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S0722: Everolimus in Treating Patients With Pleural Malignant Mesothelioma That Cannot Be Removed By Surgery

Phase II Trial of mTOR Inhibitor, Everolimus (RAD001), in Malignant Pleural Mesothelioma (MPM)

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00770120
Enrollment
61
Registered
2008-10-09
Start date
2008-12-31
Completion date
2014-04-30
Last updated
2020-03-06

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

Conditions

Malignant Mesothelioma

Keywords

recurrent malignant mesothelioma, stage II malignant mesothelioma, stage III malignant mesothelioma, stage IV malignant mesothelioma

Brief summary

RATIONALE: Everolimus may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. PURPOSE: This phase II trial is studying how well everolimus works in treating patients with pleural malignant mesothelioma that cannot be removed by surgery.

Detailed description

OBJECTIVES: Primary * To determine the 4-month progression-free survival in patients with unresectable malignant pleural mesothelioma treated with everolimus. Secondary * To determine the response rate (confirmed and unconfirmed, complete and partial responses) and disease control rate (response or stable disease) in patients with measurable disease by RECIST and modified RECIST criteria. * To determine overall survival of these patients. * To evaluate the frequency and severity of toxicities associated with this treatment regimen. OUTLINE: This is a multicenter study. Patients receive oral everolimus once daily on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed for 3 years.

Interventions

DRUGeverolimus

Sponsors

National Cancer Institute (NCI)
CollaboratorNIH
SWOG Cancer Research Network
Lead SponsorNETWORK

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

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

Inclusion criteria

DISEASE CHARACTERISTICS: * Histologically confirmed malignant pleural mesothelioma * Unresectable disease * Must have measurable or nonmeasurable disease by RECIST or modified RECIST criteria * Must have received prior systemically administered\* platinum-based chemotherapy and meets the following criteria: * No more than 2 prior systemic therapeutic regimens allowed (including biologics, targeted, and immunotherapies) * At least 1 regimen must have been platinum-based * Neoadjuvant and/or adjuvant systemic therapy is not counted as a prior regimen, assuming ≥ 12 weeks have elapsed between the end of neoadjuvant/adjuvant therapy and development of progressive disease NOTE: \*Pleural space washing with cisplatin does not constitute systemic administration * No known CNS metastases PATIENT CHARACTERISTICS: * Zubrod performance status 0-1 * ANC ≥ 1,500/mm³ * Platelet count ≥ 100,000/mm³ * Serum bilirubin normal * AST or ALT ≤ 1.5 times upper limit of normal (ULN) * Serum creatinine ≤ 1.5 times ULN OR creatinine clearance ≥ 50 mL/min * Not pregnant or nursing * Fertile patients must use effective contraception * No evidence of bleeding diathesis or coagulopathy * Previous pulmonary embolism allowed provided the patient is on therapeutic low molecular weight heparin injections or warfarin AND no evidence of bleeding * Patients on therapeutic warfarin must have an INR of \< 5 within 28 days prior to registration * No pathologic condition other than mesothelioma that carries a high risk of bleeding * No known HIV positivity * No gastrointestinal tract disease resulting in an inability to take oral or enteral medication via a feeding tube or a requirement for IV alimentation, or active peptic ulcer disease * No other prior malignancy allowed except for any of the following: * Adequately treated basal cell or squamous cell skin cancer * In situ cervical cancer * Adequately treated stage I or II cancer from which the patient is currently in complete remission * Any other cancer from which patient has been disease-free for 5 years PRIOR CONCURRENT THERAPY: * See Disease Characteristics * Recovered from all prior therapy * At least 28 days since prior systemic therapy (42 days for nitrosoureas or mitomycin C) * At least 28 days since prior thoracic or other major surgery (e.g., pleurectomy or pleurodesis) and no anticipated need for major surgical procedures during study * At least 14 days since prior radiotherapy * No prior surgical procedure affecting absorption * No prior chronic, systemic corticosteroids or other immunosuppressive agent, except corticosteroids equivalent to prednisone ≤ 20 mg daily * Must have been on a stable dosage regimen for ≥ 4 weeks * Topical and inhaled corticosteroids allowed * No prior mTOR inhibitor therapy (i.e., rapamycin, everolimus, or temsirolimus) * No concurrent immunization with attenuated live vaccines * No concurrent antiretroviral therapy for HIV-positive patients * No other concurrent investigational therapy * No other concurrent anticancer agents

Design outcomes

Primary

MeasureTime frameDescription
Progression-Free SurvivalEvery 8 weeks until disease progression, up to 3 years.Progression-Free Survival was defined as the duration from the date of registration until the date of disease progression per RECIST or death due to any cause. Patients known to be alive without evidence of disease progression were censored at the date of last contact. Disease progression was defined as a \>= 20% increase over nadir in the sum of longest diameters of target lesions, unequivocal progression of non-target lesions in the opinion of the treating investigator, appearance of new lesions, symptomatic deterioration, or death due to disease

Secondary

MeasureTime frameDescription
ResponseEvery 8 weeks until disease progression, up to 3 years.A response was defined as either a confirmed or unconfirmed complete or partial responses as defined by RECIST. A complete response (CR) was defined as the disappearance of all disease. A partial response (PR) was defined as a \>= 30% decrease in the sum of longest diameters of target lesions. A CR or PR was considered confirmed if two consecutive determinations were made at least 4 weeks apart.
Overall SurvivalEvery 8 weeks until disease progression, up to 3 years.Overall survival was defined as the duration between the date of enrollment and the date of death due to any cause. Patients last known to be alive were censored at the date of last contact.
Frequency and Severity of ToxicitiesWeekly during the first 8 weeks of treatment, then every 4 weeks while on treatment, then every 8 weeks until disease progression, then every 6 months thereafter.

Countries

United States

Participant flow

Participants by arm

ArmCount
Everolimus
Daily oral Everolimus 10 mg/day everolimus
59
Total59

Withdrawals & dropouts

PeriodReasonFG000
Overall StudyAdverse Event11
Overall StudyDeath3
Overall StudyIneligible1
Overall StudyNever Received Treatment/Not Analyzable1
Overall StudyNot Protocol Specified11
Overall StudyProgression31
Overall StudyReason under Review1
Overall StudyWithdrawal by Subject2

Baseline characteristics

CharacteristicEverolimus
Age, Continuous67 years
Ethnicity (NIH/OMB)
Hispanic or Latino
9 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
47 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
3 Participants
Histology
Biphasic
4 participants
Histology
Epithelial
36 participants
Histology
Mesothelioma, NOS
17 participants
Histology
Not Reported
2 participants
Number of Metastatic Sites
Multiple
31 participants
Number of Metastatic Sites
None
5 participants
Number of Metastatic Sites
Single
23 participants
Performance Status
0
13 participants
Performance Status
1
46 participants
Prior Systemic Regimens
1 Regimen
34 participants
Prior Systemic Regimens
2 Regimens
25 participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
Race (NIH/OMB)
Asian
0 Participants
Race (NIH/OMB)
Black or African American
1 Participants
Race (NIH/OMB)
More than one race
0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
Race (NIH/OMB)
Unknown or Not Reported
3 Participants
Race (NIH/OMB)
White
55 Participants
Sex: Female, Male
Female
14 Participants
Sex: Female, Male
Male
45 Participants
Weight Loss Last 6 Months
10% - 20%
6 participants
Weight Loss Last 6 Months
< 5%
47 participants
Weight Loss Last 6 Months
5% - < 10%
6 participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
— / —
other
Total, other adverse events
58 / 59
serious
Total, serious adverse events
25 / 59

Outcome results

Primary

Progression-Free Survival

Progression-Free Survival was defined as the duration from the date of registration until the date of disease progression per RECIST or death due to any cause. Patients known to be alive without evidence of disease progression were censored at the date of last contact. Disease progression was defined as a \>= 20% increase over nadir in the sum of longest diameters of target lesions, unequivocal progression of non-target lesions in the opinion of the treating investigator, appearance of new lesions, symptomatic deterioration, or death due to disease

Time frame: Every 8 weeks until disease progression, up to 3 years.

ArmMeasureValue (MEDIAN)
EverolimusProgression-Free Survival3.0 months
Secondary

Frequency and Severity of Toxicities

Time frame: Weekly during the first 8 weeks of treatment, then every 4 weeks while on treatment, then every 8 weeks until disease progression, then every 6 months thereafter.

Population: Number of Subjects With Greater Than Grade 2 Toxicity

ArmMeasureGroupValue (NUMBER)
EverolimusFrequency and Severity of ToxicitiesAnorexia1 participants
EverolimusFrequency and Severity of ToxicitiesConfusion1 participants
EverolimusFrequency and Severity of ToxicitiesDehydration2 participants
EverolimusFrequency and Severity of ToxicitiesDiarrhea1 participants
EverolimusFrequency and Severity of ToxicitiesDyspnea (shortness of breath)3 participants
EverolimusFrequency and Severity of ToxicitiesFatigue (asthenia, lethargy, malaise)6 participants
EverolimusFrequency and Severity of ToxicitiesGlucose, serum-high (hyperglycemia)3 participants
EverolimusFrequency and Severity of ToxicitiesHemoglobin4 participants
EverolimusFrequency and Severity of ToxicitiesINR (of prothrombin time)1 participants
EverolimusFrequency and Severity of ToxicitiesInf (clin/microbio) w/Gr 3-4 neuts - Lung1 participants
EverolimusFrequency and Severity of ToxicitiesInfection with unknown ANC - Lung (pneumonia)3 participants
EverolimusFrequency and Severity of ToxicitiesLeft ventricular systolic dysfunction1 participants
EverolimusFrequency and Severity of ToxicitiesLymphopenia2 participants
EverolimusFrequency and Severity of ToxicitiesMucositis/stomatitis (clinical exam) - Oral cavity1 participants
EverolimusFrequency and Severity of ToxicitiesMucositis/stomatitis (functional/symp) - Oral cav1 participants
EverolimusFrequency and Severity of ToxicitiesMuscle weakness, not d/t neuropathy - body/general2 participants
EverolimusFrequency and Severity of ToxicitiesPneumonitis/pulmonary infiltrates2 participants
EverolimusFrequency and Severity of ToxicitiesRash/desquamation1 participants
EverolimusFrequency and Severity of ToxicitiesTriglyceride, serum-high (hypertriglyceridemia)2 participants
Secondary

Overall Survival

Overall survival was defined as the duration between the date of enrollment and the date of death due to any cause. Patients last known to be alive were censored at the date of last contact.

Time frame: Every 8 weeks until disease progression, up to 3 years.

ArmMeasureValue (MEDIAN)
EverolimusOverall Survival6.3 months
Secondary

Response

A response was defined as either a confirmed or unconfirmed complete or partial responses as defined by RECIST. A complete response (CR) was defined as the disappearance of all disease. A partial response (PR) was defined as a \>= 30% decrease in the sum of longest diameters of target lesions. A CR or PR was considered confirmed if two consecutive determinations were made at least 4 weeks apart.

Time frame: Every 8 weeks until disease progression, up to 3 years.

ArmMeasureValue (NUMBER)
EverolimusResponse2 percentage of overall response rate

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