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Gossypol Acetic Acid in Treating Patients With Recurrent, Metastatic, or Primary Adrenocortical Cancer That Cannot Be Removed By Surgery

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. Identifier: NCT00848016
Recruitment Status : Completed
First Posted : February 20, 2009
Results First Posted : February 21, 2014
Last Update Posted : May 7, 2014
Information provided by (Responsible Party):
National Cancer Institute (NCI)

Brief Summary:
This phase II trial is studying how well gossypol acetic acid works in treating patients with recurrent, metastatic, or primary adrenocortical cancer that cannot be removed by surgery. Drugs used in chemotherapy such as gossypol acetic acid, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing.

Condition or disease Intervention/treatment Phase
Recurrent Adrenocortical Carcinoma Stage III Adrenocortical Carcinoma Stage IV Adrenocortical Carcinoma Drug: R-(-)-gossypol acetic acid Phase 2

Detailed Description:


I. To determine the proportion of patients with recurrent, metastatic, or primary unresectable adrenocortical carcinoma who achieve an objective response to R-(-)-gossypol acetic acid.


I. To evaluate the safety of this drug in these patients. II. To determine the progression-free and overall survival of these patients.

OUTLINE: This is a multicenter study.

Patients receive oral R-(-)-gossypol acetic acid once daily on days 1-21. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed up every 3 months for up to 2 years.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 29 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase II Study of the Orally Administered Negative Enantiomer of Gossypol (AT-101) in Patients With Advanced Adrenocortical Carcinoma (ACC)
Study Start Date : February 2009
Actual Primary Completion Date : March 2012
Actual Study Completion Date : June 2012

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
Experimental: Treatment (R-(-)-gossypol acetic acid)
Patients receive 20mg oral R-(-)-gossypol acetic acid once daily on days 1-21. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity.
Drug: R-(-)-gossypol acetic acid
Participants take 20mg oral R-(-)-gossypol acetic acid once daily on days 1-21. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity.
Other Name: AT-101

Primary Outcome Measures :
  1. The Proportion of Patients Who Achieve a Confirmed Objective Response to Treatment, Either Partial Response (PR) or Complete Response (CR) as Defined by Response Evaluation Criteria In Solid Tumors (RECIST) Criteria [ Time Frame: Up to 2 years ]

    In order for a patient to be a confirmed objective responder, they must achieve a PR or CR on consecutive evaluations, at least 4 weeks apart. The proportion of patients who achieve a confirmed objective response to treatment will be estimated by the standard binomial estimator, i.e., the number of successes divided by the total number of evaluable patients.

    Complete Response (CR): Disappearance of all target lesions and normalization of tumor biomarkers.

    Partial Response (PR): At least a 30% decrease in the sum of the longest dimension (LD) of target lesions taking as reference the baseline sum LD.

Secondary Outcome Measures :
  1. Overall Survival [ Time Frame: From registration to date of last follow-up or death due to any cause, assessed up to 2 years ]
    The overall survival time is defined as the time from registration to date of last follow-up or death due to any cause. Estimated using the method of Kaplan-Meier.

  2. Progression-free Survival [ Time Frame: From registration to progression or death, whichever occurs first, up to 2 years. ]
    The progression-free survival is defined as the time from registration to the date of progression or death, whichever comes first. The distributions of progression-free survival time will be estimated using the method of Kaplan-Meier.

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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

Inclusion Criteria:

  • Histologically or cytologically confirmed adrenocortical carcinoma

    • Recurrent, metastatic, or primary unresectable disease
  • Measurable disease, defined as ≥ 1 lesion accurately measured in ≥ 1 dimension as ≥ 2.0 cm by conventional techniques or ≥ 1.0 cm by spiral CT scan
  • No adrenocortical tumors that, in the Principal Investigator's opinion, are potentially resectable by surgical excision alone
  • No symptomatic or progressive brain metastases

    • Patients with treated brain metastases ≥ 6 months prior to study who are clinically and radiographically stable or improved and are off steroids are eligible
    • Must undergo an MRI of the brain or CT scan of the head with contrast ≤ 4 weeks prior to study
  • Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0-2 or Karnofsky PS 60-100%
  • Life expectancy ≥ 12 weeks
  • White blood cell count (WBC) ≥ 3,000/mm3
  • Absolute neutrophil count (ANC) ≥ 1,500/mm3
  • Platelet count ≥ 100,000/mm3
  • Total bilirubin < 1.5 mg/dL
  • Aspartate aminotransferase (AST) and Alanine aminotransferase (ALT) ≤ 2.5 times upper limit of normal
  • Serum creatinine ≤ 1.7 mg/dL or creatinine clearance ≥ 40 mL/min
  • Able to take oral medications on a regular basis
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception prior to, during, and for ≥ 1 month after completion of study treatment
  • No HIV positivity
  • 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 or social situation that would limit compliance with study requirements
  • No condition or disease that significantly affects gastrointestinal (GI) function or impairs the ability to swallow and retain oral medications including, but not limited to, any of the following:

    • GI tract disease or a requirement for IV alimentation
    • Prior resection of the stomach or small bowel or surgical procedures affecting absorption
    • Active peptic ulcer disease
    • Malabsorption syndrome
    • Ulcerative colitis
    • Inflammatory bowel disease
    • Partial or complete small bowel obstruction
  • No other malignancy within the past 2 years except nonmelanoma skin cancer or in situ cervical cancer
  • No symptomatic hypercalcemia > grade 2
  • No history of allergic reactions attributed to compounds of similar chemical or biological composition to R-(-)-gossypol acetic acid
  • Fully recovered from prior surgical procedures and recovered to ≤ grade 1 from adverse events due to previous treatments
  • No prior racemic gossypol or R-(-)-gossypol acetic acid
  • More than 4 weeks since prior chemotherapy, biologic therapy, major surgery, or radiotherapy (≥ 6 weeks for carmustine or mitomycin C)
  • Prior and concurrent mitotane and ketoconazole allowed for patients with hormonal excess
  • More than 4 weeks since prior and no concurrent treatment with another investigational agent
  • No concurrent prophylactic use of hematopoietic growth factors (e.g., filgrastim [G-CSF], sargramostim [GM-CSF], interleukin-11) during the first course of study treatment
  • Not requiring routine use of platelet transfusions to maintain ANC or platelet count above required thresholds

Exclusion Criteria:

  • No concurrent combination antiretroviral therapy for HIV-positive patients

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 identifier (NCT number): NCT00848016

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United States, California
University of Southern California
Los Angeles, California, United States, 90033-0804
United States, Minnesota
Mayo Clinic
Rochester, Minnesota, United States, 55905
Sponsors and Collaborators
National Cancer Institute (NCI)
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Principal Investigator: Michael Menefee Mayo Clinic
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Responsible Party: National Cancer Institute (NCI) Identifier: NCT00848016    
Other Study ID Numbers: NCI-2009-01160
N01CM00070 ( U.S. NIH Grant/Contract )
N01CM00038 ( U.S. NIH Grant/Contract )
First Posted: February 20, 2009    Key Record Dates
Results First Posted: February 21, 2014
Last Update Posted: May 7, 2014
Last Verified: January 2014
Additional relevant MeSH terms:
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Adrenocortical Carcinoma
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Adrenal Cortex Neoplasms
Adrenal Gland Neoplasms
Endocrine Gland Neoplasms
Neoplasms by Site
Adrenal Cortex Diseases
Adrenal Gland Diseases
Endocrine System Diseases
Acetic Acid
Retinol acetate
Gossypol acetic acid
Anti-Bacterial Agents
Anti-Infective Agents
Adjuvants, Immunologic
Immunologic Factors
Physiological Effects of Drugs
Anticarcinogenic Agents
Protective Agents
Antineoplastic Agents
Contraceptive Agents, Male
Contraceptive Agents
Reproductive Control Agents
Antineoplastic Agents, Phytogenic
Contraceptive Agents, Female