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| ID | Type | Description | Link |
|---|---|---|---|
| P30CA068485 | U.S. NIH Grant/Contract | View source | |
| VU-VICC-BRE-0949 | |||
| IRB# 090673 |
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| Name | Class |
|---|---|
| National Cancer Institute (NCI) | NIH |
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RATIONALE: Drugs used in chemotherapy, such as cisplatin and paclitaxel, 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 and by blocking blood flow to the tumor. Giving cisplatin and paclitaxel together with everolimus may kill more tumor cells.
PURPOSE: This phase I/II trial is studying the side effects of giving cisplatin and paclitaxel together with everolimus and to see how well it works in treating patients with metastatic breast cancer.
OBJECTIVES:
Primary
Secondary
OUTLINE: This is a multicenter study.
Patients receive oral everolimus once daily on days 1-28 and cisplatin IV over 1 hour and paclitaxel IV over 1 hour on days 1, 8, and 15. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
Tumor tissue samples are collected at baseline for correlative studies.
After completion of study treatment, patients are followed up at 4 weeks.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Treatment | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| cisplatin | Drug | Given through a vein in the arm 1 time a week for 3 weeks, then a one week break and then begin the process again. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Maximum Feasible Dose in Milligrams Per Meter Squared of Body Surface Area (mg/m2) of Cisplatin and Paclitaxel for Women With Metastatic Breast Cancer | The recommended dose for the Phase II trial will be the most prevalent dose delivered per week in Phase I that allows for safe and feasible administration of the medications.The maximum tolerated dose (MTD) is defined as the dose preceding that at which 2 or more of 3 patients experience dose-limiting toxicity (DLT) during the initial cycle of therapy. DLTs include Common Toxicity Criteria (CTC) Grade 4 neutropenia (absolute neutrophil count [ANC] < 0.5 x 10 9/L for > 5 days), febrile neutropenia (ANC < 1.0 x 10 0/L with fever > 38.5 degrees Centigrade) or documented infection associated with Grade 3-4 neutropenia, CTC Grade 4 thrombocytopenia < 25 x 10 9/L or CTC Grade 3 < 50-25 x 10 9/L thrombocytopenia with bleeding, and Grade 3-4 non-hematologic toxicity despite symptomatic therapy. | at 8 weeks |
| Maximum Feasible Dose in mg of RAD001 (Everolimus)for Women With Metastatic Breast Cancer | The recommended dose for the Phase II trial will be the most prevalent dose delivered per day in Phase I that allows for safe and feasible administration the medication. The MTD is defined as the dose preceding that at which 2 or more of 3 patients experience dose-limiting toxicity (DLT) during the initial cycle of therapy. DLTs include Common Toxicity Criteria (CTC) Grade 4 neutropenia (absolute neutrophil count [ANC] < 0.5 x 10 9/L for > 5 days), febrile neutropenia (ANC < 1.0 x 10 0/L with fever > 38.5 degrees Centigrade) or documented infection associated with Grade 3-4 neutropenia, CTC Grade 4 thrombocytopenia < 25 x 10 9/L or CTC Grade 3 < 50-25 x 10 9/L thrombocytopenia with bleeding, and Grade 3-4 non-hematologic toxicity despite symptomatic therapy | at 8 weeks |
| Patients With Progression-free Survival | Patients who had not experienced disease progression and who were alive at 6 months after study entry | at 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Patients With Overall Response | Per Response Evaluation Criteria in Solid Tumor (RECIST) criteria v. 1.0: measurable lesions: complete response (CR) disappearance of target lesions, partial response (PR) > 30% decrease in the sum of the longest diameter (LD) of target lesions, progressive disease (PD) > 20% increase in the sum of the LD of target lesions or appearance of new lesions, stable disease (SD) neither sufficient decrease nor increase of the sum of smallest sum of the LD of target lesions |
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DISEASE CHARACTERISTICS:
Histologically confirmed invasive mammary carcinoma
No locally recurrent breast cancer
No symptomatic brain metastases
PATIENT CHARACTERISTICS:
Pre- or post-menopausal
European Cooperative Oncology Group (ECOG) performance status 0-1
Life expectancy ≥ 6 months
Absolute neutrophil count (ANC) ≥ 1,000/mm^3
Platelet count ≥ 100,000/mm^3
Creatinine ≤ 1.5 times upper limit of normal (ULN)
Total bilirubin ≤ 1.5 times ULN (≤ 3 times ULN in the presence of liver metastasis)
serum glutamate oxaloacetate transaminase (SGOT) and serum glutamate pyruvate transaminase (SGPT) ≤ 1.5 times ULN (≤ 3 times ULN in the presence of liver metastasis)
Alkaline phosphatase ≤ 3 times ULN (in the presence of liver metastasis)
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective barrier contraception during and for 3 months after completion of study treatment
Able to swallow and retain oral medication
No malabsorption syndrome, disease significantly affecting gastrointestinal function, or resection of the stomach or small bowel
No concurrent uncontrolled illness including, but not limited to, any of the following:
No symptomatic neuropathy ≥ grade 2
No other invasive cancer within the past 5 years except for completely resected basal cell or squamous cell carcinoma of the skin or successfully treated cervical carcinoma in situ
No hypersensitivity to paclitaxel or drugs using the vehicle Cremophor, Chinese hamster ovary cell products, or other recombinant human antibodies
No history of hepatitis B or C
PRIOR CONCURRENT THERAPY:
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| Name | Affiliation | Role |
|---|---|---|
| Ingrid Mayer, MD | Vanderbilt-Ingram Cancer Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Erlanger Cancer Center at Erlanger Hospital - Baroness | Chattanooga | Tennessee | 37403 | United States | ||
Fifty-seven patients consented for this study, two were determined ineligible to participate.
This study opened to accrual in October 2009 and ran to June 2011.
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| ID | Title | Description |
|---|---|---|
| FG000 | RAD001 and Cisplatin and Pacletaxel | RAD001 (Everolimus) by mouth once a day. Cisplatin intravenously (IV) weekly for 3 weeks, then 1 week of rest; paclitaxel IV weekly for 3 weeks, then 1 week of rest. One cycle = 4 weeks. All patients began at the same dose level of the study drugs with no de-escalation of dose, thus results for Phase I and II were combined |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | RAD001 Cisplatin Paclitaxel | RAD001 (Everolimus) by mouth once a day. Cisplatin intravenously (IV) weekly for 3 weeks, then 1 week of rest; paclitaxel IV weekly for 3 weeks, then 1 week of rest. One cycle = 4 weeks. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Maximum Feasible Dose in Milligrams Per Meter Squared of Body Surface Area (mg/m2) of Cisplatin and Paclitaxel for Women With Metastatic Breast Cancer | The recommended dose for the Phase II trial will be the most prevalent dose delivered per week in Phase I that allows for safe and feasible administration of the medications.The maximum tolerated dose (MTD) is defined as the dose preceding that at which 2 or more of 3 patients experience dose-limiting toxicity (DLT) during the initial cycle of therapy. DLTs include Common Toxicity Criteria (CTC) Grade 4 neutropenia (absolute neutrophil count [ANC] < 0.5 x 10 9/L for > 5 days), febrile neutropenia (ANC < 1.0 x 10 0/L with fever > 38.5 degrees Centigrade) or documented infection associated with Grade 3-4 neutropenia, CTC Grade 4 thrombocytopenia < 25 x 10 9/L or CTC Grade 3 < 50-25 x 10 9/L thrombocytopenia with bleeding, and Grade 3-4 non-hematologic toxicity despite symptomatic therapy. | Patients enrolled to determine the safety profile and recommended doses of cisplatin + paclitaxel + everolimus (RAD001) in women with metastatic breast cancer | Posted | Number | mg/m2 | at 8 weeks |
|
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | RAD001 and Cisplatin and Paclitaxel | RAD001 (Everolimus) by mouth once a day. Cisplatin intravenously (IV) weekly for 3 weeks, then 1 week of rest; paclitaxel IV weekly for 3 weeks, then 1 week of rest. One cycle = 4 weeks. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| pain-abdomen | Gastrointestinal disorders |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| albumin, serum-low | Metabolism and nutrition disorders |
All patients began at the same dose level of the study drugs with no de-escalation of dose, thus results were combined for outcomes measures 3, 4, 5, and 6 for Phase II.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Ingrid A. Mayer, MD | Vanderbilt-Ingram Cancer Center | 615-936-2033 | ingrid.mayer@vanderbilt.edu |
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| ID | Term |
|---|---|
| D001943 | Breast Neoplasms |
| D064726 | Triple Negative Breast Neoplasms |
| ID | Term |
|---|---|
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D001941 | Breast Diseases |
| D012871 | Skin Diseases |
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| ID | Term |
|---|---|
| D002945 | Cisplatin |
| D000068338 | Everolimus |
| D017239 | Paclitaxel |
| ID | Term |
|---|---|
| D017606 | Chlorine Compounds |
| D007287 | Inorganic Chemicals |
| D017672 | Nitrogen Compounds |
| D017671 | Platinum Compounds |
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| everolimus | Drug | Taken daily by mouth. |
|
| paclitaxel | Drug | Given through a vein in the arm 1 time a week for 3 weeks, then a one week break and then begin the process again. |
|
| laboratory biomarker analysis | Other | Blood collection |
|
| every 12 weeks |
| Time to Progression | Duration in months from date on-study to date patient exhibited progressive disease | Up to 64 weeks |
| Time to Progression in Patients With Metastatic Basal-like Breast Cancer. | Median duration in months from on-study to disease progression in patients with metastatic basal-like breast cancer. All patients with basal-like breast cancer are negative for estrogen, progesterone, and human epidermal growth factor (HER2) receptors. | Up to 64 weeks |
| West Tennessee Cancer Center at Jackson-Madison County General Hospital |
| Jackson |
| Tennessee |
| 38301 |
| United States |
| Baptist Regional Cancer Center at Baptist Riverside | Knoxville | Tennessee | 37901 | United States |
| Vanderbilt-Ingram Cancer Center | Nashville | Tennessee | 37232-6838 | United States |
| Withdrawal by Subject |
|
| Still on treatment |
|
| Participants |
|
| Age, Continuous | Mean | Standard Deviation | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| Title |
|---|
| Description |
|---|
| OG000 | RAD001 and Cisplatin and Paclitazel | Cisplatin intravenously (IV) weekly for 3 weeks, then 1 week of rest; paclitaxel IV weekly for 3 weeks, then 1 week of rest. Everolimus (RAD001) po daily. One cycle = 4 weeks |
|
|
| Primary | Maximum Feasible Dose in mg of RAD001 (Everolimus)for Women With Metastatic Breast Cancer | The recommended dose for the Phase II trial will be the most prevalent dose delivered per day in Phase I that allows for safe and feasible administration the medication. The MTD is defined as the dose preceding that at which 2 or more of 3 patients experience dose-limiting toxicity (DLT) during the initial cycle of therapy. DLTs include Common Toxicity Criteria (CTC) Grade 4 neutropenia (absolute neutrophil count [ANC] < 0.5 x 10 9/L for > 5 days), febrile neutropenia (ANC < 1.0 x 10 0/L with fever > 38.5 degrees Centigrade) or documented infection associated with Grade 3-4 neutropenia, CTC Grade 4 thrombocytopenia < 25 x 10 9/L or CTC Grade 3 < 50-25 x 10 9/L thrombocytopenia with bleeding, and Grade 3-4 non-hematologic toxicity despite symptomatic therapy | Patients enrolled to determine the safety profile and recommended dose of cisplatin + RAD001 + paclitaxel in women with metastatic breast cancer | Posted | Number | mg | at 8 weeks |
|
|
|
| Secondary | Patients With Overall Response | Per Response Evaluation Criteria in Solid Tumor (RECIST) criteria v. 1.0: measurable lesions: complete response (CR) disappearance of target lesions, partial response (PR) > 30% decrease in the sum of the longest diameter (LD) of target lesions, progressive disease (PD) > 20% increase in the sum of the LD of target lesions or appearance of new lesions, stable disease (SD) neither sufficient decrease nor increase of the sum of smallest sum of the LD of target lesions | Patients for whom an overall response could be measured. Four patients were not evaluable due to: withdrew after beginning treatment (1) and not evaluable due to only 1 cycle of treatment (3). | Posted | Number | participants | every 12 weeks |
|
|
|
| Secondary | Time to Progression | Duration in months from date on-study to date patient exhibited progressive disease | Patients who were available for determination of duration of time to progressive disease. Time to progression is unknown for 8 Phase II patients due to: on-treatment (1), toxicity (3), withdrew after beginning treatment (1), and no progression (3) | Posted | Median | Full Range | months | Up to 64 weeks |
|
|
|
| Primary | Patients With Progression-free Survival | Patients who had not experienced disease progression and who were alive at 6 months after study entry | Patient who received the study drugs. Four patients were not available for measurement of progression at 6 months: toxicity (3), withdrew after beginning treatment (1) | Posted | Number | participants | at 6 months |
|
|
|
| Secondary | Time to Progression in Patients With Metastatic Basal-like Breast Cancer. | Median duration in months from on-study to disease progression in patients with metastatic basal-like breast cancer. All patients with basal-like breast cancer are negative for estrogen, progesterone, and human epidermal growth factor (HER2) receptors. | Patients who are negative for estrogen, progesterone and HER2 receptors. Time to progression was not determined for 5 patients in this group: toxicity (2), withdrew after beginning treatment (1), no progression (1), and on-treatment (1). | Posted | Median | Full Range | months | Up to 64 weeks |
|
|
|
| 9 |
| 55 |
| 55 |
| 55 |
| death not associated with CTCAE term-disease progression NOS | General disorders |
|
| Left maxillary odontogenic abscess and cellulitis | Infections and infestations |
|
| glucose, serum-low (hypoglycemia) | Metabolism and nutrition disorders |
|
| pain-back | Musculoskeletal and connective tissue disorders |
|
| neutrophils | Blood and lymphatic system disorders |
|
| leukocytes | Blood and lymphatic system disorders |
|
| platelets | Blood and lymphatic system disorders |
|
| cholecystitis | Hepatobiliary disorders |
|
| malignant pleural effusion | Respiratory, thoracic and mediastinal disorders |
|
| dyspnea | Respiratory, thoracic and mediastinal disorders |
|
| infection with unknown ANC-mucosititis | Infections and infestations |
|
| infection with unknown ANC-wound, methicillin-resistant Staphylococcus aureus | Infections and infestations |
|
| febrile neutropenia, ANC < 1.0 x 10e9L, fever ≥ 38.5 degrees Celsius | Blood and lymphatic system disorders |
|
| fever in absence of neutropenia w/ neutropenia defined as ANC < 1.0 x 10e9L | General disorders |
|
| diarrhea | Gastrointestinal disorders |
|
| nausea | Gastrointestinal disorders |
|
| vomiting | Gastrointestinal disorders |
|
| thromboembolism (vascular access-related) | Vascular disorders |
|
| enteritis, small bowel | Gastrointestinal disorders |
|
| edema, facial | General disorders |
|
| infection with unknown ANC-urinary tract NOS | Renal and urinary disorders |
|
| calcium, serum-high (hypercalcemia) | Metabolism and nutrition disorders |
|
| hydrocephalus | Nervous system disorders |
|
| pain-headache | Nervous system disorders |
|
| ventricular tachycardia | Cardiac disorders |
|
| pain-right-sided thorax (non-cardiac) | Respiratory, thoracic and mediastinal disorders |
|
| cough | Respiratory, thoracic and mediastinal disorders |
|
| pneumonia | Respiratory, thoracic and mediastinal disorders |
|
| anemia | Blood and lymphatic system disorders |
|
| thrombocytopenia | Blood and lymphatic system disorders |
|
| alkaline phosphatase | Investigations |
|
| allergic reaction\hypersensitivity (including drug fever) | Immune system disorders |
|
| allergy/immunology-other | Immune system disorders |
|
| ALT, SGPT (serum glutamic pyruvic transaminase) | Metabolism and nutrition disorders |
|
| anorexia | Metabolism and nutrition disorders |
|
| AST, SGOT (serum glutamic oxaloacetic transaminase) | Metabolism and nutrition disorders |
|
| calcium, serum-high (hypercalcemia) | Metabolism and nutrition disorders |
|
| cholesterol, serum-high (hypercholesteremia | Investigations |
|
| constipation | Gastrointestinal disorders |
|
| constitutional symptoms-other | General disorders |
|
| cough | Respiratory, thoracic and mediastinal disorders |
|
| creatinine | Investigations |
|
| dermatology/skin-other | Skin and subcutaneous tissue disorders |
|
| diarrhea | Gastrointestinal disorders |
|
| dizziness | Gastrointestinal disorders |
|
| dyspnea | Respiratory, thoracic and mediastinal disorders |
|
| edema limb | General disorders |
|
| fatigue | General disorders |
|
| gastrointestinal-other | Gastrointestinal disorders |
|
| glucose, serum-high (hyperglycemia) | Metabolism and nutrition disorders |
|
| hair loss/alopecia (scalp or body) | Skin and subcutaneous tissue disorders |
|
| heartburn/dyspepsia | Gastrointestinal disorders |
|
| hemoglobin | Blood and lymphatic system disorders |
|
| hemorrhage, pumonary/upper respiratory-nose | Respiratory, thoracic and mediastinal disorders |
|
| infection-other | Infections and infestations |
|
| infection with normal ANC or grade 1 or 2 neutrophils-urinary tract NOS | Renal and urinary disorders |
|
| insomnia | Psychiatric disorders |
|
| leukocytes (total WBC) | Blood and lymphatic system disorders |
|
| nausea | Gastrointestinal disorders |
|
| neurology-other | Nervous system disorders |
|
| neuropathy-sensory | Nervous system disorders |
|
| neutrophils/granulocytes (ANC/AGC) | Blood and lymphatic system disorders |
|
| pain back | Musculoskeletal and connective tissue disorders |
|
| pain-breast | Reproductive system and breast disorders |
|
| pain-chest wall | Musculoskeletal and connective tissue disorders |
|
| pain-extremity-limb | Musculoskeletal and connective tissue disorders |
|
| pain-head/headache | Nervous system disorders |
|
| pain-other | General disorders |
|
| platelets | Blood and lymphatic system disorders |
|
| potassium-serum-low (hypokalemia) | Metabolism and nutrition disorders |
|
| pulmonary/upper respiratory-other | Respiratory, thoracic and mediastinal disorders |
|
| rash acne/acneiform | Skin and subcutaneous tissue disorders |
|
| sodium, serum-low (hyponatremia) | Metabolism and nutrition disorders |
|
| taste alteration (dysgeusia) | Nervous system disorders |
|
| tinnitus | Ear and labyrinth disorders |
|
| triglyceride, serum-high (hypertriglyceridemia) | Metabolism and nutrition disorders |
|
| vomiting | Gastrointestinal disorders |
|
| pain-joint | Musculoskeletal and connective tissue disorders |
|
| magnesium, serum-low (hypomagnesemia) | Metabolism and nutrition disorders |
|
| metabolic/laboratory-other | Metabolism and nutrition disorders |
|
| blood/bone marrow-other | Blood and lymphatic system disorders |
|
| calcium, serum-low (hypocalcemia) | Metabolism and nutrition disorders |
|
| potassium, serum-high (hyperkalemia) | Metabolism and nutrition disorders |
|
| mucositis/stomatitis (clinical exam)-oral cavity | Gastrointestinal disorders |
|
| mucositis/stomatitis (functional/symptomatic)-oral cavity | Gastrointestinal disorders |
|
| nail changes | Skin and subcutaneous tissue disorders |
|
| pruritis/itching | Skin and subcutaneous tissue disorders |
|
| rash/desquamation | Skin and subcutaneous tissue disorders |
|
| depression | Psychiatric disorders |
|
| infection with normal ANC or Grade 1 or 2 neutrophils-nails | Infections and infestations |
|
| infection with normal ANC or Grade 1 or 2 neutrophils-upper airway NOS | Infections and infestations |
|
| lymphatics-other | Blood and lymphatic system disorders |
|
| Pain-neck | Musculoskeletal and connective tissue disorders |
|
| pain-abdomen NOS | Gastrointestinal disorders |
|
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| D017437 |
| Skin and Connective Tissue Diseases |
| D020123 |
| Sirolimus |
| D018942 | Macrolides |
| D007783 | Lactones |
| D009930 | Organic Chemicals |
| D043823 | Taxoids |
| D043822 | Cyclodecanes |
| D003516 | Cycloparaffins |
| D006840 | Hydrocarbons, Alicyclic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D004224 | Diterpenes |
| D013729 | Terpenes |
| Title | Measurements |
|---|---|
|
| Stable Disease |
|