Skip to content

Vorinostat and Bevacizumab in Treating Patients With Unresectable or Metastatic Kidney Cancer

Phase I/II Study of Suberoylanilide Hydroxamic Acid (SAHA) in Combination With the VEGF Inhibitor Bevacizumab in Patients With Metastatic Renal Cell Carcinoma

Status
Completed
Phases
Phase 1Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00324870
Enrollment
37
Registered
2006-05-11
Start date
2006-02-28
Completion date
2013-11-30
Last updated
2016-01-13

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

Conditions

Clear Cell Renal Cell Carcinoma, Recurrent Renal Cell Cancer, Stage III Renal Cell Cancer, Stage IV Renal Cell Cancer

Brief summary

This phase I/II trial is studying the side effects and best dose of vorinostat when given together with bevacizumab and to see how well they work in treating patients with unresectable or metastatic kidney cancer. Vorinostat may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Monoclonal antibodies, such as bevacizumab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Bevacizumab may also stop the growth of kidney cancer by blocking blood flow to the tumor. Giving vorinostat together with bevacizumab may kill more tumor cells.

Detailed description

PRIMARY OBJECTIVES: I. Determine the safety and tolerability of vorinostat (SAHA) in combination with bevacizumab in patients with unresectable or metastatic renal cell carcinoma. (Phase I) II. Determine the recommended dosing in patients treated with this regimen. (Phase I) III. Determine the proportion of patients who are progression-free at 6 months after receiving this regimen. (Phase II) IV. Determine the clinical response rate in patients treated with this regimen. (Phase II) SECONDARY OBJECTIVES: I. Determine the toxicity of this regimen in these patients. (Phase II) II. Determine time to progression and duration of progression-free and overall survival in patients treated with this regimen. (Phase II) III. Determine the pharmacodynamic effects in peripheral blood mononuclear cells and tumors before and after treatment with this regimen in these patients. (Phase II) IV. Determine the antiproliferative and apoptotic effects of this regimen in these patients. (Phase II) V. Determine the antiangiogenic effects of this regimen in these patients. (Phase II) VI. Determine the modulation of tumor metabolism and tumor blood flow in patients treated with this regimen. (Phase II) OUTLINE: This is a phase I, dose-escalation study of vorinostat (SAHA) followed by a phase II study. PHASE I: Patients receive oral SAHA twice daily on days 1-14 and bevacizumab IV over 30-90 minutes on day 1. Treatment repeats every 21 days in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of SAHA 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. An additional 6 patients are treated at the MTD. PHASE II: Patients receive SAHA at the MTD determined in phase I and bevacizumab as in phase I. After completion of study treatment, patients are followed at 4 weeks and then every 3 months thereafter.

Interventions

DRUGvorinostat

Given orally

DRUGbevacizumab

Given IV

Sponsors

National Cancer Institute (NCI)
Lead SponsorNIH

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* No known CNS metastasis * ECOG performance status 0-2 * Life expectancy \> 6 months * LVEF ≥ 45% * Absolute neutrophil count ≥ 1,500/mm3 * Platelet count ≥ 100,000/mm3 * Total bilirubin ≤ 1.5 times upper limit of normal (ULN) * AST/ALT ≤ 2.5 times ULN * Creatinine ≤ 1.5 times ULN OR creatinine clearance ≥ 50 mL/min * PT/INR ≤ 1.5 * Urine protein \< 1+ by urinalysis OR \< 1 g by 24-hour urine collection * Not pregnant * No nursing during and for 6 months after completion of study treatment * Negative pregnancy test * Fertile patients must use effective contraception for 2 weeks prior, during, and for 6 months after completion of study treatment * No other currently active malignancy defined as \> 30% risk of relapse upon completion of anticancer therapy, except nonmelanoma skin cancer * No history of allergic reaction attributed to compounds of similar chemical or biologic composition to vorinostat (SAHA) * No hypersensitivity to Chinese hamster ovary cell products or other recombinant human antibodies * No evidence of bleeding diathesis or coagulopathy * No active bleeding or pathological conditions that carry high risk of bleeding (i.e., tumor involving major vessels or known varices) * No ongoing, active infection * No New York Heart Association class II-IV congestive heart failure * No angina pectoris requiring nitrate therapy * No cardiac arrhythmia * No myocardial infarction within the past 6 months * No history of cerebrovascular accident within the past 6 months * No uncontrolled hypertension (defined as systolic blood pressure (BP) \> 160 mm Hg and/or diastolic BP \> 90 mm Hg on medication) * No history of peripheral vascular disease * No psychiatric illness or social situation that would preclude study compliance * No other uncontrolled illness * No serious nonhealing wound, ulcer, or bone fracture * No history of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within the past 28 days * No significant traumatic injury in the past 28 days * At least 4 weeks since prior major surgery or open biopsy * More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin) * More than 4 weeks since prior radiotherapy * At least 2 weeks since prior tyrosine kinase inhibitor * Prior palliative radiotherapy to metastatic lesions allowed provided ≥ 1 measurable and/or evaluable lesion has not been irradiated * No more than 2 prior systemic treatments for metastatic disease, including immunotherapy, receptor tyrosine kinase inhibitor therapy, chemotherapy, or investigational therapy * No prior therapy with bevacizumab, vascular endothelial growth factor-trap, or histone deacetylase inhibitors, including valproic acid * No core biopsy within 1 week prior to day 1 of study treatment * No planned major surgery during study treatment * No concurrent combination antiretroviral therapy for HIV-positive patients * No other concurrent investigational agents * Concurrent stable-dose prophylactic anticoagulation (i.e., warfarin or low molecular weight heparin) allowed provided requirements for INR are met * Histologically confirmed renal cell carcinoma, clear cell component, unresectable or metastatic disease (patients with a primary tumor in place who are eligible for surgery are strongly encouraged to undergo a nephrectomy prior to study entry to increase potential survival) * Measurable disease, defined as ≥ 1 unidimensionally measurable lesion ≥ 20 mm by conventional techniques OR ≥ 10 mm with spiral CT scan * The following histologies are not allowed: * Papillary, sarcomatoid carcinoma * Chromophobe carcinoma * Oncocytoma * Collecting duct tumor * Transitional cell carcinoma * WBC ≥ 3,000/mm\^3

Design outcomes

Primary

MeasureTime frameDescription
Progression-free Survival Assessed by Response Evaluation Criteria for Solid Tumors (RECIST) (Phase II)At 6 monthsEstimated by Kaplan-Meier method

Other

MeasureTime frameDescription
Maximum Tolerated Dose18 months from first patient dosingDetermine the maximum tolerated dose of SAHA
Clinical Response Rate of SAHA and Bevacizumab7 yearsTo determine the clinical response rate of SAHA and Bevacizumab in patients with metastatic renal cell carcinoma.

Countries

United States

Participant flow

Participants by arm

ArmCount
Arm I
Phase I: Patients receive oral SAHA twice daily on days 1-14 and bevacizumab IV over 30-90 minutes on day 1. Treatment repeats every 21 days in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of SAHA 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. An additional 6 patients are treated at the MTD. Phase II: Patients receive SAHA at the MTD determined in phase I and bevacizumab as in phase I. vorinostat: Given orally bevacizumab: Given IV
37
Total37

Baseline characteristics

CharacteristicArm I
Age, Categorical
<=18 years
0 Participants
Age, Categorical
>=65 years
17 Participants
Age, Categorical
Between 18 and 65 years
20 Participants
Age, Continuous64 years
Region of Enrollment
United States
37 participants
Sex: Female, Male
Female
6 Participants
Sex: Female, Male
Male
31 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
— / —
other
Total, other adverse events
22 / 37
serious
Total, serious adverse events
3 / 37

Outcome results

Primary

Progression-free Survival Assessed by Response Evaluation Criteria for Solid Tumors (RECIST) (Phase II)

Estimated by Kaplan-Meier method

Time frame: At 6 months

Population: Progression free survival was summarized for the entire sample (n=37). The median survival times and 6-month survival rates are estim. based on the KP curve,w/ corresp. 95% confidence intervals using the log-log method. Conducted in SAS v9.3(Cary, NC). Progr.free survival time is calc. from date of first tx until date of progres./death or last fu.

ArmMeasureValue (NUMBER)
Arm IProgression-free Survival Assessed by Response Evaluation Criteria for Solid Tumors (RECIST) (Phase II)48.6 percent
Other Pre-specified

Clinical Response Rate of SAHA and Bevacizumab

To determine the clinical response rate of SAHA and Bevacizumab in patients with metastatic renal cell carcinoma.

Time frame: 7 years

Other Pre-specified

Maximum Tolerated Dose

Determine the maximum tolerated dose of SAHA

Time frame: 18 months from first patient dosing

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