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- Ensaio Clínico 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.
Visão geral do estudo
Status
Condições
Intervenção / Tratamento
Descrição detalhada
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.
Tipo de estudo
Inscrição (Real)
Estágio
- Fase 2
Contactos e Locais
Locais de estudo
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Michigan
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Detroit, Michigan, Estados Unidos, 48202
- Henry Ford Health System
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Ohio
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Cleveland, Ohio, Estados Unidos, 44195
- Cleveland Clinic Taussig Cancer Institute, Case Comprehensive Cancer Center
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Cleveland, Ohio, Estados Unidos, 44106
- Case Medical Center, University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center
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Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
Aceita Voluntários Saudáveis
Gêneros Elegíveis para o Estudo
Descrição
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
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: N / D
- Modelo Intervencional: Atribuição de grupo único
- Mascaramento: Nenhum (rótulo aberto)
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
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Experimental: 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.
Outros nomes:
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).
Outros nomes:
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O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
---|---|---|
Central Nervous System (CNS) Progression-free Survival Rate
Prazo: 6 months after stereotactic radiosurgery (SRS)
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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.
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6 months after stereotactic radiosurgery (SRS)
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Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
---|---|---|
Central Nervous System (CNS) Progression-free Survival Rate
Prazo: 12 months after stereotactic radiosurgery (SRS)
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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.
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12 months after stereotactic radiosurgery (SRS)
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Median Time to CNS Disease Progression
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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).
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12 months
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Neurocognitive Effects
Prazo: 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
Prazo: 3 years from study start
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Number of patients that experienced treatment-related G 3-4 adverse events.
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3 years from study start
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Colaboradores e Investigadores
Patrocinador
Colaboradores
Investigadores
- Investigador principal: David M. Peereboom, MD, Cleveland Clinic Taussig Cancer Institute, Case Comprehensive Cancer Center
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo
Conclusão Primária (Real)
Conclusão do estudo (Real)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Estimativa)
Atualizações de registro de estudo
Última Atualização Postada (Estimativa)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
- Doenças Cerebrais
- Doenças do Sistema Nervoso Central
- Doenças do Sistema Nervoso
- Neoplasias
- Neoplasias por local
- Neoplasias do Sistema Nervoso Central
- Neoplasias do Sistema Nervoso
- Neoplasias Cerebrais
- Efeitos Fisiológicos das Drogas
- Mecanismos Moleculares de Ação Farmacológica
- Inibidores Enzimáticos
- Agentes Antineoplásicos
- Inibidores de angiogênese
- Agentes Moduladores da Angiogênese
- Substâncias de crescimento
- Inibidores de crescimento
- Inibidores de proteína quinase
- Sunitinibe
Outros números de identificação do estudo
- CASE1308 (Outro identificador: Case Comprehensive Cancer Center)
- P30CA043703 (Concessão/Contrato do NIH dos EUA)
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