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Sorafenib and Fulvestrant in Treating Patients With Locally Advanced or Metastatic Breast Cancer That Did Not Respond to Aromatase Inhibitor Therapy
This study is currently recruiting participants.
Verified by National Cancer Institute (NCI), January 2009
First Received: July 24, 2008   Last Updated: April 2, 2009   History of Changes
Sponsors and Collaborators: Oregon Health and Science University
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00722072
  Purpose

RATIONALE: Sorafenib 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.

Estrogen can cause the growth of breast cancer cells. Hormone therapy using fulvestrant may fight breast cancer by blocking the use of estrogen by the tumor cells. Giving sorafenib together with fulvestrant may kill more tumor cells.

PURPOSE: This phase II trial is studying how well giving sorafenib together with fulvestrant works in treating patients with locally advanced or metastatic breast cancer that did not respond to aromatase inhibitor therapy.


Condition Intervention Phase
Breast Cancer
Drug: fulvestrant
Drug: sorafenib tosylate
Phase II

Genetics Home Reference related topics: breast cancer
MedlinePlus related topics: Breast Cancer Cancer
Drug Information available for: Ici 182780 Sorafenib Sorafenib tosylate
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Open Label
Official Title: A Phase II Open-Label Study of Sorafenib Plus Fulvestrant as Salvage Therapy for Hormone Receptor Positive Metastatic Breast Cancer Failing Prior Aromatase Inhibitor Treatment

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

Primary Outcome Measures:
  • Progression-free survival rate at 4 months [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Objective response rate [ Designated as safety issue: No ]
  • Time to progression [ Designated as safety issue: No ]
  • Progression-free survival [ Designated as safety issue: No ]
  • Overall survival [ Designated as safety issue: No ]
  • Safety and tolerability profile [ Designated as safety issue: Yes ]

Estimated Enrollment: 43
Study Start Date: July 2008
Estimated Primary Completion Date: July 2010 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • To investigate the clinical activity of sorafenib tosylate and fulvestrant, as determined by a 4-month progression-free survival rate, in patients with hormone receptor-positive locally advanced or metastatic breast cancer that progressed after prior treatment with an aromatase inhibitor.

Secondary

  • To determine the objective response rate in patients treated with this regimen.
  • To determine the median time to progression in patients treated with this regimen.
  • To determine the progression-free survival of patients treated with this regimen.
  • To determine the overall survival of patients treated with this regimen.
  • To establish the safety and tolerability profile of this regimen in these patients.

OUTLINE: Patients receive oral sorafenib tosylate twice daily on days 1-28. Patients also receive fulvestrant intramuscularly on days 1 and 15 of course

1 and on day 1 of all subsequent courses. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed at 28-56 days.

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Diagnosis of incurable breast cancer

    • Locally advanced or metastatic disease
  • Measurable or evaluable disease

    • Measurable disease is defined as ≥ 1 unidimensionally measurable lesion ≥ 20 mm by conventional techniques or ≥ 10 mm by spiral CT scan

      • Bone-only metastases that can be imaged with bone scan AND MRI or bone scan AND plain x-ray is considered measurable disease
      • Tumor lesions that are situated in a previously irradiated area are considered measurable only if they are progressing at the time of study entry
    • Evaluable disease includes unresectable skin/chest wall metastases that can be photographed and whose size can be measured with a ruler

      • Bone-only metastases that can only be imaged using bone scan or malignant pleural effusion(s) only are not considered evaluable disease
  • Previously treated with a third-generation aromatase inhibitor (e.g., letrozole, anastrazole, or exemestane) AND meets one of the following criteria:

    • Progressed during palliative aromatase inhibitor therapy
    • Recurred during adjuvant aromatase inhibitor therapy
    • Recurred within 12 months of completing adjuvant aromatase inhibitor therapy
  • HER2/neu-negative tumor

    • No HER2/neu overexpression (i.e., tumor staining 3+ by IHC or gene amplified by FISH)
  • Hormone receptor status:

    • Estrogen receptor and/or progesterone receptor positive, defined as ≥ 10% of malignant cells with positive nuclear staining

PATIENT CHARACTERISTICS:

  • Postmenopausal
  • ECOG performance status 0-1
  • Life expectancy ≥ 16 weeks
  • Neutrophil count ≥ 1,500/mm³
  • Platelet count ≥ 100,000/mm³
  • Hemoglobin ≥ 9.0 g/dL
  • Creatinine < 2 mg/dL
  • Total bilirubin ≤ 1.5 times upper limit of normal (ULN)
  • ALT and AST ≤ 2.5 times ULN (≤ 5 times ULN for patients with liver involvement)
  • INR < 1.5 OR PT/PTT normal
  • LVEF normal by MUGA or ECHO
  • No known allergy to sorafenib tosylate or fulvestrant
  • No cardiac disease, including any of the following:

    • NYHA class III-IV congestive heart failure
    • Unstable angina (anginal symptoms at rest) or new-onset angina (within the past 3 months)
    • Myocardial infarction within the past 6 months
    • Cardiac ventricular arrhythmias requiring anti-arrhythmic therapy
  • No uncontrolled hypertension, defined as systolic blood pressure > 150 mm Hg or diastolic blood pressure > 90 mm Hg despite optimal medical management
  • No thrombotic or embolic events, such as cerebrovascular accident (including transient ischemic attacks), within the past 6 months
  • No known HIV infection or chronic hepatitis B or C infection
  • No infection that requires IV antibiotics or produces a fever > 100°F within the past 72 hours
  • No pulmonary hemorrhage/bleeding event ≥ CTCAE grade 2 within the past 4 weeks
  • No other hemorrhage/bleeding event ≥ CTCAE grade 3 within the past 4 weeks
  • No evidence or history of bleeding diathesis or coagulopathy
  • No significant traumatic injury within the past 2 weeks
  • No serious, nonhealing wound, ulcer, or bone fracture
  • No condition that impairs the patient's ability to swallow whole pills
  • No malabsorption problem
  • No second malignancy within the past 5 years, except adequately treated and cured basal cell or squamous cell skin cancer or carcinoma in situ of the cervix
  • No underlying medical condition that, in the principal investigator's opinion, will make the administration of study drug hazardous or would obscure the interpretation of adverse events

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • No prior chemotherapy for metastatic or unresectable locally advanced breast cancer
  • No prior sorafenib tosylate or other VEGF-targeting therapies
  • More than 2 weeks since prior major surgery or open biopsy
  • No concurrent anticoagulation with warfarin or heparin
  • No concurrent Hypericum perforatum (St. John wort) or rifampin
  • No other concurrent anticancer agents, including chemotherapy or biological therapy
  • No other concurrent investigational drugs
  • Concurrent bisphosphonates allowed
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00722072

Locations
United States, Oregon
Knight Cancer Institute at Oregon Health and Science University Recruiting
Portland, Oregon, United States, 97239-3098
Contact: Clinical Trials Office - Knight Cancer Institute at Oregon Hea     503-494-1080     trials@ohsu.edu    
Sponsors and Collaborators
Oregon Health and Science University
Investigators
Principal Investigator: Stephen Chui, MD Oregon Health and Science University
  More Information

Additional Information:
No publications provided

Responsible Party: Knight Cancer Institute at Oregon Health and Science University ( Stephen Chui )
Study ID Numbers: CDR0000601002, OHSU-4318, BAYER-OHSU-4318
Study First Received: July 24, 2008
Last Updated: April 2, 2009
ClinicalTrials.gov Identifier: NCT00722072     History of Changes
Health Authority: Unspecified

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

Study placed in the following topic categories:
Estrogens
Estrogen Antagonists
Antineoplastic Agents, Hormonal
Skin Diseases
Hormone Antagonists
Hormones, Hormone Substitutes, and Hormone Antagonists
Fulvestrant
Breast Neoplasms
Breast Cancer, Male
Protein Kinase Inhibitors
Hormones
Recurrence
Estrogen Receptor Modulators
Breast Neoplasms, Male
Aromatase Inhibitors
Sorafenib
Breast Diseases

Additional relevant MeSH terms:
Estrogen Antagonists
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents, Hormonal
Skin Diseases
Antineoplastic Agents
Hormone Antagonists
Physiological Effects of Drugs
Hormones, Hormone Substitutes, and Hormone Antagonists
Fulvestrant
Breast Neoplasms
Enzyme Inhibitors
Protein Kinase Inhibitors
Pharmacologic Actions
Estrogen Receptor Modulators
Neoplasms
Neoplasms by Site
Therapeutic Uses
Aromatase Inhibitors
Sorafenib
Breast Diseases

ClinicalTrials.gov processed this record on May 07, 2009