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MEK Inhibitor AZD6244 With or Without Temsirolimus in Treating Patients With Metastatic, Recurrent, or Locally Advanced Soft Tissue Sarcoma That Cannot Be Removed By Surgery
This study is currently recruiting participants.
Verified March 2011 by National Cancer Institute (NCI)

First Received on September 18, 2010.   Last Updated on March 5, 2011   History of Changes
Sponsor: Beckman Research Institute
Collaborators: National Cancer Institute (NCI)
National Comprehensive Cancer Network
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT01206140
  Purpose

RATIONALE: MEK inhibitor AZD6244 and temsirolimus may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. It is not yet known whether giving MEK inhibitor AZD6244 together with temsirolimus is more effective than giving MEK inhibitor AZD6244 alone.

PURPOSE: This randomized phase II trial is studying how well giving MEK inhibitor AZD6244 together with or without temsirolimus works in treating patients with metastatic, recurrent, or locally advanced soft tissue sarcoma that cannot be removed by surgery.


Condition Intervention Phase
Sarcoma
Drug: selumetinib
Drug: temsirolimus
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Masking: Open Label
Primary Purpose: Treatment
Official Title: Randomized, Phase II Trial of AZD6244 Alone and AZD6244 Plus Temsirolimus for Soft-Tissue Sarcomas

Resource links provided by NLM:


Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Progression-free survival at 4 months [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Response by Choi criteria [ Designated as safety issue: No ]
  • Toxicity [ Designated as safety issue: Yes ]

Estimated Enrollment: 70
Study Start Date: October 2010
Estimated Primary Completion Date: September 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Arm I
Patients receive oral MEK inhibitor AZD6244 twice daily on days 1-28 and temsirolimus IV over 30-60 minutes on days 1, 8, 15, and 22.
Drug: selumetinib
Given orally
Drug: temsirolimus
Given IV
Experimental: Arm II
Patients receive MEK inhibitor AZD6244 as in arm I. Patients who experience disease progression may cross over to arm I.
Drug: selumetinib
Given orally

Detailed Description:

OBJECTIVES:

Primary

  • Compare the progression-free survival (PFS) of patients with metastatic, recurrent, or locally unresectable soft tissue sarcomas treated with MEK inhibitor AZD6244 with versus without temsirolimus.

Secondary

  • Determine the rates of apoptosis, autophagy, and proliferation by immunohistochemistry in tumor and surrogate skin tissue biopsies. (exploratory)
  • Assess the activation status of Akt, 5E-BP1, eIF-4G, and S6K in tumor biopsy samples and surrogate skin tissue biopsy samples. (exploratory)
  • Assess inhibition of activated ERK1/2 in stimulated peripheral blood mononuclear cells. (exploratory)
  • Assess response by Choi criteria.
  • Compare the response rate and 4-month PFS rate in patients treated with these regimens.
  • Determine the toxicity of these regimens in these patients.

OUTLINE: This is a multicenter study. Patients are stratified according to histology (liposarcoma vs pleomorphic undifferentiated sarcoma vs synovial sarcoma vs leiomyosarcoma). Patients are randomized to 1 of 2 treatment arms.

  • Arm I: Patients receive oral MEK inhibitor AZD6244 twice daily on days 1-28 and temsirolimus IV over 30-60 minutes on days 1, 8, 15, and 22.
  • Arm II: Patients receive MEK inhibitor AZD6244 as in arm I. Patients who experience disease progression may cross over to arm I.

In both arms, courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

Patients undergo blood sample and skin biopsy collection at baseline and after completion of course 1 for correlative studies. Some patients may also undergo image-guided tumor biopsies to determine rates of apoptosis, autophagy, and treatment proliferation by IHC.

After completion of study therapy, patients are followed up for 30 days.

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Histologically confirmed soft-tissue sarcoma at original diagnosis meeting 1 of the following criteria:

    • Metastatic (de novo or recurrent) disease
    • Locally advanced unresectable disease
    • Gastrointestinal stromal tumor (GIST) subtype allowed
    • No pediatric-type sarcomas (e.g., Ewing's or primitive neuroectodermal tumor, rhabdomyosarcoma, and desmoplastic small round cell tumor)
  • Measurable disease, defined as ≥ 1 lesion that can be accurately measured in ≥ 1 dimension (longest diameter to be recorded) as ≥ 20 mm by conventional techniques or as ≥ 10 mm by spiral CT scan
  • Patients with CNS tumors must have been on a stable or decreasing dose of dexamethasone for more than 7 days
  • No known brain metastases

PATIENT CHARACTERISTICS:

  • ECOG performance status (PS) 0-2 (Karnofsky PS 60-100%)
  • Life expectancy > 12 weeks
  • ANC ≥ 1,000/μL
  • Platelet count ≥ 100,000/μL (transfusion independent)
  • Hemoglobin ≥ 8.0 mg/dL (may receive red blood cell transfusions)
  • Creatinine ≤ 1.5 times upper limit of normal (ULN) OR creatinine clearance ≥ 45 mL/min
  • Bilirubin (sum of conjugated plus unconjugated) ≤ 1.5 times ULN
  • ALT ≤ 5 times ULN
  • Serum albumin ≥ 2 g/dL
  • Fertile patients must use effective contraception during and for 4 weeks (women) or for 16 weeks (men) after completion of last dose of treatment
  • Negative pregnancy test
  • Not pregnant or nursing
  • No evidence of dyspnea at rest and/or exercise intolerance
  • Pulse oximetry > 94% if there is clinical indication for determination
  • No history of allergic reactions attributed to compounds of similar chemical or biologic composition to MEK inhibitor AZD6244
  • No QTc interval > 450 msecs, other factors that increase the risk of QT prolongation, or arrhythmic events (e.g., heart failure, hypokalemia, family history of long QT interval syndrome)
  • Able to swallow capsules
  • No refractory nausea and vomiting, chronic gastrointestinal diseases (e.g., inflammatory bowel disease), or significant bowel resection that would preclude adequate absorption
  • No uncontrolled intercurrent illness including, but not limited to, any of the following:

    • Ongoing or active infection
    • Psychiatric illness and/or social situations that would limit compliance with study requirements
  • No patients who, in the opinion of the investigator, may not be able to comply with the safety monitoring requirements of the study
  • None of the following:

    • Cardiac history of uncontrolled hypertension
    • NYHA class II-IV cardiac disease
    • Prior or current cardiomyopathy
    • Baseline LVEF < 50%
    • Ongoing atrial fibrillation
    • Recent myocardial infarction
    • Unstable ischemic heart disease

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • Up to 2 prior cytotoxic chemotherapeutic regimens (single-agent or combination of chemotherapies) for metastatic or recurrent disease allowed
  • At least 1 week since prior growth factors that support platelet or white cell number or function
  • At least 3 weeks since prior chemotherapy or radiotherapy (6 weeks for mitomycin C and nitrosoureas)
  • No prior MEK inhibitor(s)
  • No prior mTOR inhibitor for recurrent soft-tissue sarcoma
  • No concurrent growth factor(s) that support platelet or white cell count or function within the past 7 days
  • No other concurrent investigational drug
  • No other concurrent anticancer agents including chemotherapy, radiotherapy, immunotherapy, or biologic therapy
  • No concurrent combination antiretroviral therapy for HIV-positive patients
  • No concurrent strong CYP1A2 or CYP3A4 inducers and/or inhibitors
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT01206140

Locations
United States, California
Tower Cancer Research Foundation Recruiting
Beverly Hills, California, United States, 90211
Contact: Solomon I. Hamburg, MD, PhD     310-888-8680        
City of Hope Comprehensive Cancer Center Recruiting
Duarte, California, United States, 91010-3000
Contact: Clinical Trials Office - City of Hope Comprehensive Cancer Cen     800-826-4673     becomingapatient@coh.org    
USC/Norris Comprehensive Cancer Center and Hospital Recruiting
Los Angeles, California, United States, 90089-9181
Contact: Clinical Trials Office - USC/Norris Comprehensive Cancer Cente     323-865-0451        
University of California Davis Cancer Center Recruiting
Sacramento, California, United States, 95817
Contact: Clinical Trials Office - University of California Davis Cancer     916-734-3089        
City of Hope Medical Group, Incorporated Recruiting
South Pasadena, California, United States, 91030
Contact: Mark V. McNamara, MD     626-396-2900        
United States, Pennsylvania
Penn State Hershey Cancer Institute at Milton S. Hershey Medical Center Recruiting
Hershey, Pennsylvania, United States, 17033-0850
Contact: Clinical Trials Office - Penn State Hershey Cancer Institute a     717-531-3779     CTO@hmc.psu.edu    
UPMC Cancer Centers Recruiting
Pittsburgh, Pennsylvania, United States, 15232
Contact: Clinical Trials Office - UPMC Cancer Centers     412-647-8073        
Sponsors and Collaborators
Beckman Research Institute
National Comprehensive Cancer Network
Investigators
Principal Investigator: Warren A. Chow, MD Beckman Research Institute
  More Information

Additional Information:
No publications provided

Responsible Party: Warren A. Chow, City of Hope Comprehensive Cancer Center
ClinicalTrials.gov Identifier: NCT01206140     History of Changes
Other Study ID Numbers: CDR0000685408, CHNMC-PHII-95, NCCN-T06
Study First Received: September 18, 2010
Last Updated: March 5, 2011
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
recurrent adult soft tissue sarcoma
stage III adult soft tissue sarcoma
stage IV adult soft tissue sarcoma

Additional relevant MeSH terms:
Sarcoma
Neoplasms, Connective and Soft Tissue
Neoplasms by Histologic Type
Neoplasms
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 24, 2012