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Everolimus and Gefitinib in Treating Patients With Progressive Glioblastoma Multiforme or Progressive Metastatic Prostate Cancer

A Phase I/II Trial to Assess the Tolerability of RAD 001 With Gefitinib in Patients With Glioblastoma Multiforme and Prostate Cancer and Efficacy in Patients With Castrate Metastatic Prostate Cancer

Status
Completed
Phases
Phase 1Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00085566
Enrollment
61
Registered
2004-06-11
Start date
2004-03-31
Completion date
2008-02-29
Last updated
2016-01-20

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Brain and Central Nervous System Tumors, Prostate Cancer

Keywords

adult glioblastoma, recurrent prostate cancer, recurrent adult brain tumor, stage IV prostate cancer, adult giant cell glioblastoma, adult gliosarcoma

Brief summary

RATIONALE: Everolimus may stop the growth of tumor cells by stopping blood flow to the tumor. Gefitinib may stop the growth of tumor cells by blocking the enzymes necessary for their growth. Combining everolimus with gefitinib may kill more tumor cells. PURPOSE: This phase I/II trial is studying the side effects and best dose of everolimus when given together with gefitinib and to see how well they work in treating patients with progressive glioblastoma multiforme or (progressive metastatic prostate cancer closed to accrual 10/19/06).

Detailed description

OBJECTIVES: Primary * Determine the maximum tolerated dose of everolimus when given in combination with gefitinib in patients with progressive glioblastoma multiforme or (progressive castrate metastatic prostate cancer -closed to accrual as of 10/19/2006). (Phase I) * Determine the safety and efficacy of this regimen in patients with progressive glioblastoma multiforme or (progressive castrate metastatic prostate cancer - closed to accrual as of 10/19/2006). (Phase II) Secondary * Determine whether a pharmacokinetic interaction exists between everolimus and gefitinib in patients treated with this regimen. * Determine the association between clinical outcomes and markers that may predict sensitivity of a tumor in patients treated with this regimen. * Determine the pharmacodynamic effects of this regimen on post-therapy tumor specimens and peripheral blood mononuclear cells from these patients. OUTLINE: This is a phase I, open-label, non-randomized, dose-escalation study of everolimus followed by a phase II study. * Phase I: Patients receive oral everolimus on day 1 and oral gefitinib once daily on days 8-21. Beginning on day 22, patients receive oral everolimus once weekly and oral gefitinib once daily. Treatment with the combination continues in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of everolimus until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. * Phase II (prostate cancer patients only) (closed to accrual as of 10/19/2006): Patients receive oral everolimus (at the MTD determined in phase I) once weekly and oral gefitinib once daily. Treatment continues in the absence of disease progression or unacceptable toxicity.

Interventions

DRUGeverolimus
DRUGgefitinib

Sponsors

National Cancer Institute (NCI)
CollaboratorNIH
Memorial Sloan Kettering Cancer Center
Lead SponsorOTHER

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
MALE
Age
18 Years to 120 Years
Healthy volunteers
No

Inclusion criteria

DISEASE CHARACTERISTICS: * Histologically confirmed diagnosis of 1 of the following: * Glioblastoma multiforme (GBM) (phase I only) * Progressive disease despite standard therapy * Progressive disease based on 1 of the following: * New or progressive (25% bidimensional increase) soft tissue masses on CT scan or MRI * New or prior lesions that have increased in size by physical examination * Patients who had prior interstitial brachytherapy or stereotactic radiosurgery must have confirmation of true disease progression (rather than radiation necrosis) by positron-emission tomography scan, thallium scanning, magnetic resonance spectroscopy, or surgical documentation * Castrate metastatic prostate cancer (closed to accrual as of 10/19/2006) (phase I and II) * Progressive disease despite standard therapy AND castrate levels \< 50 ng/dL of testosterone * Progressive disease based on 1 or more of the following: * A minimum of 3 rising levels of prostate-specific antigen (PSA) that are obtained 1 or more weeks apart OR 2 rising PSA values obtained more than 1 month apart with at least a 25% increase over the range of values * New or progressive (25% bidimensional increase) soft tissue masses on CT scan or MRI * New metastatic lesions * Patients on an antiandrogen as part of initial therapy must show disease progression after discontinuation of the antiandrogen * Patients who have not undergone surgical orchiectomy must continue with medical therapy (e.g., gonadotropin-releasing hormone analogs) to maintain castrate levels of serum testosterone * No brain metastases PATIENT CHARACTERISTICS: Age * Over 18 Performance status * Karnofsky 70-100% Life expectancy * More than 3 months Hematopoietic * Absolute neutrophil count ≥ 1,500/mm\^3 * Platelet count ≥ 100,000/mm\^3 * WBC ≥ 3,000/mm\^3 Hepatic * ALT and AST ≤ 2.5 times upper limit of normal (ULN) * Bilirubin ≤ 1.5 mg/dL Renal * Creatinine within 1.5 times ULN (\< 1.95 mg/dL at MSKCC) Cardiovascular * No significant cardiovascular disease * No congestive heart failure * No New York Heart Association class III or IV cardiac disease * No active angina pectoris * No myocardial infarction within the past 6 months Other * Not pregnant * Negative pregnancy test * Fertile patients must use effective contraception * No serious medical illness * No severe infection * No severe malnutrition * No other active malignancy except non-melanoma skin cancer * Patients are not considered to have an active malignancy if they have completed prior therapy and currently have a \< 30% risk for relapse PRIOR CONCURRENT THERAPY: Biologic therapy * No concurrent biological therapy * No concurrent immunotherapy Chemotherapy * No concurrent chemotherapy Endocrine therapy * See Disease Characteristics Radiotherapy * See Disease Characteristics * More than 4 weeks since prior radiotherapy * No concurrent radiotherapy Surgery * See Disease Characteristics * Prior recent resection of recurrent or progressive GBM allowed provided patient has recovered * More than 4 weeks since prior major surgery Other * Recovered from all prior therapy * More than 4 weeks since prior investigational anticancer drugs * No concurrent anticonvulsant that interacts with CYP3A4 (e.g., phenytoin, carbamazepine, or phenobarbital) * No other concurrent cytotoxic therapy * No other concurrent investigational or commercial agents or therapies for the malignancy

Design outcomes

Primary

MeasureTime frameDescription
Overall Objective Response2 yearsResponse will be evaluated in this study using the new international criteria Response Evaluation Criteria in Solid Tumors (RECIST)

Countries

Spain, United States

Participant flow

Participants by arm

ArmCount
RAD 001 30 mg
30 mg RAD 001 with Gefitinib in Patients with Glioblastoma Multiforme and Prostate Cancer
3
RAD 001 50 mg
50 mg RAD 001 with Gefitinib in Patients with Glioblastoma Multiforme and Prostate Cancer
3
RAD 001 70 mg
70 mg RAD 001 with Gefitinib in Patients with Glioblastoma Multiforme and Prostate Cancer
57
Total63

Withdrawals & dropouts

PeriodReasonFG000FG001FG002
Overall StudyAdverse Event0010
Overall StudyClinical progression001
Overall StudyPatient Not treated003

Baseline characteristics

CharacteristicRAD 001 30 mgRAD 001 50 mgRAD 001 70 mgTotal
Age, Categorical
<=18 years
0 Participants0 Participants0 Participants0 Participants
Age, Categorical
>=65 years
2 Participants2 Participants25 Participants29 Participants
Age, Categorical
Between 18 and 65 years
1 Participants1 Participants32 Participants34 Participants
Sex: Female, Male
Female
0 Participants0 Participants11 Participants11 Participants
Sex: Female, Male
Male
3 Participants3 Participants46 Participants52 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
deaths
Total, all-cause mortality
— / —— / —— / —
other
Total, other adverse events
2 / 33 / 348 / 57
serious
Total, serious adverse events
0 / 31 / 318 / 57

Outcome results

Primary

Overall Objective Response

Response will be evaluated in this study using the new international criteria Response Evaluation Criteria in Solid Tumors (RECIST)

Time frame: 2 years

ArmMeasureGroupValue (NUMBER)
RAD 001 30 mgOverall Objective ResponseStable Disease (SD)0 participants
RAD 001 30 mgOverall Objective ResponsePartial Response (PR)0 participants
RAD 001 30 mgOverall Objective ResponseProgression of Disease (POD)3 participants
RAD 001 50 mgOverall Objective ResponseStable Disease (SD)1 participants
RAD 001 50 mgOverall Objective ResponseProgression of Disease (POD)2 participants
RAD 001 50 mgOverall Objective ResponsePartial Response (PR)0 participants
RAD 001 70 mgOverall Objective ResponseProgression of Disease (POD)26 participants
RAD 001 70 mgOverall Objective ResponsePartial Response (PR)2 participants
RAD 001 70 mgOverall Objective ResponseStable Disease (SD)15 participants

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026