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| ID | Type | Description | Link |
|---|---|---|---|
| 2011-002562-20 | EudraCT Number |
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The investigators hypothesize that certain mutations in the individual cancer genomes will predict response to Everolimus therapy. To identify possible genetic mutations that affect tumor response to Everolimus the investigators will obtain sequence analysis of tumors from all patients that will be treated with Everolimus in this study. Moreover, the investigators performed a systematic review of the currently available data to identify mutations that could be predictive for increased mTOR activity in cancer cells. These mutations have been described to lead to mTOR activation but their predictive value for response to Everolimus therapy remains unclear. The investigators will use the data generated in the investigators own prospective treatment study and the data from literature to select patients for entry into a second part of this trial. In this part the investigators want to test the hypothesis that selecting patients based on their specific genetic mutations increases the likelihood of response.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| everolimus | Other | All patients in first part will receive everolimus 10mg q.d. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Everolimus | Drug | All patients will receive everolimus 10mg q.d. |
|
| Measure | Description | Time Frame |
|---|---|---|
| analyse a set of 1951 genes for prediction of response measured by time to progression (TTP) ratio (defined as the TTP without drug: TTP on drug) on mTOR inhibition. | Inclusion until earliest date of disease progression (defined as a 30% volumetric increase in tumorvolume or appearance of new lesions) | An expected average of 5 months |
| Measure | Description | Time Frame |
|---|---|---|
| Progression free survival | Time from initiation of everolimus to, either radiological (RECIST 1.1) or clinical disease progression or death from any cause. | An expected average of 4 months |
| Disease control rate (DCR) |
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Inclusion Criteria:
Exclusion Criteria:
Previous treatment with mTOR inhibitors/pi3k inhibitors/AKT inhibitors
Uncontrolled hypertension defined as RR > 160/95 mmHg
Serious non-healing wound, ulcer or bone fracture
Within 7 days of surgery (including minor procedures)
Known and/or symptomatic intracerebral metastases
Pregnancy or breast feeding, reproductive potential not using effective birth control methods
Severe medical condition(s) prohibiting participation in the study
Use of other investigational agents now or last 28 days prior to study treatment start
Unable or unwilling to discontinue use of interacting medications or modify the dosing of interacting drugs for at least 14 days or five half-lives of a drug (whichever is longer) prior to the first dose of study drug and for the duration of the study
Less than four weeks after regular treatment/ palliative radiotherapy
Prolongation of Fridericia corrected QT interval (QTcF) > 480 milliseconds
Any severe and / or uncontrolled medical conditions such as:
Active, bleeding diathesis, or on oral anti-vitamin K medication (except low dose warfarin and acetylsalicylic acid or equivalent, as long as the INR is < 2.0)
Patients with a known history of HIV seropositivity
Patients being treated with drugs recognized as being strong inhibitors or inducers of the isoenzyme CYP3A within the last 5 days prior to enrollment
Patients receiving concomitant immunosuppressive agents or chronic corticosteroids use, at the time of study entry except in cases outlined below:
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| Name | Affiliation | Role |
|---|---|---|
| M.H.G. Langenberg, MD/PhD | UMC Utrecht | Principal Investigator |
| N. Steeghs, MD/PhD | NKI-AvL | Principal Investigator |
| M.J.A. de Jonge, MD/PhD | Erasmus Medical Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| NKI-AVL | Amsterdam | North Holland | 1066 CX | Netherlands | ||
| Erasmus Medical Center |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 27234642 | Derived | Cirkel GA, Weeber F, Bins S, Gadellaa-van Hooijdonk CG, van Werkhoven E, Willems SM, van Stralen M, Veldhuis WB, Ubink I, Steeghs N, de Jonge MJ, Langenberg MH, Schellens JH, Sleijfer S, Lolkema MP, Voest EE. The time to progression ratio: a new individualized volumetric parameter for the early detection of clinical benefit of targeted therapies. Ann Oncol. 2016 Aug;27(8):1638-43. doi: 10.1093/annonc/mdw223. Epub 2016 May 27. |
| Label | URL |
|---|---|
| Related Info | View source |
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| ID | Term |
|---|---|
| D000068338 | Everolimus |
| ID | Term |
|---|---|
| D020123 | Sirolimus |
| D018942 | Macrolides |
| D007783 | Lactones |
| D009930 | Organic Chemicals |
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Disease control rate (DCR) (DC = CR or PR or SD) as defined by RECIST 1.1 3 months after initiation of Everolimus.
| At 3 months after initiation of everolimus |
| Toxicity | Toxicity will be assessed according to the Common Toxicity Criteria for Adverse Events (CTCAE) version v4.03: June 14, 2010 | An expected average of 6 months |
| Median overall survival | The (median) time from initiation of Everolimus to time of death or censored at the date of last follow-up. First analysis of overall survival will be performed within one year after inclusion of last subject. | An expected average of one year |
| Rotterdam |
| South Holland |
| 3075 EA |
| Netherlands |
| University Medical Center Utrecht | Utrecht | 3584 CX | Netherlands |