Study of RAD001 in Adenoid Cystic Carcinoma (ACCRAD001)
Recruitment status was Recruiting
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Purpose
- Although mTOR is clearly an attractive therapeutic target in tumor, no clinical study on mTOR inhibition by RAD001 has been systematically conducted in adenoid cystic carcinoma.
- In phase I study of RAD001, 2 patients with adenoid cystic carcinoma show some response to RAD001 (unpublished data).
- So the investigators design this phase II study of RAD001 in adenoid cystic carcinoma to evaluate the efficacy of RAD001 in this orphan disease.
| Condition | Intervention | Phase |
|---|---|---|
|
Adenoid Cystic Carcinoma |
Drug: RAD001 |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Endpoint Classification: Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Phase II Study of RAD001monotherapy in Patients With Unresectable Adenoid Cystic Carcinoma |
- progression free survival rate at 4 months [ Time Frame: 10 months ] [ Designated as safety issue: No ]proportion of patients who are alive and progression-free at the time of 4 months of treatment among all patients
- the time to progression (TTP) [ Time Frame: 10 months ] [ Designated as safety issue: No ]
- overall survival (OS) [ Time Frame: 2 years ] [ Designated as safety issue: No ]
- response rate (RR) [ Time Frame: 6 months ] [ Designated as safety issue: No ]
- the metabolic response rate by PET-CT [ Time Frame: 2 months ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 33 |
| Study Start Date: | July 2008 |
| Estimated Study Completion Date: | December 2011 |
| Estimated Primary Completion Date: | May 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: RAD001
RAD001 daily po medication
|
Drug: RAD001
RAD001 10 mg po daily medication
|
Detailed Description:
Although the histologic appearance of adenoid cystic carcinoma is low grade, management of this malignancy is a distinct therapeutic challenge because of its insidious local growth pattern, propensity for perineural involvement, tendency for distant metastasis, and pronounced ability to recur over a prolonged period.
In prospectively performed clinical trials, objective responses to any cytotoxic agent or regimen are infrequent, whereas stabilization of disease was observed more commonly.
In adenoid cystic carcinoma, the study focusing on PI3-K/AKT/mTOR pathway is rare.
According to Younes MN et al's study, adenoid cystic carcinoma cell lines have increased pAkt activity when EGF-stimulation is added. And when treated with EGFR/VEGFR TK dual inhibitor, the phosphorylated form of Akt decreased despite of total level of Akt is remained unchanged.
When the investigators consider that the increased pAkt activity is one of possible predictor to mTOR inhibitor, the mTOR inhibitor might have an activity in adenoid cystic carcinoma.
Although mTOR is clearly an attractive therapeutic target in tumor, no clinical study on mTOR inhibition by RAD001 has been systematically conducted in adenoid cystic carcinoma.
In phase I study of RAD001, 2 patients with adenoid cystic carcinoma show some response to RAD001 (unpublished data).
So the investigators design this phase II study of RAD001 in adenoid cystic carcinoma to evaluate the efficacy of RAD001 in this orphan disease.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- 1. Histologically or cytologically confirmed adenoid cystic carcinoma
- 2. Local, locally-advanced or metastatic disease documented as having shown progression on a scan (CT, MRI, MIBI scan) taken 2 to 12 months prior to baseline compared to a previous scan taken at any time in the past. Progression must be documented according to RECIST criteria.
- 3. Disease that is not amenable to surgery, radiation or combined modality therapy with curative intent and who is previously treated with chemotherapy or local treatment (e,g transarterial chemoembolization)
- 4. Presence of at least one measurable target lesion for further evaluation according to RECIST criteria
- 5. 18 years or older
- 6. ECOG performance status 0, 1
- 7. Previous treatment with chemotherapy, loco-regional therapy (e.g chemoembolization) are permitted providing that toxicity has resolved to ≤grade 1 at study entry and that last treatment was at least 4 weeks prior to baseline assessment.
- 8. Adequate organ function
- 9. A patient with the willingness to comply with the study protocol during the study period and capable of complying with it
- 10. A patient who signed the informed consent prior to the participation of the study and who understands that he/she has a right to withdrawal from participation in the study at any time without any disadvantages.
Exclusion Criteria:
- 1. A patient with no measurable disease
- 2. Prior chemotherapy, radiation therapy or surgery within 4 weeks prior to study entry except palliative radiotherapy to non-target lesions (within 2 weeks prior to study entry)
- 3. A patient with previous active or passive immunotherapy
- 4. A patient with intestinal obstruction or impending obstruction, recent active upper GI bleeding
- 5. A pregnant or lactating patient
- 6. A patient of childbearing potential without being tested for pregnancy at baseline or with being tested for positive. (A postmenopausal woman with the amenorrhea period of at least 12 months or longer is considered to have non-childbearing potential)
- 7. A man or woman of childbearing potential who has no willingness to use a contraceptive measure during the study
- 8. A patient with history of another malignant disease within past 5 years, except curatively treated basal cell carcinoma of skin and cervical carcinoma in situ.
- 9. A patient with history of uncontrolled seizures, central nervous system disorder or psychiatric disorders that are considered clinically significant by the investigator that would prohibit the understanding of informed consent or that may be considered to interfere with the compliance of the administration of the study medications.
- 10. A patient with clinically significant heart disease (e.g. congestive heart failure, symptomatic coronary artery diseases, cardiac arrhythmia, etc) or myocardial infarction within past 12 months.
- 11. Ongoing cardiac arrhythmia of grade ≥2, atrial fibrillation of any grade, or QTc interval>450msec for males or >470msec for female.
- 12. A patient with interstitial pneumonia or diffuse symptomatic fibrosis of the lungs
- 13. A patient with peripheral neuropathy of grade 1 by NCI CTC, caused by other factors (e.g. alcohol, diabetes, etc). If the absence of deep tendon reflexes is the only neurologic disorder, this condition does not apply to the exclusion criteria.
- 14. A patient with organ transplantation requiring immunosuppressive therapy
Contacts and Locations| Contact: Yung-Jue Bang, MD,PhD | 82-2-2072-2390 | bangyj@snu.ac.kr |
| Contact: Do-Youn Oh, MD,PhD | 82-2-2072-0701 | ohdoyoun@snu.ac.kr |
| Korea, Republic of | |
| Seoul National University Hospital | Recruiting |
| Seoul, Korea, Republic of, 110-744 | |
| Contact: Yung-Jue Bang, MD, PhD 82-2-2072-2390 bangyj@snu.ac.kr | |
| Contact: Do-Youn Oh, MD, PhD 82-2-2072-0701 ohdoyoun@snu.ac.kr | |
| Principal Investigator: | Yung-Jue Bang, MD, PhD | Seoul National University Hospital |
| Study Director: | Do-Youn Oh, MD,PhD | Seoul National University Hospital |
More Information
No publications provided
| Responsible Party: | Yung-Jue Bang/Professor, Seoul National University Hospital |
| ClinicalTrials.gov Identifier: | NCT01152840 History of Changes |
| Other Study ID Numbers: | H-0710-050-223 |
| Study First Received: | May 31, 2010 |
| Last Updated: | June 28, 2010 |
| Health Authority: | Korean Food and Drug Administration:Korea, Republic of |
Keywords provided by Seoul National University Hospital:
|
Adenoid cystic carcinoma RAD001 |
Additional relevant MeSH terms:
|
Carcinoma Carcinoma, Adenoid Cystic Neoplasms, Glandular and Epithelial Neoplasms by Histologic Type Neoplasms Adenocarcinoma Sirolimus Everolimus Antibiotics, Antineoplastic |
Antineoplastic Agents Therapeutic Uses Pharmacologic Actions Antifungal Agents Anti-Infective Agents Immunosuppressive Agents Immunologic Factors Physiological Effects of Drugs Anti-Bacterial Agents |
ClinicalTrials.gov processed this record on May 21, 2013