Study of the Combination of Axitinib Plus Everolimus in Patients With Malignant Advanced Solid Tumors

NCT ID: NCT01334073

Last Updated: 2015-07-23

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE1

Total Enrollment

19 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-03-31

Study Completion Date

2015-01-31

Brief Summary

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The aim of the study is to determine the MTD of the combination of everolimus plus axitinib in solid tumors, especially RCC.

Detailed Description

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Phase I study of the combination of axitinib (AX) plus everolimus (EV) in patients with malignant advanced solid tumors.

* To determine the recommended dose for phase II study of the combination of AX + EV
* To determine the safety profile and predictive factors for toxicity, pharmacokinetics (PK), and efficacy in adult solid tumors.
* To assess functional vascular imaging (FVI) as surrogate marker of activity, biomarkers predictive of activity and preliminary efficacy data in metastatic RCC, untreated with antiangiogenics.

Phase I, multicentre, open-label, non-randomized, sequential algorithm based dose-finding (3+3), clinical study in successive cohorts of patients.

Patients will take both drugs orally, every day, without planned rest period (AX bid and EV once a day). By convention one cycle is 28 days. At the first cycle patients will take one week of AX single agent before starting EV. Patients will be treated at increasing dose levels (DLs) in successive cohorts of 3-6 patients according to the number of patients with dose limiting toxicities (DLT) until the maximum tolerated dose (MTD; i.e. the DL at which \<= 1/6 patient experiences a DLT during the first cycle). All decision concerning qualification for DLT, dose escalation, study termination, inclusion of additional patients, will be taken by a Trial Monitoring Committee..

The MTD will not be higher than the recommended dose of each single agent. Six additional patients will be entered at the MTD to confirm the feasibility of the dose and preliminarily assess the efficacy of the combination in patients with RCC untreated with antiangiogenics.

Three levels of dose will be explored.

Conditions

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Malignant Advanced Solid Tumors Carcinoma, Renal Cell

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Axitinib plus everolimus

Group Type EXPERIMENTAL

Axitinib plus everolimus

Intervention Type DRUG

Patients will take both drugs orally, every day, without planned rest period (AX bid and EV once a day). By convention one cycle is 28 days. At the first cycle patients will take one week of AX single agent before starting EV. Patients will be treated at increasing dose levels (DLs) in successive cohorts of 3-6 patients according to the number of patients with dose limiting toxicities (DLT) until the maximum tolerated dose

Interventions

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Axitinib plus everolimus

Patients will take both drugs orally, every day, without planned rest period (AX bid and EV once a day). By convention one cycle is 28 days. At the first cycle patients will take one week of AX single agent before starting EV. Patients will be treated at increasing dose levels (DLs) in successive cohorts of 3-6 patients according to the number of patients with dose limiting toxicities (DLT) until the maximum tolerated dose

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Histologically proven advanced adult solid tumors, with the exception of Hodgkin and non Hodgkin lymphoma. Patients with hepatocellular carcinomas (HCC) may be enrolled without histological documentation if they meet the consensus non-invasive diagnostic criteria.
* Failure or contra-indication of all standard therapies, except for the patients with advanced renal cell carcinoma, enrolled at the recommended dose who will be naïve of previous lines of therapy while metastatic.
* Age \> 18 years
* ECOG Performance status (PS) 0-1
* Life expectancy \> 3 months
* Measurable/evaluable disease according to RECIST CRITERIA version 1.0
* Acceptable biological values: Hemoglobin \> 10g /dL; neutrophils \> 1.5 x 109/L; platelets \> 100 x 109/L, AST and ALT \< 2.5 x the upper normal limits (UNL), or \< 5 x UNL in case of liver metastases, GGT \< 3 x the upper normal limits (UNL), PAL \< 2.5 x the upper normal limits (UNL), or \< 5 x UNL in case of liver metastases, serum bilirubin \< 1.5 x ULN, creatinine clearance (Cockroft \& Gault formula) \> 60 mL/min.
* 24 hours proteinuria ≤ 1 g/24 h
* Albumin \> 30 g/l
* Amylase and lipase ≤ 1.5 UNL
* Electrolytes (calcium, sodium, potassium, chlore, magnesium, phosphate) in the normal range. Supplementation could be possible before study entry.
* Total cholesterol ≤ 2.5 UNL
* Triglycerides ≤ 2.5 UNL
* BP \< 140/90
* Washout period from last anticancer therapy, including radiation and surgery \> 3 weeks and recovery of toxicities to NCI-CTC grade \< 1.
* Written informed Consent.
* Use of effective contraceptive method (Intrauterine device, oral combined contraceptive) for women of child-bearing age or whose partner is included in the trial.
* Patient with french social security.
* No toxicity with NCI-CTC grade \> 2 at the end of axitinib alone period just before starting axitinib and everolimus (cycle 1)
* BP \< 140/ 90

Exclusion Criteria

* Brain metastasis
* Severe underlying cardiovascular disease, even medically controlled, such as angina pectoris, myocardial infarction, cardiac insufficiency, cardiac failure, cerebral strokes, lower limb ischemic disease, thromboembolic disease, and any patient, who, in the investigator's opinion is at high risk for arterial or venous thromboembolism.
* Hepatitis B or C carrier or at a chronic state
* Uncontrolled hypertension, or diabetes mellitus despite medical treatment.
* Inability to swallow pills
* Unresolved pneumopathy, no need for antibiotherapy
* Any medical or social condition, which; in the investigator's opinion, would jeopardize patient's safety, patient's compliance to the protocol, or the interpretation of study results. These conditions include (but are not limited to): severe infection, cardiac failure, chronic gastrointestinal disease compromising oral drug absorption, psychiatric illnesses, foreseeable poor treatment compliance with oral medications, patients living far away from the investigational centers, etc…
* Hypersensitivity to Axitinib or Everolimus
* Participation to another clinical trial, or use of an unapproved medication within 4 weeks prior to study treatment initiation.
* Pregnant or lactating women.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Bordeaux

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Alain RAVAUD

Role: PRINCIPAL_INVESTIGATOR

University Hospital, Bordeaux

Adélaïde Doussau, Dr

Role: STUDY_CHAIR

University Hospital, Bordeaux

Locations

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Professeur Alain RAVAUD

Bordeaux, , France

Site Status

Professeur Jean-Pierre DELORD

Toulouse, , France

Site Status

Countries

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France

References

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Su Y, Amiri KI, Horton LW, Yu Y, Ayers GD, Koehler E, Kelley MC, Puzanov I, Richmond A, Sosman JA. A phase I trial of bortezomib with temozolomide in patients with advanced melanoma: toxicities, antitumor effects, and modulation of therapeutic targets. Clin Cancer Res. 2010 Jan 1;16(1):348-57. doi: 10.1158/1078-0432.CCR-09-2087. Epub 2009 Dec 22.

Reference Type BACKGROUND
PMID: 20028756 (View on PubMed)

O'Reilly T, Lane HA, Wood JM, Schnell C, Littlewood-Evans A, Brueggen J, McSheehy PM. Everolimus and PTK/ZK show synergistic growth inhibition in the orthotopic BL16/BL6 murine melanoma model. Cancer Chemother Pharmacol. 2011 Jan;67(1):193-200. doi: 10.1007/s00280-010-1307-z. Epub 2010 May 30.

Reference Type BACKGROUND
PMID: 20512579 (View on PubMed)

Choueiri TK. Axitinib, a novel anti-angiogenic drug with promising activity in various solid tumors. Curr Opin Investig Drugs. 2008 Jun;9(6):658-71.

Reference Type BACKGROUND
PMID: 18516765 (View on PubMed)

Other Identifiers

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CHUBX 2010/09

Identifier Type: -

Identifier Source: org_study_id

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