Trial of RAD001 in Triple Negative Metastatic Breast Cancer

This study has been terminated.
(Slow accrual)
Sponsor:
Collaborator:
Novartis
Information provided by (Responsible Party):
Allan Lipton, Milton S. Hershey Medical Center
ClinicalTrials.gov Identifier:
NCT00827567
First received: January 21, 2009
Last updated: December 11, 2013
Last verified: December 2013
  Purpose

The hypothesis of this clinical research study is to discover if the study drug RAD001 can shrink or slow the growth of Estrogen Receptor/Progesterone Receptor (ER/PR) negative or Human Epidermal growth factor Receptor 2 (Her2 Neu) negative breast cancer. The safety of RAD001 will also be studied. Patients physical state, symptoms, changes in the size of the tumor, and laboratory findings obtained while on-study will help the research team decide if RAD001 is safe and effective.


Condition Intervention Phase
Breast Cancer
Drug: RAD 001
Phase 2

Study Type: Interventional
Study Design: Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Phase II Trial of RAD001 in Triple Negative Metastatic Breast Cancer

Resource links provided by NLM:


Further study details as provided by Milton S. Hershey Medical Center:

Primary Outcome Measures:
  • Time to Progression(TTP) [ Time Frame: Each patient assessed at 8 weeks from start of study drug ] [ Designated as safety issue: No ]
    Progression is defined by RESIST criteria as any new lesion or the sum of target lesions increasing by 20% over baseline


Enrollment: 6
Study Start Date: April 2009
Study Completion Date: February 2011
Primary Completion Date: February 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: RAD 001
RAD001-10 mg by mouth once everyday
Drug: RAD 001
RAD 001-10 mg by mouth once everyday
Other Name: Everolimus

Detailed Description:

RAD001 is an orally administered cell cycle inhibitor with antitumor activity. RAD001, like Rapamycin, binds with high affinity to an intracellular immunophilin, FKBP12 and this complex specifically interacts with the mammalian target of rapamycin (mTOR) protein kinase, inhibiting downstream events such as the initiation of mRNA translation. RAD001 inhibits the growth of a wide range of histologically diverse tumor cells. RAD001 is being developed as a cytostatic agent to delay the time to tumor recurrence/progression or to increase survival in patients with various malignancies. The compound has good tolerability, a partially discovered mechanism of action. RAD001 has the ability to arrest cells in the G1 phase, and the ability to induce apoptosis. RAD001 is being investigated as an anticancer agent based on its potential to act directly on the tumor cells by inhibiting tumor cell growth and proliferation through possible inhibition of the PI3/AKT/MTOR pathway.

RAD001 was shown to have activity in human tumor cell lines originating from lung, breast, prostate, colon, kidney, melanoma and glioblastoma. RAD001 was also shown to have activity in human pancreatic neuroendocrine cells, where induction of apoptosis was reported, as well as in acute myeloid leukemia cells, adult T-cell leukemia cells, diffuse large B cell lymphoma cells, pancreatic tumor cells, ovarian cancer cells, and hepatocellular carcinoma cells.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Female
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Eastern Cooperative Group (ECOG) performance status ≤ 2
  • Age ≥ 18 years
  • At least one measurable site of disease according to RECIST criteria that has not been previously irradiated. If the patient has had previous radiation to the marker lesion(s), there must be evidence of disease progression since the radiation
  • Adequate bone marrow function as shown by: Absolute Neutrophil Count (ANC) ≥ 1.5 x 109/L, Platelets (PLT)≥ 100 x 109/L, Hemoglobin (HGB) ≥9 g/dL
  • Adequate liver function as shown by:Serum bilirubin ≤ 1.5 x upper limits of normal (ULN), Prothrombin Time (INR) ≤ 1.3 (or ≤ 3 on anticoagulants), Liver function teats ≤ 2.5x ULN (≤ 5x ULN in patients with liver metastases)
  • Adequate renal function: serum creatinine ≤ 1.5 x ULN
  • Controlled diabetes as defined by fasting serum glucose ≤1.5 x ULN
  • Fasting serum cholesterol ≤300 mg/dL or ≤7.75 mmol/L AND fasting triglycerides ≤ 2.5 x ULN.

Exclusion Criteria:

  • Currently receiving anticancer therapies or who have received anticancer therapies within 4 weeks of the start of study drug (including chemotherapy, antibody based therapy, etc.)
  • Palliative radiation therapy only allowed to localized areas (ie: painful rib lesion), at the discretion of the PI and treating radiation oncologist
  • Major surgery/significant traumatic injury within 4 weeks of start of study drug.
  • Not recovered from the side effects of any major surgery (defined as requiring general anesthesia) to Grade I or patients that may require major surgery during the course of the study.
  • Prior treatment with any investigational drug within the preceding 4 weeks
  • Receiving chronic immunosuppressive agents, except corticosteroids with a daily dosage equivalent to prednisone ≤ 20 milligrams (mg). However, patients receiving corticosteroids must have been on a stable dosage regimen for a minimum of 4 weeks prior to the first treatment with RAD001. Topical or inhaled corticosteroids are allowed.
  • May not receive immunization with attenuated live vaccines within one week of study entry or during study period.
  • Uncontrolled brain or leptomeningeal metastases, including patients who continue to require glucocorticoids for brain or leptomeningeal metastases
  • Other malignancies within the past 3 years, except for adequately treated carcinoma of the cervix and basal or squamous cell carcinomas of the skin.
  • Severe and/or uncontrolled medical conditions or other conditions that could affect their participation in the study such as: Congestive heart failure: New York Heart Association Class III/IV, Unstable angina pectoris, symptomatic congestive heart failure, myocardial infarction within 6 months of start of study drug, serious uncontrolled cardiac arrhythmia or any other clinically significant cardiac disease.
  • Impaired lung function (PFT screen at baseline) as defined as spirometry and DLCO that is 50% of the normal predicted value and/or 02 saturation that is 88% or less at rest on room air.
  • Uncontrolled diabetes as defined by fasting serum glucose ≥1.5 x ULN. Glucose control should be achieved before starting a patient on RAD001.
  • Active (acute or chronic) or uncontrolled severe infections
  • Liver disease(cirrhosis, chronic active hepatitis or chronic persistent hepatitis)
  • Known history of Human Immunodeficiency Virus (HIV) seropositivity
  • Impairment of gastrointestinal function/disease that may significantly alter the absorption of RAD001 (e.g., ulcerative disease, uncontrolled nausea, vomiting, diarrhea, malabsorption syndrome or small bowel resection)
  • Active, bleeding diathesis
  • Female patients who are pregnant or breast feeding, or adults of reproductive potential who are not using effective birth control methods.
  • Prior treatment with an mTOR inhibitor (sirolimus, temsirolimus, everolimus).
  • Known hypersensitivity to RAD001 (everolimus) or other rapamycin drugs (sirolimus, temsirolimus) or to its excipients
  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: NCT00827567

Locations
United States, Pennsylvania
Penn State Milton S. Hershey Medical Center
Hershey, Pennsylvania, United States, 17033
Sponsors and Collaborators
Milton S. Hershey Medical Center
Novartis
Investigators
Principal Investigator: Allan Lipton, MD Penn State Milton S. Hershey
  More Information

Publications:
Baselga, J. et al. Improved clinical and cell cycle response with an mTOR inhibitor, daily oral RAD001 (everolimus) plus letrozole versus placebo plus letrozole in a randomized phase II neoadjuvant trial in ER+ breast cancer. J Clin Oncol 26: 2008 (May 20 suppl; abstr 530)
Jerusalem G.H et al. Multicenter phase I clinical trial of daily and weekly RAD001 in combination with vinorelbine and trastuzumab in patients with HER2-overexpressing metastatic breast cancer with prior resistance to trastuzumab. J Clin Oncol 26: 2008 (May 20 suppl; abstr 1057)

Responsible Party: Allan Lipton, Professor of Medicine, Milton S. Hershey Medical Center
ClinicalTrials.gov Identifier: NCT00827567     History of Changes
Other Study ID Numbers: RAD001JUS48T
Study First Received: January 21, 2009
Results First Received: August 16, 2011
Last Updated: December 11, 2013
Health Authority: United States: Food and Drug Administration

Keywords provided by Milton S. Hershey Medical Center:
Breast cancer
metastatic breast
triple negative
ER/PR negative
Her2 Neu negative

Additional relevant MeSH terms:
Breast Neoplasms
Neoplasms by Site
Neoplasms
Breast Diseases
Skin Diseases
Everolimus
Sirolimus
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs
Pharmacologic Actions
Antibiotics, Antineoplastic
Antineoplastic Agents
Therapeutic Uses
Antifungal Agents
Anti-Infective Agents
Anti-Bacterial Agents

ClinicalTrials.gov processed this record on July 24, 2014