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The Efficacy and Safety of Anlotinib in Patients With Metastatic Pheochromocytoma or Paraganglioma

Primary Purpose

Malignant Adrenal Gland Pheochromocytoma, Malignant Paraganglioma, Pheochromocytoma, Metastatic

Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
anlotinib hydrochloride
Sponsored by
Peking Union Medical College Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Malignant Adrenal Gland Pheochromocytoma focused on measuring pheochromocytoma, paraganglioma, Metastatic, inoperable

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Provide written informed consent.
  2. Willing to return to enrolling institution for follow-up.
  3. Eastern Cooperative Oncology Group (ECOG) performance status 0, 1, or 2.
  4. Life expectancy > 3 months.
  5. Patients diagnosis with metastatic pheochromocytoma or paraganglioma that is unresectable.
  6. Laboratory requirements:

1)Absolute granulocyte count (AGC) greater than 1.5 x 109/L; 2)Platelet count greater than 80 x 109/L; 3) Hemoglobin greater than 90g/L; 4) Serum bilirubin less than 1.5 x upper limit of normal (ULN); 5)Serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) less than 2.5 x ULN; 6) Serum creatinine less than 1.5 x ULN or creatinine clearance (CCr)≥60ml/min; 7.Doppler ultrasound assessment: left ventricular ejection fraction (LVEF) ≥ lower limit of normal value (50%).

Exclusion Criteria:

  1. Any of the following:Pregnant women,Nursing women,Men or women of childbearing potential who are unwilling to employ adequate contraception.
  2. Patients who have previously used other anti-vascular targeted drugs, such as sunitinib, bevacizumab, endurance, etc.
  3. Chemotherapy/systemic therapy, radiotherapy, immunotherapy or surgery within 4 weeks prior to kinase inhibitor therapy.
  4. Patients with another primary malignancy within 5 years prior to starting study drug, with the exception of adequately treated in-situ carcinoma of the uterine cervix, or skin cancer (such as basal cell carcinoma, squamous cell carcinoma, or non-melanomatous skin cancer).
  5. Those who have multiple factors that affect oral medications (such as inability to swallow, chronic diarrhea, intestinal obstruction, etc.).
  6. Patients with known untreated brain metastases are excluded. Patients having a history of brain metastasis that have been previously irradiated or resected greater than 2 months prior to enrollment and are clinically and radiographically stable will be considered for enrollment. Patients with brain metastases with symptoms or symptom control for less than 2 months.
  7. Active or uncontrolled intercurrent illness including, but not limited to 1)Patients with unsatisfactory blood pressure control (systolic blood pressure ≥150 mmHg, diastolic blood pressure ≥100 mmHg); 2) Patients with uncontrolled myocardial ischemia or myocardial infarction, arrhythmia (including QTC≥480ms), and uncontrolled congestive heart failure,grade ≥2(New York Heart Association ); 3) ongoing or active infection; 4) Liver cirrhosis, decompensated liver disease, active hepatitis or chronic hepatitis require antiviral treatment; 5) Renal failure requires hemodialysis or peritoneal dialysis; 6) Have a history of immunodeficiency, including HIV or other acquired or congenital immunodeficiency diseases, or a history of organ transplantation; 7) Diabetes is poorly controlled (fasting blood glucose (FBG)> 10mmol/L); 8) Urine routines suggest that urine protein is ≥++, and the 24-hour urine protein content is confirmed to be greater than 1.0 g; 9) Patients who have seizures and need treatment;
  8. Any of the following conditions =< 6 months prior to registration: Cerebrovascular accident (CVA) or transient ischemic attack (TIA); Serious or unstable cardiac arrhythmia; Pulmonary embolism, untreated deep venous thrombosis (DVT).
  9. Received major surgical treatment, open biopsy or obvious traumatic injury within 28 days before enrollment.
  10. Those who have a history of psychotropic drug abuse and cannot be quit or have mental disorders.
  11. Imaging shows that the tumor has invaded important blood vessels or the investigator judges that the tumor is very likely to invade important blood vessels and cause fatal bleeding during the follow-up study.
  12. Regardless of the severity, patients with any signs of bleeding or medical history; within 4 weeks before enrollment, patients with any bleeding or bleeding event ≥ CTCAE grade 3, unhealed wounds, ulcers or fractures.
  13. Participated in other clinical trials within 4 weeks.
  14. Patients are using drugs that interact with Anlotinib.

Sites / Locations

  • Peking Union Medical College HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

anlotinib hydrochloride

Arm Description

Patients receive anlotinib hydrochloride 12mg orally once daily on days 1-14. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.

Outcomes

Primary Outcome Measures

Objective Response rate RECIST Using Version 1.1
Defined for all patients whose tumor met the criteria of Complete Response (CR)and Partial Response (PR)

Secondary Outcome Measures

Disease Control Rate
Defined for all patients whose tumor met the criteria of CR or PR or stable disease(SD)

Full Information

First Posted
April 22, 2021
Last Updated
June 4, 2023
Sponsor
Peking Union Medical College Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT04860700
Brief Title
The Efficacy and Safety of Anlotinib in Patients With Metastatic Pheochromocytoma or Paraganglioma
Official Title
A Phase 2 Study of Anlotinib in Patients With Metastatic Pheochromocytoma or Paraganglioma
Study Type
Interventional

2. Study Status

Record Verification Date
April 2023
Overall Recruitment Status
Recruiting
Study Start Date
April 30, 2021 (Actual)
Primary Completion Date
October 17, 2023 (Anticipated)
Study Completion Date
October 17, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Peking Union Medical College Hospital

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This phase II trial studies how well anlotinib hydrochloride works in treating patients with metastatic pheochromocytoma or paraganglioma. Anlotinib hydrochloride may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth and by blocking blood flow to the tumor.
Detailed Description
PRIMARY OBJECTIVES: To determine the anti-tumor activity of anlotinib hydrochloride (Objective Response rate,ORR) in patients with metastatic pheochromocytomas or paragangliomas. SECONDARY OBJECTIVES: I. To assess safety profile of anlotinib. II. To assess progression-free survival time. III. To assess disease control rate. OUTLINE: Patients receive anlotinib hydrochloride 12mg orally once daily on days 1-14. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. Patients undergo urine and blood sample collection, imaging examinations at baseline and periodically during study. After completion of study therapy, patients are followed up every 3-6 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Malignant Adrenal Gland Pheochromocytoma, Malignant Paraganglioma, Pheochromocytoma, Metastatic, Paraganglioma, Malignant, Paraganglioma, Extra-Adrenal
Keywords
pheochromocytoma, paraganglioma, Metastatic, inoperable

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
anlotinib hydrochloride
Arm Type
Experimental
Arm Description
Patients receive anlotinib hydrochloride 12mg orally once daily on days 1-14. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.
Intervention Type
Drug
Intervention Name(s)
anlotinib hydrochloride
Other Intervention Name(s)
anlotinib
Intervention Description
Patients receive anlotinib hydrochloride 12mg orally once daily on days 1-14. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.
Primary Outcome Measure Information:
Title
Objective Response rate RECIST Using Version 1.1
Description
Defined for all patients whose tumor met the criteria of Complete Response (CR)and Partial Response (PR)
Time Frame
minimum of 4 cycles
Secondary Outcome Measure Information:
Title
Disease Control Rate
Description
Defined for all patients whose tumor met the criteria of CR or PR or stable disease(SD)
Time Frame
minimum of 4 cycles
Other Pre-specified Outcome Measures:
Title
Progression-free Survival Time
Description
PFS is defined as the time from the first day of treatment to the first documented disease progression per RECIST 1.1 criteria and the Kaplan-Meier curve. Changes in only the largest diameter (unidimensional measurement) of the tumor lesions are used in the RECIST criteria.
Time Frame
minimum of 4 cycles
Title
Incidence of adverse events assessed by Common Terminology Criteria for Adverse safety profile of anlotinib
Description
Incidence of adverse events assessed by Common Terminology Criteria for Adverse Events version 4.0
Time Frame
minimum of 4 cycles

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Provide written informed consent. Willing to return to enrolling institution for follow-up. Eastern Cooperative Oncology Group (ECOG) performance status 0, 1, or 2. Life expectancy > 3 months. Patients diagnosis with metastatic pheochromocytoma or paraganglioma that is unresectable. Laboratory requirements: 1)Absolute granulocyte count (AGC) greater than 1.5 x 109/L; 2)Platelet count greater than 80 x 109/L; 3) Hemoglobin greater than 90g/L; 4) Serum bilirubin less than 1.5 x upper limit of normal (ULN); 5)Serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) less than 2.5 x ULN; 6) Serum creatinine less than 1.5 x ULN or creatinine clearance (CCr)≥60ml/min; 7.Doppler ultrasound assessment: left ventricular ejection fraction (LVEF) ≥ lower limit of normal value (50%). Exclusion Criteria: Any of the following:Pregnant women,Nursing women,Men or women of childbearing potential who are unwilling to employ adequate contraception. Patients who have previously used other anti-vascular targeted drugs, such as sunitinib, bevacizumab, endurance, etc. Chemotherapy/systemic therapy, radiotherapy, immunotherapy or surgery within 4 weeks prior to kinase inhibitor therapy. Patients with another primary malignancy within 5 years prior to starting study drug, with the exception of adequately treated in-situ carcinoma of the uterine cervix, or skin cancer (such as basal cell carcinoma, squamous cell carcinoma, or non-melanomatous skin cancer). Those who have multiple factors that affect oral medications (such as inability to swallow, chronic diarrhea, intestinal obstruction, etc.). Patients with known untreated brain metastases are excluded. Patients having a history of brain metastasis that have been previously irradiated or resected greater than 2 months prior to enrollment and are clinically and radiographically stable will be considered for enrollment. Patients with brain metastases with symptoms or symptom control for less than 2 months. Active or uncontrolled intercurrent illness including, but not limited to 1)Patients with unsatisfactory blood pressure control (systolic blood pressure ≥150 mmHg, diastolic blood pressure ≥100 mmHg); 2) Patients with uncontrolled myocardial ischemia or myocardial infarction, arrhythmia (including QTC≥480ms), and uncontrolled congestive heart failure,grade ≥2(New York Heart Association ); 3) ongoing or active infection; 4) Liver cirrhosis, decompensated liver disease, active hepatitis or chronic hepatitis require antiviral treatment; 5) Renal failure requires hemodialysis or peritoneal dialysis; 6) Have a history of immunodeficiency, including HIV or other acquired or congenital immunodeficiency diseases, or a history of organ transplantation; 7) Diabetes is poorly controlled (fasting blood glucose (FBG)> 10mmol/L); 8) Urine routines suggest that urine protein is ≥++, and the 24-hour urine protein content is confirmed to be greater than 1.0 g; 9) Patients who have seizures and need treatment; Any of the following conditions =< 6 months prior to registration: Cerebrovascular accident (CVA) or transient ischemic attack (TIA); Serious or unstable cardiac arrhythmia; Pulmonary embolism, untreated deep venous thrombosis (DVT). Received major surgical treatment, open biopsy or obvious traumatic injury within 28 days before enrollment. Those who have a history of psychotropic drug abuse and cannot be quit or have mental disorders. Imaging shows that the tumor has invaded important blood vessels or the investigator judges that the tumor is very likely to invade important blood vessels and cause fatal bleeding during the follow-up study. Regardless of the severity, patients with any signs of bleeding or medical history; within 4 weeks before enrollment, patients with any bleeding or bleeding event ≥ CTCAE grade 3, unhealed wounds, ulcers or fractures. Participated in other clinical trials within 4 weeks. Patients are using drugs that interact with Anlotinib.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Anli Tong
Phone
0086-13911413589
Email
tonganli@hotmail.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Anli Tong
Organizational Affiliation
Peking Union Medical College Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Peking Union Medical College Hospital
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100730
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
anli tong
Phone
0086-13911413589
Email
tonganli@hotmail.com

12. IPD Sharing Statement

Plan to Share IPD
No

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The Efficacy and Safety of Anlotinib in Patients With Metastatic Pheochromocytoma or Paraganglioma

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