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- Ensayo clínico NCT01616186
Everolimus/Sorafenib or Sunitinib in Patients With Metastatic Renal Cell Carcinoma (RCC)
A Randomized Non-Comparative Multicenter Phase II Study of Everolimus/Sorafenib or Sunitinib in Patients With Metastatic Renal Cell Carcinoma (RCC)
Descripción general del estudio
Estado
Condiciones
Intervención / Tratamiento
Descripción detallada
Tipo de estudio
Fase
- Fase 2
Criterios de participación
Criterio de elegibilidad
Edades elegibles para estudiar
Acepta Voluntarios Saludables
Géneros elegibles para el estudio
Descripción
INCLUSION CRITERIA
- Histologically- or cytologically-confirmed renal cell carcinoma, which is unresectable or metastatic and of any of the following histologies: clear cell, papillary, chromophobic, oncocytic, unclassified, or mixed. A component of clear cell histology must be present. Tumors with pure collecting duct histology are not eligible.
- Cytoreductive nephrectomy is allowed but not required
- Evidence of RECIST-defined measurable disease (lesions that can be accurately measured in at least one dimension with the longest diameter ≥ 20mm using conventional techniques or ≥ 10 mm with spiral CT scan)
Male or female at least 18 years old
- Female patients must be either surgically sterile or postmenopausal, or if of childbearing potential must have a negative pregnancy test (serum or urine) prior to enrollment and agree to use effective barrier contraception during the period of therapy, and for 3 months after the end of treatment/end of participation in the study. Oral, implantable, or injectable contraceptives may be affected by cytochrome P450 interactions, and are therefore not considered effective for this study.
- Male patients must be surgically sterile or must agree to use effective contraception during the period of therapy, and for 3 months after the end of treatment/end of participation in the study.
- The definition of effective contraception will be based on the judgment of the investigator.
- ECOG performance status 0-1
Adequate bone marrow function:
- ANC ≥ 1500/uL
- platelet count ≥ 100,000/uL
- hemoglobin ≥ 9.0 g/dL
Adequate hepatic function:
- Total bilirubin ≤ 1.5 X ULN
- AST (SGOT) ≤ 2.5 X ULN
- ALT (SGPT) ≤ 2.5 X ULN
Adequate renal function as determined by either:
Calculated or measured creatinine clearance ≥ 40 mL/min (for calculated creatinine clearance, Cockroft-Gault equation will be used)
Modified Cockcroft-Gault formula:
((140 - age (yrs)) x (actual weight(kg))) / (72 x serum creatinine(mg/dl))
* Multiply by another factor of 0.85 if female
- Serum creatinine ≤ 1.5 X ULN
- Able to swallow oral medications
- Total fasting serum cholesterol ≤ 300 mg/dL
- Resolution of any pre-existing toxicity from prior therapy to NCI CTCAE V3.0 ≤ grade 1 (with the exception of hypertension, hypothyroidism)
- Signed and dated informed consent document
- Willingness and ability to comply with scheduled visits, treatment plans, laboratory tests, and other study procedures.
- More than 28 days since any prior therapy, including investigational agents and surgical procedures.
EXCLUSION CRITERIA
- Collecting duct renal cell carcinoma is excluded. Transitional cell carcinoma of the renal pelvis is excluded.
- Prior systemic regimens for renal cell carcinoma (neoadjuvant therapy is acceptable as long as it did not include sunitinib, sorafenib, everolimus, or temsirolimus). A prior therapy which was started and stopped after no more than four weeks of therapy will not constitute a prior systemic regimen.
- Prior surgery, radiation therapy, or systemic therapy for renal cell carcinoma within 4 weeks of starting study treatment.
- History of or known brain metastasis, spinal cord compression, or carcinomatous meningitis, or new evidence of brain or leptomeningeal disease on screening CT or MRI scan (evaluation for CNS disease is required to be performed for eligibility).
- Any of the following within 6 months prior to study drug administration: myocardial infarction, unstable or severe angina, coronary or peripheral artery bypass graft, NYHA functional Class II, III, IV congestive heart failure, cerebrovascular accident or transient ischemic attack, or pulmonary embolism.
- Ejection fraction lower than institutional lower limit of normal by echocardiogram or MUGA.
- Hypertension that is unable to be controlled with medications to a blood pressure of ≤ 150/90.
- Hypothyroidism that is unable to be controlled with medications such that FT4 is outside of normal limits.
- QTc prolongation (QTc interval ≥ 480 msecs) or any other clinically significant ECG abnormalities.
- Known human immunodeficiency virus (HIV) or acquired immune deficiency syndrome (AIDS)-related illness (because of the immunosuppressive effects of therapy). Testing for HIV in the absence of a history or symptoms is not required.
- Hepatitis B or C (because of the risk of reactivation). The following serologies are acceptable for enrollment: HBsAg-/anti-HBc-/anti-HBs-; HBsAg-/anti-HBc+/anti-HBs+; HBsAg-/anti-HBc-/anti-HBs+. The following serologies are not acceptable for enrollment: HBsAg+/anti-HBc+(IgM+/-)/anti-HBs-. If the following serologies are obtained, additional testing will be required to ascertain the patient's hepatitis B status: HBsAg-/anti-HBc+/anti-HBs-.
- "Currently active" second malignancy other than non-melanoma skin cancers. Patients are not considered to have a "currently active" malignancy if they have completed therapy and are considered to have a less than 30% risk of relapse.
- Current treatment on another clinical trial.
- Pregnant or breastfeeding.
- Chronic treatment with systemic steroids or other immunosuppressive agent.
- On oral vitamin K antagonist medication (except low dose warfarin) (other anticoagulants are allowed).
- History of malabsorption syndrome, disease significantly affecting gastrointestinal function or major resection of stomach or small bowel that could interfere with absorption, distribution, metabolism, or excretion of study drugs.
- Any serious and/or unstable pre-existing medical, psychiatric, or other condition (including lab abnormalities) that could interfere with subject safety or obtaining informed consent. Examples of such include uncontrolled diabetes as defined by fasting serum glucose >1.5 x ULN (Note: optimal glycemic control should be achieved before starting trial therapy), nonhealing wound, severe infection, severe malnutrition, ventricular arrhythmias, active ischemic heart disease, chronic liver or renal disease, or active upper GI tract ulceration.
- Patients should not receive immunization with attenuated live vaccines within one week of study entry or during study period. Close contact with those who have received attenuated live vaccines should be avoided during treatment with everolimus. Examples of live vaccines include intranasal influenza, measles, mumps, rubella, oral polio, BCG, yellow fever, varicella and TY21a typhoid vaccines.
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Tratamiento
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Ninguno (etiqueta abierta)
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
---|---|
Experimental: Everolimus/Sorafenib
Patients will be stratified by current smoking status (smoker: yes or no0, for each smoking stratum patients will be randomized in a 2:1 ratio
|
(Note: everolimus and sorafenib are typically dosed in 28 day cycles, and sunitinib is typically dosed in 42 day cycles; for the purposes of this protocol to keep timing consistent, a cycle will be defined as 42 days of therapy) |
Comparador activo: Sunitinib
|
Starting dose: sunitinib 50 mg daily 4 weeks on, 2 weeks off - taken fasting, no food 1 hour before or 2 hours after dosing (Note: sunitinib is typically dosed in 42 day cycles described above: 28 days treatment, 14 days off. For the purposes of this protocol, to keep timing consistent, a cycle will be defined as 42 days of therapy) |
¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
---|---|---|
Objective response
Periodo de tiempo: 12-18 weeks
|
Computerized Tomography Scans (CT) done at Screening and every 2 cycles
|
12-18 weeks
|
Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
---|---|---|
Safety: combination of everolimus and sorafenib
Periodo de tiempo: 12-18 weeks
|
Safety/Adverse Event (AE) assessments done on Day 1, 21, 42 during Cycle 1 & Day 28 of all subsuquent cycles; assessments include Eastern Oncology Group Conference (ECOG) Performance scale, physical/history, hematology & chemistry labs; other safety data (e.g.
Electrocardiogram [ECG], Multigated Acquisition Scan [MUGA], etc.) will be considered as appropriate
|
12-18 weeks
|
Progression-free Survival (PFS)
Periodo de tiempo: 12-18 weeks
|
- PFS will be measured (using RECIST 1.1 criteria) from the start of protocol therapy until the date of the first occurrence of recurrent or progressive disease or death
|
12-18 weeks
|
Time-to-Progression (TTP)
Periodo de tiempo: 12-18 weeks
|
- TTP will be measured from the start of protocol therapy until first date that recurrent or progressive disease is documented
|
12-18 weeks
|
Clinical Benefit rate
Periodo de tiempo: 12-18 weeks
|
Clinical benefit (defined as objective response+stable disease) will be summarized for each treatment arm by the proportion of patients achieving this outcome with 95% confidence intervals
|
12-18 weeks
|
Colaboradores e Investigadores
Patrocinador
Colaboradores
Investigadores
- Silla de estudio: Andrea Harzstark, MD, University of California, San Francisco
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio
Finalización primaria (Anticipado)
Finalización del estudio (Anticipado)
Fechas de registro del estudio
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Estimar)
Actualizaciones de registros de estudio
Última actualización publicada (Estimar)
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
- Neoplasias por tipo histológico
- Neoplasias Urológicas
- Neoplasias urogenitales
- Neoplasias por sitio
- Enfermedades Renales
- Enfermedades urológicas
- Adenocarcinoma
- Neoplasias Glandulares y Epiteliales
- Neoplasias Renales
- Neoplasias
- Carcinoma De Célula Renal
- Carcinoma
- Efectos fisiológicos de las drogas
- Mecanismos moleculares de acción farmacológica
- Inhibidores de enzimas
- Agentes antineoplásicos
- Agentes inmunosupresores
- Factores inmunológicos
- Inhibidores de la angiogénesis
- Agentes moduladores de la angiogénesis
- Sustancias de crecimiento
- Inhibidores del crecimiento
- Inhibidores de la proteína quinasa
- Sorafenib
- Sunitinib
- Everolimus
Otros números de identificación del estudio
- UCSF CC# 12521
Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .
Ensayos clínicos sobre Everolimus and sorafenib
-
Southern Europe New Drug OrganizationBayer; NovartisSuspendidoSorafenib en combinación con RAD001 en tumores sólidos avanzados seleccionados en dianas molecularesTumores sólidos avanzadosItalia
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Hospices Civils de LyonDesconocidoTumores sólidos metastásicos o localmente avanzadosFrancia
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National Cancer Institute (NCI)TerminadoGlioblastoma | Tumor cerebral | Glioma anaplásicoEstados Unidos
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University Hospitals Cleveland Medical CenterDesconocidoAsma | Rinitis alérgica | Conjuntivitis alérgicaEstados Unidos
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Memorial Sloan Kettering Cancer CenterActivo, no reclutandoCáncer de tiroidesEstados Unidos
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Swiss Group for Clinical Cancer ResearchTerminadoCáncer de hígadoSuiza, Austria, Hungría
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University of CologneTerminadoCáncer de pulmón de células no pequeñas | Tumor sólido adulto no especificado, protocolo específicoAlemania
-
PfizerTerminadoCarcinoma metastásico de células renales (mRCC)España, Italia, Bélgica, Francia, Reino Unido, Austria, Grecia, Países Bajos
-
Alliance for Clinical Trials in OncologyNational Cancer Institute (NCI); NovartisActivo, no reclutandoCáncer de tiroides de células de Hurthle refractarioEstados Unidos
-
Novartis PharmaceuticalsTerminadoCarcinoma hepatocelularEstados Unidos, España, Corea, república de, Países Bajos, Taiwán