Treatment With Indinavir and Chemotherapy for Advanced Classical Kaposi's Sarcoma

The recruitment status of this study is unknown because the information has not been verified recently.
Verified February 2010 by Istituto Superiore di Sanita.
Recruitment status was  Recruiting
Sponsor:
Information provided by:
Istituto Superiore di Sanita
ClinicalTrials.gov Identifier:
NCT01067690
First received: February 10, 2010
Last updated: NA
Last verified: February 2010
History: No changes posted

February 10, 2010
February 10, 2010
June 2008
Not Provided
to determine the rate of complete responses at the end of treatment (including the maintenance phase) and of clinical responses after the maintenance phase, considering the residual debulked tumour (after the induction phase) as the reference point. [ Designated as safety issue: No ]
Same as current
No Changes Posted
to determine time to tumor progression, treatment tolerability, indinavir pharmacokinetic profile, biological markers of response (ie. angiogenesis and immunoactivation parameters, HHV8 viral load and immune response) [ Designated as safety issue: Yes ]
Same as current
Not Provided
Not Provided
 
Treatment With Indinavir and Chemotherapy for Advanced Classical Kaposi's Sarcoma
Phase II Trial for the Treatment of Advanced Classical Kaposi's Sarcoma With the HIV Protease Inhibitor Indinavir in Combination With Chemotherapy

The purpose of this study is to determine the clinical response to daily Indinavir oral administration in association with a conventional chemotherapy based on cycles of systemic Vinblastine +/- Bleomycin in patients affected by advanced classical (non HIV-associated) Kaposi's sarcoma

It has been recently demonstrated that HIV protease inhibitors (HIV-PI) exert direct anti-angiogenic and anti-tumor actions by blocking endothelial and tumor cell invasion and matrix metalloprotease (MMP) activity. Based on this data, we have started a phase II trial for the treatment of HIV-negative patients with CKS with the HIV-PI Indinavir. Indinavir was well tolerated and induced KS regression/improvement in early-stage disease, and prolonged stabilization in late-stage KS. Response required high plasma drug concentrations indicating a "therapeutic" drug threshold, and was associated with a decrease of circulating endothelial cells (CEC), basic fibroblast growth factor and MMP2 plasma levels. However, large, confluent tumor masses were generally not responsive (Monini et al, AIDS 2009). Thus, advanced KS may benefit at best by treatment with IND upon tumor debulking by conventional chemotherapy.

Interventional
Phase 2
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Kaposi's Sarcoma
Drug: Indinavir in association with Vinblastina +/- Bleomicina
Treatment consists in an induction phase where daily Indinavir (800 mg x 2/die, orally) will be combined together with systemic Vinblastine (10 mg intravenously) +/- Bleomycin (15 mg intramuscularly) in cycles administered every 3 weeks. As maximal response will occur, patients will undergo 2 additional Vinblastine +/- Bleomycin (consolidation) cycles upon continuous treatment with Indinavir. This will be followed by a maintenance phase with Indinavir alone (800 mg x 3/die, orally) in responder patients.
Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruiting
25
Not Provided
Not Provided

Inclusion Criteria:

  • Documented diagnosis of KS
  • Negative HIV ELISA test
  • Being classified as stage III or IV
  • Age ≥18 years
  • Having interrupted any other anti-KS therapy since at least 2 weeks
  • Being informed about the nature of the study and having signed the informed consent

Exclusion Criteria:

  • Inability to give informed consent
  • Presence of other concomitant diseases, neoplasia (excluding cutaneous tumors with limited extension and without diagnosis of melanoma) or any other life-threatening clinical condition that would compromise its compliance to the protocol
  • Concomitant treatments (within 2 weeks prior to the study) with systemic immunomodulatory agents (i.e. glucocorticoids used as immunosuppressive agents, interferons) or chemotherapy
  • Pregnancy
  • Monolateral nephropathy or history of nephrolithiasis during the last 5 years
  • Any clinically relevant and persistent alteration of laboratory values observed during screening
Both
18 Years and older
No
Contact: Barbara Ensoli, MD, PhD +39-06-4990 ext 3209 barbara.ensoli@iss.it
Contact: Cecilia Sgadari, MD +39-06-4990 ext 2511 cecilia.sgadari@iss.it
Italy
 
NCT01067690
CKS/IND-CX/05
Not Provided
Dr. Barbara Ensoli (Principal Investigator); Director, National AIDS Center, National AIDS Center, Istituto Superiore di Sanità, Rome, Italy
Istituto Superiore di Sanita
Not Provided
Principal Investigator: Lucia Brambilla, MD Dermatologic Unit, Ospedale Maggiore Policlinico, Milan, Italy
Istituto Superiore di Sanita
February 2010

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP