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Everolimus and Gefitinib in Treating Patients With Progressive Glioblastoma Multiforme or Progressive Metastatic Prostate Cancer

Primary Purpose

Brain and Central Nervous System Tumors, Prostate Cancer

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
everolimus
gefitinib
Sponsored by
Memorial Sloan Kettering Cancer Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Brain and Central Nervous System Tumors focused on measuring adult glioblastoma, recurrent prostate cancer, recurrent adult brain tumor, stage IV prostate cancer, adult giant cell glioblastoma, adult gliosarcoma

Eligibility Criteria

18 Years - 120 Years (Adult, Older Adult)MaleDoes not accept healthy volunteers

DISEASE CHARACTERISTICS: Histologically confirmed diagnosis of 1 of the following: Glioblastoma multiforme (GBM) (phase I only) Progressive disease despite standard therapy Progressive disease based on 1 of the following: New or progressive (25% bidimensional increase) soft tissue masses on CT scan or MRI New or prior lesions that have increased in size by physical examination Patients who had prior interstitial brachytherapy or stereotactic radiosurgery must have confirmation of true disease progression (rather than radiation necrosis) by positron-emission tomography scan, thallium scanning, magnetic resonance spectroscopy, or surgical documentation Castrate metastatic prostate cancer (closed to accrual as of 10/19/2006) (phase I and II) Progressive disease despite standard therapy AND castrate levels < 50 ng/dL of testosterone Progressive disease based on 1 or more of the following: A minimum of 3 rising levels of prostate-specific antigen (PSA) that are obtained 1 or more weeks apart OR 2 rising PSA values obtained more than 1 month apart with at least a 25% increase over the range of values New or progressive (25% bidimensional increase) soft tissue masses on CT scan or MRI New metastatic lesions Patients on an antiandrogen as part of initial therapy must show disease progression after discontinuation of the antiandrogen Patients who have not undergone surgical orchiectomy must continue with medical therapy (e.g., gonadotropin-releasing hormone analogs) to maintain castrate levels of serum testosterone No brain metastases PATIENT CHARACTERISTICS: Age Over 18 Performance status Karnofsky 70-100% Life expectancy More than 3 months Hematopoietic Absolute neutrophil count ≥ 1,500/mm^3 Platelet count ≥ 100,000/mm^3 WBC ≥ 3,000/mm^3 Hepatic ALT and AST ≤ 2.5 times upper limit of normal (ULN) Bilirubin ≤ 1.5 mg/dL Renal Creatinine within 1.5 times ULN (< 1.95 mg/dL at MSKCC) Cardiovascular No significant cardiovascular disease No congestive heart failure No New York Heart Association class III or IV cardiac disease No active angina pectoris No myocardial infarction within the past 6 months Other Not pregnant Negative pregnancy test Fertile patients must use effective contraception No serious medical illness No severe infection No severe malnutrition No other active malignancy except non-melanoma skin cancer Patients are not considered to have an active malignancy if they have completed prior therapy and currently have a < 30% risk for relapse PRIOR CONCURRENT THERAPY: Biologic therapy No concurrent biological therapy No concurrent immunotherapy Chemotherapy No concurrent chemotherapy Endocrine therapy See Disease Characteristics Radiotherapy See Disease Characteristics More than 4 weeks since prior radiotherapy No concurrent radiotherapy Surgery See Disease Characteristics Prior recent resection of recurrent or progressive GBM allowed provided patient has recovered More than 4 weeks since prior major surgery Other Recovered from all prior therapy More than 4 weeks since prior investigational anticancer drugs No concurrent anticonvulsant that interacts with CYP3A4 (e.g., phenytoin, carbamazepine, or phenobarbital) No other concurrent cytotoxic therapy No other concurrent investigational or commercial agents or therapies for the malignancy

Sites / Locations

  • Memorial Sloan Kettering Cancer Center
  • Vall d'Hebron University Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Everolimus (RAD-001) and Gefitinib

Arm Description

•Phase I: Patients receive oral everolimus on day 1 and oral gefitinib once daily on days 8-21. Beginning on day 22, patients receive oral everolimus once weekly and oral gefitinib once daily. Treatment with the combination continues in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of everolimus until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. •Phase II (prostate cancer patients only) (closed to accrual as of 10/19/2006): Patients receive oral everolimus (at the MTD determined in phase I) once weekly and oral gefitinib once daily. Treatment continues in the absence of disease progression or unacceptable toxicity.

Outcomes

Primary Outcome Measures

Overall Objective Response
Response will be evaluated in this study using the new international criteria Response Evaluation Criteria in Solid Tumors (RECIST)

Secondary Outcome Measures

Full Information

First Posted
June 10, 2004
Last Updated
December 15, 2015
Sponsor
Memorial Sloan Kettering Cancer Center
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00085566
Brief Title
Everolimus and Gefitinib in Treating Patients With Progressive Glioblastoma Multiforme or Progressive Metastatic Prostate Cancer
Official Title
A Phase I/II Trial to Assess the Tolerability of RAD 001 With Gefitinib in Patients With Glioblastoma Multiforme and Prostate Cancer and Efficacy in Patients With Castrate Metastatic Prostate Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
December 2015
Overall Recruitment Status
Completed
Study Start Date
March 2004 (undefined)
Primary Completion Date
February 2008 (Actual)
Study Completion Date
February 2008 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Memorial Sloan Kettering Cancer Center
Collaborators
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
RATIONALE: Everolimus may stop the growth of tumor cells by stopping blood flow to the tumor. Gefitinib may stop the growth of tumor cells by blocking the enzymes necessary for their growth. Combining everolimus with gefitinib may kill more tumor cells. PURPOSE: This phase I/II trial is studying the side effects and best dose of everolimus when given together with gefitinib and to see how well they work in treating patients with progressive glioblastoma multiforme or (progressive metastatic prostate cancer closed to accrual 10/19/06).
Detailed Description
OBJECTIVES: Primary Determine the maximum tolerated dose of everolimus when given in combination with gefitinib in patients with progressive glioblastoma multiforme or (progressive castrate metastatic prostate cancer -closed to accrual as of 10/19/2006). (Phase I) Determine the safety and efficacy of this regimen in patients with progressive glioblastoma multiforme or (progressive castrate metastatic prostate cancer - closed to accrual as of 10/19/2006). (Phase II) Secondary Determine whether a pharmacokinetic interaction exists between everolimus and gefitinib in patients treated with this regimen. Determine the association between clinical outcomes and markers that may predict sensitivity of a tumor in patients treated with this regimen. Determine the pharmacodynamic effects of this regimen on post-therapy tumor specimens and peripheral blood mononuclear cells from these patients. OUTLINE: This is a phase I, open-label, non-randomized, dose-escalation study of everolimus followed by a phase II study. Phase I: Patients receive oral everolimus on day 1 and oral gefitinib once daily on days 8-21. Beginning on day 22, patients receive oral everolimus once weekly and oral gefitinib once daily. Treatment with the combination continues in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of everolimus until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. Phase II (prostate cancer patients only) (closed to accrual as of 10/19/2006): Patients receive oral everolimus (at the MTD determined in phase I) once weekly and oral gefitinib once daily. Treatment continues in the absence of disease progression or unacceptable toxicity.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Brain and Central Nervous System Tumors, Prostate Cancer
Keywords
adult glioblastoma, recurrent prostate cancer, recurrent adult brain tumor, stage IV prostate cancer, adult giant cell glioblastoma, adult gliosarcoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
61 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Everolimus (RAD-001) and Gefitinib
Arm Type
Experimental
Arm Description
•Phase I: Patients receive oral everolimus on day 1 and oral gefitinib once daily on days 8-21. Beginning on day 22, patients receive oral everolimus once weekly and oral gefitinib once daily. Treatment with the combination continues in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of everolimus until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. •Phase II (prostate cancer patients only) (closed to accrual as of 10/19/2006): Patients receive oral everolimus (at the MTD determined in phase I) once weekly and oral gefitinib once daily. Treatment continues in the absence of disease progression or unacceptable toxicity.
Intervention Type
Drug
Intervention Name(s)
everolimus
Intervention Type
Drug
Intervention Name(s)
gefitinib
Primary Outcome Measure Information:
Title
Overall Objective Response
Description
Response will be evaluated in this study using the new international criteria Response Evaluation Criteria in Solid Tumors (RECIST)
Time Frame
2 years

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
120 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically confirmed diagnosis of 1 of the following: Glioblastoma multiforme (GBM) (phase I only) Progressive disease despite standard therapy Progressive disease based on 1 of the following: New or progressive (25% bidimensional increase) soft tissue masses on CT scan or MRI New or prior lesions that have increased in size by physical examination Patients who had prior interstitial brachytherapy or stereotactic radiosurgery must have confirmation of true disease progression (rather than radiation necrosis) by positron-emission tomography scan, thallium scanning, magnetic resonance spectroscopy, or surgical documentation Castrate metastatic prostate cancer (closed to accrual as of 10/19/2006) (phase I and II) Progressive disease despite standard therapy AND castrate levels < 50 ng/dL of testosterone Progressive disease based on 1 or more of the following: A minimum of 3 rising levels of prostate-specific antigen (PSA) that are obtained 1 or more weeks apart OR 2 rising PSA values obtained more than 1 month apart with at least a 25% increase over the range of values New or progressive (25% bidimensional increase) soft tissue masses on CT scan or MRI New metastatic lesions Patients on an antiandrogen as part of initial therapy must show disease progression after discontinuation of the antiandrogen Patients who have not undergone surgical orchiectomy must continue with medical therapy (e.g., gonadotropin-releasing hormone analogs) to maintain castrate levels of serum testosterone No brain metastases PATIENT CHARACTERISTICS: Age Over 18 Performance status Karnofsky 70-100% Life expectancy More than 3 months Hematopoietic Absolute neutrophil count ≥ 1,500/mm^3 Platelet count ≥ 100,000/mm^3 WBC ≥ 3,000/mm^3 Hepatic ALT and AST ≤ 2.5 times upper limit of normal (ULN) Bilirubin ≤ 1.5 mg/dL Renal Creatinine within 1.5 times ULN (< 1.95 mg/dL at MSKCC) Cardiovascular No significant cardiovascular disease No congestive heart failure No New York Heart Association class III or IV cardiac disease No active angina pectoris No myocardial infarction within the past 6 months Other Not pregnant Negative pregnancy test Fertile patients must use effective contraception No serious medical illness No severe infection No severe malnutrition No other active malignancy except non-melanoma skin cancer Patients are not considered to have an active malignancy if they have completed prior therapy and currently have a < 30% risk for relapse PRIOR CONCURRENT THERAPY: Biologic therapy No concurrent biological therapy No concurrent immunotherapy Chemotherapy No concurrent chemotherapy Endocrine therapy See Disease Characteristics Radiotherapy See Disease Characteristics More than 4 weeks since prior radiotherapy No concurrent radiotherapy Surgery See Disease Characteristics Prior recent resection of recurrent or progressive GBM allowed provided patient has recovered More than 4 weeks since prior major surgery Other Recovered from all prior therapy More than 4 weeks since prior investigational anticancer drugs No concurrent anticonvulsant that interacts with CYP3A4 (e.g., phenytoin, carbamazepine, or phenobarbital) No other concurrent cytotoxic therapy No other concurrent investigational or commercial agents or therapies for the malignancy
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Howard I. Scher, MD
Organizational Affiliation
Memorial Sloan Kettering Cancer Center
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Neal Rosen, MD
Organizational Affiliation
Memorial Sloan Kettering Cancer Center
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Lauren E. Abrey, MD
Organizational Affiliation
Memorial Sloan Kettering Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Memorial Sloan Kettering Cancer Center
City
New York
State/Province
New York
ZIP/Postal Code
10065
Country
United States
Facility Name
Vall d'Hebron University Hospital
City
Barcelona
ZIP/Postal Code
08035
Country
Spain

12. IPD Sharing Statement

Learn more about this trial

Everolimus and Gefitinib in Treating Patients With Progressive Glioblastoma Multiforme or Progressive Metastatic Prostate Cancer

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