Erlotinib in Treating Patients With Advanced Kidney Cancer (OSI-774)

This study has been completed.
Sponsor:
Collaborator:
Information provided by (Responsible Party):
The University of Texas Health Science Center at San Antonio
ClinicalTrials.gov Identifier:
NCT00045487
First received: September 6, 2002
Last updated: December 9, 2013
Last verified: December 2013
  Purpose

RATIONALE: Erlotinib may stop the growth of tumor cells by blocking the enzymes necessary for tumor cell growth.

PURPOSE: Phase II trial to study the effectiveness of erlotinib in treating patients who have advanced kidney cancer.


Condition Intervention Phase
Kidney Cancer
Drug: OSI-774
Phase 2

Study Type: Interventional
Study Design: Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Phase II, Pharmacokinetic And Biologic Correlative Study of OSI-774, An EGFR Tyrosine Kinase Inhibitor, In Patients With Advanced Renal Cell Carcinoma

Resource links provided by NLM:


Further study details as provided by The University of Texas Health Science Center at San Antonio:

Primary Outcome Measures:
  • Number of Patients With Ani-tumor Activity After Taking OSI-774. [ Time Frame: Disease progression or 52 weeks duration ] [ Designated as safety issue: No ]
    Antitumor activity is measured with conventional techniques such as CT, MRI or X-ray. Scans are done at baseline then evaluated for response every 2 months. All tumor measurements must be recorded millimeters (or decimal fractions of centimeters).


Enrollment: 41
Study Start Date: June 2002
Study Completion Date: May 2008
Primary Completion Date: May 2008 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: OSI-774 Drug: OSI-774
OSI-774 is an orally active, potent, selective inhibitor of the epidermal growth factor receptor (EGFR) tyrosine kinase.
Other Name: OSI-774

Detailed Description:

OBJECTIVES:

  • Determine the antitumor activity of erlotinib in patients with advanced renal cell carcinoma.
  • Evaluate the safety and tolerability, in terms of the toxicity profile, of this drug in these patients.
  • Determine the biologic activity of this drug, in terms of early disease progression, progression-free survival, 12-month survival rate, and overall survival, in these patients.
  • Determine the pharmacodynamics of this drug in these patients.
  • Analyze the postreceptor effects of epidermal growth factor receptor-tyrosinase kinase inhibition by this drug on cell cycle, apoptosis, and angiogenesis in tumor biopsies from these patients.
  • Correlate changes in biological measurements with indices of outcome in patients treated with this drug.

OUTLINE: This is an open-label, multicenter study.

Patients receive oral erlotinib once daily on days 1-28. Courses repeat every 4 weeks for 52 weeks in the absence of disease progression or unacceptable toxicity.

Patients are followed every 2 months.

PROJECTED ACCRUAL: A total of 19-40 patients will be accrued for this study within 8-10 months.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patients must have histologically or cytologically confirmed diagnosis of advanced renal cell carcinoma (RCC). Papillary RCC is permitted only if immunohistochemical evidence of strong (2-3+) EGFR expression.
  • Disease that is recurrent or refractory to IL-2 or IFN-based therapy or new diagnosis in previously untreated patients who are not appropriate candidates to receive IL-2 -based treatment
  • Patients must have measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded) as >20 mm with conventional techniques or as >10 mm with spiral CT scan.
  • Prior nephrectomy or resection of metastatic lesions permitted if full surgical recovery has occurred.
  • Age > 18 years Because no dosing or adverse event data are currently available on the use of OSI-774 in patients <18 years of age, children are excluded from this study but will be eligible for future pediatric single-agent trials, if applicable.
  • Life expectancy of at least 12 weeks
  • ECOG performance status of 0,1 or 2 or Karnofsky >60%
  • Patients must have normal organ and marrow function as defined below:

Hematopoietic

  1. Absolute neutrophil count at least ≥ 1,500/ul
  2. Platelet ≥ 100,000/uL
  3. Hemoglobin ≥ 9.0 g/dL, concomitant erythropoetin permitted Hepatic

a. Total bilirubin within normal institutional limits b. AST (SGOT)/ALT (SGPT) ≤ 2.5 times institutional upper limit of normal (≤5 times ULN if liver metastases present) Renal

a. Serum creatinine ≤ 1.5 times ULN or calculated creatinine clearance > 60 mL/min/1.73m2 Calcium

a. Corrected calcium < 12.0 mg/dl, concomitant hypocalcemic agents permitted

  • Complete supportive and palliative care will continue to be provided to ameliorate signs and symptoms that were pre-existing or may arise while on study and which do not interfere with the objectives of the study. The use of erythropoietin and biphosphonates is permitted.
  • Patients must have tumor blocks available for EGFR expression analysis to be eligible for treatment on this study.

Exclusion Criteria:

  • History of active malignancy (other than RCC) in the past 3 years, other than nonmelanomatous skin cancer or in situ breast cancer or in situ cervical cancer.
  • Patients with known brain metastases will be excluded from this clinical trial because of their poor prognosis and because they often develop progressive neurologic dysfunction that would confound the evaluation of neurologic and other adverse events.
  • Patients who have had chemotherapy or radiotherapy within 4 weeks (6 weeks for nitrosoureas or mitomycin C) prior to entering the study or those who have not recovered from adverse events due to agents administered more than 4 weeks earlier.
  • Patients may not be receiving any other investigational agents.
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to OSI-774.
  • Prior treatment with EGFR targeting therapies.
  • Inability to understand the written informed consent document.
  • Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
  • Major surgery, or significant traumatic injury occurring within 21 days prior to treatment.
  • Abnormalities of the cornea based on history (e.g., dry eye syndrome, Sjogren's syndrome), congenital abnormality (e.g., Fuch's dystrophy), abnormal slit-lamp examination using a vital dye (e.g., fluorescein, Bengal Rose), and/or an abnormal corneal sensitivity test (Schirmer test or similar tear production test).
  • Gastrointestinal tract disease resulting in an inability to take oral medication or a requirement for IV alimentation, prior surgical procedures affecting absorption, or active peptic ulcer disease.
  • Pregnant women are excluded from this study because OSI-774 is an epidermal growth factor inhibitor with the potential for teratogenic or abortifacient effects based on the data suggesting that EGFR expression is important for normal organ development. For this reason, women of childbearing potential and men must also agree to use adequate contraception (hormonal or barrier method of birth control) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with OSI-774, breastfeeding should be discontinued if the mother is treated with OSI-774.
  • Because patients with immune deficiency are at increased risk of lethal infections when treated with marrow-suppressive therapy, HIV-positive patients receiving combination anti-retroviral therapy are excluded from the study because of possible pharmacokinetic interactions with OSI-774. Appropriate studies will be undertaken in patients receiving combination anti-retroviral therapy when indicated.
  • Informed Consent - No study specific procedures will be performed without a written and signed informed consent document. Patients who do not demonstrate the ability to understand or the willingness to sign the written informed consent document are excluded from study entry.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00045487

Locations
United States, Texas
University of Texas Health Science Center San Antonio
San Antonio, Texas, United States, 78229
Sponsors and Collaborators
The University of Texas Health Science Center at San Antonio
Investigators
Study Chair: Anthony W. Tolcher, MD University of Texas Health Science Center San Antonio
Principal Investigator: Alain Mita, MD Cedar Sinai
  More Information

Additional Information:
No publications provided

Responsible Party: The University of Texas Health Science Center at San Antonio
ClinicalTrials.gov Identifier: NCT00045487     History of Changes
Other Study ID Numbers: CDR0000256598, IDD 01-27, NCI-5410
Study First Received: September 6, 2002
Results First Received: May 7, 2013
Last Updated: December 9, 2013
Health Authority: United States: Food and Drug Administration
United States: Institutional Review Board

Keywords provided by The University of Texas Health Science Center at San Antonio:
recurrent renal cell cancer
stage III renal cell cancer
stage IV renal cell cancer

Additional relevant MeSH terms:
Carcinoma, Renal Cell
Kidney Neoplasms
Adenocarcinoma
Carcinoma
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Neoplasms
Urologic Neoplasms
Urogenital Neoplasms
Neoplasms by Site
Kidney Diseases
Urologic Diseases
Erlotinib
Protein Kinase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Pharmacologic Actions

ClinicalTrials.gov processed this record on April 21, 2014