Magnetic Resonance Imaging (MRI) in Predicting Response to Sunitinib Malate in Patients With Locally Advanced or Metastatic Kidney Cancer
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Purpose
Rationale: Diagnostic procedures, such as MRI, may help doctors predict a patient's response to treatment and help plan the best treatment.
Purpose: This clinical trial is studying MRI in predicting response to sunitinib malate in patients with locally advanced or metastatic kidney cancer.
| Condition | Intervention |
|---|---|
|
Renal Cell Carcinoma Stage III Renal Cell Cancer Stage IV Renal Cell Cancer |
Genetic: mutation analysis Other: pharmacological study Procedure: dynamic contrast-enhanced magnetic resonance imaging Drug: sunitinib malate Other: immunohistochemistry staining method Other: laboratory biomarker analysis |
| Study Type: | Interventional |
| Study Design: | Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Diagnostic |
| Official Title: | An Imaging and Histopathologic Study to Predict Response to Sunitinib Therapy in Patients With Metastatic or Locally Advanced Renal Cell Carcinoma |
- Progression-free survival [ Designated as safety issue: No ]
- Correlation of tumor vascular permeability as measured by dynamic contrast-enhanced MRI with clinical outcome and with tumor angiogenesis as measured by immunohistochemistry (IHC) [ Designated as safety issue: No ]
- Tumor regression as measured by Response Evaluation Criteria In Solid Tumors (RECIST) criteria [ Designated as safety issue: No ]
| Estimated Enrollment: | 40 |
| Study Start Date: | April 2009 |
| Estimated Study Completion Date: | April 2013 |
| Estimated Primary Completion Date: | April 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Arm I
Patients receive oral sunitinib malate once daily on days 1-28. Treatment repeats every 42 days in the absence of disease progression or unacceptable toxicity. Patients undergo dynamic contrast-enhanced MRI at baseline and after the first 4 weeks of sunitinib malate. |
Genetic: mutation analysis
Correlative study
Other: pharmacological study
Correlative study
Other Name: pharmacological studies
Procedure: dynamic contrast-enhanced magnetic resonance imaging
Undergo DCE-MRI
Other Name: DCE-MRI
Drug: sunitinib malate
Given orally
Other Names:
Other: immunohistochemistry staining method
Correlative study
Other Name: immunohistochemistry
Other: laboratory biomarker analysis
Correlative study
|
Detailed Description:
Primary Objectives:
I. To correlate tumor vascular permeability by DCE-MRI with clinical outcome for patients treated with sunitinib (PFS).
II. To correlate genetic and histologic characteristics of the primary tumor with vascular permeability by DCE-MRI.
Secondary Objectives:
I. To correlate genetic and histologic characteristics of the primary tumor with clinical outcome for patients treated with sunitinib.
II. Samples will be collected for potential future exploratory analyses of pharmacokinetic and pharmacogenomic parameters.
Outline: Patients receive oral sunitinib malate once daily on days 1-28. Treatment repeats every 42 days in the absence of disease progression or unacceptable toxicity.
Patients undergo dynamic contrast-enhanced MRI at baseline and after the first 4 weeks of sunitinib malate.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion
- AJCC stage IV or locally advanced (or inoperable) renal cell carcinoma for which archival tissue is available
- No prior anti-angiogenic therapy
- Prior radiation therapy to a symptomatic site of disease is allowed
- ECOG performance status of 0, 1 or 2
- White Blood Count >= 3,000/mm^3
- Absolute Granulocyte Count >= 1,500/mm^3
- Platelet Count >= 100,000/mm^3
- Serum creatinine =< 2.0 x upper limit of normal (ULN) OR serum creatinine clearance (CrCl) >= 40 ml/min
- Total Bilirubin =< 1.5 x ULN (< 3.0 x ULN in the presence of Gilbert's disease)
- AST/ALT =< 2.5 x ULN (=< 5.0 ULN in the presence of liver metastases)
- INR =< 1.5 and a PTT within normal limits; patients who are taking warfarin must have documentation of an INR =< 1.5 and a PTT within normal limits prior to the initiation of anticoagulation to rule out a baseline coagulopathy
- Patient must not have pre-existing thyroid abnormality with thyroid stimulating hormone that cannot be maintained in the normal range with medication
- Patient must not have hypertension that cannot be controlled by medications (diastolic blood pressure >= 100 mm Hg despite optimal medical therapy)
- Patient must not have ongoing cardiac dysrhythmias of NCI CTCAE Version 3.0 grade >= 2
- Patients must not receive any other investigational agents during the period on study
- Patients must not have a history or clinical evidence of brain metastasis; however, patients with resected or radiated brain metastases are eligible
- Patients must not have a serious intercurrent illness including, but not limited to, ongoing or active infection requiring parenteral antibiotics, clinically significant cardiovascular disease (e.g., uncontrolled hypertension, myocardial infarction, unstable angina), New York heart association grade II or greater congestive heart failure, serious cardiac arrhythmia requiring medication
- Patients must not have a serious intercurrent illness including, but not limited to, grade II or greater peripheral vascular disease within 1 year prior to study entry, or psychiatric illness/social situations that would limit compliance with study requirements
- Patients must not be taking cytochrome P450 enzyme-inducing antiepileptic drugs (phenytoin, carbamazepine or phenobarbital), rifampin or St. John's wort
- Women must not be pregnant or breast-feeding
- All females of childbearing potential must have a blood test or urine study within 2 weeks prior to registration to rule out pregnancy
- Women of child-bearing potential and men must agree to use adequate contraception (hormonal, barrier method of birth control, or abstinence) prior to study entry and for the duration of study participation
Contacts and Locations| Contact: Stephen Keefe, MD | 855-216-0098 | PennCancerTrials@emergingmed.com |
| United States, Pennsylvania | |
| Abramson Cancer Center of The University of Pennsylvania | Recruiting |
| Philadelphia, Pennsylvania, United States, 19104 | |
| Contact: Stephen Keefe 855-216-0098 PennCancerTrials@emergingmed.com | |
| Principal Investigator: Stephen Keefe | |
| Principal Investigator: | Stephen Keefe | Abramson Cancer Center of the University of Pennsylvania |
More Information
No publications provided
| Responsible Party: | Abramson Cancer Center of the University of Pennsylvania |
| ClinicalTrials.gov Identifier: | NCT01026337 History of Changes |
| Other Study ID Numbers: | UPCC 03809, NCI-2009-01414 |
| Study First Received: | December 2, 2009 |
| Last Updated: | February 25, 2013 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Abramson Cancer Center of the University of Pennsylvania:
|
recurrent renal cell cancer |
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 Sunitinib Antineoplastic Agents Therapeutic Uses Pharmacologic Actions Angiogenesis Inhibitors Angiogenesis Modulating Agents Growth Substances Physiological Effects of Drugs Growth Inhibitors |
ClinicalTrials.gov processed this record on May 16, 2013