Trial Outcomes & Findings for Trial of RAD001 in Patients With Operable Non-Small Cell Lung Cancer (NSCLC) (NCT NCT00401778)

NCT ID: NCT00401778

Last Updated: 2016-12-21

Results Overview

All patients had baseline imaging in a fasted state with 18F-2-fluoro-2-deoxy-D-glucose fluorodeoxyglucose (18FDG)-PET scan and a repeat scan at 3 to 4 weeks later using routine clinical protocol for patient preparation, radiotracer administration and data acquisition. The repeat imaging occurred no longer than 24 hours before surgical resection.

Recruitment status

COMPLETED

Study phase

PHASE1

Target enrollment

33 participants

Primary outcome timeframe

Day 21

Results posted on

2016-12-21

Participant Flow

All enrolled patients were recruited through the multidisciplinary thoracic oncology clinics of Emory Clinic of Emory University.

Eligible patients were enrolled concurrently on the active and control arms. Patient preference for a specific arm was entertained until the control cohort was completely filled after which all patients were competitively enrolled on the active treatment arm of the study.

Participant milestones

Participant milestones
Measure
Control
No everolimus taken.
Everolimus 5 mg
Everolimus dose of 5 mg/day for 21-28 days sequentially taken orally in tablet form.
Everolimus 10 mg
Everolimus dose of 10 mg/day for 21-28 days sequentially taken orally in tablet form.
Overall Study
STARTED
10
12
11
Overall Study
COMPLETED
9
11
10
Overall Study
NOT COMPLETED
1
1
1

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Trial of RAD001 in Patients With Operable Non-Small Cell Lung Cancer (NSCLC)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Control
n=10 Participants
No everolimus taken.
Everolimus 5 mg
n=12 Participants
Everolimus dose of 5 mg/day for 21-28 days sequentially taken orally in tablet form.
Everolimus 10 mg
n=11 Participants
Everolimus dose of 10 mg/day for 21-28 days sequentially taken orally in tablet form.
Total
n=33 Participants
Total of all reporting groups
Age, Continuous
63 years
n=5 Participants
58 years
n=7 Participants
70 years
n=5 Participants
64 years
n=4 Participants
Gender
Female
6 Participants
n=5 Participants
6 Participants
n=7 Participants
7 Participants
n=5 Participants
19 Participants
n=4 Participants
Gender
Male
4 Participants
n=5 Participants
6 Participants
n=7 Participants
4 Participants
n=5 Participants
14 Participants
n=4 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
Black or African American
3 Participants
n=5 Participants
2 Participants
n=7 Participants
4 Participants
n=5 Participants
9 Participants
n=4 Participants
Race (NIH/OMB)
White
7 Participants
n=5 Participants
10 Participants
n=7 Participants
7 Participants
n=5 Participants
24 Participants
n=4 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Region of Enrollment
United States
10 participants
n=5 Participants
12 participants
n=7 Participants
11 participants
n=5 Participants
33 participants
n=4 Participants

PRIMARY outcome

Timeframe: Day 21

All patients had baseline imaging in a fasted state with 18F-2-fluoro-2-deoxy-D-glucose fluorodeoxyglucose (18FDG)-PET scan and a repeat scan at 3 to 4 weeks later using routine clinical protocol for patient preparation, radiotracer administration and data acquisition. The repeat imaging occurred no longer than 24 hours before surgical resection.

Outcome measures

Outcome measures
Measure
Control
n=9 Participants
No everolimus taken.
Everolimus 5 mg
n=11 Participants
Everolimus dose of 5 mg/day for 21-28 days sequentially taken orally in tablet form.
Everolimus 10 mg
n=10 Participants
Everolimus dose of 10 mg/day for 21-28 days sequentially taken orally in tablet form.
Clinical Response as Assessed Metabolically by Changes in Positron Emission Tomography (PET) Scan Between Baseline and Immediately Prior to Surgery.
Progressive metabolic disease (PM)
22 percentage of patients
36 percentage of patients
50 percentage of patients
Clinical Response as Assessed Metabolically by Changes in Positron Emission Tomography (PET) Scan Between Baseline and Immediately Prior to Surgery.
Stable metabolic disease (SMD)
78 percentage of patients
64 percentage of patients
50 percentage of patients

PRIMARY outcome

Timeframe: 6 months

Changes in the expression of key signaling proteins in the mTOR/phosphatidylinositol 3-kinase (PI3K) pathway were determined by immunohistochemistry using previously published protocols and manufacturers' recommendations for antigen retrieval and antibody dilution along with positive and negative controls. Two investigators assessed protein expression jointly by light microscopy. The degree of expression was assessed by intensity (0, 1+, 2+, 3+) and percentage of cell staining in line with published algorithm. A derivative score (immunoscore) ranging between 0 and 300 was calculated as the product of intensity and percent cell staining.

Outcome measures

Outcome measures
Measure
Control
n=9 Participants
No everolimus taken.
Everolimus 5 mg
n=11 Participants
Everolimus dose of 5 mg/day for 21-28 days sequentially taken orally in tablet form.
Everolimus 10 mg
n=10 Participants
Everolimus dose of 10 mg/day for 21-28 days sequentially taken orally in tablet form.
Effects of RAD001 on the Regulation of Key Proteins Involved With the Mammalian Target of Rapamycin (mTOR) Axis in Tumor Specimens and Buccal Mucosa in Patients With Operable Non-small Cell Lung Cancer (NSCLC).
S6
-36.06 % change in immunoscore
Standard Deviation 100.02
-13.69 % change in immunoscore
Standard Deviation 144.05
-77.03 % change in immunoscore
Standard Deviation 16.02
Effects of RAD001 on the Regulation of Key Proteins Involved With the Mammalian Target of Rapamycin (mTOR) Axis in Tumor Specimens and Buccal Mucosa in Patients With Operable Non-small Cell Lung Cancer (NSCLC).
pS6
-41.25 % change in immunoscore
Standard Deviation 65.62
-61.57 % change in immunoscore
Standard Deviation 35.8
-47.21 % change in immunoscore
Standard Deviation 44.96
Effects of RAD001 on the Regulation of Key Proteins Involved With the Mammalian Target of Rapamycin (mTOR) Axis in Tumor Specimens and Buccal Mucosa in Patients With Operable Non-small Cell Lung Cancer (NSCLC).
pS6/S6
-85.75 % change in immunoscore
Standard Deviation 20.15
-100 % change in immunoscore
Standard Deviation NA
Insufficient tissue sample for testing
128.57 % change in immunoscore
Standard Deviation 219.26
Effects of RAD001 on the Regulation of Key Proteins Involved With the Mammalian Target of Rapamycin (mTOR) Axis in Tumor Specimens and Buccal Mucosa in Patients With Operable Non-small Cell Lung Cancer (NSCLC).
pMTOR
-6.58 % change in immunoscore
Standard Deviation 138.88
30 % change in immunoscore
Standard Deviation 153.95
-63.82 % change in immunoscore
Standard Deviation 51.3
Effects of RAD001 on the Regulation of Key Proteins Involved With the Mammalian Target of Rapamycin (mTOR) Axis in Tumor Specimens and Buccal Mucosa in Patients With Operable Non-small Cell Lung Cancer (NSCLC).
p4E-BP1
-95.37 % change in immunoscore
Standard Deviation 4.24
150 % change in immunoscore
Standard Deviation NA
Insufficient tissue sample for testing
-78.75 % change in immunoscore
Standard Deviation 14.36
Effects of RAD001 on the Regulation of Key Proteins Involved With the Mammalian Target of Rapamycin (mTOR) Axis in Tumor Specimens and Buccal Mucosa in Patients With Operable Non-small Cell Lung Cancer (NSCLC).
p70s6k
25 % change in immunoscore
Standard Deviation 176.78
137.14 % change in immunoscore
Standard Deviation 442.07
-78.62 % change in immunoscore
Standard Deviation 22.79
Effects of RAD001 on the Regulation of Key Proteins Involved With the Mammalian Target of Rapamycin (mTOR) Axis in Tumor Specimens and Buccal Mucosa in Patients With Operable Non-small Cell Lung Cancer (NSCLC).
p70s6k Cytoplasmic
-19.17 % change in immunoscore
Standard Deviation 73.16
0.56 % change in immunoscore
Standard Deviation 14.93
305.37 % change in immunoscore
Standard Deviation 686.3
Effects of RAD001 on the Regulation of Key Proteins Involved With the Mammalian Target of Rapamycin (mTOR) Axis in Tumor Specimens and Buccal Mucosa in Patients With Operable Non-small Cell Lung Cancer (NSCLC).
p70s6k Nuclear
-3.33 % change in immunoscore
Standard Deviation 100.17
135 % change in immunoscore
Standard Deviation 49.5
223.43 % change in immunoscore
Standard Deviation 437.7
Effects of RAD001 on the Regulation of Key Proteins Involved With the Mammalian Target of Rapamycin (mTOR) Axis in Tumor Specimens and Buccal Mucosa in Patients With Operable Non-small Cell Lung Cancer (NSCLC).
pe1f4e
-50 % change in immunoscore
Standard Deviation 86.6
2.78 % change in immunoscore
Standard Deviation 5.56
-27.13 % change in immunoscore
Standard Deviation 42.17
Effects of RAD001 on the Regulation of Key Proteins Involved With the Mammalian Target of Rapamycin (mTOR) Axis in Tumor Specimens and Buccal Mucosa in Patients With Operable Non-small Cell Lung Cancer (NSCLC).
PAKT Nuclear
-33.33 % change in immunoscore
Standard Deviation 57.74
NA % change in immunoscore
Standard Deviation NA
Insufficient tissue sample for testing
0 % change in immunoscore
Standard Deviation 0
Effects of RAD001 on the Regulation of Key Proteins Involved With the Mammalian Target of Rapamycin (mTOR) Axis in Tumor Specimens and Buccal Mucosa in Patients With Operable Non-small Cell Lung Cancer (NSCLC).
PAKT Cytoplasmic
200 % change in immunoscore
Standard Deviation 469.04
NA % change in immunoscore
Standard Deviation NA
Insufficient tissue sample for testing
-25 % change in immunoscore
Standard Deviation 50
Effects of RAD001 on the Regulation of Key Proteins Involved With the Mammalian Target of Rapamycin (mTOR) Axis in Tumor Specimens and Buccal Mucosa in Patients With Operable Non-small Cell Lung Cancer (NSCLC).
Bim
-11.76 % change in immunoscore
Standard Deviation NA
Insufficient tissue sample for testing
NA % change in immunoscore
Standard Deviation NA
Insufficient tissue sample for testing
-21.76 % change in immunoscore
Standard Deviation 60.07

PRIMARY outcome

Timeframe: 6 months

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 6 months

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 6 months

Outcome measures

Outcome measures
Measure
Control
n=10 Participants
No everolimus taken.
Everolimus 5 mg
n=20 Participants
Everolimus dose of 5 mg/day for 21-28 days sequentially taken orally in tablet form.
Everolimus 10 mg
Everolimus dose of 10 mg/day for 21-28 days sequentially taken orally in tablet form.
Duration of Hospital Stay Following Surgery.
5 days
Interval 2.0 to 15.0
5 days
Interval 3.0 to 43.0

Adverse Events

Control

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Everolimus 5 & 10 mg

Serious events: 1 serious events
Other events: 21 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Control
n=10 participants at risk
No everolimus taken.
Everolimus 5 & 10 mg
n=23 participants at risk
Everolimus dose of 5 or 10 mg/day for 21-28 days sequentially taken orally in tablet form.
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Symptomatic Progression of Lung Cancer
0.00%
0/10 • 4 weeks
4.3%
1/23 • 4 weeks

Other adverse events

Other adverse events
Measure
Control
n=10 participants at risk
No everolimus taken.
Everolimus 5 & 10 mg
n=23 participants at risk
Everolimus dose of 5 or 10 mg/day for 21-28 days sequentially taken orally in tablet form.
Blood and lymphatic system disorders
Hyperglycemia
0.00%
0/10 • 4 weeks
91.3%
21/23 • 4 weeks
Respiratory, thoracic and mediastinal disorders
Cough
0.00%
0/10 • 4 weeks
43.5%
10/23 • 4 weeks
Vascular disorders
Elevated Cholesterol
0.00%
0/10 • 4 weeks
56.5%
13/23 • 4 weeks
General disorders
Fatigue
0.00%
0/10 • 4 weeks
60.9%
14/23 • 4 weeks
Gastrointestinal disorders
Diarrhea
0.00%
0/10 • 4 weeks
13.0%
3/23 • 4 weeks
General disorders
Night Sweats
0.00%
0/10 • 4 weeks
13.0%
3/23 • 4 weeks
General disorders
Fever
0.00%
0/10 • 4 weeks
13.0%
3/23 • 4 weeks
Renal and urinary disorders
Elevated Creatinine
0.00%
0/10 • 4 weeks
34.8%
8/23 • 4 weeks
General disorders
Insomnia
0.00%
0/10 • 4 weeks
21.7%
5/23 • 4 weeks
General disorders
Hoarseness
0.00%
0/10 • 4 weeks
8.7%
2/23 • 4 weeks
Gastrointestinal disorders
Heartburn
0.00%
0/10 • 4 weeks
8.7%
2/23 • 4 weeks
Metabolism and nutrition disorders
Weight-loss
0.00%
0/10 • 4 weeks
21.7%
5/23 • 4 weeks
Respiratory, thoracic and mediastinal disorders
Dyspnea
0.00%
0/10 • 4 weeks
34.8%
8/23 • 4 weeks
General disorders
Nausea
0.00%
0/10 • 4 weeks
34.8%
8/23 • 4 weeks
Blood and lymphatic system disorders
Elevated ALT
0.00%
0/10 • 4 weeks
39.1%
9/23 • 4 weeks
Blood and lymphatic system disorders
Elevated AST
0.00%
0/10 • 4 weeks
43.5%
10/23 • 4 weeks
Blood and lymphatic system disorders
Elevated Alkaline Phosphatase
0.00%
0/10 • 4 weeks
39.1%
9/23 • 4 weeks
Blood and lymphatic system disorders
Hypocalcemia
0.00%
0/10 • 4 weeks
52.2%
12/23 • 4 weeks
Blood and lymphatic system disorders
Hyponatremia
0.00%
0/10 • 4 weeks
43.5%
10/23 • 4 weeks
Blood and lymphatic system disorders
Hypokalemia
0.00%
0/10 • 4 weeks
43.5%
10/23 • 4 weeks
Blood and lymphatic system disorders
Anemia
0.00%
0/10 • 4 weeks
52.2%
12/23 • 4 weeks
Blood and lymphatic system disorders
Hypophosphatemia
0.00%
0/10 • 4 weeks
17.4%
4/23 • 4 weeks
Blood and lymphatic system disorders
Hypoalbuminemia
0.00%
0/10 • 4 weeks
52.2%
12/23 • 4 weeks
Ear and labyrinth disorders
Vertigo
0.00%
0/10 • 4 weeks
4.3%
1/23 • 4 weeks
Respiratory, thoracic and mediastinal disorders
Productive Cough
0.00%
0/10 • 4 weeks
13.0%
3/23 • 4 weeks
Respiratory, thoracic and mediastinal disorders
Difficulty in Breathing
0.00%
0/10 • 4 weeks
4.3%
1/23 • 4 weeks
Blood and lymphatic system disorders
Hypertriglyceridemia
0.00%
0/10 • 4 weeks
65.2%
15/23 • 4 weeks
Nervous system disorders
Headache
0.00%
0/10 • 4 weeks
13.0%
3/23 • 4 weeks
Immune system disorders
Low Leukocytes
0.00%
0/10 • 4 weeks
13.0%
3/23 • 4 weeks
Skin and subcutaneous tissue disorders
Mouth Sores
0.00%
0/10 • 4 weeks
21.7%
5/23 • 4 weeks
Respiratory, thoracic and mediastinal disorders
Chest Pain
0.00%
0/10 • 4 weeks
21.7%
5/23 • 4 weeks
Respiratory, thoracic and mediastinal disorders
Sore Throat
0.00%
0/10 • 4 weeks
13.0%
3/23 • 4 weeks
Infections and infestations
Bronchitis
0.00%
0/10 • 4 weeks
4.3%
1/23 • 4 weeks
Gastrointestinal disorders
Mucositis
0.00%
0/10 • 4 weeks
17.4%
4/23 • 4 weeks
Gastrointestinal disorders
Constipation
0.00%
0/10 • 4 weeks
26.1%
6/23 • 4 weeks
Musculoskeletal and connective tissue disorders
Arthralgia
0.00%
0/10 • 4 weeks
4.3%
1/23 • 4 weeks
Gastrointestinal disorders
Reflux
0.00%
0/10 • 4 weeks
8.7%
2/23 • 4 weeks
Skin and subcutaneous tissue disorders
Eczema
0.00%
0/10 • 4 weeks
4.3%
1/23 • 4 weeks
Respiratory, thoracic and mediastinal disorders
Hemoptysis
0.00%
0/10 • 4 weeks
4.3%
1/23 • 4 weeks
Renal and urinary disorders
Burning with Urination
0.00%
0/10 • 4 weeks
4.3%
1/23 • 4 weeks
General disorders
Pain in Lower Flank
0.00%
0/10 • 4 weeks
4.3%
1/23 • 4 weeks
General disorders
Intermittent Discomfort in Left Leg
0.00%
0/10 • 4 weeks
4.3%
1/23 • 4 weeks
Psychiatric disorders
Depression
0.00%
0/10 • 4 weeks
8.7%
2/23 • 4 weeks
Blood and lymphatic system disorders
Low Platelets
0.00%
0/10 • 4 weeks
8.7%
2/23 • 4 weeks
Respiratory, thoracic and mediastinal disorders
Respiratory Failure
0.00%
0/10 • 4 weeks
8.7%
2/23 • 4 weeks
Infections and infestations
MRSA Bacteremia
0.00%
0/10 • 4 weeks
4.3%
1/23 • 4 weeks
Renal and urinary disorders
Acute Renal Failure
0.00%
0/10 • 4 weeks
4.3%
1/23 • 4 weeks
General disorders
Malaise
0.00%
0/10 • 4 weeks
4.3%
1/23 • 4 weeks
Skin and subcutaneous tissue disorders
Rash
0.00%
0/10 • 4 weeks
30.4%
7/23 • 4 weeks
Infections and infestations
Upper Respiratory Infection
0.00%
0/10 • 4 weeks
8.7%
2/23 • 4 weeks
Psychiatric disorders
Anxiety
0.00%
0/10 • 4 weeks
4.3%
1/23 • 4 weeks
Blood and lymphatic system disorders
Edema
0.00%
0/10 • 4 weeks
21.7%
5/23 • 4 weeks
Blood and lymphatic system disorders
Hyperbilirubinemia
0.00%
0/10 • 4 weeks
4.3%
1/23 • 4 weeks
Ear and labyrinth disorders
Tinnitus
0.00%
0/10 • 4 weeks
4.3%
1/23 • 4 weeks
Musculoskeletal and connective tissue disorders
Myalgia
0.00%
0/10 • 4 weeks
13.0%
3/23 • 4 weeks
Musculoskeletal and connective tissue disorders
Sinusitis
0.00%
0/10 • 4 weeks
21.7%
5/23 • 4 weeks
Respiratory, thoracic and mediastinal disorders
Odynophagia
0.00%
0/10 • 4 weeks
4.3%
1/23 • 4 weeks
Nervous system disorders
Pain
0.00%
0/10 • 4 weeks
26.1%
6/23 • 4 weeks
Nervous system disorders
Neuropathy
0.00%
0/10 • 4 weeks
8.7%
2/23 • 4 weeks
General disorders
Dizziness
0.00%
0/10 • 4 weeks
8.7%
2/23 • 4 weeks
General disorders
Restlessness
0.00%
0/10 • 4 weeks
4.3%
1/23 • 4 weeks
Skin and subcutaneous tissue disorders
Erythema
0.00%
0/10 • 4 weeks
4.3%
1/23 • 4 weeks
General disorders
Confusion
0.00%
0/10 • 4 weeks
4.3%
1/23 • 4 weeks
General disorders
Loss of Energy
0.00%
0/10 • 4 weeks
4.3%
1/23 • 4 weeks
General disorders
Difficulty in Walking
0.00%
0/10 • 4 weeks
4.3%
1/23 • 4 weeks
General disorders
Loss of Balance
0.00%
0/10 • 4 weeks
4.3%
1/23 • 4 weeks
Endocrine disorders
Hot Flashes
0.00%
0/10 • 4 weeks
4.3%
1/23 • 4 weeks
Blood and lymphatic system disorders
Hypercalcemia
0.00%
0/10 • 4 weeks
4.3%
1/23 • 4 weeks
Eye disorders
Conjuctivitis
0.00%
0/10 • 4 weeks
4.3%
1/23 • 4 weeks
General disorders
Photosensitivity
0.00%
0/10 • 4 weeks
4.3%
1/23 • 4 weeks
Blood and lymphatic system disorders
Thrombocytopenia
0.00%
0/10 • 4 weeks
8.7%
2/23 • 4 weeks
Blood and lymphatic system disorders
Leukopenia
0.00%
0/10 • 4 weeks
4.3%
1/23 • 4 weeks
Ear and labyrinth disorders
Ear Ache
0.00%
0/10 • 4 weeks
4.3%
1/23 • 4 weeks
Renal and urinary disorders
Urinary Frequency
0.00%
0/10 • 4 weeks
4.3%
1/23 • 4 weeks
General disorders
Cramping Feet
0.00%
0/10 • 4 weeks
4.3%
1/23 • 4 weeks

Additional Information

Suresh S. Ramalingam, MD

Emory University

Phone: 404-778-5378

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place