Sunitinib Before and After Surgery in Treating Patients With Metastatic Kidney Cancer That Can Be Removed By Surgery
Primary Purpose
Kidney Cancer
Status
Terminated
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
sunitinib malate
gene expression analysis
reverse transcriptase-polymerase chain reaction
western blotting
immunohistochemistry staining method
laboratory biomarker analysis
adjuvant therapy
neoadjuvant therapy
therapeutic conventional surgery
Sponsored by
About this trial
This is an interventional treatment trial for Kidney Cancer focused on measuring stage IV renal cell cancer, clear cell renal cell carcinoma, recurrent renal cell cancer
Eligibility Criteria
DISEASE CHARACTERISTICS:
Diagnosis of clear cell renal cell carcinoma
- Metastatic disease
- Primary tumor is considered amenable to surgery
- Measurable disease, defined as ≥ 1 lesion that can be accurately measured in ≥ 1 dimension (longest diameter to be recorded) as > 20 mm by conventional techniques or as > 10 mm by spiral CT scan
No untreated brain metastases
- Treated brain metastases allowed provided lesion has been stable on two consecutive CT or MRI scans separated by ≥ 2 months
PATIENT CHARACTERISTICS:
- ECOG performance status 0-2
- Leukocytes ≥ 3,000/μL
- ANC ≥ 1,500/μL
- Platelet count ≥ 75,000/μL
- Hemoglobin ≥ 8.5 g/dL
- Total Bilirubin ≤ 2 times upper limits of normal (ULN)
- AST and ALT ≤ 2.5 times ULN
- Creatinine ≤ 2.5 times ULN
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
- Able to undergo nephrectomy and treatment with sunitinib malate
- No history of allergic reactions attributed to compounds of similar chemical or biological composition to sunitinib malate
No uncontrolled intercurrent illness including, but not limited to, any of the following:
- Ongoing or active infection
- Symptomatic congestive heart failure
- Unstable angina pectoris
- Cardiac arrhythmia
- Psychiatric illness/social situations that would limit compliance with study requirements
PRIOR CONCURRENT THERAPY:
- No prior systemic treatment with sunitinib malate
- No other concurrent investigational agents
- No concurrent combination antiretroviral therapy for HIV-positive patients
- Concurrent medications or substances known to affect, or with the potential to affect, the activity or pharmacokinetics of sunitinib malate allowed at the discretion of the principal investigator
Sites / Locations
- Hollings Cancer Center at Medical University of South Carolina
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Sunitinib
Arm Description
Sunitinib will be administered for 8 weeks prior to sugery
Outcomes
Primary Outcome Measures
Describe the gene expression of VEGF and non-VEGF from eligible patients being treatment with Sunitinib.
Describe the association between quantitative gene expression levels of VEGF and non-VEGF angiogenic factors with the clinical efficacy of Sunitinib as measured by response, duration or response and time to progression
Secondary Outcome Measures
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT00747305
Brief Title
Sunitinib Before and After Surgery in Treating Patients With Metastatic Kidney Cancer That Can Be Removed By Surgery
Official Title
Biomarkers of Tumor Angiogenesis and Response to Sunitinib Maleate in Renal Cell Carcinoma
Study Type
Interventional
2. Study Status
Record Verification Date
April 2015
Overall Recruitment Status
Terminated
Why Stopped
Study terminated early due to low accrual.
Study Start Date
October 2008 (undefined)
Primary Completion Date
July 2014 (Actual)
Study Completion Date
July 2014 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Harry Drabkin
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
RATIONALE: Sunitinib 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. Giving sunitinib before surgery may make the tumor smaller and reduce the amount of normal tissue that needs to be removed. Giving it after surgery may kill any tumor cells that remain after surgery.
PURPOSE: This clinical trial is studying how well sunitinib works when given before and after surgery in treating patients with metastatic kidney cancer that can be removed by surgery.
Detailed Description
OBJECTIVES:
To describe the gene expression of VEGF and non-VEGF angiogenic growth factor genes in kidney cancer specimens from patients with metastatic renal cell carcinoma treated with sunitinib malate.
To describe the association between quantitative gene expression levels of VEGF and non-VEGF angiogenic factors and clinical efficacy of this drug, as measured by response, duration of response, and time to progression in these patients.
OUTLINE: Patients receive oral sunitinib malate once daily for 8 weeks. Within 2 weeks after completion of neoadjuvant chemotherapy, patients undergo a nephrectomy and evaluation for response to therapy. Beginning 4-8 weeks after surgery patients resume oral sunitinib malate once daily for up to 12 months in the absence of disease progression or unacceptable toxicity.
Patients with disease progression after 8 weeks of adjuvant treatment receive treatment off study with other agents.
Viable (non-necrotic) tumor and non-tumor kidney tissue samples are obtained at the time of nephrectomy for correlative biomarker studies. Tissue samples are analyzed for gene expression of VEGF and non-VEGF angiogenic factors by real-time RT-PCR, western blot, and/or IHC. Blood samples are obtained at baseline and at 4 and 8 weeks for evaluation of circulating levels of VEGF and selected chemokines.
After completion of study therapy, patients are followed monthly.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Kidney Cancer
Keywords
stage IV renal cell cancer, clear cell renal cell carcinoma, recurrent renal cell cancer
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
17 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Sunitinib
Arm Type
Experimental
Arm Description
Sunitinib will be administered for 8 weeks prior to sugery
Intervention Type
Drug
Intervention Name(s)
sunitinib malate
Intervention Type
Genetic
Intervention Name(s)
gene expression analysis
Intervention Type
Genetic
Intervention Name(s)
reverse transcriptase-polymerase chain reaction
Intervention Type
Genetic
Intervention Name(s)
western blotting
Intervention Type
Other
Intervention Name(s)
immunohistochemistry staining method
Intervention Type
Other
Intervention Name(s)
laboratory biomarker analysis
Intervention Type
Procedure
Intervention Name(s)
adjuvant therapy
Intervention Type
Procedure
Intervention Name(s)
neoadjuvant therapy
Intervention Type
Procedure
Intervention Name(s)
therapeutic conventional surgery
Primary Outcome Measure Information:
Title
Describe the gene expression of VEGF and non-VEGF from eligible patients being treatment with Sunitinib.
Time Frame
at various points throughout the study duration
Title
Describe the association between quantitative gene expression levels of VEGF and non-VEGF angiogenic factors with the clinical efficacy of Sunitinib as measured by response, duration or response and time to progression
Time Frame
at various points throughout the study duration
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
120 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS:
Diagnosis of clear cell renal cell carcinoma
Metastatic disease
Primary tumor is considered amenable to surgery
Measurable disease, defined as ≥ 1 lesion that can be accurately measured in ≥ 1 dimension (longest diameter to be recorded) as > 20 mm by conventional techniques or as > 10 mm by spiral CT scan
No untreated brain metastases
Treated brain metastases allowed provided lesion has been stable on two consecutive CT or MRI scans separated by ≥ 2 months
PATIENT CHARACTERISTICS:
ECOG performance status 0-2
Leukocytes ≥ 3,000/μL
ANC ≥ 1,500/μL
Platelet count ≥ 75,000/μL
Hemoglobin ≥ 8.5 g/dL
Total Bilirubin ≤ 2 times upper limits of normal (ULN)
AST and ALT ≤ 2.5 times ULN
Creatinine ≤ 2.5 times ULN
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception
Able to undergo nephrectomy and treatment with sunitinib malate
No history of allergic reactions attributed to compounds of similar chemical or biological composition to sunitinib malate
No uncontrolled intercurrent illness including, but not limited to, any of the following:
Ongoing or active infection
Symptomatic congestive heart failure
Unstable angina pectoris
Cardiac arrhythmia
Psychiatric illness/social situations that would limit compliance with study requirements
PRIOR CONCURRENT THERAPY:
No prior systemic treatment with sunitinib malate
No other concurrent investigational agents
No concurrent combination antiretroviral therapy for HIV-positive patients
Concurrent medications or substances known to affect, or with the potential to affect, the activity or pharmacokinetics of sunitinib malate allowed at the discretion of the principal investigator
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Harry A. Drabkin, MD
Organizational Affiliation
Medical University of South Carolina
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hollings Cancer Center at Medical University of South Carolina
City
Charleston
State/Province
South Carolina
ZIP/Postal Code
29425
Country
United States
12. IPD Sharing Statement
Learn more about this trial
Sunitinib Before and After Surgery in Treating Patients With Metastatic Kidney Cancer That Can Be Removed By Surgery
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