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A Phase I Study of SUNITINIB and Rapamycin in Advanced Non-Small Cell Lung Cancer (NSCLC) (SU/Rapamycin)

Primary Purpose

Non-Small Cell Lung Cancer

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
sunitinib and rapamycin (Drug will be held)
Sponsored by
Washington University School of Medicine
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Non-Small Cell Lung Cancer focused on measuring NSCLC

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers
  • Patients must have a histologically or cytologically proven NSCLC, including adenocarcinoma, broncho-alveolar cell and large cell anaplastic carcinoma
  • Patients need not have measurable disease to be eligible for this study. Patients with non-measurable lesions will be eligible. Measurable and non-measurable disease will be defined by RECIST criteria
  • Age ≥18 years
  • ECOG 0-2
  • Life Expectancy: ≥3 months
  • Patients who have had prior therapy must have completed chemotherapy at least 3 weeks, and radiotherapy at least 2 weeks, prior to study drug administration, with all side effects resolved. Patients who have not received prior therapy are eligible if they are not good candidates for standard treatment with cytotoxic chemotherapy, or do not wish to receive cytotoxic chemotherapy.
  • Patients may not have undergone major surgery within 4 weeks prior to starting study drug administration. In addition, any surgical complications must be resolved, and the surgical scar must be determined by the surgeon to be healing appropriately
  • Patients must have recovered from uncontrolled intercurrent illness including, but not limited to, ongoing active infection
  • Patients may not have had any of the following within 6 months prior to study drug administration: MI, severe/unstable angina, coronary/peripheral artery bypass graft, symptomatic CHF, CVA, TIA or PE
  • Patients may not have had a grade 3 hemorrhage within 4 weeks of study drug administration
  • Patients may not have a history of or active spinal cord compression or carcinomatous meningitis. In addition, any previous brain metastases should be adequately treated, and there should be no evidence of new brain or leptomeningeal metastases on a screening CT or MRI scan
  • Patients may not have ongoing cardiac dysrhythmias of grade ≥2. In addition, they may not have a prolonged QTc interval on baseline EKG
  • Patients may not have uncontrolled hypertension or thyroid disease
  • Patients may not have a severe acute or chronic medical or psychiatric condition, or laboratory abnormality
  • Patients must have adequate bone marrow function defined as an absolute neutrophil count ≥ 1,500 cells/mm3, Hgb ≥ 9g/dl and platelet count ≥ 100,000 cells/mm3
  • Patients must have adequate liver function defined as bilirubin <=2 x the upper limit of institutional normal and SGOT and SGPT <=2.5 x the upper limit of institutional normal, or SGOT and SGPT <=5 x the upper limit of institutional normal if liver function abnormalities are due to underlying malignancy
  • Patients must have adequate renal function defined as serum creatinine <=1.5 x the upper limit of institutional normal
  • Patients must have serum calcium ≤12.0 mg/dL
  • No previous history of severe hypersensitivity reaction attributed to a receptor tyrosine kinase inhibitor.
  • For all patients with reproductive potential, the use of adequate contraception and will be required for the duration of treatment and the 3 months following treatment
  • Pregnant and nursing women are not eligible
  • After being informed of the treatment involved, patients must give written consent. The patient should not have any serious medical or psychiatric illness that would prevent either the giving of informed consent or the receipt of treatment
  • Entry to this study is open to both men and women and to all racial and ethnic subgroups

Sites / Locations

  • Washington University School of medicine

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

1

Arm Description

Patients will be instructed to take sunitinib and rapamycin every morning for 4 weeks, then to take 2 weeks off. The sunitinib dose will be 25mg in the first cohort and the rapamycin dose will be 2 mg.

Outcomes

Primary Outcome Measures

To define the optimal dose of sunitinib when given in combination with rapamycin 2mg daily.
Determine the dose limiting toxicity of sunitinib and rapamycin

Secondary Outcome Measures

Incidence and severity of other toxicities
Cycles are 6 weeks long and can have as many as 9 cycles
Response rates
Overall survival

Full Information

First Posted
November 7, 2007
Last Updated
May 5, 2016
Sponsor
Washington University School of Medicine
Collaborators
Pfizer
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1. Study Identification

Unique Protocol Identification Number
NCT00555256
Brief Title
A Phase I Study of SUNITINIB and Rapamycin in Advanced Non-Small Cell Lung Cancer (NSCLC)
Acronym
SU/Rapamycin
Official Title
A Phase I Study of SUNITINIB and Rapamycin in Advanced Non-Small Cell Lung Cancer (NSCLC)
Study Type
Interventional

2. Study Status

Record Verification Date
March 2013
Overall Recruitment Status
Completed
Study Start Date
November 2007 (undefined)
Primary Completion Date
February 2010 (Actual)
Study Completion Date
December 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Washington University School of Medicine
Collaborators
Pfizer

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
To define the optimal dose of sunitinib when given in combination with rapamycin 2mg. To determine the maximum tolerated dosage of sunitinib and rapamycin given in this fashion. To determine the how many times and how severe other toxicities of this combination therapy. To determine how quickly the patient(s) will respond the the drug, overall survival and time to progression for this combination therapy.
Detailed Description
We propose to conduct a phase I study of sunitinib and rapamycin administered daily for weeks 1-4)in a 6-week cycle. The rationale for this study includes: Sunitinib is a tyrosine kinase inhibitor that targets multiple receptor pathways critical for cell growth. It has both antiangiogenic and direct antitumor activities. Resistance to receptor tyrosine kinase inhibitors is well-documented. The mammalian target of rapamycin (mTOR) pathway may play a critical role in imatinib-refractory GIST. Rapamycin and other agents that inhibit mTOR demonstrate antiangiogenic and antitumor properties by decreasing VEGF production and decreasing responsiveness to VEGF. Sunitinib is approved and well-tolerated at doses as high as 75mg daily. The typical dose in most Phase II and III trials has been 50mg/day, given on a four weeks on/two weeks off schedule. There are, however, recent trials looking at a lower dosage, 37.5 mg, in NSCLC. Rapamycin at doses greater than 2 mg daily is documented to be well-tolerated in renal transplant patients. In renal transplant patients, 2mg daily is the typical starting dose. This dose was used in one of the phase I studies of rapamycin in glioblastoma. The administration of two oral medications, taken once daily, may be more convenient to patients than iv administration of chemotherapy at an infusion center every 1-3 weeks. Based on these data, initial dosing of sunitinib beginning at 37.5 mg orally everyday for 4 weeks, followed by 2 weeks off, in combination with rapamycin 2 mg/day orally for 6 weeks during a 6 week cycle should be well tolerated and allow for dose-finding escalation.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Non-Small Cell Lung Cancer
Keywords
NSCLC

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
19 (Actual)

8. Arms, Groups, and Interventions

Arm Title
1
Arm Type
Experimental
Arm Description
Patients will be instructed to take sunitinib and rapamycin every morning for 4 weeks, then to take 2 weeks off. The sunitinib dose will be 25mg in the first cohort and the rapamycin dose will be 2 mg.
Intervention Type
Drug
Intervention Name(s)
sunitinib and rapamycin (Drug will be held)
Intervention Description
Any toxicity causing a total of 14 days delay of therapy will be considered dose limiting.
Primary Outcome Measure Information:
Title
To define the optimal dose of sunitinib when given in combination with rapamycin 2mg daily.
Time Frame
6 weeks
Title
Determine the dose limiting toxicity of sunitinib and rapamycin
Time Frame
6 weeks
Secondary Outcome Measure Information:
Title
Incidence and severity of other toxicities
Description
Cycles are 6 weeks long and can have as many as 9 cycles
Time Frame
30 days after the end of treatment
Title
Response rates
Time Frame
30 days after end of treatment
Title
Overall survival
Time Frame
12 months from date of first treatment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Patients must have a histologically or cytologically proven NSCLC, including adenocarcinoma, broncho-alveolar cell and large cell anaplastic carcinoma Patients need not have measurable disease to be eligible for this study. Patients with non-measurable lesions will be eligible. Measurable and non-measurable disease will be defined by RECIST criteria Age ≥18 years ECOG 0-2 Life Expectancy: ≥3 months Patients who have had prior therapy must have completed chemotherapy at least 3 weeks, and radiotherapy at least 2 weeks, prior to study drug administration, with all side effects resolved. Patients who have not received prior therapy are eligible if they are not good candidates for standard treatment with cytotoxic chemotherapy, or do not wish to receive cytotoxic chemotherapy. Patients may not have undergone major surgery within 4 weeks prior to starting study drug administration. In addition, any surgical complications must be resolved, and the surgical scar must be determined by the surgeon to be healing appropriately Patients must have recovered from uncontrolled intercurrent illness including, but not limited to, ongoing active infection Patients may not have had any of the following within 6 months prior to study drug administration: MI, severe/unstable angina, coronary/peripheral artery bypass graft, symptomatic CHF, CVA, TIA or PE Patients may not have had a grade 3 hemorrhage within 4 weeks of study drug administration Patients may not have a history of or active spinal cord compression or carcinomatous meningitis. In addition, any previous brain metastases should be adequately treated, and there should be no evidence of new brain or leptomeningeal metastases on a screening CT or MRI scan Patients may not have ongoing cardiac dysrhythmias of grade ≥2. In addition, they may not have a prolonged QTc interval on baseline EKG Patients may not have uncontrolled hypertension or thyroid disease Patients may not have a severe acute or chronic medical or psychiatric condition, or laboratory abnormality Patients must have adequate bone marrow function defined as an absolute neutrophil count ≥ 1,500 cells/mm3, Hgb ≥ 9g/dl and platelet count ≥ 100,000 cells/mm3 Patients must have adequate liver function defined as bilirubin <=2 x the upper limit of institutional normal and SGOT and SGPT <=2.5 x the upper limit of institutional normal, or SGOT and SGPT <=5 x the upper limit of institutional normal if liver function abnormalities are due to underlying malignancy Patients must have adequate renal function defined as serum creatinine <=1.5 x the upper limit of institutional normal Patients must have serum calcium ≤12.0 mg/dL No previous history of severe hypersensitivity reaction attributed to a receptor tyrosine kinase inhibitor. For all patients with reproductive potential, the use of adequate contraception and will be required for the duration of treatment and the 3 months following treatment Pregnant and nursing women are not eligible After being informed of the treatment involved, patients must give written consent. The patient should not have any serious medical or psychiatric illness that would prevent either the giving of informed consent or the receipt of treatment Entry to this study is open to both men and women and to all racial and ethnic subgroups
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ramaswamy Govindan, M.D.
Organizational Affiliation
Washington University School of Medicine
Official's Role
Principal Investigator
Facility Information:
Facility Name
Washington University School of medicine
City
St. Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States

12. IPD Sharing Statement

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Links:
URL
http://www.siteman.wustl.edu
Description
Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine

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A Phase I Study of SUNITINIB and Rapamycin in Advanced Non-Small Cell Lung Cancer (NSCLC)

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