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Everolimus (RAD001) For Advanced Renal Cell Carcinoma (RCC) Before Kidney Removal

This study has been terminated.
(Difficulty in accrual and by the order of the cancer center.)
Sponsor:
Collaborator:
University of Texas Southwestern Medical Center
Information provided by (Responsible Party):
Linda C. Higgins, Baylor College of Medicine
ClinicalTrials.gov Identifier:
NCT00831480
First received: January 27, 2009
Last updated: February 19, 2016
Last verified: December 2014
  Purpose

The purpose of this multicenter, pilot, open-label, Phase II clinical trial is to discover if Everolimus(RAD001) is safe and effective in people who have advanced kidney cancer (renal cell carcinoma - RCC).

Since 2002, Everolimus has been studied in more than 2500 patients with various types of cancer as a single agent (a drug that is used alone to treat the cancer) or in combination with a number of well known anticancer therapies. Various studies, in animals such as in mice with cancer and in humans with cancer have shown that Everolimus can slow the growth of cancer.

Everolimus will be taken in pill form by mouth daily for 3-5 weeks followed by surgery to remove the effected kidney. After 2-4 weeks following the surgery, Everolimus will be resumed at the same dose.


Condition Intervention Phase
Kidney Cancer
Drug: everolimus
Phase 2

Study Type: Interventional
Study Design: Endpoint Classification: Safety Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Prevention
Official Title: Neoadjuvant Everolimus (RAD001)for Advanced RCC Before Cytoreductive Nephrectomy, With Correlative Tumor Studies (Protocol #: 06-08-20-01)

Resource links provided by NLM:


Further study details as provided by Baylor College of Medicine:

Primary Outcome Measures:
  • Disease Progression Diagnosed by Biopsy [ Time Frame: up to one year ] [ Designated as safety issue: No ]
    Clinical progression validated by biopsy of metastatic site. Progression-free survival (PFS) will be measured from the post-op treatment start date to either the date the patient is first recorded as having disease progression, or the date of death if the patient dies due to any causes before progression. If a patient is lost to follow-up or removed for toxicities, the patient will be censored as of the last date of contact. Patients who start a new treatment before they progress will be censored as of the date of start of the new treatment. If a patient has not progressed or died, PFS is censored at the date of last follow-up. Patients removed from therapy with everolimus due to toxicities will not be included in the PFS estimation.


Enrollment: 15
Study Start Date: April 2011
Study Completion Date: December 2014
Primary Completion Date: November 2013 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: 1
All subjects will take everolimus
Drug: everolimus
everolimus 10 mg PO once daily for 3-5 weeks followed by removal of the kidney. Everolimus will begin again between 2 to 4 weeks after surgery.
Other Names:
  • RAD001
  • Afinitor

Detailed Description:
Everolimus has significantly improved outcomes following prior therapy. This study is a biomarker driven Phase II trial that will assess the activity of everolimus as first-line therapy for renal cell carcinoma. Following initial kidney tumor biopsy, everolimus is administered for 3-5 weeks before cytoreductive nephrectomy and everolimus is then resumed and continued until tumor progression or intolerable toxicities. Any correlation of tumor tissue biomarker changes from initial biopsy to nephrectomy specimen with long-term progression-free survival will be determined. This trial may enable the identification of factors predictive of significant benefit from everolimus administered as first-line therapy by employing the neoadjuvant therapy paradigm.
  Eligibility

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

Inclusion Criteria:

  • Advanced (metastatic) RCC
  • Histology: clear cell, papillary or chromophobe
  • 3 out 6 risk factors (by Memorial Sloan Kettering Cancer Center criteria and one additional criterion: multiple sites of metastasis) or not candidates for or refuse sunitinib.
  • Must have at least one measurable metastatic site according to Response Evaluation Criteria In Solid Tumors (RECIST) criteria that has not been previously irradiated.
  • Must be deemed surgical candidates for cytoreductive nephrectomy by the urologist.
  • Age 18 years of age or older
  • Eastern Cooperative Oncology Group (EGOG) PS 0-2
  • Adequate bone marrow function
  • Adequate liver function as shown by:
  • Adequate renal function
  • Fasting serum cholesterol AND fasting triglycerides within normal limits
  • Signed informed consent

Exclusion Criteria:

  • Collecting duct, medullary histologies or sarcomatoid differentiation.
  • Central Nervous System (CNS) or leptomeningeal metastases.
  • Inappropriate candidates for cytoreductive nephrectomy or who have any severe and/or uncontrolled medical conditions or other conditions that could affect their participation in the study
  • severely impaired lung function
  • uncontrolled diabetes
  • active (acute or chronic) or uncontrolled severe infections
  • liver disease such as cirrhosis, chronic active hepatitis or chronic persistent hepatitis
  • Ineligible for cytoreductive nephrectomy
  • Current or prior systemic anticancer therapies (including chemotherapy, antibody based therapy, or investigational drugs)
  • Other malignancies within the past 3 years except for localized carcinoma of the cervix, basal or squamous cell carcinomas of the skin, or localized prostate cancer with Gleason Score less than 7 treated with radiation or surgery and no evidence of progression.
  • Major surgery (defined as requiring general anesthesia) or significant traumatic injury within 4 weeks of start of enrollment
  • Anticipated major surgery (other than CN) during the course of the study
  • A known history of HIV seropositivity
  • Hepatitis C seropositivity
  • Chronic, systemic treatment with corticosteroids or another immunosuppressive agent. Topical or inhaled corticosteroids are allowed.
  • Immunization with attenuated live vaccines within one week of study entry or during study period
  • Known hypersensitivity to RAD001 (everolimus) or other rapamycins or to its excipients
  • Impairment of gastrointestinal function or gastrointestinal disease
  • Active, bleeding diathesis
  • Female patients who are pregnant or breast feeding, or adults of reproductive potential who are not using effective birth control methods.
  • History of noncompliance to medical regimens
  • Unwilling to or unable to comply with the protocol including mandated biopsies
  Contacts and Locations
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, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00831480

Locations
United States, Texas
UT Southwestern Medical Center
Dallas, Texas, United States, 75390
Baylor College of Medicine
Houston, Texas, United States, 77030
Sponsors and Collaborators
Linda C. Higgins
University of Texas Southwestern Medical Center
Investigators
Principal Investigator: Gilad E. Amiel, MD Baylor College of Medicine
  More Information

Responsible Party: Linda C. Higgins, Study Contact, Baylor College of Medicine
ClinicalTrials.gov Identifier: NCT00831480     History of Changes
Other Study ID Numbers: H-23409 
Study First Received: January 27, 2009
Results First Received: November 20, 2014
Last Updated: February 19, 2016
Health Authority: United States: Food and Drug Administration
Individual Participant Data  
Plan to Share IPD: Undecided

Keywords provided by Baylor College of Medicine:
Renal cell carcinoma
Everolimus
Neoadjuvant
advanced kidney 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
Everolimus
Sirolimus
Antineoplastic Agents
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs
Anti-Bacterial Agents
Anti-Infective Agents
Antibiotics, Antineoplastic
Antifungal Agents

ClinicalTrials.gov processed this record on September 29, 2016