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Azacitidine and Entinostat in Treating Patients With Metastatic Colorectal Cancer

30. juli 2014 oppdatert av: 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.

Studieoversikt

Status

Fullført

Forhold

Intervensjon / Behandling

Detaljert 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.

Studietype

Intervensjonell

Registrering (Faktiske)

47

Fase

  • Fase 2

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

  • Forente stater
    • Arizona
      • Scottsdale, Arizona, Forente stater, 85259
        • Mayo Clinic in Arizona
    • California
      • Los Angeles, California, Forente stater, 90033
        • University of Southern California/Norris Cancer Center
    • Florida
      • Jacksonville, Florida, Forente stater, 32224-9980
        • Mayo Clinic in Florida
    • Maryland
      • Baltimore, Maryland, Forente stater, 21287
        • Johns Hopkins University/Sidney Kimmel Comprehensive Cancer Center
    • Michigan
      • Detroit, Michigan, Forente stater, 48201
        • Wayne State University/Karmanos Cancer Institute
    • Minnesota
      • Maplewood, Minnesota, Forente stater, 55109
        • Minnesota Oncology Hematology PA-Maplewood
      • Rochester, Minnesota, Forente stater, 55905
        • Mayo Clinic
      • Saint Louis Park, Minnesota, Forente stater, 55416
        • Metro-Minnesota CCOP
      • Saint Paul, Minnesota, Forente stater, 55102
        • United Hospital
      • Stillwater, Minnesota, Forente stater, 55082
        • Lakeview Hospital
    • Missouri
      • Saint Louis, Missouri, Forente stater, 63110
        • Washington University School of Medicine
    • Pennsylvania
      • Pittsburgh, Pennsylvania, Forente stater, 15232
        • University of Pittsburgh
      • Pittsburgh, Pennsylvania, Forente stater, 15232
        • University of Pittsburgh Cancer Institute
    • Wisconsin
      • Madison, Wisconsin, Forente stater, 53792
        • University of Wisconsin Hospital and Clinics

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

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

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: N/A
  • Intervensjonsmodell: Enkeltgruppeoppdrag
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: 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.
Annen: laboratoriebiomarkøranalyse
Korrelative studier
Legemiddel: entinostat
Gis muntlig
Andre navn:
  • HDAC-hemmer SNDX-275
  • SNDX-275
Legemiddel: azacitidin
Gitt SC
Andre navn:
  • 5-AC
  • Vidaza
  • 5-azacytidin
  • azacytidin

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
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
Tiltaksbeskrivelse
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

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

National Cancer Institute (NCI)

Etterforskere

  • Hovedetterforsker: Nilofer Azad, Mayo Clinic

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Generelle publikasjoner

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart

1. april 2010

Primær fullføring (Faktiske)

1. mars 2012

Studiet fullført (Faktiske)

1. mai 2014

Datoer for studieregistrering

Først innsendt

15. april 2010

Først innsendt som oppfylte QC-kriteriene

15. april 2010

Først lagt ut (Anslag)

16. april 2010

Oppdateringer av studieposter

Sist oppdatering lagt ut (Anslag)

1. august 2014

Siste oppdatering sendt inn som oppfylte QC-kriteriene

30. juli 2014

Sist bekreftet

1. juli 2014

Mer informasjon

Begreper knyttet til denne studien

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • NCI-2010-02024 (Registeridentifikator: CTRP (Clinical Trial Reporting Program))
  • P30CA015083 (U.S. NIH-stipend/kontrakt)
  • N01CM00099 (U.S. NIH-stipend/kontrakt)
  • N01CM00038 (U.S. NIH-stipend/kontrakt)
  • 8341 (Annen identifikator: CTEP)
  • CDR0000670136
  • MC084B (Annen identifikator: Mayo Clinic)

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .

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