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Phase II Clinical Trial of Gemcitabine and Doxil® for Metastatic Renal Cell Carcinoma

This study has been completed.
Sponsor:
ClinicalTrials.gov Identifier:
NCT00630409
First Posted: March 7, 2008
Last Update Posted: March 10, 2017
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
Information provided by (Responsible Party):
Leonard Appleman, University of Pittsburgh
  Purpose
The purpose of this study is to test the hypothesis that the combination of gemcitabine and doxil will have clinical activity in patients with metastatic renal cell carcinoma.

Condition Intervention Phase
Metastatic Renal Cell Carcinoma Drug: Gemcitabine Drug: Doxil Phase 2

Study Type: Interventional
Study Design: Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Phase II Clinical Trial of Gemcitabine and Doxil® for Metastatic Renal Cell Carcinoma

Resource links provided by NLM:


Further study details as provided by Leonard Appleman, University of Pittsburgh:

Primary Outcome Measures:
  • Response Rate [ Time Frame: Up to 18 weeks for individual; Up to 40 months for cohort ]
    Number of participants that experienced response/total number of participants per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by CT scan. Response was defined as Complete Response (CR), the disappearance of all target lesions; Partial Response (PR), a 30% or greater decrease in the sum of the longest diameter of target lesions.


Secondary Outcome Measures:
  • Time to Progression [ Time Frame: Up to 40 months ]
    Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as at least a 20% increase in the sum of the longest diameter (LD) of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions.


Enrollment: 5
Study Start Date: September 2004
Study Completion Date: September 2009
Primary Completion Date: September 2009 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Treatment
Patients will receive 3 cycles of therapy as an outpatient. Each 21-day cycle of therapy will comprise: Gemcitabine: IV on days 1 and 8. Doxil: on day 1. Patients with either responding or stable disease will continue to receive additional 3 cycles of therapy with gemcitabine and Doxil until there is radiological evidence of disease progression or they are unable or unwilling to continue treatment.
Drug: Gemcitabine
800 mg IV day 1 and 8
Other Name: Gemzar
Drug: Doxil
24 mg/m2 every 21 days IV
Other Names:
  • doxorubicin
  • adriamycin

Detailed Description:
Patients with metastatic renal cell carcinoma who have received prior therapy with sorafenib, sunitinib or temsirolimus and have progressive disease may participate in this study if all eligibility criteria are met. Doxil will be administered on day 1 and gemcitabine on day 1 and 8 of a 21 day cycle. Tumor responses will be evaluated by RECIST. Up to six cycles of study treatment may be administered. Cardiac ejection fraction will be monitored.
  Eligibility

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Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patients with renal cell carcinoma who have had disease progression through sorafenib, sunitinib, or temsirolimus (within 6 months of treatment).
  • Diagnosis of RCC has been confirmed by pathological or cytological examination of tissue obtained from the primary tumor or a metastatic site.
  • Clear cell and non-clear cell histological variants are permitted.
  • With the exception of prior gemcitabine or any anthracycline (e.g., doxorubicin, epirubicin, DOXIL), any number of prior therapies with are permitted.
  • Prior nephrectomy is permitted but not required for eligibility.
  • Patients who have received palliative radiation therapy (XRT) to any area other than the brain (see below) may begin therapy immediately after completion of XRT as long as the irradiated lesion(s) is/are not used for clinical response assessment.

Brain metastases:

  • Patients requiring XRT or gamma-knife (or similar) therapy to the brain must wait at least 4 weeks after the completion of irradiation before starting therapy.
  • Only patients with either stable or regressing brain metastases after irradiation, as determined by CT or MRI, are eligible for therapy.

    • No systemic therapy within 28 days prior to enrollment except as below:
    • No sorafenib, sunitinib, temsirolimus therapy within 14 days prior to enrollment.
    • Toxicities from prior therapy must have resolved to ≤Grade I.
    • Survival: anticipated survival of at least three months.
    • Renal function: creatinine ≥ 2.0 mg/dL.
  • Patients must have a MUGA scan or 2-D echocardiogram indicating an ejection fraction of ≥50% within 42 days prior to the first dose of study drug. The method used at baseline must be used for later monitoring.
  • Prior to each new cycle of therapy: hepatic function: AST, ALT ≥ 3X the upper limit of normal, unless the liver is involved by tumor, in which case the transaminases must be ≥ 5X the upper limit of normal. Total bilirubin must be ≥ 1.5 mg/dL.
  • Prior to each new cycle of therapy: bone marrow function: absolute neutrophil count (ANC) ≥ 1,500; platelet count ≥ 100,000; hemoglobin ≥ 10 g/dL.
  • Performance status: ECOG 0 or 1.
  • Age: ≥ 18 years.
  • Signed informed consent must be obtained from participating individuals.
  • Patients with reproductive potential must use an adequate contraceptive method (e.g., abstinence, intrauterine device, oral contraceptives, barrier device with spermicide, or surgical sterilization) during treatment and for three months after completing treatment. If a patient becomes pregnant while on study, the patient will be removed from the study and all drug treatment discontinued.

Exclusion Criteria:

  • Patients who have received prior therapy with gemcitabine or an anthracycline drug (e.g., doxorubicin, epirubicin, DOXIL).
  • Patients with untreated central nervous system metastases.
  • Patients with active bacterial or fungal infections.
  • Patients with psychiatric disorders that would interfere with consent, compliance with protocol requirements, or follow-up.
  • Patients with a history of prior malignancy other than RCC, except for adequately treated basal cell or squamous cell skin cancer, in-situ cervical cancer, or other cancer for which the patient has been disease-free for 5 years.
  • Patients with any other severe concurrent disease, which, in the judgment of the investigator, would make the patient inappropriate for the entry into the study.
  • Pregnant or lactating women.
  • History of hypersensitivity reactions attributed to a conventional formulation of doxorubicin HCL or the component of DOXIL,
  • History of cardiac disease with New York Heart Association Class II or greater cardiac function or clinical evidence of congestive heart failure.
  Contacts and Locations
Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00630409


Locations
United States, Pennsylvania
Hillman Cancer Center
Pittsburgh, Pennsylvania, United States, 15232
Sponsors and Collaborators
University of Pittsburgh
Investigators
Principal Investigator: Leonard J Appleman, MD, PhD University of Pittsburgh
  More Information

Responsible Party: Leonard Appleman, Assistant Professor of Medicine, University of Pittsburgh
ClinicalTrials.gov Identifier: NCT00630409     History of Changes
Other Study ID Numbers: 04-033
First Submitted: February 28, 2008
First Posted: March 7, 2008
Results First Submitted: January 14, 2016
Results First Posted: March 10, 2017
Last Update Posted: March 10, 2017
Last Verified: January 2017

Keywords provided by Leonard Appleman, University of Pittsburgh:
Renal cell carcinoma
Kidney Cancer
Gemcitabine
Doxil
Chemotherapy

Additional relevant MeSH terms:
Carcinoma
Carcinoma, Renal Cell
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Neoplasms
Adenocarcinoma
Kidney Neoplasms
Urologic Neoplasms
Urogenital Neoplasms
Neoplasms by Site
Kidney Diseases
Urologic Diseases
Gemcitabine
Doxorubicin
Liposomal doxorubicin
Antimetabolites, Antineoplastic
Antimetabolites
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Antiviral Agents
Anti-Infective Agents
Enzyme Inhibitors
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs
Antibiotics, Antineoplastic
Topoisomerase II Inhibitors
Topoisomerase Inhibitors