Erlotinib and Sirolimus for the Treatment of Metastatic Renal Cell Carcinoma

NCT ID: NCT00353301

Last Updated: 2014-04-14

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE2
• Total Enrollment: 25 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2006-07-31
• Study Completion Date: 2012-03-31

Brief Summary

The purpose of this study is to test the safety and efficacy of the combination of erlotinib hydrochloride (Tarceva™) and sirolimus (Rapamune™) in the treatment of patients with metastatic kidney cancer.

Detailed Description

Despite recent advances metastatic renal cell carcinoma remains an incurable condition. Currently available treatment with high-dose interleukin-2 can lead to complete responses in a small minority of selected patients but is markedly toxic and not broadly available. FDA-approved multikinase inhibitors (sorafenib and sunitinib malate) often cause partial and transient tumor regression. There is no standard treatment metastatic renal cell carcinoma for patients whose disease progressed on multikinase inhibitors. The kinase mammalian target of rapamycin (mTOR) is overstimulated in a subset of renal cell carcinomas and other malignancies and can be blocked by sirolimus leading to growth arrest. Erlotinib hydrochloride is a drug that blocks the function of the epidermal growth factor receptor (EGFR), often over expressed in kidney cancer. Sirolimus and EGFR inhibitors and been safely used in combination. In vitro experiments show that erlotinib enhances the sirolimus induced growth impairment in a panel of renal cell carcinoma cells. In the present study patients with metastatic renal cell carcinoma whose disease progressed on multikinase inhibitors will be treated with the combination of erlotinib hydrochloride (Tarceva™) and sirolimus (Rapamune™). This is a single arm trial with no placebo or drug-based control arm

Conditions

Renal Cell Carcinoma

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Erlotinib and Sirolimus

Erlotinib hydrochloride (Tarceva) will be self-administered in an open-label unblinded manner to all patients enrolled in the study. During the treatment period, patients will receive single-agent Tarceva, 150 mg/day.

Sirolimus (Rapamune) will be self-administered in an open-label unblinded manner to all patients enrolled in the study. Patients will receive a loading dose of 6 mg of Rapamune seven days after beginning treatment with Tarceva™ followed by a dose of 2mg/day.

Group Type: EXPERIMENTAL

Erlotinib hydrochloride

Intervention Type: DRUG

Patients will receive single-agent Tarceva, 150 mg/day

Sirolimus

Intervention Type: DRUG

Patients will receive a loading dose of 6 mg of Rapamune seven days after beginning treatment with Tarceva™ followed by a dose of 2mg/day.

Interventions

Erlotinib hydrochloride

Patients will receive single-agent Tarceva, 150 mg/day

Intervention Type: DRUG

Sirolimus

Patients will receive a loading dose of 6 mg of Rapamune seven days after beginning treatment with Tarceva™ followed by a dose of 2mg/day.

Intervention Type: DRUG

Other Intervention Names

Tarceva; Rapamune

Eligibility Criteria

Inclusion Criteria

• Signed informed consent to participate in this study.
• Histological diagnosis of renal cell carcinoma.
• Age greater or equal 18 years.
• Eastern Cooperative Oncology Group (ECOG) Performance status of 2 or better.
• Life expectancy of at least 3 months.
• Failure or intolerance to previous treatment with Sutent® and/or Nexavar®.
• Most recent systemic treatment at least 1 month from the beginning of treatment.
• Most recent local treatment (surgery or irradiation) > 2 weeks from the beginning of treatment.
• At least one site of measurable disease by CT scan or MRI (RECIST criteria).
• Baseline hemoglobin >9 g/dl, platelets > 100,000/mm3, absolute neutrophil count (ANC >1500/mm3.

Exclusion Criteria

• Previous treatment with Tarceva™, Iressa™, Rapamune™, temsirolimus or everolimus.
• Untreated metastasis to the central nervous system.
• Previous solid organ, bone marrow or stem-cell transplant.
• Known AIDS or HIV infection.
• Symptomatic or poorly controlled chronic heart failure.
• Chronic renal failure requiring dialysis on a regular basis.
• Chronic liver failure.
• Serum aspartate aminotransferase (AST), Alanine Aminotransferase (ALT), alkaline phosphatase or bilirubin >1.5 x the upper limit of normal for the local laboratory.
• Pregnant or breast-feeding women.
• Other invasive malignant diseases within 5 years (other than squamous or basal cell carcinoma of the skin).
• Inability to provide informed consent
• Any other serious and/or unstable medical, psychiatric, or other condition considered by the P.I. to preclude safe or reasonably compliant participation in the protocol.

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Genentech, Inc.

INDUSTRY

Sponsor Role: collaborator

University of Colorado, Denver

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Thomas W Flaig, MD

Role: PRINCIPAL_INVESTIGATOR

University of Colorado, Denver

Locations

University of Colorado Hospital

Aurora, Colorado, United States

Countries

United States

References

Gemmill RM, Zhou M, Costa L, Korch C, Bukowski RM, Drabkin HA. Synergistic growth inhibition by Iressa and Rapamycin is modulated by VHL mutations in renal cell carcinoma. Br J Cancer. 2005 Jun 20;92(12):2266-77. doi: 10.1038/sj.bjc.6602646.

Reference Type: BACKGROUND

PMID: 15956968 (View on PubMed)

Other Identifiers

05-1135.cc

Identifier Type: -

Identifier Source: org_study_id