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RAD001 Plus Docetaxel in Patients With Metastatic Breast Cancer
This study is currently recruiting participants.
Verified by M.D. Anderson Cancer Center, October 2008
Sponsors and Collaborators: M.D. Anderson Cancer Center
Novartis Pharmaceuticals
Information provided by: M.D. Anderson Cancer Center
ClinicalTrials.gov Identifier: NCT00253318
  Purpose

Primary:

To assess the safety and tolerability and to find the maximum tolerated dose of the combination administration of RAD001 plus docetaxel when given to patients with metastatic breast cancer who are being considered for standard docetaxel treatment (phase I).

To characterize the pharmacokinetics of RAD001 and docetaxel when co-administered (phase I).

Secondary:

To assess the clinical efficacy of the combination regimens in this patient population as shown by response (according to the modified RECIST criteria) (phase II).

To determine the phosphorylation status of the components of the mTOR signaling pathway and the expression of modifiers of apoptosis in the primary breast tumors, in order to determine whether these markers can be used as predictors of sensitivity to the combination of RAD001 and docetaxel

To determine the effect of the combination of RAD001 and docetaxel on the expression and phosphorylation of mTOR's targets in the accessible tumor tissue, in order to identify potential pharmacodynamics markers of response to this drug combination


Condition Intervention Phase
Breast Cancer
Drug: Docetaxel
Drug: RAD001
Phase I
Phase II

Genetics Home Reference related topics: breast cancer
MedlinePlus related topics: Breast Cancer Cancer
Drug Information available for: Docetaxel Everolimus
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Non-Randomized, Open Label, Uncontrolled, Single Group Assignment, Safety/Efficacy Study
Official Title: Phase I/II, Open Label, Dose Escalation Study of the Safety, Tolerability, and Pharmacokinetics of the Combination RAD001 Plus Docetaxel in Patients With Metastatic Breast Cancer

Further study details as provided by M.D. Anderson Cancer Center:

Primary Outcome Measures:
  • To find the highest safe dose of docetaxel and RAD001 that can be given in combination in the treatment of metastatic breast cancer. [ Time Frame: 4 Years ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • To study the safety and effectiveness of this combination. [ Time Frame: 4 Years ] [ Designated as safety issue: No ]

Estimated Enrollment: 65
Study Start Date: November 2005
Estimated Primary Completion Date: November 2009 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
1: Experimental
RAD001 + Docetaxel
Drug: Docetaxel
75 mg/m^2 IV over 1 hour on Day 1.
Drug: RAD001
30 mg PO on Days 1 and 8.

Detailed Description:

Docetaxel is a drug approved for the treatment of metastatic breast cancer in patients who are either newly diagnosed or have failed earlier chemotherapy. RAD001 is an investigational drug that has shown to have anticancer properties. It also works by weakening the immune system. RAD001 works by blocking some of the steps required for cancer growth. Researchers hope that RAD001 may increase the anticancer activity of docetaxel.

Before you can start treatment on this study, you will have what are called "screening tests." These tests will help the doctor decide if you are eligible to take part in the study. You will have a complete medical history and physical exam. Blood (between 1-2 teaspoons) will be collected for routine tests. You will have scans (MRI or CT) to check on the status of your cancer as ordered by your primary physician. Women who are able to have children must have a negative blood pregnancy test. As part of the study, researchers will also look at the tissue of your original cancer. Special stains will be done that will help find ways in which researchers can predict the response of your cancer to RAD001.

If you are found to be eligible to take part in this study, you will receive docetaxel by vein on Day 1 over one hour. RAD001 will be given by mouth on Days 1 and 8. RAD001 will be given on an empty stomach or after a light meal. You will repeat this treatment every 21 days. Three (3 ) weeks equals 1 cycle.

Patients who participate on the first part of this study will be enrolled in groups of 3 at a time. The dose of RAD001 will be increased with each new group of patients. The dose of docetaxel will remain the same. The second part of the study will be using the highest dose of RAD001 and docetaxel that was found to be safe and effective during the first part of the study.

Dexamethasone will be given by mouth twice a day for 3 days, starting the day before you receive docetaxel. Dexamethasone helps decrease the risk of and control nausea, vomiting, and fluid retention.

Blood (between 1-2 teaspoons) will be drawn for routine tests at each visit. X-rays and scans (CT or MRI) will be done every 6 weeks to see if the tumor is responding to treatment.

After 6 cycles of the combination, docetaxel will be stopped and you will continue to take RAD001 alone. However, you may be able to take more than 6 cycles of the combination if you are not having any side effects and is found to be of benefit by your primary doctor.

Once you go off treatment, you will have a physical exam, including routine blood tests (1-2 teaspoons).

This is an investigational study. Docetaxel is approved by the FDA and commercially available for the treatment of breast cancer. RAD001 is authorized for use in research only. About 65 patients will take part in the study. All will be enrolled at M. D. Anderson.

  Eligibility

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

Inclusion Criteria:

  1. 18 years of age or older.
  2. Diagnosis of metastatic breast cancer with at least one measurable or evaluable lesion. For the phase II portion of the study patients will be required to have measurable disease. Response will be determined using the RECIST criteria.
  3. No limit on the prior number of chemotherapies for the phase I portion of the study. No more than one prior chemotherapy regimen for the phase II portion of the study.
  4. Signed informed consent to participate in the study must be obtained from patients after they have been fully informed on the nature and potential risks by the investigator with the aid of written information.
  5. Adequate bone marrow function as shown by: ANC > or = 1.5 x 10(9)/L, Platelets > or = 100 x 10(9)/L, Hgb > or = 10g/dL.
  6. Normal renal function as shown by serum creatinine < or = 1.5 x ULN.
  7. Hepatic Function Variables:

    • Bilirubin < or = ULN
    • Alkaline phosphatase < or = 5 x ULN. If alkaline phosphatase is < or = 2.5 x ULN, ALT/AST must be < or = 2.0 x ULN. If alkaline phosphatase is > 2.5 but < or = 5 x ULN, ALT/AST must be < or = 1.5 x ULN
  8. Performance Status 0-2 on the WHO scale.

Exclusion Criteria:

  1. Patients enrolled in the Phase I portion of the trial may have received prior docetaxel in the adjuvant or metastatic setting. Patients enrolled in the Phase II portion of the trial will not be considered eligible if they have received prior docetaxel as treatment for metastatic breast cancer. For the purposes of this protocol, patients who develop systemic metastasis < 6 months from adjuvant docetaxel will be considered to have had treatment with docetaxel for metastatic breast cancer and will be ineligible for protocol participation.
  2. Patients with a history of thromboembolism within the prior 6 months or active thrombophlebitis.
  3. For the phase I portion of the study, patients with grade > 2 neuropathy, for the phase II portion of the trial, patients with > or = grade 2 neuropathy.
  4. For the phase I portion of the trial, patients with treated brain metastasis that are stable for 3 months will be eligible for protocol participation. However, patients with brain metastasis will be excluded from the phase II portion of the trial.
  5. Patients with an uncontrolled infection.
  6. Patients with a known history of HIV seropositivity.
  7. Patients with an active, bleeding diathesis, or on oral anti-vitamin K medication (except patients receiving 1 mg of warfarin to prevent central venous catheter thrombosis).
  8. Patients with other concurrent severe and/or uncontrolled medical disease which could compromise participation in the study (i.e., uncontrolled diabetes, uncontrolled hypertension, congestive cardiac failure, ventricular arrhythmias, active ischemic heart disease, myocardial infarction within six months, chronic liver or renal disease, active upper GI tract ulceration).
  9. Patients with impairment of gastrointestinal function or gastrointestinal disease that may significantly alter the absorption of RAD001 (e.g., ulcerative disease, uncontrolled nausea, vomiting, diarrhea, malabsorption syndrome or small bowel resection).
  10. Patients who received any other investigational drugs within the preceding 30 days.
  11. Patients who have received mitomycin C or nitrosourea.
  12. Patients receiving anti-neoplastic therapy less than 14 days prior to entry onto this study or who have not recovered from the toxic effects of such therapy.
  13. Patients who received radiation therapy within 3 weeks prior to entry on this study or who have not recovered from the toxic effects of such therapy.
  14. Patients who had surgery within 2 weeks prior to entry on this study or who have not recovered from the side effects of such therapy.
  15. Patients with a history of noncompliance to medical regimens.
  16. Patients unwilling to or unable to comply with the protocol.
  17. Patients being treated with drugs recognized as being strong inhibitors or inducers of the isoenzyme CYP3A4 or patients taking lithium chloride.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00253318

Contacts
Contact: Julia A Moore, RN, BSN 713-563-0770 jmoore@mdanderson.org
Contact: Carol Stalzer, RN, BSN 713-745-6806 cstalzer@mdanderson.org

Locations
United States, Texas
U.T. M.D. Anderson Cancer Center Recruiting
Houston, Texas, United States, 77230-1439
Contact: Julia Moore, RN, BSN     713-563-0770     jmoore@mdanderson.org    
Contact: Carol Stalzer, RN, BSN     713-745-6806     cstalzer@mdanderson.org    
Principal Investigator: Stacy Moulder, MD            
Sponsors and Collaborators
M.D. Anderson Cancer Center
Novartis Pharmaceuticals
Investigators
Principal Investigator: Stacy Moulder, MD U.T. M.D. Anderson Cancer Center
  More Information

UT MD Anderson Cancer Center Website  This link exits the ClinicalTrials.gov site

Responsible Party: U.T.M.D. Anderson Cancer Center ( Stacy Moulder, MD/Assistant Professor )
Study ID Numbers: 2004-0758
Study First Received: November 11, 2005
Last Updated: October 31, 2008
ClinicalTrials.gov Identifier: NCT00253318  
Health Authority: United States: Food and Drug Administration

Keywords provided by M.D. Anderson Cancer Center:
Neoplasm Metastasis
Breast Cancer
Docetaxel
RAD001
Taxotere

Study placed in the following topic categories:
Everolimus
Docetaxel
Skin Diseases
Neoplasm Metastasis
Breast Neoplasms
Breast Diseases

Additional relevant MeSH terms:
Neoplasms
Neoplasms by Site
Immunologic Factors
Antineoplastic Agents
Therapeutic Uses
Physiological Effects of Drugs
Immunosuppressive Agents
Pharmacologic Actions

ClinicalTrials.gov processed this record on January 14, 2009