A Phase I/II Trial to Assess the Tolerability of RAD 001 With Gefitinib in Patients With Glioblastoma Multiforme and Prostate Cancer and Efficacy in Patients With Castrate Metastatic Prostate Cancer
everolimus
+ gefitinib
Maladies génito-urinaires+19
+ Maladies Génitales
+ Astrocytome
Étude thérapeutique
Résumé
Date de début de l'étude : 1 mars 2004
Date à laquelle le premier participant a commencé l'étude.OBJECTIVES: Primary * Determine the maximum tolerated dose of everolimus when given in combination with gefitinib in patients with progressive glioblastoma multiforme or (progressive castrate metastatic prostate cancer -closed to accrual as of 10/19/2006). (Phase I) * Determine the safety and efficacy of this regimen in patients with progressive glioblastoma multiforme or (progressive castrate metastatic prostate cancer - closed to accrual as of 10/19/2006). (Phase II) Secondary * Determine whether a pharmacokinetic interaction exists between everolimus and gefitinib in patients treated with this regimen. * Determine the association between clinical outcomes and markers that may predict sensitivity of a tumor in patients treated with this regimen. * Determine the pharmacodynamic effects of this regimen on post-therapy tumor specimens and peripheral blood mononuclear cells from these patients. OUTLINE: This is a phase I, open-label, non-randomized, dose-escalation study of everolimus followed by a phase II study. * Phase I: Patients receive oral everolimus on day 1 and oral gefitinib once daily on days 8-21. Beginning on day 22, patients receive oral everolimus once weekly and oral gefitinib once daily. Treatment with the combination continues in the absence of disease progression or unacceptable toxicity. 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 preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. * Phase II (prostate cancer patients only) (closed to accrual as of 10/19/2006): Patients receive oral everolimus (at the MTD determined in phase I) once weekly and oral gefitinib once daily. Treatment continues in the absence of disease progression or unacceptable toxicity.
Protocole
Cette section fournit des détails sur le plan de l'étude, y compris la manière dont l'étude est conçue et ce qu'elle évalue.61 participants à inclure
Nombre total de participants que l'essai clinique vise à recruter.Traitement
Éligibilité
Les chercheurs recherchent des patients correspondant à une certaine description appelée critères d'éligibilité : état de santé général ou traitements antérieurs du patient.Homme
Le sexe biologique des participants éligibles à s'inscrire.De 18 à 120 ans
Tranche d'âge des participants éligibles à participer.Volontaires sains non autorisés
Indique si les individus en bonne santé et ne présentant pas la condition étudiée peuvent participer.Conditions
Pathologie
Critères
DISEASE CHARACTERISTICS: * Histologically confirmed diagnosis of 1 of the following: * Glioblastoma multiforme (GBM) (phase I only) * Progressive disease despite standard therapy * Progressive disease based on 1 of the following: * New or progressive (25% bidimensional increase) soft tissue masses on CT scan or MRI * New or prior lesions that have increased in size by physical examination * Patients who had prior interstitial brachytherapy or stereotactic radiosurgery must have confirmation of true disease progression (rather than radiation necrosis) by positron-emission tomography scan, thallium scanning, magnetic resonance spectroscopy, or surgical documentation * Castrate metastatic prostate cancer (closed to accrual as of 10/19/2006) (phase I and II) * Progressive disease despite standard therapy AND castrate levels \< 50 ng/dL of testosterone * Progressive disease based on 1 or more of the following: * A minimum of 3 rising levels of prostate-specific antigen (PSA) that are obtained 1 or more weeks apart OR 2 rising PSA values obtained more than 1 month apart with at least a 25% increase over the range of values * New or progressive (25% bidimensional increase) soft tissue masses on CT scan or MRI * New metastatic lesions * Patients on an antiandrogen as part of initial therapy must show disease progression after discontinuation of the antiandrogen * Patients who have not undergone surgical orchiectomy must continue with medical therapy (e.g., gonadotropin-releasing hormone analogs) to maintain castrate levels of serum testosterone * No brain metastases PATIENT CHARACTERISTICS: Age * Over 18 Performance status * Karnofsky 70-100% Life expectancy * More than 3 months Hematopoietic * Absolute neutrophil count ≥ 1,500/mm\^3 * Platelet count ≥ 100,000/mm\^3 * WBC ≥ 3,000/mm\^3 Hepatic * ALT and AST ≤ 2.5 times upper limit of normal (ULN) * Bilirubin ≤ 1.5 mg/dL Renal * Creatinine within 1.5 times ULN (\< 1.95 mg/dL at MSKCC) Cardiovascular * No significant cardiovascular disease * No congestive heart failure * No New York Heart Association class III or IV cardiac disease * No active angina pectoris * No myocardial infarction within the past 6 months Other * Not pregnant * Negative pregnancy test * Fertile patients must use effective contraception * No serious medical illness * No severe infection * No severe malnutrition * No other active malignancy except non-melanoma skin cancer * Patients are not considered to have an active malignancy if they have completed prior therapy and currently have a \< 30% risk for relapse PRIOR CONCURRENT THERAPY: Biologic therapy * No concurrent biological therapy * No concurrent immunotherapy Chemotherapy * No concurrent chemotherapy Endocrine therapy * See Disease Characteristics Radiotherapy * See Disease Characteristics * More than 4 weeks since prior radiotherapy * No concurrent radiotherapy Surgery * See Disease Characteristics * Prior recent resection of recurrent or progressive GBM allowed provided patient has recovered * More than 4 weeks since prior major surgery Other * Recovered from all prior therapy * More than 4 weeks since prior investigational anticancer drugs * No concurrent anticonvulsant that interacts with CYP3A4 (e.g., phenytoin, carbamazepine, or phenobarbital) * No other concurrent cytotoxic therapy * No other concurrent investigational or commercial agents or therapies for the malignancy
Plan de l'étude
Découvrez tous les traitements administrés dans cette étude, leur description détaillée et ce qu'ils impliquent.Un seul groupe d'intervention est désigné dans cette étude
Cette étude ne comporte pas de groupe placebo.
Groupes de traitement
Groupe I
ExpérimentalObjectifs de l'étude
Objectifs principaux
Centres d'étude
Ce sont les hôpitaux, cliniques ou centres de recherche où l'essai est conduit. Vous pouvez trouver le site le plus proche de vous ainsi que son statut.Cette étude comporte 2 sites
Vall d'Hebron University Hospital
Barcelona, Spain