, and RT-PCR assays. Pharmacogenomic studies may also be conducted.
After completion of study therapy, patients are followed up every 3-6 months for up to 3 years.
Undersøgelsestype
Interventionel
Tilmelding (Faktiske)
47
Fase
- Fase 2
Kontakter og lokationer
Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.
Studiesteder
-
-
Arizona
-
Scottsdale, Arizona, Forenede Stater, 85259
- Mayo Clinic in Arizona
-
-
California
-
Los Angeles, California, Forenede Stater, 90033
- University of Southern California/Norris Cancer Center
-
-
Florida
-
Jacksonville, Florida, Forenede Stater, 32224-9980
- Mayo Clinic in Florida
-
-
Maryland
-
Baltimore, Maryland, Forenede Stater, 21287
- Johns Hopkins University/Sidney Kimmel Comprehensive Cancer Center
-
-
Michigan
-
Detroit, Michigan, Forenede Stater, 48201
- Wayne State University/Karmanos Cancer Institute
-
-
Minnesota
-
Maplewood, Minnesota, Forenede Stater, 55109
- Minnesota Oncology Hematology PA-Maplewood
-
Rochester, Minnesota, Forenede Stater, 55905
- Mayo Clinic
-
Saint Louis Park, Minnesota, Forenede Stater, 55416
- Metro-Minnesota CCOP
-
Saint Paul, Minnesota, Forenede Stater, 55102
- United Hospital
-
Stillwater, Minnesota, Forenede Stater, 55082
- Lakeview Hospital
-
-
Missouri
-
Saint Louis, Missouri, Forenede Stater, 63110
- Washington University School of Medicine
-
-
Pennsylvania
-
Pittsburgh, Pennsylvania, Forenede Stater, 15232
- University of Pittsburgh
-
Pittsburgh, Pennsylvania, Forenede Stater, 15232
- University of Pittsburgh Cancer Institute
-
-
Wisconsin
-
Madison, Wisconsin, Forenede Stater, 53792
- University of Wisconsin Hospital and Clinics
-
-
Deltagelseskriterier
Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.
Berettigelseskriterier
Aldre berettiget til at studere
18 år og ældre (Voksen, Ældre voksen)
Tager imod sunde frivillige
Ingen
Køn, der er berettiget til at studere
Alle
Beskrivelse
Inclusion Criteria:
- Histologically confirmed metastatic colorectal cancer
- Measurable disease
- Patient has failed ≥ 2 prior chemotherapy regimens
- Not a candidate for curative resection
No CNS metastases within ≤ 2 years
- Treatment for brain metastasis and whole brain disease that has remained stable for > 3 months allowed
- Patients who have not been treated with steroid therapy may be allowed
- ECOG performance status 0-1
- Life expectancy ≥ 12 weeks
- Leukocytes ≥ 3,000/mm^3
- ANC ≥ 1,500/mm^3
- Platelet count ≥ 100,000/mm^3
- Total bilirubin ≤ 1.5 times upper limit of normal (ULN)
- AST and ALT ≤ 2.5 times ULN
- Creatinine normal OR creatinine clearance ≥ 60 mL/min
- Negative pregnancy test
- Not pregnant or nursing
- Fertile patients must use effective contraception
- Sensory neuropathy ≤ grade 2 allowed
- Willing to provide tissue and blood samples
- No history of allergic reactions attributed to compounds of similar chemical or biologic composition to entinostat, azacitidine, mannitol, or other agents used in the study
No uncontrolled intercurrent illness including, but not limited to, any of the following:
- Ongoing or active infection
- NYHA class II-IV symptomatic congestive heart failure
- Unstable angina pectoris
- Cardiac arrhythmia
- Psychiatric illness and/or social situations that would limit compliance with study requirements
- No history of severe bleeding without thrombocytopenia
- No concurrent radiotherapy including palliative treatment
- Toxicities from prior therapy have resolved to ≤ grade 1
- More than 4 weeks since prior chemotherapy (> 6 weeks for nitrosoureas or mitomycin C)
- More than 4 weeks since prior major surgical procedure
- No prior histone deacetylase inhibitors (including valproic acid) or demethylating agents
- No concurrent investigational agents
- No concurrent combination antiretroviral therapy in HIV-positive patients
- No concurrent investigational or commercial anticancer agents or therapies
Studieplan
Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: N/A
- Interventionel model: Enkelt gruppeopgave
- Maskning: Ingen (Åben etiket)
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
|---|---|
|
Eksperimentel: Treatment (entinostat, azacitidine)
Patients receive azacitidine subcutaneously on days 1-5 and 8-10 and oral entinostat on days 3 and 10.
Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
|
Korrelative undersøgelser
Gives oralt
Andre navne:
Givet SC
Andre navne:
|
Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Confirmed Tumor Response
Tidsramme: At 6 month evaluation
|
Each evaluable patient is classified as having a confirmed tumor response if they have either a complete response (CR) or partial response (PR) lasts at least 4 weeks.
Tumor response is measured by using RECIST v1.1 (Response Evaluation Criteria in Solid Tumors).
A CR is defined as a disappearance of all target lesions, and each target lymph node must have reduction in short axis to <1.0 cm.
A PR is defined as a 30% decrease in the sum of the longest diameter for all target lesions plus the sum of the short axis of all the target lymph nodes at current evaluation, compared to pre-treatment measurements.
The confirmed response rate is calculated as the number of confirmed CR+PR, divided by the total number of evaluable patients, with 95% confidence intervals estimated using the approach of Duffy and Santner.
|
At 6 month evaluation
|
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Time to Progression
Tidsramme: From the start of treatment to the earliest of the date documenting disease progression, assessed up to 3 years
|
Time to disease progression (TTP) is defined as the time from the start of treatment to the earliest of the date documenting disease progression or most recent assessment for patients having no progression.
The distribution of TTP is estimated using the method of Kaplan-Meier.
|
From the start of treatment to the earliest of the date documenting disease progression, assessed up to 3 years
|
Samarbejdspartnere og efterforskere
Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.
Sponsor
Efterforskere
- Ledende efterforsker: Nilofer Azad, Mayo Clinic
Publikationer og nyttige links
Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.
Datoer for undersøgelser
Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.
Studer store datoer
Studiestart
1. april 2010
Primær færdiggørelse (Faktiske)
1. marts 2012
Studieafslutning (Faktiske)
1. maj 2014
Datoer for studieregistrering
Først indsendt
15. april 2010
Først indsendt, der opfyldte QC-kriterier
15. april 2010
Først opslået (Skøn)
16. april 2010
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Skøn)
1. august 2014
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
30. juli 2014
Sidst verificeret
1. juli 2014
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
- Sygdomme i fordøjelsessystemet
- Patologiske processer
- Neoplasmer
- Neoplasmer efter sted
- Sygdomsegenskaber
- Gastrointestinale neoplasmer
- Neoplasmer i fordøjelsessystemet
- Gastrointestinale sygdomme
- Tyktarmssygdomme
- Tarmsygdomme
- Intestinale neoplasmer
- Endetarmssygdomme
- Kolorektale neoplasmer
- Tilbagevenden
- Rektale neoplasmer
- Colon neoplasmer
- Molekylære mekanismer for farmakologisk virkning
- Enzymhæmmere
- Antimetabolitter, Antineoplastisk
- Antimetabolitter
- Antineoplastiske midler
- Azacitidin
- Histon deacetylase hæmmere
- Entinostat
Andre undersøgelses-id-numre
- NCI-2010-02024 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
- P30CA015083 (U.S. NIH-bevilling/kontrakt)
- N01CM00099 (U.S. NIH-bevilling/kontrakt)
- N01CM00038 (U.S. NIH-bevilling/kontrakt)
- 8341 (Anden identifikator: CTEP)
- CDR0000670136
- MC084B (Anden identifikator: Mayo Clinic)
Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .