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AZD2171 and Temsirolimus in Patients With Advanced Gynecological Malignancies

Primary Purpose

Endometrial Cancer, Ovarian Cancer, Cervical Cancer

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
temsirolimus
cediranib
Sponsored by
Susana M. Campos, MD
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Endometrial Cancer focused on measuring AZD2171, temsirolimus, advanced gynecological malignancies

Eligibility Criteria

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

Inclusion Criteria:

  • Patients with metastatic endometrial cancer
  • Patients with recurrent ovarian, fallopian and peritoneal cancer
  • Patients with recurrent cervical cancer
  • Patients may have either measurable or non-measurable disease
  • Up to one prior line of chemotherapy in the recurrent setting is allowed. Biologic therapies will be considered as a prior line but hormonal therapies do not count.
  • No prior VEGF inhibitor therapy allowed.
  • Toxic side effects related to prior chemotherapy or hormonal therapy must have resolved to less than or equal to grade 1 or to baseline (excluding alopecia), or for peripheral neuropathy to less than or equal to grade 2.
  • Subjects may begin AZD2171 and temsirolimus at least 3 weeks after their last dose of chemotherapy or hormonal therapy, assuming they are otherwise eligible.
  • 18 years of age or older
  • At present, the potential of AZD2171 for clinically significant drug interactions involving the CYP isozymes is unknown. Eligibility of patients receiving any medication or substances known to affect or with teh potential to affect the activity or PK of AZD2171 will be determined following review of their case by the principal investigator.
  • Subjects with treated limited stage basal cell or squamous cell carcinoma of the skin or carcinoma in situ of the breast or cervix are eligible if they otherwise meet eligibility. Subjects with stage I or II cancer treated with curative intent are also eligible with no evidence of recurrent disease.
  • No evidence of preexisting uncontrolled hypertension. If patient has hypertension, it must be medically controlled prior to starting AZD2171.
  • Women of child-bearing potential must have a negative pregnancy test prior to study entry. Women of child-bearing potential must agree to use adequate contraception prior to study entry and for the duration of study participation.
  • No therapeutic anticoagulation. The use of low dose warfarin, intermittent doses of TPA, or heparin flushes to prophylaxis against central venous catheter-associated clots is permitted.
  • ECOG Performance status 0-2
  • Patients must have normal organ and marrow function as defined in the protocol

Exclusion Criteria:

  • Patients who have had chemotherapy, radiotherapy, or major surgery within 3 weeks (6 weeks for nitrosoureas or mitomycin C) prior to entering the study or those who have not recovered from adverse events due to agents administered more than 3 weeks earlier.
  • Patients may not be receiving any other investigational agents nor have participated in an investigational trial within the past 4 weeks. Prior bevacizumab is allowed.
  • Patients may not be receiving any medication that may markedly affect renal function. NSAIDs should be avoided if possible.
  • Patients with known brain metastases should be excluded from this clinical trial. A CT of the head is required prior to entry into the study.
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to AZD2171.
  • Mean QTc of 470msec or greater in screening electrocardiogram or history of familial long QT syndrome.
  • Greater than +1 proteinuria on two consecutive dipsticks taken no less than 1 week apart
  • Uncontrolled intercurrent illness including, but not limited to hypertension, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, myocardial infarction cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
  • Inability to take and absorb orally administered medication.
  • Pregnant women. Breastfeeding should be discontinued.
  • Major surgical procedure or medical interference with peritoneum or pleura within 4 weeks of baseline CA-125 assessments. This excludes the need for a paracentesis.
  • Subjects with a history of an active malignancy during the last 3 years except non-melanomatous skin cancer, in situ breast or cervical cancer or stage I or II cancer treated with a curative intent and no active cancer recurrence.
  • HIV-positive patients on combination antiretroviral therapy are ineligible because of the potential for pharmacokinetic interactions with AZD2171.
  • New York Heart Association classification of III or IV
  • Conditions requiring concurrent use of drugs or biologics with proarrhythmic potential.

Sites / Locations

  • Massachusetts General Hospital
  • Beth Israel Deaconess Medical Center
  • Dana-Farber Cancer Institute

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Cediranib and Temsirolimus

Arm Description

Please see interventions section.

Outcomes

Primary Outcome Measures

To determine the maximum tolerated dose of cediranib with temsirolimus in patients with recurrent/refractory gynecological malignancies.

Secondary Outcome Measures

To determine the efficacy of this combination as measured by response rate or clinical benefit.

Full Information

First Posted
February 8, 2010
Last Updated
April 20, 2021
Sponsor
Susana M. Campos, MD
Collaborators
Massachusetts General Hospital, Beth Israel Deaconess Medical Center, National Comprehensive Cancer Network, Wyeth is now a wholly owned subsidiary of Pfizer, AstraZeneca
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1. Study Identification

Unique Protocol Identification Number
NCT01065662
Brief Title
AZD2171 and Temsirolimus in Patients With Advanced Gynecological Malignancies
Official Title
A Phase I/IB Study fo AZD2171 and Temsirolimus in Patients With Advanced Gynecological Malignancies
Study Type
Interventional

2. Study Status

Record Verification Date
April 2021
Overall Recruitment Status
Completed
Study Start Date
February 2010 (undefined)
Primary Completion Date
September 2013 (Actual)
Study Completion Date
March 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Susana M. Campos, MD
Collaborators
Massachusetts General Hospital, Beth Israel Deaconess Medical Center, National Comprehensive Cancer Network, Wyeth is now a wholly owned subsidiary of Pfizer, AstraZeneca

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this research study is to determine the safety of the combination of the two drugs cediranib and temsirolimus and the highest doses of these two drugs that can be given in combination to people safely. Cediranib is a drug that may stop blood supply to the tumor and therefore help keep cancer cells from growing. Temsirolimus is a drug that may stop cancer cells from growing. These drugs have been used in other research studies in ovarian and kidney cancer and these studies suggest that these drugs may help to keep cancer from growing in this research study.
Detailed Description
We are looking for the highest dose of the study drugs that can be administered safely without severe or unmanageable side effects in participants that have recurrent gynecological cancers. Not everyone who participates in this research study will receive the same dose of the study drug. There will be samples of blood taken that measure any additional effect of the study drugs and to look for a marker for the participant's particular type of cancer. Blood will be taken at a certain point in the study to evaluate the interaction of the two study drugs, cediranib and temsirolimus when given together. These are called pharmacokinetic (PK) samples. About 6 teaspoons of blood will be taken with each PK sample with a total of 34 samples taken. Participants will be given a study medication diary for each treatment cycle. Each cycle lasts four weeks (28 days). Temsirolimus will be given on days 1, 8, 15 and 22 of each cycle. Cediranib wil be taken orally once daily in the morning. Participants will be asked to monitor their blood pressure on a daily basis at home and keep a blood pressure diary. The following tests and procedures will be performed at specific time periods during the course of the study: medical history; side effect assessment; physical exam; vital signs; blood tests; CT scan; MUGA or ECHO; EKG and urine test.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Endometrial Cancer, Ovarian Cancer, Cervical Cancer, Fallopian Tube Cancer, Peritoneal Cancer
Keywords
AZD2171, temsirolimus, advanced gynecological malignancies

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Cediranib and Temsirolimus
Arm Type
Experimental
Arm Description
Please see interventions section.
Intervention Type
Drug
Intervention Name(s)
temsirolimus
Intervention Description
Given on days 1, 8, 15 and 22 of each cycle
Intervention Type
Drug
Intervention Name(s)
cediranib
Intervention Description
Taken orally daily
Primary Outcome Measure Information:
Title
To determine the maximum tolerated dose of cediranib with temsirolimus in patients with recurrent/refractory gynecological malignancies.
Time Frame
1 year
Secondary Outcome Measure Information:
Title
To determine the efficacy of this combination as measured by response rate or clinical benefit.
Time Frame
2 years

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients with metastatic endometrial cancer Patients with recurrent ovarian, fallopian and peritoneal cancer Patients with recurrent cervical cancer Patients may have either measurable or non-measurable disease Up to one prior line of chemotherapy in the recurrent setting is allowed. Biologic therapies will be considered as a prior line but hormonal therapies do not count. No prior VEGF inhibitor therapy allowed. Toxic side effects related to prior chemotherapy or hormonal therapy must have resolved to less than or equal to grade 1 or to baseline (excluding alopecia), or for peripheral neuropathy to less than or equal to grade 2. Subjects may begin AZD2171 and temsirolimus at least 3 weeks after their last dose of chemotherapy or hormonal therapy, assuming they are otherwise eligible. 18 years of age or older At present, the potential of AZD2171 for clinically significant drug interactions involving the CYP isozymes is unknown. Eligibility of patients receiving any medication or substances known to affect or with teh potential to affect the activity or PK of AZD2171 will be determined following review of their case by the principal investigator. Subjects with treated limited stage basal cell or squamous cell carcinoma of the skin or carcinoma in situ of the breast or cervix are eligible if they otherwise meet eligibility. Subjects with stage I or II cancer treated with curative intent are also eligible with no evidence of recurrent disease. No evidence of preexisting uncontrolled hypertension. If patient has hypertension, it must be medically controlled prior to starting AZD2171. Women of child-bearing potential must have a negative pregnancy test prior to study entry. Women of child-bearing potential must agree to use adequate contraception prior to study entry and for the duration of study participation. No therapeutic anticoagulation. The use of low dose warfarin, intermittent doses of TPA, or heparin flushes to prophylaxis against central venous catheter-associated clots is permitted. ECOG Performance status 0-2 Patients must have normal organ and marrow function as defined in the protocol Exclusion Criteria: Patients who have had chemotherapy, radiotherapy, or major surgery within 3 weeks (6 weeks for nitrosoureas or mitomycin C) prior to entering the study or those who have not recovered from adverse events due to agents administered more than 3 weeks earlier. Patients may not be receiving any other investigational agents nor have participated in an investigational trial within the past 4 weeks. Prior bevacizumab is allowed. Patients may not be receiving any medication that may markedly affect renal function. NSAIDs should be avoided if possible. Patients with known brain metastases should be excluded from this clinical trial. A CT of the head is required prior to entry into the study. History of allergic reactions attributed to compounds of similar chemical or biologic composition to AZD2171. Mean QTc of 470msec or greater in screening electrocardiogram or history of familial long QT syndrome. Greater than +1 proteinuria on two consecutive dipsticks taken no less than 1 week apart Uncontrolled intercurrent illness including, but not limited to hypertension, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, myocardial infarction cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements. Inability to take and absorb orally administered medication. Pregnant women. Breastfeeding should be discontinued. Major surgical procedure or medical interference with peritoneum or pleura within 4 weeks of baseline CA-125 assessments. This excludes the need for a paracentesis. Subjects with a history of an active malignancy during the last 3 years except non-melanomatous skin cancer, in situ breast or cervical cancer or stage I or II cancer treated with a curative intent and no active cancer recurrence. HIV-positive patients on combination antiretroviral therapy are ineligible because of the potential for pharmacokinetic interactions with AZD2171. New York Heart Association classification of III or IV Conditions requiring concurrent use of drugs or biologics with proarrhythmic potential.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Susana Campos, MD
Organizational Affiliation
Dana-Farber Cancer Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Facility Name
Beth Israel Deaconess Medical Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Facility Name
Dana-Farber Cancer Institute
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States

12. IPD Sharing Statement

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AZD2171 and Temsirolimus in Patients With Advanced Gynecological Malignancies

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