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Everolimus Dose Finding Study for Stage IV or Recurrent Cervical Cancer

Primary Purpose

Cervical Cancer

Status
Withdrawn
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
RAD001
Cisplatin
External Beam Whole Pelvis Radiation Therapy
Sponsored by
Accelerated Community Oncology Research Network
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cervical Cancer focused on measuring Stage IV or Recurrent Cervical cancer

Eligibility Criteria

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

Inclusion Criteria:

  • Patients must have at least one measurable site of disease according to Response Evaluation Criteria in Solid Tumors criteria that has not been previously irradiated.
  • Female patient aged ≥18 years.
  • Patient has life expectancy of at least 12 weeks at study start.
  • Patient has Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 at study start.
  • Patient has diagnosis of stage IV or recurrent, non-resectable, cervical cancer at study start.
  • Patient has received no prior chemotherapy.
  • Patient has adequate hematologic function:

    • Absolute neutrophil count [ANC] ≥1500/μL
    • Platelets ≥100,000/μL
    • Hemoglobin > 9g/dL
  • Patient has adequate renal function:

    • Serum creatinine ≤ 2.0 mg/dL
    • Calculated creatinine clearance ≥ 50 mL/min
  • Patient has adequate hepatic function:

    • Serum bilirubin ≤1.5 x ULN
    • ALT and AST ≤2.5 × ULN (≤ 5 x ULN in patients with liver metastases)
  • INR <1.5 (or < 3 on anticoagulants)
  • Patient has fasting serum cholesterol ≤300 mg/dL OR ≤7.75 mmol/L AND fasting triglycerides ≤ 2.5 x ULN.
  • Patient is able to provide signed informed consent.

Exclusion Criteria:

  • Patient has neuroendocrine or small cell carcinoma of the cervix.
  • Patient has previously used any biologic therapy with VEGF, VEGFR, or ErbB1/ErbB2 inhibitors.
  • Patient is currently receiving anticancer therapies or has received anticancer therapies within 4 weeks of the start of study drug (including chemotherapy, radiation therapy, antibody based therapy, etc.).
  • Patient has had a major surgery or significant traumatic injury within 4 weeks of start of study drug; patient has not recovered from the side effects of any major surgery (defined as requiring general anesthesia) or patient might require major surgery during the course of the study.
  • Patient has had prior treatment with any investigational drug within the preceding 4 weeks before study start.
  • Patient is receiving chronic, systemic treatment with corticosteroids or another immunosuppressive agent. Topical or inhaled corticosteroids are allowed.
  • Patients should not receive immunization with attenuated live vaccines within one week of study entry or during study period. Patients should also avoid close contact with people who have received live vaccines during treatment with everolimus. Examples of live vaccines are: intranasal influenza, measles, mumps, rubella, oral polio, BCG, yellow fever, and TY21a typhoid vaccines.
  • Patient has known brain or leptomeningeal metastases.
  • Patient has had other malignancies within the past 3 years except for adequately treated squamous cell carcinomas of the skin.
  • Patients has any severe and/or uncontrolled medical conditions or other conditions that could affect their participation in the study such as:

    • Symptomatic congestive heart failure of New York Heart Association Class III or IV.
    • Unstable angina pectoris, symptomatic congestive heart failure, myocardial infarction within 6 months of start of study drug, serious uncontrolled cardiac arrhythmia or any other clinically significant cardiac disease.
    • Severely impaired lung function defined as spirometry and diffusing capacity (DLCO) that is 50% of the normal predicted value and/or O2 saturation that is 88% or less at rest on room air.
    • Uncontrolled diabetes as defined by fasting serum glucose >1.5 × ULN.
    • Active (acute or chronic) or uncontrolled severe infections.
    • Liver disease such as cirrhosis, chronic active hepatitis or chronic persistent hepatitis.
  • Patient has a known history of human immunodeficiency virus seropositivity.
  • Patient has impairment of gastrointestinal function or gastrointestinal disease that may significantly alter the absorption of RAD001 (e.g., ulcerative disease, uncontrolled nausea, vomiting, diarrhea, malabsorption syndrome or small bowel resection).
  • Patient has an active, bleeding diathesis.
  • Female patient who is pregnant or breast feeding, or an adult of reproductive potential who is not using effective birth control methods. If barrier contraceptives are being used, these must be continued throughout the trial and for up to 8 weeks after ending treatment by both sexes. Hormonal contraceptives are not acceptable as a sole method of contraception. (Women of childbearing potential must have a negative urine or serum pregnancy test within 7 days prior to administration of RAD001.)
  • Patient has received prior treatment with an mTOR inhibitor (sirolimus, temsirolimus, everolimus).
  • Patient has a known hypersensitivity to RAD001 (everolimus) or other rapamycins (sirolimus, temsirolimus) or to its excipients.
  • Patient has history of noncompliance to medical regimens.
  • Patient is unwilling to or unable to comply with the protocol.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    Single arm

    Arm Description

    All subjects receive RAD001 in combination with standard field whole pelvic radiation and cisplatin.

    Outcomes

    Primary Outcome Measures

    To determine the maximum tolerated dose for RAD001 as adjunct therapy to standard upfront treatment of advanced stage cervical cancer in combination with weekly cisplatin and whole pelvic external beam radiation
    To determine the dose limiting toxicities for RAD001 as adjunct therapy to standard upfront treatment of advanced stage cervical cancer in combination with weekly cisplatin and whole pelvic external beam radiation

    Secondary Outcome Measures

    To determine the pharmacokinetics of RAD001 given as adjunct therapy to standard upfront treatment of advanced stage cervical cancer
    To evaluate the pharmacogenetics of RAD001 in the specified patient population
    To evaluate microvessel density pre-and post-treatment with the specified treatment regimen in the specified patient population
    To evaluate potential correlations between biomarkers HIF-1a, TSP-1, P53, VEGF, and VEGFR and use of the specified treatment regimen in the specified patient population
    To evaluate progression free survival in the specified patient population
    To assess quality of life as indicated by the Patient Care Monitor in the specified patient population

    Full Information

    First Posted
    August 27, 2009
    Last Updated
    February 13, 2014
    Sponsor
    Accelerated Community Oncology Research Network
    Collaborators
    Novartis Pharmaceuticals
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    1. Study Identification

    Unique Protocol Identification Number
    NCT00967928
    Brief Title
    Everolimus Dose Finding Study for Stage IV or Recurrent Cervical Cancer
    Official Title
    Phase I Everolimus Dose Finding Study for the Treatment of Stage IV or Recurrent, Non-resectable, Cervical Cancer With Standard Whole Pelvic Radiation Therapy in Combination With Weekly Cisplatin and Daily Everolimus
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    February 2014
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    Lack of enrollment
    Study Start Date
    December 2009 (undefined)
    Primary Completion Date
    December 2010 (Anticipated)
    Study Completion Date
    December 2010 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Accelerated Community Oncology Research Network
    Collaborators
    Novartis Pharmaceuticals

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    This Phase 1, single-site, dose-escalation study is being conducted to determine the maximum tolerated dose (MTD) of RAD001 as part of a specified combination regimen.
    Detailed Description
    This Phase 1, single-site, dose-escalation study is being conducted to determine the MTD of RAD001 as part of a specified combination regimen. The combination regimen will be standard field whole pelvic RT in combination with cisplatin at 40mg/m2 weekly with RAD001 at dose escalation daily starting at 5 mg qod, then 5 mg qd, then 10 mg qd during the period of whole pelvic radiation therapy.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Cervical Cancer
    Keywords
    Stage IV or Recurrent Cervical cancer

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 1
    Interventional Study Model
    Single Group Assignment
    Masking
    None (Open Label)
    Allocation
    N/A
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Single arm
    Arm Type
    Experimental
    Arm Description
    All subjects receive RAD001 in combination with standard field whole pelvic radiation and cisplatin.
    Intervention Type
    Drug
    Intervention Name(s)
    RAD001
    Other Intervention Name(s)
    Afinitor, Everolimus
    Intervention Description
    RAD001 will be administered orally as 5 mg qod, 5 mg qd, or 10mg qd continuously from study Day 1 until the end of whole pelvic radiation therapy unless the patient develops progression of disease or unacceptable toxicity prior to that.
    Intervention Type
    Drug
    Intervention Name(s)
    Cisplatin
    Other Intervention Name(s)
    CDDP, Platinol
    Intervention Description
    Cisplatin will be administered intravenously once weekly at 40mg/m2 for 6 weeks. The preferred administration day is Monday.
    Intervention Type
    Radiation
    Intervention Name(s)
    External Beam Whole Pelvis Radiation Therapy
    Intervention Description
    Patients will receive 180 cGy daily fraction Monday through Friday x 25 days (4500 cGy total) using a four field technique throughout the entire treatment with all fields treated each day.
    Primary Outcome Measure Information:
    Title
    To determine the maximum tolerated dose for RAD001 as adjunct therapy to standard upfront treatment of advanced stage cervical cancer in combination with weekly cisplatin and whole pelvic external beam radiation
    Time Frame
    every 7 days
    Title
    To determine the dose limiting toxicities for RAD001 as adjunct therapy to standard upfront treatment of advanced stage cervical cancer in combination with weekly cisplatin and whole pelvic external beam radiation
    Time Frame
    every 7 days
    Secondary Outcome Measure Information:
    Title
    To determine the pharmacokinetics of RAD001 given as adjunct therapy to standard upfront treatment of advanced stage cervical cancer
    Time Frame
    day 1 and day 15 during study treatment
    Title
    To evaluate the pharmacogenetics of RAD001 in the specified patient population
    Time Frame
    day 1 prior to starting study treatment
    Title
    To evaluate microvessel density pre-and post-treatment with the specified treatment regimen in the specified patient population
    Time Frame
    day 1 and end of treatment
    Title
    To evaluate potential correlations between biomarkers HIF-1a, TSP-1, P53, VEGF, and VEGFR and use of the specified treatment regimen in the specified patient population
    Time Frame
    day 1 and end of treatment
    Title
    To evaluate progression free survival in the specified patient population
    Time Frame
    from the time of treatment start until progression or up to 5 years after completion of study treatment
    Title
    To assess quality of life as indicated by the Patient Care Monitor in the specified patient population
    Time Frame
    every 7 days during study treatment

    10. Eligibility

    Sex
    Female
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Patients must have at least one measurable site of disease according to Response Evaluation Criteria in Solid Tumors criteria that has not been previously irradiated. Female patient aged ≥18 years. Patient has life expectancy of at least 12 weeks at study start. Patient has Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 at study start. Patient has diagnosis of stage IV or recurrent, non-resectable, cervical cancer at study start. Patient has received no prior chemotherapy. Patient has adequate hematologic function: Absolute neutrophil count [ANC] ≥1500/μL Platelets ≥100,000/μL Hemoglobin > 9g/dL Patient has adequate renal function: Serum creatinine ≤ 2.0 mg/dL Calculated creatinine clearance ≥ 50 mL/min Patient has adequate hepatic function: Serum bilirubin ≤1.5 x ULN ALT and AST ≤2.5 × ULN (≤ 5 x ULN in patients with liver metastases) INR <1.5 (or < 3 on anticoagulants) Patient has fasting serum cholesterol ≤300 mg/dL OR ≤7.75 mmol/L AND fasting triglycerides ≤ 2.5 x ULN. Patient is able to provide signed informed consent. Exclusion Criteria: Patient has neuroendocrine or small cell carcinoma of the cervix. Patient has previously used any biologic therapy with VEGF, VEGFR, or ErbB1/ErbB2 inhibitors. Patient is currently receiving anticancer therapies or has received anticancer therapies within 4 weeks of the start of study drug (including chemotherapy, radiation therapy, antibody based therapy, etc.). Patient has had a major surgery or significant traumatic injury within 4 weeks of start of study drug; patient has not recovered from the side effects of any major surgery (defined as requiring general anesthesia) or patient might require major surgery during the course of the study. Patient has had prior treatment with any investigational drug within the preceding 4 weeks before study start. Patient is receiving chronic, systemic treatment with corticosteroids or another immunosuppressive agent. Topical or inhaled corticosteroids are allowed. Patients should not receive immunization with attenuated live vaccines within one week of study entry or during study period. Patients should also avoid close contact with people who have received live vaccines during treatment with everolimus. Examples of live vaccines are: intranasal influenza, measles, mumps, rubella, oral polio, BCG, yellow fever, and TY21a typhoid vaccines. Patient has known brain or leptomeningeal metastases. Patient has had other malignancies within the past 3 years except for adequately treated squamous cell carcinomas of the skin. Patients has any severe and/or uncontrolled medical conditions or other conditions that could affect their participation in the study such as: Symptomatic congestive heart failure of New York Heart Association Class III or IV. Unstable angina pectoris, symptomatic congestive heart failure, myocardial infarction within 6 months of start of study drug, serious uncontrolled cardiac arrhythmia or any other clinically significant cardiac disease. Severely impaired lung function defined as spirometry and diffusing capacity (DLCO) that is 50% of the normal predicted value and/or O2 saturation that is 88% or less at rest on room air. Uncontrolled diabetes as defined by fasting serum glucose >1.5 × ULN. Active (acute or chronic) or uncontrolled severe infections. Liver disease such as cirrhosis, chronic active hepatitis or chronic persistent hepatitis. Patient has a known history of human immunodeficiency virus seropositivity. Patient has impairment of gastrointestinal function or gastrointestinal disease that may significantly alter the absorption of RAD001 (e.g., ulcerative disease, uncontrolled nausea, vomiting, diarrhea, malabsorption syndrome or small bowel resection). Patient has an active, bleeding diathesis. Female patient who is pregnant or breast feeding, or an adult of reproductive potential who is not using effective birth control methods. If barrier contraceptives are being used, these must be continued throughout the trial and for up to 8 weeks after ending treatment by both sexes. Hormonal contraceptives are not acceptable as a sole method of contraception. (Women of childbearing potential must have a negative urine or serum pregnancy test within 7 days prior to administration of RAD001.) Patient has received prior treatment with an mTOR inhibitor (sirolimus, temsirolimus, everolimus). Patient has a known hypersensitivity to RAD001 (everolimus) or other rapamycins (sirolimus, temsirolimus) or to its excipients. Patient has history of noncompliance to medical regimens. Patient is unwilling to or unable to comply with the protocol.
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Todd D Tillmanns, MD
    Organizational Affiliation
    The West Clinic
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Learn more about this trial

    Everolimus Dose Finding Study for Stage IV or Recurrent Cervical Cancer

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