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Efficacy of RAD001 in Breast Cancer Patients With Bone Metastases (RADAR)

Primary Purpose

Breast Cancer

Status
Unknown status
Phase
Phase 2
Locations
Germany
Study Type
Interventional
Intervention
RAD001
Placebo
Sponsored by
German Breast Group
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Breast Cancer focused on measuring Breast Cancer, Bone metastases as only metastatic site, Breast cancer, HER2 negative, Bone metastasis as only metastatic site, Pretreated with endocrine therapy, Up to one previous chemotherapy, Previous treatment with bisphosphonates allowed

Eligibility Criteria

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

Inclusion Criteria:

  • Written informed consent prior to beginning specific protocol procedures, including expected cooperation of the patients for the treatment and follow-up, must be obtained and documented according to the local regulatory requirements.
  • Histologically confirmed invasive adenocarcinoma of the breast.
  • Primary tumour or metastasis negative or positive (≥ 10% positive stained cells) for oestrogen and/or progesterone receptor detected by immunohistochemistry.
  • Single or multiple bone metastasis (x-ray, CT or MRI) as only metastatic site.
  • Postmenopausal hormone receptor positive patients should have received an aromatase inhibitor in any given previous breast cancer therapy. Concurrent endocrine treatment for metastatic bone disease is obligatory. Previous treatment with bisphosphonates is allowed.
  • Up to one previous chemotherapy for metastatic disease is allowed.
  • Patients must have either measurable or non-measurable target lesions according to the WHO criteria.
  • At least 1 target lesion must be completely outside the radiation portal or there must be pathologic proof of progressive disease.
  • At least 2 weeks since major surgery with full recovery.
  • Complete staging within 4 weeks prior to registration.
  • Karnofsky performance status evaluation > 60%.
  • Age >18 years.
  • Absolute neutrophil count >1,500 cells/µl, platelet count >100,000 cells/µl.
  • Bilirubin >1.5x the upper normal limit for the institution (UNL); elevation of transaminases, alkaline phosphatase < 2.5x UNL and serum albumin < 30g/l. Normal renal function (creatinine >1.5x upper normal limit)
  • If of childbearing potential, negative pregnancy test. In addition the patient has to agree to use an effective method to avoid pregnancy for the duration of the study.

Exclusion Criteria:

  • Known hypersensitivity reaction to the compounds or incorporated substances (e.g. everolimus or sirolimus [rapamycin] or lactose).
  • Concurrent immunotherapy or hormone replacement therapy and use of hormonal contraceptives.
  • Need for chemotherapy or irradiation of bone metastasis during study treatment
  • HER2 positive primary tumour and/or lesion
  • Evidence of metastasis in other organs
  • Uncompensated diabetes mellitus; fasting value of blood sugar of >120 (mg/dl)
  • Corrected (adjusted for serum albumin) serum calcium concentration < 8.0 mg/dl (2.00 mmol/l) or > 12.0 mg/dl (3.00 mmol/l)
  • Abnormal renal function as evidenced by a calculated creatinine clearance < 30 ml/minute
  • Life expectancy of less than 3 months
  • Serious intercurrent medical or psychiatric illness that may interfere with the planned treatment (including AIDS and serious active infection).
  • History of other malignancy within the last 5 years which could affect the diagnosis or assessment of metastatic breast cancer
  • Concurrent treatment with other experimental drugs. Participation in another clinical trial with any investigational not marketed drug within 30 days prior to study entry.
  • Patients being treated with drugs recognized as being strong inhibitors or inducers of the isoenzyme CYP3A (e.g. rifabutin, rifampicin, clarithromycin, ketoconazole, itraconazole, ritonavir, telithromycin, erythromycin, verapamil, dilitazem) within the last 5 days or the expected need for these treatments during study participation.
  • Pregnant or nursing women.
  • The patient is not accessible for treatment and follow-up. Patients registered on this trial must be treated and followed at the participating centre which could be the Principal or Co-Investigator's site.

Sites / Locations

  • Dr. med. Christoph Mundhenke

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

1

2

Arm Description

Patients with stable disease after 8 week run in randomized to RAD001 (blinded)

Patients with stable disease after 8 week run in receive placebo (blinded)

Outcomes

Primary Outcome Measures

To determine the time to progression (TTP) in patients with no change in bone metastases after an 8 week run in treatment with RAD001 compared to placebo

Secondary Outcome Measures

To determine the objective response rate after 8 weeks of RAD001
To determine the TTP in patients with a response after 8 weeks of RAD001
To determine the overall clinical benefit defined as CR, PR or stable disease > 24 weeks for patients continuing RAD001 after the 8 week run in phase
To evaluate the safety and toxicity of RAD001
To assess the frequency of bone related events
To assess changes of pain intensity during treatment

Full Information

First Posted
April 25, 2007
Last Updated
August 29, 2012
Sponsor
German Breast Group
Collaborators
Novartis
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1. Study Identification

Unique Protocol Identification Number
NCT00466102
Brief Title
Efficacy of RAD001 in Breast Cancer Patients With Bone Metastases
Acronym
RADAR
Official Title
RADAR: A Randomized Discontinuation Phase II Study to Determine the Efficacy of RAD001 in Breast Cancer Patients With Bone Metastases
Study Type
Interventional

2. Study Status

Record Verification Date
August 2012
Overall Recruitment Status
Unknown status
Study Start Date
December 2006 (undefined)
Primary Completion Date
December 2010 (Actual)
Study Completion Date
December 2012 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
German Breast Group
Collaborators
Novartis

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to determine wether RAD001 can inhibit growth of tumour cells and/or stop the formation and activity of bone degrading osteoclasts.
Detailed Description
RAD001 is an orally bioavailable and well tolerated rapamycin ester analogue, which acts by selectively inhibiting mTOR (mammalian target of rapamycin). mTor is an intracellular protein kinase implicated in the control of cellular proliferation in neoplastic cells. Treatment with RAD001 has been shown to inhibit these signalling events and leads to growth retardation of tumour cells. In addition RAD001 in vitro stops the formation and activity of osteoclasts. Therefore a therapy of advanced breast cancer with progressive bone metastases seems to be reasonable with RAD001. Comparison: All patients receive RAD001 in an 8 week run in phase. Patients who show a response after 8 weeks will continue receiving RAD001. All patients with stable disease after the run in phase will be randomised to receive either RAD001 or placebo and will be followed up until progression of disease. Patients with progressive disease after the 8 week run in phase will be withdrawn from the trial.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Breast Cancer
Keywords
Breast Cancer, Bone metastases as only metastatic site, Breast cancer, HER2 negative, Bone metastasis as only metastatic site, Pretreated with endocrine therapy, Up to one previous chemotherapy, Previous treatment with bisphosphonates allowed

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
130 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
1
Arm Type
Active Comparator
Arm Description
Patients with stable disease after 8 week run in randomized to RAD001 (blinded)
Arm Title
2
Arm Type
Placebo Comparator
Arm Description
Patients with stable disease after 8 week run in receive placebo (blinded)
Intervention Type
Drug
Intervention Name(s)
RAD001
Intervention Description
Tablet of 5 mg, 2 tablets (10 mg) are taken once daily during study therapy
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
2 tablets are taken once daily during study therapy
Primary Outcome Measure Information:
Title
To determine the time to progression (TTP) in patients with no change in bone metastases after an 8 week run in treatment with RAD001 compared to placebo
Time Frame
40 weeks
Secondary Outcome Measure Information:
Title
To determine the objective response rate after 8 weeks of RAD001
Time Frame
8 weeks
Title
To determine the TTP in patients with a response after 8 weeks of RAD001
Time Frame
8 weeks
Title
To determine the overall clinical benefit defined as CR, PR or stable disease > 24 weeks for patients continuing RAD001 after the 8 week run in phase
Time Frame
40 weeks
Title
To evaluate the safety and toxicity of RAD001
Time Frame
40 weeks
Title
To assess the frequency of bone related events
Time Frame
40 weeks
Title
To assess changes of pain intensity during treatment
Time Frame
40 weeks

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Written informed consent prior to beginning specific protocol procedures, including expected cooperation of the patients for the treatment and follow-up, must be obtained and documented according to the local regulatory requirements. Histologically confirmed invasive adenocarcinoma of the breast. Primary tumour or metastasis negative or positive (≥ 10% positive stained cells) for oestrogen and/or progesterone receptor detected by immunohistochemistry. Single or multiple bone metastasis (x-ray, CT or MRI) as only metastatic site. Postmenopausal hormone receptor positive patients should have received an aromatase inhibitor in any given previous breast cancer therapy. Concurrent endocrine treatment for metastatic bone disease is obligatory. Previous treatment with bisphosphonates is allowed. Up to one previous chemotherapy for metastatic disease is allowed. Patients must have either measurable or non-measurable target lesions according to the WHO criteria. At least 1 target lesion must be completely outside the radiation portal or there must be pathologic proof of progressive disease. At least 2 weeks since major surgery with full recovery. Complete staging within 4 weeks prior to registration. Karnofsky performance status evaluation > 60%. Age >18 years. Absolute neutrophil count >1,500 cells/µl, platelet count >100,000 cells/µl. Bilirubin >1.5x the upper normal limit for the institution (UNL); elevation of transaminases, alkaline phosphatase < 2.5x UNL and serum albumin < 30g/l. Normal renal function (creatinine >1.5x upper normal limit) If of childbearing potential, negative pregnancy test. In addition the patient has to agree to use an effective method to avoid pregnancy for the duration of the study. Exclusion Criteria: Known hypersensitivity reaction to the compounds or incorporated substances (e.g. everolimus or sirolimus [rapamycin] or lactose). Concurrent immunotherapy or hormone replacement therapy and use of hormonal contraceptives. Need for chemotherapy or irradiation of bone metastasis during study treatment HER2 positive primary tumour and/or lesion Evidence of metastasis in other organs Uncompensated diabetes mellitus; fasting value of blood sugar of >120 (mg/dl) Corrected (adjusted for serum albumin) serum calcium concentration < 8.0 mg/dl (2.00 mmol/l) or > 12.0 mg/dl (3.00 mmol/l) Abnormal renal function as evidenced by a calculated creatinine clearance < 30 ml/minute Life expectancy of less than 3 months Serious intercurrent medical or psychiatric illness that may interfere with the planned treatment (including AIDS and serious active infection). History of other malignancy within the last 5 years which could affect the diagnosis or assessment of metastatic breast cancer Concurrent treatment with other experimental drugs. Participation in another clinical trial with any investigational not marketed drug within 30 days prior to study entry. Patients being treated with drugs recognized as being strong inhibitors or inducers of the isoenzyme CYP3A (e.g. rifabutin, rifampicin, clarithromycin, ketoconazole, itraconazole, ritonavir, telithromycin, erythromycin, verapamil, dilitazem) within the last 5 days or the expected need for these treatments during study participation. Pregnant or nursing women. The patient is not accessible for treatment and follow-up. Patients registered on this trial must be treated and followed at the participating centre which could be the Principal or Co-Investigator's site.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Nicolai Maass, MD, Prof.
Organizational Affiliation
Universitätsfrauenklinik Aachen
Official's Role
Principal Investigator
Facility Information:
Facility Name
Dr. med. Christoph Mundhenke
City
Kiel
State/Province
Schleswig-Holstein
ZIP/Postal Code
24105
Country
Germany

12. IPD Sharing Statement

Links:
URL
http://www.germanbreastgroup.de
Description
Related Info

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Efficacy of RAD001 in Breast Cancer Patients With Bone Metastases

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