Everolimus in Combination With Imatinib in Patients With Glivec Refractory/Resistant Gastrointestinal Stromal Tumors
Gastrointestinal Stromal Tumors
About this trial
This is an interventional treatment trial for Gastrointestinal Stromal Tumors focused on measuring RAD001, everolimusGIST, everolimus, mTOR, Imatinib resistant, Imatinib-refractory/resistant, gastrointestinal stromal tumors, Gastrointestinal Stromal Tumors(GIST), soft tissue sarcoma, stomach tumor, tumor of interstitial cells of Cajal (ICC), digestive system cancer
Eligibility Criteria
Inclusion Criteria:
Phase l:
- Patients aged ≥ 18 years
- Patients with a histologically proven diagnosis of GIST and clinical evidence of resistance to imatinib despite at least 4 months continuous treatment with imatinib
- Patients with at least 2 months at a dosage of ≥ 600 mg/day (progression despite uninterrupted therapy for 2 months at ≥800 mg/d for patients entering the Phase I cohort investigating the 800 mg/d dose)
- Patients were to have at least one measurable lesion (longest diameter ≥20 mm on conventional CT or MRI scan
- patients were to have ≥10 mm on spiral CT) and were to have a WHO Performance Status Score ≤ 2.
- Patients also were to have adequate bone marrow, liver and renal function on imatinib treatment, as specified in the protocol
Phase ll:
• For Phase II (Stratum 2) patients must have progression on other 2nd line drug therapies following prior progression on imatinib (Stratum 2)
Exclusion Criteria:
- Women who are pregnant or breast-feeding
- Patients presenting with known or symptomatic CNS metastases or leptomeningeal involvement
- Patients with any concurrent major medical condition liable to compromise the patient's participation in the study (e.g. known HIV infection, uncontrolled diabetes, serious cardiac dysrhythmia or condition, New York Heart Association classification of III or IV, congestive cardiac failure, myocardial infarction with 6 months, unstable angina, chronic or acute renal or liver disease, uncontrolled infections including abscess or fistulae, etc.)
- Patients with a history of another malignancy within 5 years prior to study entry, except curatively treated non-melanotic skin cancer or in-situ cervical cancer
- Patients unwilling to or unable to comply with the protocol
- Patients who are receiving glucocorticoids (only if the p70s6 kinase1 assay is being performed), since these have been shown to inhibit p70s6 kinase1 activity.
Sites / Locations
- Dana Farber Cancer Institute Dept of Sarcoma Oncology
- College of Physicians and Surgeons of Columbia University
- Fox Chase Cancer Center
- Novartis Investigative Site
- Novartis Investigative Site
- Novartis Investigative Site
- Novartis Investigative Site
- Novartis Investigative Site
- Novartis Investigative Site
- Novartis Investigative Site
- Novartis Investigative Site
- Novartis Investigative Site
- Novartis Investigative Site
- Novartis Investigative Site
- Novartis Investigative Site
- Novartis Investigative Site
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Arm 6
Experimental
Experimental
Experimental
Experimental
Experimental
Experimental
Phase l: RAD001 20mg/week
Phase l: RAD001 2.5mg/day + Glivec 600mg/day
Phase l: RAD001 5mg/day + Glivec 600mg/day
Phase l: RAD001 2.5mg/day + Glivec 800mg/day
Phase ll - Stratum l (first-line resistant/refractory): RAD001 2.5mg/day + Glivec 600mg/day
Phase ll - Stratum ll: (post second-line therapy): RAD001 2.5mg/day + Glivec 600mg/day
RAD001 20 mg was given once a week.
RAD001 2.5 mg was given in combination with Glivec/Gleevec 600mg/day.
RAD001 5 mg was given in combination with Glivec/Gleevec 600mg/day.
RAD001 2.5 mg was given in combination with Glivec/Gleevec 800mg/day.
All first-line resistant/refractory patients received RAD001 2.5mg/day in combination with Glivec/Gleevec at a dose of 600mg/day.
All post-second-line patients received RAD001 2.5mg/day in combination with Glivec/Gleevec at a dose of 600mg/day