| ID | Type | Description | Link |
|---|---|---|---|
| MSKCC-06129 |
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| Name | Class |
|---|---|
| National Cancer Institute (NCI) | NIH |
RATIONALE: Drugs used in chemotherapy, such as cisplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Everolimus may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Everolimus may also help cisplatin work better by making tumor cells more sensitive to the drug. Giving cisplatin together with everolimus may kill more tumor cells.
PURPOSE: This phase I trial is studying the side effects and best dose of everolimus when given together with cisplatin in treating patients with advanced solid tumors or recurrent or metastatic solid tumors.
OBJECTIVES:
Primary
Secondary
OUTLINE: This is a dose-escalation study of everolimus (part A) followed by a biological marker study (part B).
Cohorts of 3-6 patients receive escalating doses of everolimus until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose proceeding that at which 2 of 6 patients experience dose-limiting toxicity (DLT) during course 1. The recommended phase II dose is defined as the dose at which 1 of 6 patients experience DLT during course 1.
Blood is drawn periodically on days 1 and 8 of course 1 for pharmacokinetic studies.
Patients undergo another tumor biopsy on day 15 of course 1, before receiving chemotherapy. The pre- and post-therapy tissue is examined by immunochemistry and analyzed for p53 and p21 expression.
PROJECTED ACCRUAL: A total of 30 people will be accrued for this study.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| cisplatin & RAD001 | Experimental | This will be a single institution phase I study of low dose weekly cisplatin (20 mg/m2 intravenously on Days 1, 8, and 15) plus escalating doses of daily RAD001 tablets (per oral or via percutaneous gastrostomy tube, Days 1 -21 of a 28-Day Cycle) for patients with advanced solid tumors |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| cisplatin | Drug | cisplatin (20 mg/m2 intravenously on Days 1, 8, and 15) |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Recommended phase II dose of everolimus | 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| Pharmacokinetic profile of cisplatin and everolimus | 1 year | |
| Pharmacodynamic profile of cisplatin and everolimus | 1 year |
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DISEASE CHARACTERISTICS:
Histologically confirmed diagnosis of 1 of the following:
Advanced solid tumor (part A)
Solid tumor (part B)
Measurable disease
No uncontrolled brain or leptomeningeal metastases
PATIENT CHARACTERISTICS:
Karnofsky performance status 70-100%
Absolute neutrophil count ≥ 1,500/mm³
Platelet count ≥ 100,000/mm³
Hemoglobin > 10 g/dL
Bilirubin ≤ 1.5 times upper limit of normal (ULN)
AST and ALT ≤ 2.5 times ULN (< 5 times ULN if liver metastases are present)
Creatinine normal OR creatinine clearance ≥ 55 mL/min
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception during and for at least 3 months after completion of study therapy
No HIV positivity
No peripheral neuropathy ≥ grade 2
No hypertriglyceridemia ≥ grade 2
No impaired gastrointestinal function or gastrointestinal disease that may alter the absorption of everolimus, including any of the following:
No other concurrent severe and/or uncontrolled medical disease that would compromise study participation, including any of the following:
PRIOR CONCURRENT THERAPY:
No more than 3 prior cytotoxic chemotherapy regimens for recurrent or metastatic disease
At least 4 weeks since prior major surgery and recovered
At least 4 weeks since prior radiation therapy and recovered
At least 4 weeks since prior systemic anticancer therapy and recovered
At least 4 weeks since prior and no other concurrent investigational drugs
No prior everolimus or other agents specifically targeting mTOR
No prior radiation therapy to > 25% of the bone marrow
No prior radiation therapy to the whole pelvis and/or brain
No concurrent chronic steroid treatment (> 5 mg/day of prednisone)
No concurrent immunosuppressive agents
No other concurrent anticancer agents
No concurrent agents known to be strong inhibitors or inducers of isoenzyme CYP3A
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| Name | Affiliation | Role |
|---|---|---|
| Matthew G. Fury, MD, PhD | Memorial Sloan Kettering Cancer Center | Principal Investigator |
| David G. Pfister, MD | Memorial Sloan Kettering Cancer Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Memorial Sloan-Kettering Cancer Center | New York | New York | 10065 | United States |
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| everolimus |
| Drug |
escalating doses of daily RAD001 tablets (per oral or via percutaneous gastrostomy tube, Days 1 -21 of a 28-Day Cycle) |
|
| gene expression analysis | Genetic | Each biopsy specimen will be formalin-fixed and paraffin-embedded for IHC, and analysis of p53 and p21 will follow methods previous reported by our group. The avidin-biotin immunoperoxidase technique will be employed. |
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| immunohistochemistry staining method | Other | After the phase 2 recommended dose is established in the phase I portion of the study (Part A), we plan to enroll an additional 6 patients for pharmacodynamic studies (Part B). Entry into Part B requires the patient have tumor tissue which is easily accessible for research biopsy. The patients will be asked to provide written informed consent for the research biopsies. Patients also will be asked to provide written informed consent to allow the use of their tissue for future research studies. The research biopsies are not mandatory for any patient. Patients who do not consent to the research biopsies or who withdraw consent for the research biopsies may still receive RAD001 + cisplatin in the study |
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| laboratory biomarker analysis | Other | Laboratory data (complete blood count, comprehensive metabolic panel including magnesium) regarding adverse events will be collected on each cisplatin treatment day. Additional adverse event data will be collected at regularly scheduled clinic visits at which history and physical are performed by the investigator (Cycle 1 - Days 1, 8, 15, and 21. Cycle 2 - Days 1 and 15. Cycle 3 and beyond - Day 1) |
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| pharmacological study | Other | For patients in Part A, research bloods for pharmacokinetics are drawn on Day 1 and Day 8. |
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| biopsy | Procedure | "Pre-treatment Research Biopsy:" Within 14 days prior to treatment, research biopsy (of primary tumor, metastatic deposit, or involved lymph node) will be performed. Baseline labs should be drawn within 14 days of the research biopsy. The biopsy sample will be formalin-fixed and paraffin-embedded for immunohistochemistry. Post-treatment Research Biopsy:" Research biopsy (of primary tumor, metastatic deposit, or involved lymph node) will be requested again for Day 15 of Cycle 1, prior to administration of RAD001 and cisplatin on that day. |
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| ID | Term |
|---|---|
| D002945 | Cisplatin |
| D000068338 | Everolimus |
| D020869 | Gene Expression Profiling |
| D007150 | Immunohistochemistry |
| D001706 | Biopsy |
| ID | Term |
|---|---|
| D017606 | Chlorine Compounds |
| D007287 | Inorganic Chemicals |
| D017672 | Nitrogen Compounds |
| D017671 | Platinum Compounds |
| D020123 | Sirolimus |
| D018942 | Macrolides |
| D007783 | Lactones |
| D009930 | Organic Chemicals |
| D005821 | Genetic Techniques |
| D008919 | Investigative Techniques |
| D006651 | Histocytochemistry |
| D003584 | Cytological Techniques |
| D019411 | Clinical Laboratory Techniques |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
| D006652 | Histological Techniques |
| D007158 | Immunologic Techniques |
| D003581 | Cytodiagnosis |
| D013048 | Specimen Handling |
| D003949 | Diagnostic Techniques, Surgical |
| D013514 | Surgical Procedures, Operative |
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