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A Phase II Trial of Perifosine Following Tyrosine Kinase Inhibitor (TKI) - Failure in Patients With Renal Cancer

Primary Purpose

Renal Cell Carcinoma

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Perifosine
Sponsored by
AEterna Zentaris
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Renal Cell Carcinoma focused on measuring renal cell carcinoma, tyrosine kinase inhibitor failure

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Patients will be required to have clear cell renal cell carcinoma with less than 50% of any other histology (papillary or chromophobe or oncocytic). There must be histologic confirmation by the treating center of either the primary or a metastatic lesion
  • Patients must have experienced disease progression by RECIST criteria while on sorafenib or sunitinib
  • Patients must be off of sorafenib or sunitinib for >= 2 weeks prior to initiation of perifosine and <= 3 months prior to enrollment
  • Patients may have had sorafenib or sunitinib in the adjuvant setting as long as they have experienced disease recurrence while on therapy
  • Patients must have measurable disease that is not curable by standard radiation therapy or surgery
  • Age >= 18 years
  • ECOG performance status 0 or 1
  • - Patients must have the ability to understand and willingness to sign a written informed consent document

Exclusion Criteria:

  • History or clinical evidence of CNS disease, including primary brain tumor, seizures not controlled with standard medical therapy, any brain metastasis, or history of stroke
  • Other than sorafenib or sunitinib, patients may have only had prior immunotherapy for stage IV disease
  • Patients may have had prior sorafenib OR sunitinib and cannot have been treated with both TKIs
  • Patients who have stopped sorafenib or sunitinib due to toxicity but have only progressed off therapy will not be allowed
  • Patients may have had prior anti-angiogenic such as bevacizumab only if given in combination with either sorafenib or sunitinib
  • Prior Thalidomide or IFNα are allowed for adjuvant therapy or stage IV disease
  • Patients may not have had prior mTOR inhibitors (CCI-779, RAD001)

Sites / Locations

  • Investigative Site
  • Dana Farber Cancer Institute
  • Investigative Site
  • Investigative Site

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Perifosine

Arm Description

Perifosine will be administered orally at 100mg PO daily with food. One treatment cycle will consist of 42 days (6 weeks).

Outcomes

Primary Outcome Measures

To estimate the progression free survival
To estimate the progression free survival of Multi-Targeted Kinase Inhibitor (TKI) resistant patients with metastatic Renal Cell Carcinoma (RCC) who are treated with perifosine

Secondary Outcome Measures

To determine the objective response rate of perifosine
To determine the objective response rate of TKI resistant patients with metastatic RCC treated with perifosine.
To investigate the tolerability and toxicity
To investigate the tolerability and toxicity of perifosine in TKI resistant patients
To investigate surrogates of biologic target inhibition
To investigate surrogates of biologic target inhibition on PBMC's before and after therapy.
To collect pre-treatment tissue specimens
To collect pre-treatment tissue specimens and assess the pre-treatment activation status of the MAP-Kinase and PI3K-Akt pathways and correlate with clinical outcome.
To follow levels of pro-angiogenic cytokines
To follow levels of pro-angiogenic cytokines and surrogates of HIF activation before and during therapy.

Full Information

First Posted
March 15, 2007
Last Updated
February 27, 2018
Sponsor
AEterna Zentaris
Collaborators
Dana-Farber Cancer Institute
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1. Study Identification

Unique Protocol Identification Number
NCT00448721
Brief Title
A Phase II Trial of Perifosine Following Tyrosine Kinase Inhibitor (TKI) - Failure in Patients With Renal Cancer
Official Title
A Phase II Trial of Perifosine Following Tyrosine Kinase Inhibitor Failure in Patients With Advanced Renal Cell Carcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
February 2012
Overall Recruitment Status
Completed
Study Start Date
March 2007 (undefined)
Primary Completion Date
October 2010 (Actual)
Study Completion Date
October 2011 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
AEterna Zentaris
Collaborators
Dana-Farber Cancer Institute

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a single-arm phase II trial of perifosine in renal cancer patients who have experienced disease progression after receiving either sorafenib or sunitinib.
Detailed Description
This is a single-arm phase II trial assessing the antitumor activity as measured by progression free survival of perifosine in patients with metastatic RCC who have progressed on sorafenib or sunitinib. A total of 48 patients will be enrolled in the trial. All subjects will have histologically confirmed metastatic RCC with predominantly clear cell features (≤ 50% other histologic features). Patients who have been taken off sorafenib or sunitinib may only have been off therapy for less than three months prior to study enrollment. Patients who remain on sorafenib or sunitinib may continue on drug at their current dose until two weeks prior to the initiation of perifosine therapy. The study consists of three periods: pre-treatment/screening, treatment, and follow-up. Day 1 will be defined as the first day of perifosine therapy. Patients will remain in the treatment phase until progression or toxicity. Patients will be seen by an MD every 3 weeks with 6 weeks defining one cycle of therapy. Tumor evaluations will occur every 6 weeks.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Renal Cell Carcinoma
Keywords
renal cell carcinoma, tyrosine kinase inhibitor failure

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
24 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Perifosine
Arm Type
Experimental
Arm Description
Perifosine will be administered orally at 100mg PO daily with food. One treatment cycle will consist of 42 days (6 weeks).
Intervention Type
Drug
Intervention Name(s)
Perifosine
Other Intervention Name(s)
D-21266, KRX-0401
Intervention Description
Perifosine will be administered orally at 100mg PO daily with food.
Primary Outcome Measure Information:
Title
To estimate the progression free survival
Description
To estimate the progression free survival of Multi-Targeted Kinase Inhibitor (TKI) resistant patients with metastatic Renal Cell Carcinoma (RCC) who are treated with perifosine
Time Frame
Every 6 weeks
Secondary Outcome Measure Information:
Title
To determine the objective response rate of perifosine
Description
To determine the objective response rate of TKI resistant patients with metastatic RCC treated with perifosine.
Time Frame
Every 6 weeks
Title
To investigate the tolerability and toxicity
Description
To investigate the tolerability and toxicity of perifosine in TKI resistant patients
Time Frame
Every 6 weeks
Title
To investigate surrogates of biologic target inhibition
Description
To investigate surrogates of biologic target inhibition on PBMC's before and after therapy.
Time Frame
Every 6 weeks
Title
To collect pre-treatment tissue specimens
Description
To collect pre-treatment tissue specimens and assess the pre-treatment activation status of the MAP-Kinase and PI3K-Akt pathways and correlate with clinical outcome.
Time Frame
Every 6 weeks
Title
To follow levels of pro-angiogenic cytokines
Description
To follow levels of pro-angiogenic cytokines and surrogates of HIF activation before and during therapy.
Time Frame
Every 6 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients will be required to have clear cell renal cell carcinoma with less than 50% of any other histology (papillary or chromophobe or oncocytic). There must be histologic confirmation by the treating center of either the primary or a metastatic lesion Patients must have experienced disease progression by RECIST criteria while on sorafenib or sunitinib Patients must be off of sorafenib or sunitinib for >= 2 weeks prior to initiation of perifosine and <= 3 months prior to enrollment Patients may have had sorafenib or sunitinib in the adjuvant setting as long as they have experienced disease recurrence while on therapy Patients must have measurable disease that is not curable by standard radiation therapy or surgery Age >= 18 years ECOG performance status 0 or 1 - Patients must have the ability to understand and willingness to sign a written informed consent document Exclusion Criteria: History or clinical evidence of CNS disease, including primary brain tumor, seizures not controlled with standard medical therapy, any brain metastasis, or history of stroke Other than sorafenib or sunitinib, patients may have only had prior immunotherapy for stage IV disease Patients may have had prior sorafenib OR sunitinib and cannot have been treated with both TKIs Patients who have stopped sorafenib or sunitinib due to toxicity but have only progressed off therapy will not be allowed Patients may have had prior anti-angiogenic such as bevacizumab only if given in combination with either sorafenib or sunitinib Prior Thalidomide or IFNα are allowed for adjuvant therapy or stage IV disease Patients may not have had prior mTOR inhibitors (CCI-779, RAD001)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Daniel Cho, MD
Organizational Affiliation
Dana-Farber Cancer Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
Investigative Site
City
Duarte
State/Province
California
ZIP/Postal Code
91010
Country
United States
Facility Name
Dana Farber Cancer Institute
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Facility Name
Investigative Site
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
Investigative Site
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37232
Country
United States

12. IPD Sharing Statement

Citations:
Citation
Journal of Clinical Oncology, 2009 ASCO Annual Meeting Proceedings (Post-Meeting Edition). Vol 27, No 15S (May 20 Supplement), 2009: 5101
Results Reference
result

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A Phase II Trial of Perifosine Following Tyrosine Kinase Inhibitor (TKI) - Failure in Patients With Renal Cancer

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