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Everolimus and Whole-Brain Radiation Therapy in Treating Patients With Brain Metastasis From Non-Small Cell Lung Cancer
This study is not yet open for participant recruitment.
Verified by National Cancer Institute (NCI), April 2009
First Received: May 2, 2009   No Changes Posted
Sponsors and Collaborators: Vanderbilt-Ingram Cancer Center
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00892801
  Purpose

RATIONALE: Everolimus 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.

Radiation therapy uses high-energy x-rays to kill tumor cells. Giving everolimus together with whole-brain radiation therapy may kill more tumor cells.

PURPOSE: This phase I/II trial is studying the side effects and best dose of everolimus and to see how well it works when given together with whole-brain radiation therapy in treating patients with brain metastasis from non-small cell lung cancer.


Condition Intervention Phase
Brain and Central Nervous System Tumors
Lung Cancer
Drug: everolimus
Radiation: whole-brain radiation therapy
Phase I
Phase II

MedlinePlus related topics: Cancer Lung Cancer Radiation Therapy
Drug Information available for: Everolimus
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Open Label
Official Title: A Phase I/II Study of RAD001 and Radiation Therapy in Patients With Brain Metastasis From Non-Small Cell Lung Cancer (NSCLC)

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

Primary Outcome Measures:
  • Safety, as assessed by the rate of ≥ grade 3 hematological and non-hematologic toxicities (phase I) [ Designated as safety issue: Yes ]
  • Median survival (phase II) [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Intracranial response rate (phase II) [ Designated as safety issue: No ]
  • Time to CNS (neurologic) progression (phase II) [ Designated as safety issue: No ]
  • Time to systemic non-CNS progression (phase II) [ Designated as safety issue: No ]

Estimated Enrollment: 62
Study Start Date: April 2009
Estimated Primary Completion Date: January 2014 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • To determine the maximum-tolerated dose of everolimus when combined concurrently with whole-brain radiotherapy in patients with brain metastasis from stage IV non-small cell lung cancer. (Phase I)
  • To evaluate the median survival of these patients treated with this regimen. (Phase II)

Secondary

  • To assess the response rates in these patients. (Phase II)
  • To assess the safety and tolerability of this regimen in these patients. (Phase II)
  • To determine time to CNS (neurological) progression, confirmed by MRI, in these patients. (Phase II)
  • To determine time to systemic (non-CNS) progression in these patients. (Phase II)

OUTLINE: This is a multicenter, dose-escalation study of everolimus.

Patients undergo 10 fractions of whole-brain radiotherapy (WBRT) beginning on day 0, 5 days per week, and receive oral everolimus once daily on days -1 to 13. Beginning 2 weeks after completion of WBRT, patients receive oral everolimus once daily for 28 days in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed every 2 months for 2 years.

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Radiographically confirmed brain metastases with histopathologically confirmed primary non-small cell lung cancer that will benefit from whole-brain radiotherapy
  • Must have ≥ 1 measurable intracranial site of disease, according to RECIST criteria, that has not been previously treated with stereotactic radiation
  • Must have stable extracranial disease for 4 weeks

PATIENT CHARACTERISTICS:

  • ECOG performance status 0-2
  • Life expectancy ≥ 12 weeks
  • ANC > 1,500/mm³
  • Platelets > 100,000/mm³
  • Hemoglobin > 11 g
  • BUN ≤ 25 mg
  • Serum creatinine < 1.5 times upper limit of normal (ULN)
  • Serum bilirubin ≤ 1.5 times ULN
  • Serum transaminases ≤ 2 times ULN (< 5 times ULN if patient has liver metastases)
  • Cholesterol ≤ 300 mg/dL
  • Triglycerides ≤ 2.5 times ULN
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for ≥ 3 months after completion of study treatment
  • No other malignancies within the past 3 years, except for adequately treated carcinoma in situ of the cervix or basal or squamous cell carcinomas of the skin
  • No severe and/or uncontrolled medical conditions or other conditions that could affect participation in the study, including any of the following:

    • Unstable angina pectoris, symptomatic congestive heart failure, myocardial infarction within the past 6 months, or serious uncontrolled cardiac arrhythmia
    • Severely impaired lung function (i.e., FEV1 < 0.8 cc)
    • Uncontrolled diabetes as defined by fasting serum glucose ≥ 1.5 times ULN
    • Any active (acute or chronic) or uncontrolled infection/disorders
    • Non-malignant medical illnesses that are uncontrolled or whose control may be jeopardized by the treatment with the study therapy
    • Liver disease, such as cirrhosis, chronic active hepatitis, or chronic persistent hepatitis
  • No known history of HIV seropositivity
  • No impairment of gastrointestinal function or gastrointestinal disease that may significantly alter the absorption of everolimus (e.g., ulcerative disease, uncontrolled nausea, vomiting, diarrhea, malabsorption syndrome, or small bowel resection)
  • No active, bleeding diathesis
  • No known hypersensitivity to everolimus or other rapamycin (i.e., sirolimus, temsirolimus) or to its excipients
  • No history of noncompliance to medical regimens

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • Recovered from the acute toxicities of any prior therapy
  • Prior surgical resection of a brain metastasis allowed

    • The extent of surgical resection in patients having prior resection of 1 of multiple metastases shall be documented as a biopsy, subtotal resection, or total resection as described by the operative report and/or post-operative imaging
  • At least 3 weeks since prior major surgery or completion of extracranial radiation
  • At least 3 weeks since prior and no concurrent systemic anticancer therapy, other than the study medications administered as part of this study protocol
  • At least 6 weeks since prior nitrosoureas
  • More than 1 week since prior and no concurrent immunization with attenuated live vaccines
  • More than 3 weeks since prior chemotherapy
  • No prior brain radiotherapy of any form
  • No concurrent chronic treatment with systemic steroids or other immunosuppressive agents, except steroids for neurological stability following the diagnosis of brain metastases
  • No prior treatment with an mTOR inhibitor
  • No concurrent anti-vitamin K medication, except low dose coumarin
  • No concurrent drugs or substances known to be inhibitors or inducers of the isoenzyme CYP3A
  • No other concurrent investigational therapy
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00892801

Sponsors and Collaborators
Vanderbilt-Ingram Cancer Center
Investigators
Principal Investigator: Bo Lu, MD, PhD Vanderbilt-Ingram Cancer Center
  More Information

Additional Information:
No publications provided

Responsible Party: Vanderbilt-Ingram Cancer Center ( Bo Lu )
Study ID Numbers: CDR0000641751, VU-VICC-THO-0772, IRB#090314
Study First Received: May 2, 2009
Last Updated: May 2, 2009
ClinicalTrials.gov Identifier: NCT00892801     History of Changes
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
adult tumors metastatic to brain
recurrent non-small cell lung cancer
stage IV non-small cell lung cancer

Study placed in the following topic categories:
Thoracic Neoplasms
Everolimus
Immunologic Factors
Central Nervous System Neoplasms
Immunosuppressive Agents
Recurrence
Carcinoma
Respiratory Tract Diseases
Lung Neoplasms
Lung Diseases
Neoplasm Metastasis
Non-small Cell Lung Cancer
Carcinoma, Non-Small-Cell Lung
Nervous System Neoplasms
Neoplasms, Glandular and Epithelial

Additional relevant MeSH terms:
Everolimus
Thoracic Neoplasms
Respiratory Tract Neoplasms
Neoplasms by Histologic Type
Immunologic Factors
Physiological Effects of Drugs
Nervous System Diseases
Central Nervous System Neoplasms
Immunosuppressive Agents
Pharmacologic Actions
Carcinoma
Neoplastic Processes
Neoplasms
Pathologic Processes
Neoplasms by Site
Respiratory Tract Diseases
Lung Neoplasms
Lung Diseases
Neoplasm Metastasis
Carcinoma, Non-Small-Cell Lung
Nervous System Neoplasms
Neoplasms, Glandular and Epithelial

ClinicalTrials.gov processed this record on May 07, 2009