Sunitinib Malate After Stereotactic Radiosurgery in Treating Patients With Newly Diagnosed Brain Metastases
2014年9月25日 更新者：Case Comprehensive Cancer Center
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.
調査の概要
詳細な説明
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.
研究の種類
介入
入学 (実際)
14
段階
- フェーズ2
連絡先と場所
このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。
研究場所
-
-
Michigan
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Detroit、Michigan、アメリカ、48202
- Henry Ford Health System
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Ohio
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Cleveland、Ohio、アメリカ、44195
- Cleveland Clinic Taussig Cancer Institute, Case Comprehensive Cancer Center
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Cleveland、Ohio、アメリカ、44106
- Case Medical Center, University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center
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-
参加基準
研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。
適格基準
就学可能な年齢
18年歳以上 (大人、高齢者)
健康ボランティアの受け入れ
いいえ
受講資格のある性別
全て
説明
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
研究計画
このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：処理
- 割り当て：なし
- 介入モデル：単一グループの割り当て
- マスキング：なし（オープンラベル）
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
実験的：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.
他の名前：
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).
他の名前：
|
この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Central Nervous System (CNS) Progression-free Survival Rate
時間枠：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)
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Central Nervous System (CNS) Progression-free Survival Rate
時間枠：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)
|
|
Median Time to CNS Disease Progression
時間枠：up to12 months from SRS
|
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.
|
up to12 months from SRS
|
|
Overall Survival
時間枠：12 months from SRS
|
The number of subjects surviving at least 12 months from stereotactic radiosurgery.
|
12 months from SRS
|
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Time to Progression
時間枠：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
時間枠：12 months
|
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
|
|
Neurocognitive Effects
時間枠：at 2 months after treatment
|
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
|
at 2 months after treatment
|
|
Safety and Tolerability
時間枠：3 years from study start
|
Number of patients that experienced treatment-related G 3-4 adverse events.
|
3 years from study start
|
協力者と研究者
ここでは、この調査に関係する人々や組織を見つけることができます。
捜査官
- 主任研究者：David M. Peereboom, MD、Cleveland Clinic Taussig Cancer Institute, Case Comprehensive Cancer Center
研究記録日
これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。
主要日程の研究
研究開始
2009年4月1日
一次修了 (実際)
2012年1月1日
研究の完了 (実際)
2014年4月1日
試験登録日
最初に提出
2009年5月28日
QC基準を満たした最初の提出物
2009年5月28日
最初の投稿 (見積もり)
2009年5月29日
学習記録の更新
投稿された最後の更新 (見積もり)
2014年9月29日
QC基準を満たした最後の更新が送信されました
2014年9月25日
最終確認日
2014年9月1日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
- CASE1308 (その他の識別子：Case Comprehensive Cancer Center)
- P30CA043703 (米国 NIH グラント/契約)
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
いいえ
米国FDA規制機器製品の研究
いいえ
米国で製造され、米国から輸出された製品。
いいえ
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