Velcade and Sorafenib in Unresected or Metastatic Renal Cell Carcinoma
Primary Purpose
Metastatic Renal Cell Carcinoma
Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Velcade and Sorafenib
Sponsored by
About this trial
This is an interventional treatment trial for Metastatic Renal Cell Carcinoma focused on measuring Renal Cell Carcinoma, metastatic renal cell cancer, kidney cancer
Eligibility Criteria
Inclusion Criteria:
Each patient must meet all of the following inclusion criteria to be enrolled in the study:
- Voluntary written informed consent before performance of any study-related procedure not part of normal medical care, with the understanding that consent may be withdrawn by the subject at any time without prejudice to future medical care.
- Female subject is either post-menopausal or surgically sterilized or willing to use an acceptable method of birth control (i.e., a hormonal contraceptive, intra-uterine device, diaphragm with spermicide, condom with spermicide, or abstinence) for the duration of the study.
- Male subject agrees to use an acceptable method for contraception for the duration of the study.
- All patients, 18 years or older with cytologically confirmed clear cell renal with no prior chemotherapy are eligible.
- Patients must have a life expectancy of at least 12 weeks
- Patients must have a Zebroid performance of 0-2
- Patients should have adequate bone marrow function defined by an absolute peripheral granulocyte count of > 1500 cells/mm3 and platelet count > 100,000/mm3 and absence of a regular red blood cell transfusion requirement.
- Patients should have adequate hepatic function with a total bilirubin < 2 mg/dl and Serum glutamic oxaloacetic transaminase (SGOT) or serum glutamic-pyruvic transaminase (SGPT) < two times the upper limit of normal, and adequate renal function as defined by a Serum creatinine < 1.5 x the upper limit of normal.
Exclusion Criteria:
Patients meeting any of the following exclusion criteria are not to be enrolled in the study:
- Patients with non-measurable disease.
- Patients who are unable to take medications orally.
- Patients with resectable renal cell carcinoma
- Patients with a history of Hepatitis B, or Hepatitis C
- Patients known to be Human Immunodeficiency Virus (HIV) positive
- Patients with poorly controlled diabetes mellitus
- Patients with poorly controlled hypertension or hypotension
- Chronic pulmonary disease and a diffusion capacity < 50 %, or a forced vital capacity (FVC) or forced expiratory volume in 1 second (FEV1) of <50%
- Severe renal impairment (Creatinine clearance [CrCL]< 13 ml/min)
- Patients with known malabsorption syndromes.
- Patient has Grade 2 peripheral neuropathy within 14 days before enrollment.
- Myocardial infarction within 6 months prior to enrollment or has New York Heart Association (NYHA) Class III or IV heart failure, uncontrolled angina, severe uncontrolled ventricular arrhythmias, or electrocardiographic evidence of acute ischemia or active conduction system abnormalities. Prior to study entry, any ECG abnormality at Screening has to be documented by the investigator as not medically relevant.
- Patient has hypersensitivity to bortezomib, boron or mannitol or sorafenib.
- Female subject is pregnant or breast-feeding. Confirmation that the subject is not pregnant must be established by a negative serum B-human chorionic gonadotropin (B-hCG) pregnancy test result obtained during screening. Pregnancy testing is not required for post-menopausal or surgically sterilized women.
- Patient has received other investigational drugs with 28 days before enrollment.
- Serious medical or psychiatric illness likely to interfere with participation in this clinical study.
- Diagnosed or treated for another malignancy within 3 years of enrollment, with the exception of complete resection of basal cell carcinoma or squamous cell carcinoma of the skin, an in situ malignancy, or low-risk prostate cancer after curative therapy.
- Patients may receive no other concurrent chemotherapy or radiation therapy (XRT) during this trial.
- Patients may not have received XRT within 4 weeks prior to the first treatment.
Sites / Locations
- University of New Mexico Cancer Center
- The Cancer Center at Presbyterian
- Memorial Medical Center- Cancer Center
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Arm 1: VELCADE and Sorafenib
Arm Description
Patients will be given VELCADE® (bortezomib) 1mg/m2 intravenously on days 1,4,8 & 11 and sorafenib at a dosage of 200 mg orally twice per day. One full course is comprised of 21 days.
Outcomes
Primary Outcome Measures
Progression Free Survival (PFS)
Progression free survival will be measured from the beginning of treatment until there is evidence of progressive disease or death from any cause. Progression is evaluated according to Response Evaluation Criteria in Solid Tumors (RECIST) (version 1.0). Target lesions are assessed by computerized tomography (CT) or magnetic resonance imaging (MRI): Progressive Disease (PD), 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions.
Secondary Outcome Measures
Overall Response Rate (ORR)
Tumor response is evaluated according to Response Evaluation Criteria in Solid Tumors (RECIST) (version 1.0). Target lesions are assessed by computerized tomography (CT) or magnetic resonance imaging (MRI:) Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), >=30% decrease in the sum of the longest diameter of target lesions. Overall response rate (ORR) is the percentage of patients who achieve a CR or PR
Toxicity Profile
Toxicity is assessed using National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) version 3.0. Toxicity profile is reported as the number of patients who received at least one dose of on-study treatment and experienced a grade 3 or grade 4 adverse event (AE). For a more complete listing of all AEs experienced by patients on study, please see the Adverse Event section.
Full Information
NCT ID
NCT01100242
First Posted
April 6, 2010
Last Updated
August 14, 2015
Sponsor
New Mexico Cancer Care Alliance
1. Study Identification
Unique Protocol Identification Number
NCT01100242
Brief Title
Velcade and Sorafenib in Unresected or Metastatic Renal Cell Carcinoma
Official Title
Velcade (Bortezomib) and Sorafenib in Unresected or Metastatic Renal Cell Carcinoma
Study Type
Interventional
2. Study Status
Record Verification Date
August 2015
Overall Recruitment Status
Terminated
Why Stopped
Low accrual
Study Start Date
April 2010 (undefined)
Primary Completion Date
January 2014 (Actual)
Study Completion Date
February 2015 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
New Mexico Cancer Care Alliance
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This is an open label, non-randomized, single arm phase II study. The primary objective of this study is to investigate the efficacy of combination of sorafenib and VELCADE® (bortezomib). The primary efficacy endpoint is Progression-Free Survival (PFS). The secondary objectives of this study are to:
Assess the response rate of this combination in this patient population and Assess the toxicity of this combination in this patient population
Detailed Description
Pretreatment, a complete history and physical examination to include performance status, weight and concurrent non-malignant disease and therapy will be done before starting treatment. Prior surgery, chemotherapy, and radiotherapy details will be noted.
Prior to the initiation of treatment, laboratory studies should include a CBC with differential cell count, platelet count, urinalysis, complete metabolic profile, magnesium and electrocardiogram. A baseline imaging study of the tumor will be performed. Other X-rays will be done as clinically indicated.
Physical examination, performance status and toxicity recording will be done before each course of therapy.
During the study, patients will be followed with complete blood count (CBC), differential and platelet counts on days 1, 4, 8, and 11. Chemistries will also be performed before each course within a 3 day leeway prior to treatment. Clinical schedules will be considered when scheduling patients for treatment, specimen collection and processing, and specimen shipment.
Measureable and evaluable disease will be evaluated by the same imaging studies done at baseline and every 2 courses thereafter to determine tumor response.
For patients on warfarin, International Normalized Ration (INR) testing will be performed prior to the first cycle, weekly during the first cycle, and then prior to day one for subsequent cycles if the INR is in an acceptable range during the first cycle. If the INR has not been in an acceptable range during the first cycle, the INR will be monitored weekly until the value is stable on three consecutive measurements one week apart.
Since Sorafenib is a competitive inhibitor of cytochrome P450 isoenzyme 3A4 (CYP3A4) patients will be assessed each cycle for medications or changes in diet that would affect CYP3A4 metabolism.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metastatic Renal Cell Carcinoma
Keywords
Renal Cell Carcinoma, metastatic renal cell cancer, kidney cancer
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
17 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Arm 1: VELCADE and Sorafenib
Arm Type
Experimental
Arm Description
Patients will be given VELCADE® (bortezomib) 1mg/m2 intravenously on days 1,4,8 & 11 and sorafenib at a dosage of 200 mg orally twice per day. One full course is comprised of 21 days.
Intervention Type
Drug
Intervention Name(s)
Velcade and Sorafenib
Other Intervention Name(s)
velcade, bortezomib, sorafenib
Intervention Description
Velcade will be administered intravenously; sorafenib will be self-administered on an outpatient basis. At least 2 courses will be administered to each patient unless there is early progression of disease or unacceptable toxicity. Repeated courses may be given to patients who benefit from the treatment (complete or partial remission or stabilization of disease)
Primary Outcome Measure Information:
Title
Progression Free Survival (PFS)
Description
Progression free survival will be measured from the beginning of treatment until there is evidence of progressive disease or death from any cause. Progression is evaluated according to Response Evaluation Criteria in Solid Tumors (RECIST) (version 1.0). Target lesions are assessed by computerized tomography (CT) or magnetic resonance imaging (MRI): Progressive Disease (PD), 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions.
Time Frame
36 weeks
Secondary Outcome Measure Information:
Title
Overall Response Rate (ORR)
Description
Tumor response is evaluated according to Response Evaluation Criteria in Solid Tumors (RECIST) (version 1.0). Target lesions are assessed by computerized tomography (CT) or magnetic resonance imaging (MRI:) Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), >=30% decrease in the sum of the longest diameter of target lesions. Overall response rate (ORR) is the percentage of patients who achieve a CR or PR
Time Frame
42 days
Title
Toxicity Profile
Description
Toxicity is assessed using National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) version 3.0. Toxicity profile is reported as the number of patients who received at least one dose of on-study treatment and experienced a grade 3 or grade 4 adverse event (AE). For a more complete listing of all AEs experienced by patients on study, please see the Adverse Event section.
Time Frame
42 days
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Each patient must meet all of the following inclusion criteria to be enrolled in the study:
Voluntary written informed consent before performance of any study-related procedure not part of normal medical care, with the understanding that consent may be withdrawn by the subject at any time without prejudice to future medical care.
Female subject is either post-menopausal or surgically sterilized or willing to use an acceptable method of birth control (i.e., a hormonal contraceptive, intra-uterine device, diaphragm with spermicide, condom with spermicide, or abstinence) for the duration of the study.
Male subject agrees to use an acceptable method for contraception for the duration of the study.
All patients, 18 years or older with cytologically confirmed clear cell renal with no prior chemotherapy are eligible.
Patients must have a life expectancy of at least 12 weeks
Patients must have a Zebroid performance of 0-2
Patients should have adequate bone marrow function defined by an absolute peripheral granulocyte count of > 1500 cells/mm3 and platelet count > 100,000/mm3 and absence of a regular red blood cell transfusion requirement.
Patients should have adequate hepatic function with a total bilirubin < 2 mg/dl and Serum glutamic oxaloacetic transaminase (SGOT) or serum glutamic-pyruvic transaminase (SGPT) < two times the upper limit of normal, and adequate renal function as defined by a Serum creatinine < 1.5 x the upper limit of normal.
Exclusion Criteria:
Patients meeting any of the following exclusion criteria are not to be enrolled in the study:
Patients with non-measurable disease.
Patients who are unable to take medications orally.
Patients with resectable renal cell carcinoma
Patients with a history of Hepatitis B, or Hepatitis C
Patients known to be Human Immunodeficiency Virus (HIV) positive
Patients with poorly controlled diabetes mellitus
Patients with poorly controlled hypertension or hypotension
Chronic pulmonary disease and a diffusion capacity < 50 %, or a forced vital capacity (FVC) or forced expiratory volume in 1 second (FEV1) of <50%
Severe renal impairment (Creatinine clearance [CrCL]< 13 ml/min)
Patients with known malabsorption syndromes.
Patient has Grade 2 peripheral neuropathy within 14 days before enrollment.
Myocardial infarction within 6 months prior to enrollment or has New York Heart Association (NYHA) Class III or IV heart failure, uncontrolled angina, severe uncontrolled ventricular arrhythmias, or electrocardiographic evidence of acute ischemia or active conduction system abnormalities. Prior to study entry, any ECG abnormality at Screening has to be documented by the investigator as not medically relevant.
Patient has hypersensitivity to bortezomib, boron or mannitol or sorafenib.
Female subject is pregnant or breast-feeding. Confirmation that the subject is not pregnant must be established by a negative serum B-human chorionic gonadotropin (B-hCG) pregnancy test result obtained during screening. Pregnancy testing is not required for post-menopausal or surgically sterilized women.
Patient has received other investigational drugs with 28 days before enrollment.
Serious medical or psychiatric illness likely to interfere with participation in this clinical study.
Diagnosed or treated for another malignancy within 3 years of enrollment, with the exception of complete resection of basal cell carcinoma or squamous cell carcinoma of the skin, an in situ malignancy, or low-risk prostate cancer after curative therapy.
Patients may receive no other concurrent chemotherapy or radiation therapy (XRT) during this trial.
Patients may not have received XRT within 4 weeks prior to the first treatment.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Richard Lauer, MD
Organizational Affiliation
New Mexico Cancer Care Alliance
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of New Mexico Cancer Center
City
Albuquerque
State/Province
New Mexico
ZIP/Postal Code
87106
Country
United States
Facility Name
The Cancer Center at Presbyterian
City
Albuquerque
State/Province
New Mexico
ZIP/Postal Code
87110
Country
United States
Facility Name
Memorial Medical Center- Cancer Center
City
Las Cruces
State/Province
New Mexico
ZIP/Postal Code
88011
Country
United States
12. IPD Sharing Statement
Citations:
PubMed Identifier
25777345
Citation
Rao A, Lauer R. Phase II study of sorafenib and bortezomib for first-line treatment of metastatic or unresectable renal cell carcinoma. Oncologist. 2015 Apr;20(4):370-1. doi: 10.1634/theoncologist.2015-0055. Epub 2015 Mar 16.
Results Reference
derived
Links:
URL
http://www.cancer.unm.edu
Description
University of New Mexico Cancer Center
URL
http://www.nmcca.org
Description
New Mexico Cancer Care Alliance
Learn more about this trial
Velcade and Sorafenib in Unresected or Metastatic Renal Cell Carcinoma
We'll reach out to this number within 24 hrs