Recurrent Rectal Cancer Clinical Trial
Official title:
Phase II Study of Sorafenib/Avastin® as Salvage Therapy in Patients With Metastatic Colorectal Cancer
This phase II trial is studying how well giving sorafenib together with bevacizumab works in treating patients with metastatic colorectal cancer. Sorafenib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Monoclonal antibodies, such as bevacizumab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Sorafenib and bevacizumab may also stop the growth of tumor cells by blocking blood flow to the tumor. Giving sorafenib together with bevacizumab may kill more tumor cells
Status | Active, not recruiting |
Enrollment | 83 |
Est. completion date | |
Est. primary completion date | January 2010 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | 18 Years and older |
Eligibility |
Inclusion Criteria: - Diagnosis of stage IV colorectal cancer (histologic proof is not required) - Measurable disease - Spiral CT scan required for both pre- and post-treatment tumor assessments of lesions measuring 1-2 cm - Progressive disease during or within 6 months of most recent prior chemotherapy regimen (bevacizumab, fluoropyrimidine, oxaliplatin, or irinotecan-based treatment) OR considered ineligible for standard therapy - Documentation of submission of tumor material for Kirsten Rat Sarcoma (KRAS) testing available - Prior anti-epidermal growth factor receptor (EGFR) antibody therapy (e.g., cetuximab or panitumumab) required for patients with wild-type KRAS tumor - No known brain metastasis - Patients with neurological symptoms must undergo a CT scan or MRI of the brain to exclude brain metastasis - Eastern Cooperative Oncology Group (ECOG) performance status 0-1 - Life expectancy = 6 months - Hemoglobin = 9.0 g/dL - Absolute neutrophil count (ANC) = 1,500/mm³ - Platelet count = 100,000/mm³ - White blood cell count (WBC) = 3,400/mm³ - International normalized ratio (INR) < 1.5 (= 3.0 if on anti-coagulation therapy [e.g., warfarin or heparin]) - Total bilirubin = 1.5 times upper limit of normal (ULN) - Aspartate aminotransferase (AST) = 2.5 times ULN (= 5 times ULN if there is liver involvement) - Alkaline phosphatase = 3 times ULN - Creatinine = 1.5 times ULN - Urine protein:creatinine ratio < 1 OR urine dipstick < 2+ OR urine protein < 1,000 mg by 24-hour urine collection - Not pregnant or nursing - Negative pregnancy test - Fertile patients must use effective contraception during and for = 6 months after completion of study treatment (= 2 weeks after completion of treatment with sorafenib tosylate alone) - Willing to provide mandatory blood samples for translational research studies - Able to swallow whole pills - No inadequately controlled hypertension (i.e., systolic BP > 150 mm Hg or diastolic BP > 100 mm Hg on anti-hypertensive medications) - No prior hypertensive crisis or hypertensive encephalopathy - No myocardial infarction or unstable angina within the past 6 months - No congestive heart failure requiring use of ongoing maintenance therapy for life-threatening ventricular arrhythmias - No thrombolic or embolic events (e.g., cerebrovascular accident, including transient ischemic attacks) within the past 6 months - No hemorrhage or bleeding event > grade 3 within the past 4 weeks - No evidence or history of bleeding diathesis or coagulopathy (in the absence of therapeutic anticoagulation) - No greater than normal risk of bleeding - No active or recent hemoptysis (= ½ teaspoon of bright red blood per episode) within the past 30 days - No concurrent uncontrolled illness including, but not limited to, any of the following: - Ongoing or active infection - Symptomatic congestive heart failure - Unstable angina pectoris - Cardiac arrhythmia requiring anti-arrhythmic drugs - Psychiatric illness or social situations that would limit compliance with study requirements - No known HIV infection or chronic hepatitis B or C infection - No serious, non-healing wound, active ulcer, or untreated bone fracture - Patients with fractures secondary to metastatic disease are eligible after appropriate radiotherapy - No significant traumatic injury within the past 4 weeks - No known or suspected allergy or hypersensitivity to any component of bevacizumab, sorafenib tosylate, or their excipients or to any other agent given in the course of this study - No malabsorption problem - None of the following within the past 6 months: - Significant vascular disease (e.g., aortic aneurysm or aortic dissection) - Peripheral arterial thrombosis - Symptomatic peripheral vascular disease - Abdominal fistula - Gastrointestinal perforation - Intra-abdominal abscess - No other active malignancy within the past 3 years except non melanoma skin cancer or carcinoma in situ of the cervix - Prior malignancy allowed provided patient is not receiving other specific treatment for that malignancy (other than hormonal therapy) - No other concurrent investigational agent for this cancer - Prior radiotherapy allowed - No prior sorafenib tosylate - No prior discontinuation of bevacizumab due to adverse events - More than 4 weeks since prior and no concurrent participation in any other experimental drug study - More than 4 weeks since prior St. John's wort or rifampin - More than 4 weeks since prior and no concurrent major surgical procedure or open biopsy - More than 7 days since prior core biopsy or minor surgical procedure, including placement of a vascular access device - No concurrent anticoagulant, except low-dose warfarin or heparin for deep venous thrombosis prophylaxis |
Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
Country | Name | City | State |
---|---|---|---|
United States | Bixby Medical Center | Adrian | Michigan |
United States | Hickman Cancer Center | Adrian | Michigan |
United States | Michigan Cancer Research Consortium Community Clinical Oncology Program | Ann Arbor | Michigan |
United States | Saint Joseph Mercy Hospital | Ann Arbor | Michigan |
United States | Hospital District Sixth of Harper County | Anthony | Kansas |
United States | The Medical Center of Aurora | Aurora | Colorado |
United States | Saint Francis Hospital and Health Centers | Beech Grove | Indiana |
United States | Sanford Clinic North-Bemidgi | Bemidji | Minnesota |
United States | Constantinou, Costas L MD (UIA Investigator) | Bettendorf | Iowa |
United States | Billings Clinic | Billings | Montana |
United States | Hematology-Oncology Centers of the Northern Rockies PC | Billings | Montana |
United States | Montana Cancer Consortium CCOP | Billings | Montana |
United States | Northern Rockies Radiation Oncology Center | Billings | Montana |
United States | Saint Vincent Healthcare | Billings | Montana |
United States | Bismarck Cancer Center | Bismarck | North Dakota |
United States | Mid Dakota Clinic | Bismarck | North Dakota |
United States | Saint Alexius Medical Center | Bismarck | North Dakota |
United States | Sanford Bismarck Medical Center | Bismarck | North Dakota |
United States | Saint Joseph Medical Center | Bloomington | Illinois |
United States | Boulder Community Hospital | Boulder | Colorado |
United States | Toledo Clinic Cancer Centers-Bowling Green | Bowling Green | Ohio |
United States | Bozeman Deaconess Cancer Center | Bozeman | Montana |
United States | Fairview Ridges Hospital | Burnsville | Minnesota |
United States | Saint James Community Hospital and Cancer Treatment Center | Butte | Montana |
United States | Graham Hospital Association | Canton | Illinois |
United States | Memorial Hospital | Carthage | Illinois |
United States | Cedar Rapids Oncology Association | Cedar Rapids | Iowa |
United States | Mercy Hospital | Cedar Rapids | Iowa |
United States | Oncology Associates at Mercy Medical Center | Cedar Rapids | Iowa |
United States | Cancer Center of Kansas - Chanute | Chanute | Kansas |
United States | Medical Oncology and Hematology Associates-West Des Moines | Clive | Iowa |
United States | North Coast Cancer Care-Clyde | Clyde | Ohio |
United States | Penrose-Saint Francis Healthcare | Colorado Springs | Colorado |
United States | Mercy Hospital | Coon Rapids | Minnesota |
United States | Geisinger Medical Center | Danville | Pennsylvania |
United States | Dayton CCOP | Dayton | Ohio |
United States | Good Samaritan Hospital - Dayton | Dayton | Ohio |
United States | Grandview Hospital | Dayton | Ohio |
United States | Miami Valley Hospital | Dayton | Ohio |
United States | Samaritan North Health Center | Dayton | Ohio |
United States | Oakwood Hospital | Dearborn | Michigan |
United States | Colorado Cancer Research Program CCOP | Denver | Colorado |
United States | Exempla Saint Joseph Hospital | Denver | Colorado |
United States | Porter Adventist Hospital | Denver | Colorado |
United States | Presbyterian - Saint Lukes Medical Center - Health One | Denver | Colorado |
United States | Rose Medical Center | Denver | Colorado |
United States | Saint Anthony Central Hospital | Denver | Colorado |
United States | Iowa Lutheran Hospital | Des Moines | Iowa |
United States | Iowa Methodist Medical Center | Des Moines | Iowa |
United States | Iowa Oncology Research Association CCOP | Des Moines | Iowa |
United States | Medical Oncology and Hematology Associates | Des Moines | Iowa |
United States | Medical Oncology and Hematology Associates-Des Moines | Des Moines | Iowa |
United States | Mercy Capitol | Des Moines | Iowa |
United States | Mercy Medical Center - Des Moines | Des Moines | Iowa |
United States | Saint John Hospital and Medical Center | Detroit | Michigan |
United States | Cancer Center of Kansas - Dodge City | Dodge City | Kansas |
United States | Essentia Health Duluth Clinic CCOP | Duluth | Minnesota |
United States | Essentia Health Saint Mary's Medical Center | Duluth | Minnesota |
United States | Miller-Dwan Hospital | Duluth | Minnesota |
United States | Mayo Clinic Health System Eau Claire Hospital - Luther Campus | Eau Claire | Wisconsin |
United States | Midelfort Clinic-Clairemont Campus | Eau Claire | Wisconsin |
United States | Fairview-Southdale Hospital | Edina | Minnesota |
United States | Cancer Center of Kansas - El Dorado | El Dorado | Kansas |
United States | Elkhart General Hospital | Elkhart | Indiana |
United States | Hematology Oncology Center Incorporated | Elyria | Ohio |
United States | Swedish Medical Center | Englewood | Colorado |
United States | Green Bay Oncology - Escanaba | Escanaba | Michigan |
United States | Eureka Hospital | Eureka | Illinois |
United States | Sanford Clinic North-Fargo | Fargo | North Dakota |
United States | Sanford Medical Center-Fargo | Fargo | North Dakota |
United States | Blanchard Valley Hospital | Findlay | Ohio |
United States | Genesys Regional Medical Center-West Flint Campus | Flint | Michigan |
United States | Hurley Medical Center | Flint | Michigan |
United States | Cancer Center of Kansas - Fort Scott | Fort Scott | Kansas |
United States | Atrium Medical Center-Middletown Regional Hospital | Franklin | Ohio |
United States | Fredericksburg Oncology Inc | Fredericksburg | Virginia |
United States | Unity Hospital | Fridley | Minnesota |
United States | Galesburg Clinic | Galesburg | Illinois |
United States | Galesburg Cottage Hospital | Galesburg | Illinois |
United States | Altru Cancer Center | Grand Forks | North Dakota |
United States | Saint Mary's Hospital and Regional Medical Center | Grand Junction | Colorado |
United States | Berdeaux, Donald MD (UIA Investigator) | Great Falls | Montana |
United States | Great Falls Clinic | Great Falls | Montana |
United States | North Colorado Medical Center | Greeley | Colorado |
United States | Green Bay Oncology at Saint Vincent Hospital | Green Bay | Wisconsin |
United States | Green Bay Oncology Limited at Saint Mary's Hospital | Green Bay | Wisconsin |
United States | Saint Mary's Hospital | Green Bay | Wisconsin |
United States | Saint Vincent Hospital | Green Bay | Wisconsin |
United States | Wayne Hospital | Greenville | Ohio |
United States | Mason District Hospital | Havana | Illinois |
United States | Northern Montana Hospital | Havre | Montana |
United States | Geisinger Medical Center-Cancer Center Hazelton | Hazleton | Pennsylvania |
United States | Saint Peter's Community Hospital | Helena | Montana |
United States | Hutchinson Area Health Care | Hutchinson | Minnesota |
United States | Cancer Center of Kansas-Independence | Independence | Kansas |
United States | Green Bay Oncology - Iron Mountain | Iron Mountain | Michigan |
United States | Allegiance Health | Jackson | Michigan |
United States | Mayo Clinic in Florida | Jacksonville | Florida |
United States | Glacier Oncology PLLC | Kalispell | Montana |
United States | Kalispell Medical Oncology | Kalispell | Montana |
United States | Kalispell Regional Medical Center | Kalispell | Montana |
United States | Kettering Medical Center | Kettering | Ohio |
United States | Cancer Center of Kansas-Kingman | Kingman | Kansas |
United States | Community Howard Regional Health | Kokomo | Indiana |
United States | Indiana University Health La Porte Hospital | La Porte | Indiana |
United States | Sparrow Hospital | Lansing | Michigan |
United States | Lawrence Memorial Hospital | Lawrence | Kansas |
United States | Lima Memorial Hospital | Lima | Ohio |
United States | Saint Mary Mercy Hospital | Livonia | Michigan |
United States | Sky Ridge Medical Center | Lone Tree | Colorado |
United States | Longmont United Hospital | Longmont | Colorado |
United States | McKee Medical Center | Loveland | Colorado |
United States | Mcdonough District Hospital | Macomb | Illinois |
United States | Holy Family Memorial Hospital | Manitowoc | Wisconsin |
United States | Immanuel-Saint Joseph Hospital-Mayo Health System | Mankato | Minnesota |
United States | Minnesota Oncology Hematology PA-Maplewood | Maplewood | Minnesota |
United States | Saint John's Hospital - Healtheast | Maplewood | Minnesota |
United States | Bay Area Medical Center | Marinette | Wisconsin |
United States | Mercy Medical Center - North Iowa | Mason City | Iowa |
United States | Saint Luke's Hospital | Maumee | Ohio |
United States | Toledo Clinic Cancer Centers-Maumee | Maumee | Ohio |
United States | Toledo Radiation Oncology at Northwest Ohio Onocolgy Center | Maumee | Ohio |
United States | Abbott-Northwestern Hospital | Minneapolis | Minnesota |
United States | Hennepin County Medical Center | Minneapolis | Minnesota |
United States | Virginia Piper Cancer Institute | Minneapolis | Minnesota |
United States | Saint Joseph Regional Medical Center-Mishawaka | Mishawaka | Indiana |
United States | Community Medical Hospital | Missoula | Montana |
United States | Guardian Oncology and Center for Wellness | Missoula | Montana |
United States | Montana Cancer Specialists | Missoula | Montana |
United States | Saint Patrick Hospital - Community Hospital | Missoula | Montana |
United States | Garneau, Stewart C MD (UIA Investigator) | Moline | Illinois |
United States | Porubcin, Michael MD (UIA Investigator) | Moline | Illinois |
United States | Sharis, Christine M MD (UIA Investigator) | Moline | Illinois |
United States | Stoffel, Thomas J MD (UIA Investigator) | Moline | Illinois |
United States | Holy Family Medical Center | Monmouth | Illinois |
United States | Community Cancer Center of Monroe | Monroe | Michigan |
United States | Mercy Memorial Hospital | Monroe | Michigan |
United States | Cancer Center of Kansas - Newton | Newton | Kansas |
United States | Bromenn Regional Medical Center | Normal | Illinois |
United States | Community Cancer Center Foundation | Normal | Illinois |
United States | Green Bay Oncology - Oconto Falls | Oconto Falls | Wisconsin |
United States | Saint Charles Hospital | Oregon | Ohio |
United States | Toledo Clinic Cancer Centers-Oregon | Oregon | Ohio |
United States | Illinois CancerCare-Ottawa Clinic | Ottawa | Illinois |
United States | Ottawa Regional Hospital and Healthcare Center | Ottawa | Illinois |
United States | Cancer Center of Kansas - Parsons | Parsons | Kansas |
United States | Pekin Cancer Treatment Center | Pekin | Illinois |
United States | Pekin Hospital | Pekin | Illinois |
United States | Illinois CancerCare-Peoria | Peoria | Illinois |
United States | Illinois Oncology Research Association CCOP | Peoria | Illinois |
United States | Methodist Medical Center of Illinois | Peoria | Illinois |
United States | OSF Saint Francis Medical Center | Peoria | Illinois |
United States | Proctor Hospital | Peoria | Illinois |
United States | Illinois Valley Hospital | Peru | Illinois |
United States | Saint Joseph Mercy Oakland | Pontiac | Michigan |
United States | Saint Joseph Mercy Port Huron | Port Huron | Michigan |
United States | Adventist Medical Center | Portland | Oregon |
United States | Cancer Center of Kansas - Pratt | Pratt | Kansas |
United States | Perry Memorial Hospital | Princeton | Illinois |
United States | Saint Mary Corwin Medical Center | Pueblo | Colorado |
United States | Reid Hospital and Health Care Services | Richmond | Indiana |
United States | North Memorial Medical Health Center | Robbinsdale | Minnesota |
United States | Mayo Clinic | Rochester | Minnesota |
United States | Saint Mary's of Michigan | Saginaw | Michigan |
United States | Center for Cancer Care and Research | Saint Louis | Missouri |
United States | Missouri Baptist Medical Center | Saint Louis | Missouri |
United States | Metro-Minnesota CCOP | Saint Louis Park | Minnesota |
United States | Park Nicollet Clinic - Saint Louis Park | Saint Louis Park | Minnesota |
United States | Regions Hospital | Saint Paul | Minnesota |
United States | United Hospital | Saint Paul | Minnesota |
United States | Cancer Center of Kansas - Salina | Salina | Kansas |
United States | North Coast Cancer Care | Sandusky | Ohio |
United States | Mayo Clinic in Arizona | Scottsdale | Arizona |
United States | Saint Francis Regional Medical Center | Shakopee | Minnesota |
United States | Welch Cancer Center | Sheridan | Wyoming |
United States | Mercy Medical Center-Sioux City | Sioux City | Iowa |
United States | Saint Luke's Regional Medical Center | Sioux City | Iowa |
United States | Siouxland Hematology Oncology Associates | Sioux City | Iowa |
United States | Memorial Hospital of South Bend | South Bend | Indiana |
United States | Northern Indiana Cancer Research Consortium | South Bend | Indiana |
United States | South Bend Clinic | South Bend | Indiana |
United States | Saint Margaret's Hospital | Spring Valley | Illinois |
United States | Saint John's Hospital | Springfield | Missouri |
United States | Lakeland Hospital | St. Joseph | Michigan |
United States | Geisinger Medical Group | State College | Pennsylvania |
United States | Green Bay Oncology - Sturgeon Bay | Sturgeon Bay | Wisconsin |
United States | Flower Hospital | Sylvania | Ohio |
United States | North Suburban Medical Center | Thornton | Colorado |
United States | Mercy Hospital of Tiffin | Tiffin | Ohio |
United States | Mercy Cancer Center at Saint Anne Mercy Hospital | Toledo | Ohio |
United States | Saint Vincent Mercy Medical Center | Toledo | Ohio |
United States | The Toledo Hospital/Toledo Children's Hospital | Toledo | Ohio |
United States | Toledo Clinic Cancer Centers-Toledo | Toledo | Ohio |
United States | Toledo Community Hospital Oncology Program CCOP | Toledo | Ohio |
United States | University of Toledo | Toledo | Ohio |
United States | Upper Valley Medical Center | Troy | Ohio |
United States | Ridgeview Medical Center | Waconia | Minnesota |
United States | Saint John Macomb-Oakland Hospital | Warren | Michigan |
United States | Fulton County Health Center | Wauseon | Ohio |
United States | Cancer Center of Kansas - Wellington | Wellington | Kansas |
United States | Exempla Lutheran Medical Center | Wheat Ridge | Colorado |
United States | Associates In Womens Health | Wichita | Kansas |
United States | Cancer Center of Kansas - Main Office | Wichita | Kansas |
United States | Cancer Center of Kansas-Wichita Medical Arts Tower | Wichita | Kansas |
United States | Via Christi Regional Medical Center | Wichita | Kansas |
United States | Wichita CCOP | Wichita | Kansas |
United States | Geisinger Wyoming Valley | Wilkes-Barre | Pennsylvania |
United States | Clinton Memorial Hospital | Wilmington | Ohio |
United States | Cancer Center of Kansas - Winfield | Winfield | Kansas |
United States | Minnesota Oncology and Hematology PA-Woodbury | Woodbury | Minnesota |
United States | Greene Memorial Hospital | Xenia | Ohio |
Lead Sponsor | Collaborator |
---|---|
Alliance for Clinical Trials in Oncology | National Cancer Institute (NCI) |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Progression-free Survival Rate | The primary endpoint of this trial is progression free survival at 3 months. All patients meeting the eligibility criteria who have signed a consent form and have begun treatment will be considered evaluable. Patients lost to follow-up before 3 months (e.g., progression, refusing further treatment, etc.) will be considered treatment failures. All eligible patients will be followed until death or a minimum of 3 years. The proportion of successes will be estimated by the number of successes divided by the total number of evaluable patients. Progression is defined as at least a 20% increase in the sum of longest liameter of target lesions taking as reference the smallest sum longest diameter recorded since the treatment started or the appearance of one or more new lesions. |
At 3 months | No |
Secondary | Response Rate | Simple frequency analysis will be conducted to see if response rate is related to prior treatment and the selected tumor biomarkers. Descriptive statistics will be used to investigate how prior treatment affects various other measures as well. | Up to 2 years | No |
Secondary | Overall Survival | The distribution of overall survival will be estimated using Kaplan-Meier methodology. | Time from registration to death, assessed up to 2 years | No |
Secondary | Feasibility of Study Treatment | Will be evaluated based on the number of patients who are able to > tolerate the regimen, how long they tolerate it and whether they elect to stop treatment. |
Up to 2 years | No |
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