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Combretastatin A4 Phosphate in Treating Patients With Advanced Anaplastic Thyroid Cancer

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00060242
Recruitment Status : Completed
First Posted : May 7, 2003
Last Update Posted : June 11, 2010
National Cancer Institute (NCI)
Information provided by:
Case Comprehensive Cancer Center

Brief Summary:

RATIONALE: Combretastatin A4 phosphate may stop the growth of anaplastic thyroid cancer by stopping blood flow to the tumor.

PURPOSE: This phase II trial is studying how well combretastatin A4 phosphate works in treating patients with advanced recurrent or metastatic anaplastic thyroid cancer.

Condition or disease Intervention/treatment Phase
Head and Neck Cancer Drug: fosbretabulin disodium Phase 2

Detailed Description:


  • Determine the objective response rate of patients with advanced anaplastic thyroid cancer treated with combretastatin A4 phosphate.
  • Determine whether this drug alters the natural history of anaplastic thyroid cancer, in terms of doubling the median survival from 4-6 months to 12 months, in these patients.
  • Determine the safety profile of this drug in these patients.
  • Correlate clinical response with pretreatment tumor microvessel density and immature vessel staining, changes in sICAM-1 levels over the course of treatment, and pharmacokinetic parameters in patients treated with this drug.

OUTLINE: This is a multicenter study.

Patients receive combretastatin A4 phosphate IV over 10 minutes on days 1, 8, and 15. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients achieving a complete response (CR) receive 2 courses beyond documentation of the CR.

Patients are followed monthly.

PROJECTED ACCRUAL: A total of 32 patients will be accrued for this study within 18-24 months.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 26 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Phase II Trial Of Combretastatin A-4 Phosphate (CA4P) In Advanced Anaplastic Carcinoma Of The Thyroid
Study Start Date : February 2003
Actual Primary Completion Date : February 2007
Actual Study Completion Date : January 2008

Intervention Details:
  • Drug: fosbretabulin disodium
    Combretastatin A4 phosphate IV over 10 minutes on days 1, 8, and 15. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients achieving a complete response (CR) receive 2 courses beyond documentation of the CR.
    Other Name: Combretastatin A4 phosphate

Primary Outcome Measures :
  1. Median survival [ Time Frame: every 8 weeks ]

Secondary Outcome Measures :
  1. Objective disease response [ Time Frame: every 8 weeks ]

Information from the National Library of Medicine

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, Learn About Clinical Studies.

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No


  • Histologically confirmed* anaplastic or poorly differentiated variant thyroid cancer, including 1 of the following:

    • Recurrent/regionally advanced disease no longer amenable to definitive curative surgery or radiotherapy
    • Untreated metastatic disease NOTE: *If original/diagnostic tumor blocks are unavailable, tumor must be accessible for pretreatment core needle biopsy
  • Must have relapsed or progressed during or after prior combined modality therapy (e.g., systemic chemotherapy and radiotherapy) for regionally advanced (but not metastatic) disease
  • Measurable or evaluable disease
  • Patent trachea and airway by screening direct and indirect laryngoscopy* NOTE: *For patients with bulky thyroid/neck masses and/or suspected airway obstruction
  • No active brain metastases, as evidenced by any of the following:

    • Symptomatic involvement
    • Cerebral edema by CT scan or MRI
    • Radiographic evidence of progression since definitive therapy
    • Continued requirement for corticosteroids



  • 18 and over

Performance status

  • ECOG 0-2

Life expectancy

  • At least 12 weeks


  • Absolute granulocyte count at least 1,500/mm^3
  • Platelet count at least 75,000/mm^3
  • Hemoglobin at least 8.5 g/dL


  • Bilirubin no greater than 1.5 times upper limit of normal (ULN)
  • ALT and AST no greater than 3.5 times ULN


  • Creatinine no greater than 1.5 times ULN


  • LVEF at least 50% by MUGA
  • EKG normal

    • No evidence of prior myocardial infarction (e.g., significant Q waves), QTc greater than 450 msec, or other clinically significant abnormalities
  • No history of angina (even if controlled by medication)
  • No congestive heart failure
  • No uncontrolled atrial arrhythmias
  • No clinically significant arrhythmias, including any of the following:

    • Conduction abnormalities
    • Nodal junctional arrhythmias and dysrhythmias
    • Sinus bradycardia or tachycardia
    • Supraventricular arrhythmias
    • Atrial fibrillation or flutter
    • Syncope or vasovagal episodes
  • No significant heart wall abnormality or heart muscle damage by MUGA
  • No uncontrolled hypertension (blood pressure consistently greater than 150 mm Hg systolic and 100 mm Hg diastolic regardless of medication)

    • Patients with previous hypertension are allowed provided there is clinical documentation of controlled blood pressure for 2 months prior to study enrollment
  • No symptomatic peripheral vascular disease
  • No symptomatic cerebrovascular disease


  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No grade 2 or greater preexisting motor or sensory peripheral neuropathy
  • No uncontrolled hypokalemia or hypomagnesemia
  • No concurrent serious infection
  • No other nonmalignant medical illness that is uncontrolled or whose control may be jeopardized by study therapy
  • No psychiatric disorders or other conditions that would preclude study compliance


Biologic therapy

  • No concurrent biologic therapy
  • No concurrent immunotherapy
  • No concurrent prophylactic colony-stimulating factors (e.g., filgrastim [G-CSF] or sargramostim [GM-CSF])


  • See Disease Characteristics
  • At least 3 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin)
  • No other concurrent chemotherapy

Endocrine therapy

  • See Disease Characteristics
  • No concurrent hormonal therapy, except any of the following:

    • Gonadotropin-releasing hormone agonists for hormone-refractory prostate cancer
    • Hormone replacement therapy
    • Oral contraceptives
    • Megestrol for anorexia/cachexia


  • See Disease Characteristics
  • More than 4 weeks since prior radiotherapy with progressive disease beyond radiation ports
  • No prior radiotherapy to more than 30% of the bone marrow
  • No concurrent radiotherapy


  • See Disease Characteristics
  • More than 4 weeks since prior major surgery


  • At least 6 weeks since other prior therapy associated with delayed toxicity
  • No prior therapy for metastatic disease
  • No concurrent medication(s) known to prolong the QTc interval, unless medication(s) can be held for at least 72 hours before, during, and for at least 6 hours after study drug administration
  • No other concurrent investigational therapy
  • No other concurrent antineoplastic or cytotoxic therapy

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00060242

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United States, Michigan
Josephine Ford Cancer Center at Henry Ford Hospital
Detroit, Michigan, United States, 48202
United States, Ohio
Ireland Cancer Center at University Hosptials Case Medical Center, Case Comprehensive Cancer Center
Cleveland, Ohio, United States, 44106-5065
United States, Pennsylvania
Hillman Cancer Center at University of Pittsburgh Cancer Institute
Pittsburgh, Pennsylvania, United States, 15232
Sponsors and Collaborators
Case Comprehensive Cancer Center
National Cancer Institute (NCI)
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Study Chair: Panayiotis Savvides, MD Ireland Cancer Center at University Hosptials Case Medical Center, Case Comprehensive Cancer Center
Publications of Results:
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Responsible Party: Panayiotis Savvides, MD, Ireland Cancer Center at University Hospitals Case Medical Center, Case Comprehensive Cancer Center Identifier: NCT00060242    
Other Study ID Numbers: ICC2302
P30CA043703 ( U.S. NIH Grant/Contract )
CASE-CWRU-ICC-2302 ( Other Identifier: Case Comprehensive Cancer Center )
First Posted: May 7, 2003    Key Record Dates
Last Update Posted: June 11, 2010
Last Verified: June 2010
Keywords provided by Case Comprehensive Cancer Center:
anaplastic thyroid cancer
recurrent thyroid cancer
Additional relevant MeSH terms:
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Thyroid Carcinoma, Anaplastic
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Antineoplastic Agents, Phytogenic
Antineoplastic Agents
Tubulin Modulators
Antimitotic Agents
Mitosis Modulators
Molecular Mechanisms of Pharmacological Action