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AZD6244 in Treating Patients With Papillary Thyroid Cancer That Did Not Respond to Radioactive Iodine
This study is currently recruiting participants.
Verified by National Cancer Institute (NCI), October 2008
Sponsors and Collaborators: H. Lee Moffitt Cancer Center and Research Institute
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00559949
  Purpose

RATIONALE: AZD6244 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 AZD6244 works in treating patients with papillary thyroid cancer that did not respond to radioactive iodine.


Condition Intervention Phase
Head and Neck Cancer
Drug: MEK inhibitor AZD6244
Procedure: fluorescence in situ hybridization
Procedure: gene expression analysis
Procedure: immunohistochemistry staining method
Procedure: laboratory biomarker analysis
Procedure: mutation analysis
Procedure: pharmacological study
Procedure: polymerase chain reaction
Procedure: protein expression analysis
Phase II

MedlinePlus related topics: Cancer Head and Neck Cancer Thyroid Cancer
Drug Information available for: Iodine Cadexomer iodine Sodium iodide I 131 Thyroid ARRY 142886
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Open Label
Official Title: Phase 2 Study of AZD6244 in Iodine-131 Refractory Papillary Thyroid Carcinoma and Papillary Thyroid Carcinoma With Follicular Elements

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

Primary Outcome Measures:
  • Objective response rate (complete response and partial response) [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Toxicity [ Designated as safety issue: Yes ]
  • Progression-free survival [ Designated as safety issue: No ]
  • Overall survival [ Designated as safety issue: No ]

Estimated Enrollment: 32
Study Start Date: December 2007
Estimated Primary Completion Date: June 2010 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • Ascertain the objective response rate (complete response and partial response) in patients with iodine I 131-refractory papillary thyroid cancer treated with AZD6244.

Secondary

  • Determine the toxicity of this treatment in these patients.
  • Determine the pharmacokinetic profile of this treatment in these patients.
  • Determine the progression-free and overall survival of these patients.
  • Assess proxy measures of treatment response (thyroglobulin and PET scan) in patients treated with AZD6244.
  • Compare relevant laboratory correlates between responders and non-responders.

OUTLINE: This is a multicenter study.

Patients receive oral AZD6244 twice daily on days 1-28. Treatment repeats every 28 days in the absence of unacceptable toxicity or disease progression.

Archived tissue is examined for gene mutations, including RET, BRAF, NTRK, and RAS, by fluorescence in situ hybridization and/or polymerase chain reaction and fluorescence melting curve analysis. Protein expression of ERK and phosphorylated ERK is assessed by immunohistochemical staining.

Blood samples are collected periodically for pharmacokinetic analysis and biomarker assessment (thyroglobulin and antithyroglobulin autoantibodies).

After completion of study therapy, patients are followed periodically for up to 2 years.

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Histologically or cytologically confirmed papillary thyroid cancer or papillary thyroid cancer with follicular elements
  • No longer amenable to radioactive iodine therapy or curative surgical resection

    • Tumor is no longer iodine avid
    • Tumor did not respond to the most recent radioactive iodine treatment
    • Patient is ineligible for further radioactive iodine therapy due to medical contraindications (e.g., lung toxicity)
  • Measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded) as ≥ 20 mm with conventional techniques or as ≥ 10 mm with spiral CT scan
  • Evidence of disease progression (objective growth of existing tumors)

    • New or enlarging measurable lesions within the past 12 months
    • If the most recent imaging study is older than 12 months, patients will still be eligible if objectively measurable disease progression is associated with clinical symptoms
  • Archival tumor tissue available for mutational analysis
  • No known brain metastases

PATIENT CHARACTERISTICS:

Inclusion criteria:

  • ECOG performance status (PS) 0-2 OR Karnofsky PS 60-100%
  • Life expectancy > 12 weeks
  • WBC ≥ 3,000/µL
  • ANC ≥ 1,500/µL
  • Platelet count ≥ 100,000/µL
  • Total bilirubin normal
  • AST and ALT < 2.5 times upper limit of normal
  • Creatinine normal OR creatinine clearance ≥ 60 mL/min
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception prior to, during, and for 4 weeks after completion of study treatment
  • Able to understand and willing to sign a written informed consent document

Exclusion criteria:

  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to AZD6244 or its excipient Captisol®
  • QTc interval > 450 msec or other factors that increase the risk of QT prolongation
  • Arrhythmic events (e.g., heart failure, hypokalemia, family history of long QT interval syndrome), including heart failure that meets NYHA class III and IV definition
  • Refractory nausea and vomiting, chronic gastrointestinal diseases (e.g., inflammatory bowel disease), or significant bowel resection that would preclude adequate absorption
  • Concurrent uncontrolled illness including, but not limited to, ongoing or active infection or psychiatric illness/social situations that would limit compliance with study requirements

PRIOR CONCURRENT THERAPY:

Inclusion criteria:

  • At least 4 weeks since prior radiotherapy or chemotherapy (6 weeks for nitrosoureas or mitomycin C)

Exclusion criteria:

  • Prior treatment with tyrosine kinase inhibitors that target RET or RAF
  • Prior treatment with MEK inhibitors
  • Concurrent combination antiretroviral therapy for HIV-positive patients
  • Concurrent grapefruit or grapefruit juice
  • Concurrent medication that can prolong the QT interval
  • Other concurrent investigational agents
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00559949

Locations
United States, Florida
H. Lee Moffitt Cancer Center and Research Institute at University of South Florida Recruiting
Tampa, Florida, United States, 33612-9497
Contact: Clinical Trials Office - H. Lee Moffitt Cancer Center and Rese     800-456-7121     canceranswers@moffitt.org    
United States, Illinois
University of Chicago Cancer Research Center Recruiting
Chicago, Illinois, United States, 60637-1470
Contact: Clinical Trials Office - University of Chicago Cancer Research     773-834-7424        
United States, Pennsylvania
Fox Chase Cancer Center - Philadelphia Recruiting
Philadelphia, Pennsylvania, United States, 19111-2497
Contact: Clinical Trials Office - Fox Chase Cancer Center - Philadelphi     215-728-4790        
United States, Tennessee
Vanderbilt-Ingram Cancer Center Recruiting
Nashville, Tennessee, United States, 37232-6838
Contact: Christine Chung, MD     615-322-4967        
Sponsors and Collaborators
H. Lee Moffitt Cancer Center and Research Institute
Investigators
Study Chair: D. Neil Hayes UNC Lineberger Comprehensive Cancer Center
  More Information

Clinical trial summary from the National Cancer Institute's PDQ® database  This link exits the ClinicalTrials.gov site

Study ID Numbers: CDR0000574262, MCC-15305, MCC-LOI-7918
Study First Received: November 16, 2007
Last Updated: November 25, 2008
ClinicalTrials.gov Identifier: NCT00559949  
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
stage I papillary thyroid cancer
stage II papillary thyroid cancer
stage III papillary thyroid cancer
stage IV papillary thyroid cancer
recurrent thyroid cancer

Study placed in the following topic categories:
Thyroid Neoplasms
Head and Neck Neoplasms
Iodine
Endocrine System Diseases
Endocrinopathy
Thyroid Diseases
Recurrence
Thyroid cancer, papillary
Endocrine Gland Neoplasms
Carcinoma

Additional relevant MeSH terms:
Neoplasms
Neoplasms by Site

ClinicalTrials.gov processed this record on January 16, 2009