- ICH GCP
- USA klinikai vizsgálatok nyilvántartása
- Klinikai vizsgálat NCT00910039
Sunitinib Malate After Stereotactic Radiosurgery in Treating Patients With Newly Diagnosed Brain Metastases
SUNDANCE Trial: Phase II Trial of Sunitinib as Maintenance Therapy After Stereotactic Radiosurgery in Patients With 1-3 Newly Diagnosed Brain Metastases
RATIONALE: Sunitinib malate may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth and by blocking blood flow to the tumor.
PURPOSE: This phase II trial is studying how well sunitinib malate works after stereotactic radiosurgery in treating patients with newly diagnosed brain metastases.
A tanulmány áttekintése
Állapot
Körülmények
Beavatkozás / kezelés
Részletes leírás
OBJECTIVES:
Primary
- Determine the CNS progression-free survival rate in patients with 1-3 newly diagnosed brain metastases treated with sunitinib malate after stereotactic radiosurgery (SRS).
Secondary
- Determine the rate of local (site of SRS treatment) failure at 12 months in these patients.
- Determine the median time to CNS disease progression in these patients.
- Determine the overall survival of these patients.
- Determine the time to progression of systemic disease in these patients.
- Evaluate the safety of sunitinib malate when administered after SRS in these patients.
- Assess the neurocognitive effects of SRS followed by sunitinib malate in these patients.
OUTLINE: Patients receive oral sunitinib malate once daily on days 1-28. Courses repeat every 42 days in the absence of disease progression or unacceptable toxicity.
Patients undergo neuropsychological battery testing at baseline and periodically during study to assess cognitive function (memory, verbal fluency, visual-motor speed, executive function, and motor dexterity), activities of daily living, and quality of life.
Tanulmány típusa
Beiratkozás (Tényleges)
Fázis
- 2. fázis
Kapcsolatok és helyek
Tanulmányi helyek
-
-
Michigan
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Detroit, Michigan, Egyesült Államok, 48202
- Henry Ford Health System
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Ohio
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Cleveland, Ohio, Egyesült Államok, 44195
- Cleveland Clinic Taussig Cancer Institute, Case Comprehensive Cancer Center
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Cleveland, Ohio, Egyesült Államok, 44106
- Case Medical Center, University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center
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-
Részvételi kritériumok
Jogosultsági kritériumok
Tanulmányozható életkorok
Egészséges önkénteseket fogad
Tanulmányozható nemek
Leírás
DISEASE CHARACTERISTICS:
- Histologically or cytologically confirmed carcinoma
- Has 1-3 newly diagnosed brain metastases amenable to stereotactic radiosurgery
- Patients may enroll up to 1 month after the completion of stereotactic radiosurgery provided they can undergo the required neuropsychiatric battery before beginning treatment.
- Patients must begin treatment within 1 month of stereotactic radiosurgery.
- No CNS metastases from lymphoma or small cell lung cancer
- No leptomeningeal metastases
- No CNS complications requiring urgent neurosurgical intervention (e.g., resection or shunt placement)
PATIENT CHARACTERISTICS:
- Karnofsky performance status 70-100% (RTOG RPA class I or II)
- Life expectancy > 6 weeks
- ANC ≥ 1,500/mm^3
- Platelet count ≥ 100,000/mm^3
- Hemoglobin ≥ 9.0 g/dL (transfusion allowed)
- AST and ALT ≤ 2.5 times upper limit of normal (ULN)
- Total serum bilirubin ≤ 1.5 times ULN
- Serum calcium ≤ 12.0 mg/dL
- Serum creatinine ≤ 2.5 mg/dL
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
- Willing and able to comply with schedule visits, treatment plans, laboratory tests, and other study procedures
- No medical problem (unrelated to the malignancy) that would pose an undue risk or that would limit full compliance with the study
- No unresolved bowel obstruction
- No uncontrolled infectious process
No evidence of bleeding diathesis or coagulopathy
- Hematuria from a primary renal tumor is allowed provided all other eligibility criteria are met
- No hypertension that cannot be controlled by medications to a blood pressure of < 160/90 mm Hg
None of the following within the past 6 months:
- Myocardial infarction
- Severe/unstable angina
- Severe peripheral vascular disease (claudication) or procedure on peripheral vasculature
- Coronary/peripheral artery bypass graft
- NYHA class II-IV congestive heart failure
- Cerebrovascular accident or transient ischemic attack
- Clinically significant bleeding
- Deep venous thrombosis or pulmonary embolism
- No other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or study drug administration, or that may interfere with the interpretation of study results and, in the judgement of the investigator, would make the patient inappropriate for entry into this study
PRIOR CONCURRENT THERAPY:
- See Disease Characteristics
- No prior sunitinib malate
- No prior cranial external beam radiotherapy
- No concurrent coumadin or other agents containing warfarin, except for low-dose coumadin (≤ 1 mg) administered prophylactically for maintenance of in-dwelling lines or ports
- No concurrent hepatic enzyme-inducing anticonvulsants
- No concurrent participation in another clinical trial
- No other concurrent investigational agents
- Concurrent steroids allowed provided dose is stable for ≥ 1 week
- Concurrent systemic therapy for management of stable systemic disease allowed
Tanulási terv
Hogyan készül a tanulmány?
Tervezési részletek
- Elsődleges cél: Kezelés
- Kiosztás: N/A
- Beavatkozó modell: Egyetlen csoportos hozzárendelés
- Maszkolás: Nincs (Open Label)
Fegyverek és beavatkozások
Résztvevő csoport / kar |
Beavatkozás / kezelés |
|---|---|
|
Kísérleti: Sunitinib malate
Oral sunitinib malate once daily on days 1-28. Courses repeat every 42 days in the absence of disease progression or unacceptable toxicity. Patients undergo neuropsychological battery testing at baseline and periodically during study to assess cognitive function (memory, verbal fluency, visual-motor speed, executive function, and motor dexterity), activities of daily living, and quality of life. |
Treatment will be administered on an outpatient basis.
Patients will receive sunitinib 37.5mg once daily in the morning without regard to meals in repeated 6-week cycles comprising daily therapy for 4 weeks followed by a 2-week rest period.
Patients who tolerate this dose may increase the dose to 50 mg once daily.
Más nevek:
The memory test has six alternate forms.
The other tests measure motor and information processing speed and are relatively resistant to the effects of practice.
The total time for test administration, including the QOL and symptom measures, is 40 minutes.The difference between the pre-treatment baseline and follow-up assessment scores will be determined by the reliable change (RC) index.
This index is derived from the standard error of measurement (SEM) for each test in the battery: 1 (deterioration), 2 (no change), or and 3 (improved).
Más nevek:
|
Mit mér a tanulmány?
Elsődleges eredményintézkedések
Eredménymérő |
Intézkedés leírása |
Időkeret |
|---|---|---|
|
Central Nervous System (CNS) Progression-free Survival Rate
Időkeret: 6 months after stereotactic radiosurgery (SRS)
|
The number of subjects surviving at least six months from SRS without progressive disease anywhere in the brain (local or regional failure), assessed by the McDonald's standard criteria.Progressive neurologic abnormalities not explained by causes unrelated to tumor progression (e.g.
anticonvulsant or corticosteroid toxicity, electrolyte abnormalities, hyperglycemia, etc.) or a greater than 25% increase in the size of the tumor by MRI/CT scan.
|
6 months after stereotactic radiosurgery (SRS)
|
Másodlagos eredményintézkedések
Eredménymérő |
Intézkedés leírása |
Időkeret |
|---|---|---|
|
Central Nervous System (CNS) Progression-free Survival Rate
Időkeret: 12 months after stereotactic radiosurgery (SRS)
|
The number of subjects surviving at least 12 months from SRS without progressive disease anywhere in the brain (local or regional failure), assessed by the McDonald's standard criteria.
Progressive neurologic abnormalities not explained by causes unrelated to tumor progression (e.g.
anticonvulsant or corticosteroid toxicity, electrolyte abnormalities, hyperglycemia, etc.) or a greater than 25% increase in the size of the tumor by MRI/CT scan.
|
12 months after stereotactic radiosurgery (SRS)
|
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Median Time to CNS Disease Progression
Időkeret: up to12 months from SRS
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Time to disease progression will be recorded from the first day of protocol therapy until the criteria for disease progression are met, patient death from any cause or removal of the patient from study for any reason, whichever comes first.
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up to12 months from SRS
|
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Overall Survival
Időkeret: 12 months from SRS
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The number of subjects surviving at least 12 months from stereotactic radiosurgery.
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12 months from SRS
|
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Time to Progression
Időkeret: at 3 yrs from SRS
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Time to progression (all sites of disease) - interval between stereotactic radiosurgery and the earliest date of progression (systemic or CNS) or death due to any cause.
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at 3 yrs from SRS
|
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Rate of Local Failure at 12 Months
Időkeret: 12 months
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Rate of local vs regional failure -rates of progression at site of stereotactic radiosurgery (local failure)vs progression anywhere else in CNS (regional failure).
|
12 months
|
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Neurocognitive Effects
Időkeret: at 2 months after treatment
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The number of patients that had statistically significant change (p's > 0.05) in their neurocognitive assessment (improvement or decline) from baseline.
Neurocognitive function was assessed in several domains, including memory, verbal fluency, visual-motor speed, executive function and motor dexterity.The difference between the pre-treatment baseline and follow-up assessment scores were determined by the reliable change (RC) index.
RC Index: 1=deterioration, 2=no change, 3=improved
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at 2 months after treatment
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Safety and Tolerability
Időkeret: 3 years from study start
|
Number of patients that experienced treatment-related G 3-4 adverse events.
|
3 years from study start
|
Együttműködők és nyomozók
Szponzor
Együttműködők
Nyomozók
- Kutatásvezető: David M. Peereboom, MD, Cleveland Clinic Taussig Cancer Institute, Case Comprehensive Cancer Center
Tanulmányi rekorddátumok
Tanulmány főbb dátumok
Tanulmány kezdete
Elsődleges befejezés (Tényleges)
A tanulmány befejezése (Tényleges)
Tanulmányi regisztráció dátumai
Először benyújtva
Először nyújtották be, amely megfelel a minőségbiztosítási kritériumoknak
Első közzététel (Becslés)
Tanulmányi rekordok frissítései
Utolsó frissítés közzétéve (Becslés)
Az utolsó frissítés elküldve, amely megfelel a minőségbiztosítási kritériumoknak
Utolsó ellenőrzés
Több információ
A tanulmányhoz kapcsolódó kifejezések
Kulcsszavak
További vonatkozó MeSH feltételek
- Agyi betegségek
- Központi idegrendszeri betegségek
- Idegrendszeri betegségek
- Neoplazmák
- Neoplazmák webhelyenként
- A központi idegrendszer daganatai
- Idegrendszeri neoplazmák
- Agyi neoplazmák
- A gyógyszerek élettani hatásai
- A farmakológiai hatás molekuláris mechanizmusai
- Enzim gátlók
- Antineoplasztikus szerek
- Angiogenezis gátlók
- Angiogenezist moduláló szerek
- Növekedést elősegítő anyagok
- Növekedésgátlók
- Protein kináz inhibitorok
- Szunitinib
Egyéb vizsgálati azonosító számok
- CASE1308 (Egyéb azonosító: Case Comprehensive Cancer Center)
- P30CA043703 (Az Egyesült Államok NIH támogatása/szerződése)
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