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Vandetanib in Treating Patients With Refractory or Relapsed Ovarian Epithelial Cancer, Fallopian Tube Cancer, or Primary Peritoneal Cavity Cancer
This study is ongoing, but not recruiting participants.
First Received: March 7, 2007   Last Updated: February 6, 2009   History of Changes
Sponsored by: National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00445549
  Purpose

RATIONALE: Vandetanib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth and by blocking blood flow to the tumor.

PURPOSE: This phase II trial is studying how well vandetanib works in treating patients with refractory or relapsed ovarian epithelial cancer, fallopian tube cancer, or primary peritoneal cavity cancer.


Condition Intervention Phase
Fallopian Tube Cancer
Ovarian Cancer
Peritoneal Cavity Cancer
Drug: vandetanib
Genetic: protein expression analysis
Genetic: proteomic profiling
Other: immunoenzyme technique
Other: immunohistochemistry staining method
Other: laboratory biomarker analysis
Procedure: biopsy
Procedure: dynamic contrast-enhanced magnetic resonance imaging
Phase II

MedlinePlus related topics: Cancer Ovarian Cancer
Drug Information available for: Vandetanib
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Non-Randomized, Open Label, Uncontrolled
Official Title: Phase II Study of Clinical Activity and Proteomic Pathway Profiling of the VEGFR2 Inhibitor, ZD6474 (Vandetanib) in Women With Relapsed or Refractory Epithelial Ovarian, Fallopian Tube or Primary Peritoneal Cancer

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

Primary Outcome Measures:
  • Clinical outcome (complete response, partial response, or disease stabilization lasting 6 months or longer) [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Biochemical modulation of activated (phosphorylated) vascular endothelial growth factor receptor 2, epidermal growth factor receptor, extracellular signal-regulated kinase, and AKT [ Designated as safety issue: No ]
  • Toxicity [ Designated as safety issue: Yes ]
  • Quality of life [ Designated as safety issue: No ]
  • Progression-free survival [ Designated as safety issue: No ]

Estimated Enrollment: 38
Study Start Date: January 2007
Estimated Primary Completion Date: July 2008 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • Evaluate the clinical efficacy (complete response, partial response, or disease stabilization for 6 months) of vandetanib in patients with refractory or relapsed ovarian epithelial, fallopian tube, or primary peritoneal cavity cancer.

Secondary

  • Determine the differences in levels of phospho (p)- vascular endothelial growth factor receptor (VEGFR) 2, p-epidermal growth factor receptor (EGFR), p-AKT, and p-extracellular signal-regulated kinase (ERK) between pre- and post-treatment tumor specimens.
  • Correlate toxicity with changes in the quantity of activated (phosphorylated) VEGFR2, EGFR, AKT, and ERK.
  • Correlate clinical outcome with changes in the quantity of activated VEGFR2, EGFR, AKT, and ERK.
  • Measure tumor vascularity using dynamic contrast-enhanced MRI prior to and during treatment to determine target activity and to assess potential predictive value.
  • Assess modulation or circulating proangiogenic cytokines in response to treatment with vandetanib.
  • Investigate quality of life differences before and during treatment with vandetanib.

OUTLINE: This is an open-label, nonrandomized study.

Patients receive oral vandetanib once daily on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

Patients undergo core biopsies of a sentinel lesion at baseline and at 6 weeks after beginning study therapy. Tumor tissue lysates are arrayed and analyzed by protein proteomics for phosphorylated (p)-vascular endothelial growth factor receptor (VEGFR) 2, p-epidermal growth factor receptor (EGFR), p-ERK, and P-AKT. VEGFR2, p-VEGFR2, EGFR, and p-EGFR expression are analyzed by immunohistochemistry. VEGF, interleukin (IL)-6, and IL-8 are measured by enzyme-linked immunosorbent assay. Patients undergo dynamic contrast-enhanced MRI at baseline, on day 3 of course 1, and at 6 weeks after beginning study therapy.

Patients complete a quality of life questionnaire at baseline and after 4 weeks, 8 weeks, and 16 weeks of treatment.

After completion of study treatment, patients are followed monthly.

PROJECTED ACCRUAL: A total of 38 patients will be accrued for this study.

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Biopsy-confirmed ovarian epithelial, fallopian tube, or primary peritoneal cavity cancer
  • Measurable disease
  • Relapsed disease OR disease refractory to prior standard platinum- and taxane-based therapy

    • Metastatic disease allowed
  • Presence of a sentinal lesion adequate for percutaneous core biopsy
  • No CNS involvement

PATIENT CHARACTERISTICS:

  • ECOG performance status 0-2
  • WBC > 3,000/mm³
  • Absolute neutrophil count > 1,000/mm³
  • Platelet count > 150,000/mm³
  • Creatinine < 1.5 mg/dL
  • AST and ALT ≤ 2.5 times upper limit of normal (ULN)
  • Bilirubin < 1.5 mg/dL
  • Potassium between 4.0 mg/dL and ULN (supplementation allowed)
  • Magnesium and calcium normal (supplementation allowed)
  • Systolic blood pressure (BP) < 160 mm Hg and diastolic BP < 100 mm Hg (therapy permitted)
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective barrier contraception prior to study entry, during therapy, and for 3 months after completion of study therapy
  • No severe or uncontrolled systemic disease or concurrent condition that would preclude study compliance or participation
  • No peripheral neuropathy > grade 2
  • No history of clinically significant cardiac disorders, including any of the following:

    • Myocardial infarction
    • New York Heart Association class II-IV cardiac disease within the past 3 months
    • History of medication-induced QTc prolongation requiring discontinuation of that medication
    • Congenital long QT syndrome
    • Unmeasurable QTc OR QTc ≥ 480 msec by ECG
    • First-degree relative with unexplained early sudden cardiac death (at < 40 years of age)
    • Left bundle branch block
    • Cardiac disease, that in the opinion of the investigator, increases the risk of ventricular arrhythmia
    • Uncontrolled symptomatic arrhythmia, including any of the following:

      • Multifocal premature ventricular contractions
      • Bigeminy or trigeminy
      • Ventricular tachycardia
      • Uncontrolled atrial fibrillation
  • No deep venous thrombosis or pulmonary embolism within the past 3 months
  • No active infection

    • Patients may become eligible once infection has resolved and they have been off antibiotic treatment for at least 7 days
  • No incomplete wound healing from prior surgery or injury
  • No active diarrhea that is uncontrolled with medication (e.g., bulk agents or loperamide) and that may affect the ability to absorb vandetanib
  • No prior or concurrent malignancies within the past 5 years except for the following:

    • Curatively treated cervical carcinoma in situ
    • Curatively treated ductal or lobular carcinoma in situ that does not require ongoing therapeutic intervention
  • No gastrointestinal bleeding or gross hematuria within the past 30 days

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • Recovered from all prior therapies
  • No more than 4 prior regimens for the treatment of ovarian cancer
  • At least 4 weeks since prior chemotherapy, radiotherapy, hormonal therapy, or alternative therapy
  • At least 6 weeks since prior carboplatin
  • At least 4 weeks since prior major surgical procedures
  • At least 4 weeks since prior investigational agents
  • No medication that may cause QTc prolongation or induce torsades de pointes 2 weeks prior to, during, and for at least 4 weeks after study therapy
  • No concurrent CYP3A4 inhibiting drugs
  • No concurrent complementary or alternative medication (e.g., Hypericum perforatum [St. John's wort]) or other agents (e.g., phenytoin, carbamazepine, barbiturates) that may interact with vandetanib
  • No concurrent radiotherapy
  • No concurrent anticoagulation
  • No concurrent grapefruit juice
  • No other concurrent anticancer agents
  • No other concurrent investigational agents
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00445549

Locations
United States, Maryland
Warren Grant Magnuson Clinical Center - NCI Clinical Trials Referral Office
Bethesda, Maryland, United States, 20892-1182
Sponsors and Collaborators
Investigators
Principal Investigator: Elise C. Kohn, MD NCI - Medical Oncology Branch
  More Information

Additional Information:
No publications provided

Study ID Numbers: CDR0000532810, NCI-07-C-0061, NCI-P7041
Study First Received: March 7, 2007
Last Updated: February 6, 2009
ClinicalTrials.gov Identifier: NCT00445549     History of Changes
Health Authority: United States: Food and Drug Administration

Keywords provided by National Cancer Institute (NCI):
peritoneal cavity cancer
fallopian tube cancer
recurrent ovarian epithelial cancer
stage IV ovarian epithelial cancer

Study placed in the following topic categories:
Fallopian Tube Cancer
Digestive System Neoplasms
Ovarian Neoplasms
Gonadal Disorders
Genital Neoplasms, Female
Endocrine System Diseases
Urogenital Neoplasms
Ovarian Diseases
Ovarian Epithelial Cancer
Abdominal Neoplasms
Fallopian Tube Neoplasms
Recurrence
Fallopian Tube Diseases
Genital Diseases, Female
Digestive System Diseases
Peritoneal Diseases
Ovarian Cancer
Gastrointestinal Neoplasms
Endocrinopathy
Peritoneal Neoplasms
Endocrine Gland Neoplasms

Additional relevant MeSH terms:
Digestive System Neoplasms
Ovarian Neoplasms
Gonadal Disorders
Genital Neoplasms, Female
Endocrine System Diseases
Urogenital Neoplasms
Ovarian Diseases
Abdominal Neoplasms
Fallopian Tube Neoplasms
Fallopian Tube Diseases
Adnexal Diseases
Genital Diseases, Female
Neoplasms
Digestive System Diseases
Neoplasms by Site
Peritoneal Diseases
Peritoneal Neoplasms
Endocrine Gland Neoplasms

ClinicalTrials.gov processed this record on May 06, 2009