Stereotactic Body Radiotherapy (SBRT) and Sorafenib in Patients With Metastatic, Recurrent, or Unresectable Renal Cell Cancer (RCC)

This study has been terminated.
(Slow accrual)
Sponsor:
Collaborator:
Bayer
Information provided by:
Duke University
ClinicalTrials.gov Identifier:
NCT00672178
First received: May 4, 2008
Last updated: January 9, 2011
Last verified: January 2011
  Purpose

The purpose of this study is to determine the safety and efficacy of combined stereotactic body radiotherapy (SBRT) + sorafenib in the treatment of patients with Stage IV renal cell carcinoma (RCC) who have recurred locally, developed progression of an unresectable primary or progression of extra-cranial and/or extra-pulmonary metastases while on sorafenib. All subjects will remain on sorafenib during SBRT.


Condition Intervention Phase
Renal Cell Carcinoma
Radiation: Stereotactic body radiation
Phase 1
Phase 2

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Phase I/II Trial Evaluating Toxicity and Efficacy of Adding Stereotactic Body Radiotherapy to Sorafenib in Patients With Metastatic, Recurrent, or Unresectable Renal Cell Cancer

Resource links provided by NLM:


Further study details as provided by Duke University:

Primary Outcome Measures:
  • Number of Participants With Overall Complete and Partial Response (CR+PR) [ Time Frame: 8 weeks ] [ Designated as safety issue: No ]

Enrollment: 1
Study Start Date: March 2008
Study Completion Date: September 2009
Primary Completion Date: September 2009 (Final data collection date for primary outcome measure)
Intervention Details:
    Radiation: Stereotactic body radiation
    Stereotactic body radiotherapy will be given in three cohorts of increasingly higher dose levels: Cohort 1: 6 Gy/fraction x 3 fractions (total=18 Gy) over 5 days; Cohort 2: 8 Gy/fraction x 3 fractions over 5 days; Cohort 3: 10 Gy/fraction x 3 fractions over 5 days.
Detailed Description:

In the phase I portion of this investigation, subjects will be enrolled in cohorts of three to the SBRT dose groups. Subjects will remain on sorafenib therapy during SBRT. Any change in sorafenib dosage before, during or after SBRT will be at the discretion of the subject's medical oncologist. Subjects will be assessed during, immediately after and at 4 and 8 weeks post-therapy for toxicity.

Stereotactic body radiotherapy will be given in increasingly higher dose levels each cohort until the maximum tolerated dose of radiation is determined.

  Eligibility

Ages Eligible for Study:   18 Years to 80 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Age > 18 years old
  • Zubrod Performance Status 0 or 1
  • Adequate bone marrow, liver and renal function as assessed by the following:

    • Hemoglobin > 9.0 g/dl
    • Absolute neutrophil count (ANC) > 1,500/mm3
    • Platelet count > 100,000/mm3
    • Total bilirubin < 1.5 times institutional upper limit of normal (ULN)
    • Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) < 2.5 times the institutional ULN
    • Creatinine < 1.5 times institutional ULN
  • Histologically or cytologically confirmed renal cell carcinoma, which is metastatic, unresectable or recurrent.
  • Life expectancy > 6 months
  • Local recurrence or progression of primary lesion or progression, or symptomatic progression in extra-cranial, extra-pulmonary metastases while on sorafenib
  • Measurable disease
  • Bone metastases must have a tissue component measurable by imaging.
  • No untreated brain metastases
  • Resolution of pre-existing toxicity from prior therapy excluding alopecia and taste alteration.
  • Willingness and ability to comply with continuing sorafenib, visits, treatment plans, laboratory tests and study procedures.
  • All treated lesions must comply with SBRT dose constraints
  • More than 28 days since any prior systemic or local therapy for this cancer, including investigational agents and surgical procedures exclusive of sorafenib
  • Women of childbearing potential and men must agree to use adequate contraception (barrier method of birth control)
  • Women of childbearing potential must have a negative serum pregnancy test performed within 7 days prior to the start of treatment.
  • Ability to understand and the willingness to sign a written informed consent.
  • Prothrombin time(PT) and partial thromboplastin time (PTT) within normal limits.

Exclusion Criteria:

  • Lesion in remaining (solo) kidney
  • Contraindications to radiotherapy or prior radiotherapy overlapping current site(s) of disease.
  • Cardiac disease: Congestive heart failure. Patients must not have unstable angina (anginal symptoms at rest) or new onset angina (began within the last 3 months) or myocardial infarction within the past 6 months.
  • Cardiac ventricular arrhythmias requiring anti-arrhythmic therapy.
  • Uncontrolled hypertension defined as systolic blood pressure > 150 mmHg or diastolic pressure > 90 mmHg, despite optimal medical management.
  • Known human immunodeficiency virus (HIV) infection or chronic Hepatitis B or C.
  • Active clinically serious infection
  • Thrombolic or embolic events such as a cerebrovascular accident including transient ischemic attacks within the past 6 months.
  • Pulmonary hemorrhage/bleeding event within 4 weeks of first dose of study drug.
  • Any other hemorrhage/bleeding event within 4 weeks of first dose of study drug.
  • Serious non-healing wound, ulcer, or bone fracture.
  • Evidence or history of bleeding problems
  • Major surgery, open biopsy or significant traumatic injury within 4 weeks of first study drug.
  • Use of St. John's Wort or rifampin (rifampicin).
  • Known or suspected allergy to sorafenib or any agent given in the course of this trial.
  • Any condition that impairs patient's ability to swallow whole pills.
  • Any malabsorption problem.
  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: NCT00672178

Locations
United States, North Carolina
Duke University Medical Center
Durham, North Carolina, United States, 27710
Sponsors and Collaborators
Duke University
Bayer
Investigators
Principal Investigator: John Kirkpatrick, MD Duke University
  More Information

No publications provided

Responsible Party: John Kirkpatrick, MD, Duke University Medical Center, Department of Radiaiton Oncology
ClinicalTrials.gov Identifier: NCT00672178     History of Changes
Other Study ID Numbers: Pro00001398
Study First Received: May 4, 2008
Results First Received: September 21, 2010
Last Updated: January 9, 2011
Health Authority: United States: Institutional Review Board

Keywords provided by Duke University:
RCC
metastatic
sorafenib

Additional relevant MeSH terms:
Carcinoma
Carcinoma, Renal Cell
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Neoplasms
Adenocarcinoma
Kidney Neoplasms
Urologic Neoplasms
Urogenital Neoplasms
Neoplasms by Site
Kidney Diseases
Urologic Diseases
Sorafenib
Antineoplastic Agents
Therapeutic Uses
Pharmacologic Actions
Protein Kinase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action

ClinicalTrials.gov processed this record on July 20, 2014