- ICH GCP
- Amerikanska kliniska prövningsregistret
- Klinisk prövning NCT00085566
Everolimus and Gefitinib in Treating Patients With Progressive Glioblastoma Multiforme or Progressive Metastatic Prostate Cancer
A Phase I/II Trial to Assess the Tolerability of RAD 001 With Gefitinib in Patients With Glioblastoma Multiforme and Prostate Cancer and Efficacy in Patients With Castrate Metastatic Prostate Cancer
RATIONALE: Everolimus may stop the growth of tumor cells by stopping blood flow to the tumor. Gefitinib may stop the growth of tumor cells by blocking the enzymes necessary for their growth. Combining everolimus with gefitinib may kill more tumor cells.
PURPOSE: This phase I/II trial is studying the side effects and best dose of everolimus when given together with gefitinib and to see how well they work in treating patients with progressive glioblastoma multiforme or (progressive metastatic prostate cancer closed to accrual 10/19/06).
Studieöversikt
Status
Intervention / Behandling
Detaljerad beskrivning
OBJECTIVES:
Primary
- Determine the maximum tolerated dose of everolimus when given in combination with gefitinib in patients with progressive glioblastoma multiforme or (progressive castrate metastatic prostate cancer -closed to accrual as of 10/19/2006). (Phase I)
- Determine the safety and efficacy of this regimen in patients with progressive glioblastoma multiforme or (progressive castrate metastatic prostate cancer - closed to accrual as of 10/19/2006). (Phase II)
Secondary
- Determine whether a pharmacokinetic interaction exists between everolimus and gefitinib in patients treated with this regimen.
- Determine the association between clinical outcomes and markers that may predict sensitivity of a tumor in patients treated with this regimen.
- Determine the pharmacodynamic effects of this regimen on post-therapy tumor specimens and peripheral blood mononuclear cells from these patients.
OUTLINE: This is a phase I, open-label, non-randomized, dose-escalation study of everolimus followed by a phase II study.
- Phase I: Patients receive oral everolimus on day 1 and oral gefitinib once daily on days 8-21. Beginning on day 22, patients receive oral everolimus once weekly and oral gefitinib once daily. Treatment with the combination continues in the absence of disease progression or unacceptable toxicity.
Cohorts of 3-6 patients receive escalating doses of everolimus until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity.
- Phase II (prostate cancer patients only) (closed to accrual as of 10/19/2006): Patients receive oral everolimus (at the MTD determined in phase I) once weekly and oral gefitinib once daily. Treatment continues in the absence of disease progression or unacceptable toxicity.
Studietyp
Inskrivning (Faktisk)
Fas
- Fas 2
- Fas 1
Kontakter och platser
Studieorter
-
-
New York
-
New York, New York, Förenta staterna, 10065
- Memorial Sloan Kettering Cancer Center
-
-
-
-
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Barcelona, Spanien, 08035
- Vall d'Hebron University Hospital
-
-
Deltagandekriterier
Urvalskriterier
Åldrar som är berättigade till studier
Tar emot friska volontärer
Kön som är behöriga för studier
Beskrivning
DISEASE CHARACTERISTICS:
Histologically confirmed diagnosis of 1 of the following:
Glioblastoma multiforme (GBM) (phase I only)
- Progressive disease despite standard therapy
Progressive disease based on 1 of the following:
- New or progressive (25% bidimensional increase) soft tissue masses on CT scan or MRI
- New or prior lesions that have increased in size by physical examination
- Patients who had prior interstitial brachytherapy or stereotactic radiosurgery must have confirmation of true disease progression (rather than radiation necrosis) by positron-emission tomography scan, thallium scanning, magnetic resonance spectroscopy, or surgical documentation
Castrate metastatic prostate cancer (closed to accrual as of 10/19/2006) (phase I and II)
- Progressive disease despite standard therapy AND castrate levels < 50 ng/dL of testosterone
Progressive disease based on 1 or more of the following:
- A minimum of 3 rising levels of prostate-specific antigen (PSA) that are obtained 1 or more weeks apart OR 2 rising PSA values obtained more than 1 month apart with at least a 25% increase over the range of values
- New or progressive (25% bidimensional increase) soft tissue masses on CT scan or MRI
- New metastatic lesions
- Patients on an antiandrogen as part of initial therapy must show disease progression after discontinuation of the antiandrogen
- Patients who have not undergone surgical orchiectomy must continue with medical therapy (e.g., gonadotropin-releasing hormone analogs) to maintain castrate levels of serum testosterone
- No brain metastases
PATIENT CHARACTERISTICS:
Age
- Over 18
Performance status
- Karnofsky 70-100%
Life expectancy
- More than 3 months
Hematopoietic
- Absolute neutrophil count ≥ 1,500/mm^3
- Platelet count ≥ 100,000/mm^3
- WBC ≥ 3,000/mm^3
Hepatic
- ALT and AST ≤ 2.5 times upper limit of normal (ULN)
- Bilirubin ≤ 1.5 mg/dL
Renal
- Creatinine within 1.5 times ULN (< 1.95 mg/dL at MSKCC)
Cardiovascular
- No significant cardiovascular disease
- No congestive heart failure
- No New York Heart Association class III or IV cardiac disease
- No active angina pectoris
- No myocardial infarction within the past 6 months
Other
- Not pregnant
- Negative pregnancy test
- Fertile patients must use effective contraception
- No serious medical illness
- No severe infection
- No severe malnutrition
No other active malignancy except non-melanoma skin cancer
- Patients are not considered to have an active malignancy if they have completed prior therapy and currently have a < 30% risk for relapse
PRIOR CONCURRENT THERAPY:
Biologic therapy
- No concurrent biological therapy
- No concurrent immunotherapy
Chemotherapy
- No concurrent chemotherapy
Endocrine therapy
- See Disease Characteristics
Radiotherapy
- See Disease Characteristics
- More than 4 weeks since prior radiotherapy
- No concurrent radiotherapy
Surgery
- See Disease Characteristics
- Prior recent resection of recurrent or progressive GBM allowed provided patient has recovered
- More than 4 weeks since prior major surgery
Other
- Recovered from all prior therapy
- More than 4 weeks since prior investigational anticancer drugs
- No concurrent anticonvulsant that interacts with CYP3A4 (e.g., phenytoin, carbamazepine, or phenobarbital)
- No other concurrent cytotoxic therapy
- No other concurrent investigational or commercial agents or therapies for the malignancy
Studieplan
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Behandling
- Tilldelning: N/A
- Interventionsmodell: Enskild gruppuppgift
- Maskning: Ingen (Open Label)
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
|---|---|
|
Experimentell: Everolimus (RAD-001) and Gefitinib
•Phase I: Patients receive oral everolimus on day 1 and oral gefitinib once daily on days 8-21. Beginning on day 22, patients receive oral everolimus once weekly and oral gefitinib once daily. Treatment with the combination continues in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of everolimus until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. •Phase II (prostate cancer patients only) (closed to accrual as of 10/19/2006): Patients receive oral everolimus (at the MTD determined in phase I) once weekly and oral gefitinib once daily. Treatment continues in the absence of disease progression or unacceptable toxicity. |
Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Overall Objective Response
Tidsram: 2 years
|
Response will be evaluated in this study using the new international criteria Response Evaluation Criteria in Solid Tumors (RECIST)
|
2 years
|
Samarbetspartners och utredare
Samarbetspartners
Utredare
- Huvudutredare: Lauren E. Abrey, MD, Memorial Sloan Kettering Cancer Center
- Huvudutredare: Howard I. Scher, MD, Memorial Sloan Kettering Cancer Center
- Huvudutredare: Neal Rosen, MD, Memorial Sloan Kettering Cancer Center
Studieavstämningsdatum
Studera stora datum
Studiestart
Primärt slutförande (Faktisk)
Avslutad studie (Faktisk)
Studieregistreringsdatum
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Första postat (Uppskatta)
Uppdateringar av studier
Senaste uppdatering publicerad (Uppskatta)
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Mer information
Termer relaterade till denna studie
Nyckelord
Ytterligare relevanta MeSH-villkor
- Sjukdomar i nervsystemet
- Neoplasmer efter histologisk typ
- Neoplasmer
- Urogenitala neoplasmer
- Neoplasmer efter plats
- Neoplasmer, körtel och epitel
- Genitala neoplasmer, manliga
- Prostatasjukdomar
- Astrocytom
- Gliom
- Neoplasmer, neuroepitelial
- Neuroektodermala tumörer
- Neoplasmer, könsceller och embryonala
- Neoplasmer, nervvävnad
- Prostatiska neoplasmer
- Glioblastom
- Neoplasmer i nervsystemet
- Neoplasmer i centrala nervsystemet
- Läkemedels fysiologiska effekter
- Molekylära mekanismer för farmakologisk verkan
- Enzyminhibitorer
- Antineoplastiska medel
- Immunsuppressiva medel
- Immunologiska faktorer
- Proteinkinashämmare
- Gefitinib
- Everolimus
Andra studie-ID-nummer
- 04-010
- MSKCC-04010
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