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IMC-A12 and Temsirolimus in Treating Patients With Locally Recurrent or Metastatic Breast Cancer
This study is currently recruiting participants.
Verified by National Cancer Institute (NCI), December 2008
First Received: June 17, 2008   Last Updated: April 14, 2009   History of Changes
Sponsors and Collaborators: Mayo Clinic
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00699491
  Purpose

RATIONALE: Monoclonal antibodies, such as IMC-A12, 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. Temsirolimus may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Giving IMC-A12 together with temsirolimus may kill more tumor cells.

PURPOSE: This phase I/II trial is studying the side effects and best dose of IMC-A12 when given together with temsirolimus and to see how well they work in treating patients with locally recurrent or metastatic breast cancer.


Condition Intervention Phase
Breast Cancer
Biological: cixutumumab
Drug: temsirolimus
Genetic: fluorescence in situ hybridization
Genetic: gene expression analysis
Genetic: mutation analysis
Genetic: proteomic profiling
Genetic: reverse transcriptase-polymerase chain reaction
Genetic: western blotting
Other: immunohistochemistry staining method
Other: laboratory biomarker analysis
Other: pharmacological study
Phase I
Phase II

Genetics Home Reference related topics: breast cancer
MedlinePlus related topics: Breast Cancer Cancer
Drug Information available for: CCI 779
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Open Label
Official Title: Phase I/II Trial of IMC-A12 in Combination With Temsirolimus in Patients With Metastatic Breast Cancer

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

Primary Outcome Measures:
  • Recommended dose level (phase I) [ Designated as safety issue: Yes ]
  • Safety profile (phase I) [ Designated as safety issue: Yes ]
  • Antitumor activity (phase II) [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Adverse events (phase II) [ Designated as safety issue: Yes ]
  • Duration of response (phase II) [ Designated as safety issue: No ]
  • Progression-free survival (phase II) [ Designated as safety issue: No ]
  • Survival time (phase II) [ Designated as safety issue: No ]
  • Serum estradiol and progesterone levels prior to treatment (phase II) [ Designated as safety issue: No ]
  • Levels of IGF-1, IGF-2, IGFBP1-3, insulin, glucose, C-peptide (phase II) [ Designated as safety issue: No ]

Estimated Enrollment: 68
Study Start Date: October 2008
Estimated Primary Completion Date: April 2009 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • To establish the recommended dose level of anti-IGF-1R recombinant monoclonal antibody IMC-A12 and temsirolimus for the phase II study in patients with metastatic breast cancer. (Phase I)
  • To examine the safety profile of this combination in patients with metastatic breast cancer. (Phase I)
  • To assess the anti-tumor activity (in terms of overall response rate) and toxicity profile of anti-IGF-1R recombinant monoclonal antibody IMC-A12 in combination with temsirolimus in patients with metastatic breast cancer. (Phase II)

Secondary

  • To estimate the progression-free survival (PFS) and overall survival distributions (as well as the 6-month PFS rate). (Phase II)
  • To evaluate the in vivo mechanisms of action of temsirolimus in combination with anti-IGF-1R recombinant monoclonal antibody IMC-A12 and to examine potential biomarker predictors of treatment response. (Phase II)

OUTLINE: This is a multicenter study.

Patients receive temsirolimus IV over 30 minutes and anti-IGF-1R recombinant monoclonal antibody IMC-A12 IV over 60 minutes on days 1, 8, 15, and 22.

Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

Peripheral blood samples are collected periodically for circulating markers and mononuclear cells. Samples are analyzed for pharmacodynamic assessments via western blot and proteomic studies.

If pre-existing tumor tissue is available, tissue is examined by immunohistochemical staining for markers (e.g., pIRS-1, pIGF-IR, pMAPK, pAKT [S473], pS6, PTEN, Stathmin). Fluorescence in situ hybridization is used to assess IGF-IR amplification. Gene resequencing is performed to identify mutations of PIK3CA (exons 9 and 20), AKT1, and other genes. Genes IGF-1, IGF-II, IGFBP-1, IGFBP-3, and others are analyzed by reverse transcriptase-polymerase chain reaction.

After completion of study treatment, patients are followed periodically for up to 2 (phase I) or 5 (phase II) years.

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Histologically confirmed diagnosis of breast cancer

    • Metastatic or locally recurrent disease (locally recurrent disease should be stage IV [e.g., chest wall involvement])
  • 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 by conventional techniques or as ≥ 10 mm by spiral CT scan (phase II only)
  • Must have received at least 1, but no more than 2, prior chemotherapy regimens in the setting of metastatic or locally recurrent (stage IV chest wall involvement) disease (phase II only)
  • No uncontrolled brain metastases

    • Brain metastases are not permitted on study unless the metastases have been treated by surgery or radiotherapy, and the patient has been neurologically stable and off of steroids for ≥ 12 weeks

PATIENT CHARACTERISTICS:

  • ECOG performance status (PS) 0-1 OR Karnofsky PS 80-100%
  • Life expectancy > 12 weeks
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for 3 months after completion of study treatment
  • Absolute neutrophil count ≥ 1,500/μL
  • Hemoglobin ≥ 8.5 g/dL
  • Platelets ≥ 100,000/μL
  • Total bilirubin ≤ 1.5 times upper limit of normal (ULN)
  • AST and ALT ≤ 3 times ULN (5 times ULN if LFT elevations due to liver metastases)
  • Creatinine ≤ 1.5 times ULN OR creatinine clearance ≥ 60 mL/min
  • Fasting serum cholesterol ≤ 350 mg/dL (9.0 mmol/L)
  • Fasting triglycerides ≤ 400 mg/dL (4.56 mmol/L)
  • Albumin ≥ 3.4 mg/dL
  • Fasting serum glucose < 120 mg/dL
  • No baseline diabetes requiring oral hypoglycemics or insulin (phase I only)
  • No poorly controlled diabetes mellitus (phase II only)

    • Patients with a history of diabetes mellitus on oral hypoglycemics or insulin are allowed to participate, provided that their fasting blood glucose is < 120 mg/dL and that they are on a stable dietary or therapeutic regimen for this condition
  • No prior invasive non-breast malignancy, except for adequately treated basal cell or squamous cell carcinoma of the skin or other cancer from which the patient has been disease free for ≥ 5 years
  • No known hypersensitivity reactions to macrolide antibiotics (such as erythromycin, clarithromycin, and azithromycin)
  • No allergic reactions attributed to compounds of similar chemical or biologic composition to anti-IGF-1R recombinant monoclonal antibody IMC-A12 or temsirolimus
  • Known HIV-positive patients who have CD4 counts below the normal range are not eligible
  • No uncontrolled intercurrent illness including, but not limited to:

    • Ongoing or active infection
    • Symptomatic congestive heart failure
    • Unstable angina pectoris
    • Uncontrolled symptomatic cardiac arrhythmia
    • Psychiatric illness/social situations that would limit compliance with study requirements

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • No systemic anticancer therapy within the past 3 weeks
  • No radiotherapy within the past 2 weeks
  • No prior treatment with agents targeting the IGF-IR/IGFs or PI3K/Akt/mTOR pathway
  • Any number of prior therapy regimens allowed (phase I only)
  • No concurrent hormonal agents used for the treatment of breast cancer with the exception that premenopausal women who have been on a gonadotrophin-releasing hormone (GnRH) agonist and subsequently progressed may, at the discretion of the treating physician, continue on the GnRH agonist
  • No other concurrent investigational agents or herbal preparations
  • No concurrent oral corticosteroids except for replacement for adrenal insufficiency
  • No concurrent combination antiretroviral therapy for HIV-positive patients
  • No concurrent enzyme-inducing antiepileptic drugs (EIAEDs) (e.g., phenytoin, carbamazepine, phenobarbital) or any other CYP3A4 inducer such as rifampin or Hypericum perforatum (St. John's wort)
  • No other concurrent chemotherapy or radiotherapy
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00699491

Locations
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, Minnesota
Mayo Clinic Cancer Center Recruiting
Rochester, Minnesota, United States, 55905
Contact: Clinical Trials Office - All Mayo Clinic Locations     507-538-7623        
United States, Missouri
Siteman Cancer Center at Barnes-Jewish Hospital - Saint Louis Recruiting
Saint Louis, Missouri, United States, 63110
Contact: Cynthia X. Ma, MD, PhD     314-362-8903        
Sponsors and Collaborators
Mayo Clinic
Investigators
Study Chair: Cynthia X. Ma, MD, PhD Siteman Cancer Center at Barnes-Jewish Hospital - Saint Louis
Investigator: Gini F. Fleming, MD University of Chicago
  More Information

Additional Information:
No publications provided

Responsible Party: Mayo Clinic Cancer Center ( Charles Erlichman )
Study ID Numbers: CDR0000598057, MAYO-MC0736
Study First Received: June 17, 2008
Last Updated: April 14, 2009
ClinicalTrials.gov Identifier: NCT00699491     History of Changes
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
stage IV breast cancer
male breast cancer
recurrent breast cancer

Study placed in the following topic categories:
Skin Diseases
Breast Neoplasms, Male
Breast Neoplasms
Breast Cancer, Male
Breast Diseases
Recurrence

Additional relevant MeSH terms:
Neoplasms
Neoplasms by Site
Skin Diseases
Breast Neoplasms
Breast Diseases

ClinicalTrials.gov processed this record on May 07, 2009