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Clinical Trial Details — Status: Withdrawn

Administrative data

NCT number NCT00521092
Other study ID # NCI-2009-00229
Secondary ID NCI-2009-00229CA
Status Withdrawn
Phase Phase 2
First received August 24, 2007
Last updated May 2, 2014
Start date January 2009

Study information

Verified date December 2012
Source National Cancer Institute (NCI)
Contact n/a
Is FDA regulated No
Health authority United States: Food and Drug Administration
Study type Interventional

Clinical Trial Summary

Sunitinib malate 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. This phase II trial is studying the side effects and how well sunitinib malate works in treating patients with Kaposi sarcoma.


Description:

PRIMARY OBJECTIVES:

I. Determine the clinical response of sunitinib malate in patients with Kaposi sarcoma (KS) in Uganda and Kenya.

II. Compare clinical response rates in endemic versus epidemic (AIDS) KS. III. Determine the safety and tolerability of sunitinib malate in patients with endemic or epidemic (AIDS) KS.

SECONDARY OBJECTIVES:

I Monitor the impact of sunitinib malate on underlying HIV-1 and Kaposi sarcoma-associated herpesvirus (KSHV) viral infection (HIV-1 plasma RNA and KSHV cell-associated DNA).

II. Evaluate morphological changes in KS lesions after treatment. III. Determine the pharmacokinetic profile of sunitinib malate in patients with KS.

IV Evaluate KSHV gene expression in endemic and epidemic KS lesions in patients in Uganda and Kenya.

OUTLINE: This is a multicenter study. Patients are stratified according to HIV-serostatus (endemic [HIV-seronegative] vs epidemic [HIV-seropositive/AIDS] kaposi sarcoma).

Patients receive oral sunitinib malate 50 mg once daily for 4 weeks. Treatment repeats every 6 weeks in the absence of disease progression or unacceptable toxicity.

Patients undergo tumor tissue and blood sample collection periodically for correlative and pharmacokinetic studies. Samples are analyzed for CD4 lymphocyte counts, HIV-1 plasma RNA levels, KSHV specific antibodies, expression pattern of KSHV in vitro and in vivo, expression of latently versus lytically expressed genes in tumor tissue, and plasma concentrations of sunitinib malate and its active metabolite, SU12662.

After completion of study treatment, patients are followed every 6 weeks.


Recruitment information / eligibility

Status Withdrawn
Enrollment 0
Est. completion date
Est. primary completion date October 2010
Accepts healthy volunteers No
Gender Both
Age group 18 Years and older
Eligibility Inclusion Criteria:

- ECOG performance status 0-1

- Documented HIV-serostatus [HIV-seronegative (endemic KS) or HIV-seropositive (epidemic/AIDS KS)]

- No symptomatic organ involvement, visceral crisis, or life-threatening disease (e.g., extensive or symptomatic pulmonary disease or reticuloendothelial system/hepatic involvement) for which aggressive double- or triple-drug combination chemotherapy for urgent cytoreduction is indicated (i.e., doxorubicin hydrochloride, bleomycin, and vinblastine [ABV], BV, or AV)

- Histologically confirmed Kaposi sarcoma

- Platelet count > 75,000/uL

- Life expectancy >= 24 weeks

- Absolute granulocyte count > 1,000/uL

- Hemoglobin > 8.0 g/dL OR hematocrit > 24%

- Serum creatinine =< 2.0 mg/dL

- AST < 3 times normal

- Fertile patients must use effective contraception

- Normal clinical cardiac examination and normotensive (systolic and diastolic BP < 140/90 mm Hg) documented on at least two occasions prior to enrollment

- Normal ECG including QTc interval < 500 msec

- Normal echocardiogram prior to enrollment (if feasibly possible)

- Must be able to swallow study medication

- No acute infections [Patients with chronic infections (e.g., malaria, tuberculosis, parasitic infections, or hepatitis B or C) that may be active but under treatment are allowed provided all eligibility criteria are met]

- At least 60 days since prior local treatment modalities (e.g., resection, cryosurgery, radiotherapy, or intralesional therapy) AND treated lesions must have clearly progressed following such therapies if the lesions are to be used as an index lesion

- No prior systemic anticancer therapy for Kaposi sarcoma

- Concurrent antiretroviral therapy required for HIV-seropositive patients (Patient must be on a stable regimen 8 weeks prior to study enrollment--An exception may be made for patients who have exhausted or are intolerant to all available regimens)

- No other concurrent systemic anticancer therapy

- Patient resides in Uganda or Kenya, East Africa

Exclusion Criteria:

- Pregnant or nursing

- Baseline diarrhea >= grade 2 by CTCAE

- Uncontrolled intercurrent illness including, but not limited to, any of the following:

- Ongoing or acute active infection

- Symptomatic congestive heart failure (NYHA class III or IV heart disease)

- Unstable angina pectoris

- Uncontrolled intercurrent illness including, but not limited to, any of the following: 1) Cardiac arrhythmia (i.e., history of serious ventricular arrhythmia, ventricular fibrillation, or ventricular tachycardia >= 3 beats in a row OR QTc >= 500 msec) 2) Psychiatric illness or social situation that would limit compliance with study requirements

Study Design

Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment


Intervention

Drug:
sunitinib malate
Given orally
Procedure:
laboratory biomarker analysis
Correlative study
pharmacological study
Correlative study

Locations

Country Name City State
n/a

Sponsors (2)

Lead Sponsor Collaborator
National Cancer Institute (NCI) National Institute of Allergy and Infectious Diseases (NIAID)

Outcome

Type Measure Description Time frame Safety issue
Primary Response rate The true response rate will be estimated based on the number of responses using a binomial distribution. The confidence intervals for them can be estimated using same distribution. Chi-square test or Fisher's exact test will be used to examine the difference of response rate between the two cohorts and log-rank test for the difference of survival outcomes. Up to 11 months No
Primary Overall survival Will be estimated by Kaplan-Meier method. From the date of treatment to date of death, assessed up to 11 months No
Primary Progression-free survival Will be estimated by Kaplan-Meier method. From the date of treatment to date of death or date of disease progression, assessed up to 11 months No
Primary Levels of plasma-associated HIV-1 RNA viral load and cell-associated KSHV DNA viral load Multivariate analysis will be performed using the Cox proportional hazards model. The effects of CD4+ lymphocyte counts, plasma HIV-1 RNA viral load and KSHV DNA level on the objective response rate will be evaluated using multivariate logistic regression. Up to 11 months No
Secondary Changes in CD4+ and CD8+ cell counts, levels of plasma-associated HIV-1 RNA, and cell-associated KSHV DNA load For each treatment cohort and for all groups combined, the Wilcoxon signed rank test (the non-parametric version of paired T-test) will be used to evaluate the changes. Baseline and 6 weeks No
See also
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Terminated NCT04893018 - NT-I7 for Kaposi Sarcoma in Patients With or Without HIV Phase 1
Completed NCT00064142 - Halofuginone Hydrobromide in Treating Patients With HIV-Related Kaposi's Sarcoma Phase 2
Terminated NCT00020683 - A Phase II Trial of COL-3 in Patients With HIV Related Kaposi's Sarcoma Phase 2
Completed NCT00003350 - Paclitaxel Compared With Doxorubicin in Treating Patients With Advanced AIDS-Related Kaposi's Sarcoma Phase 3
Not yet recruiting NCT05411237 - Paclitaxel and Pegylated Liposomal Doxorubicin for Treatment of HIV-related Kaposi Sarcoma Phase 3
Active, not recruiting NCT05510973 - Evaluation of Advanced HIV Disease Differentiated Care Model in Malawi N/A
Recruiting NCT05510908 - Use of a Screening Tool to Describe HIV-Related Cancer Burden and Patient Characteristics in the AMC
Withdrawn NCT02137564 - Gamma Secretase Inhibitor PF-03084014 in Treating Patients With AIDS-Associated Kaposi Sarcoma Phase 2
Completed NCT01016730 - Bortezomib in Treating Patients With Relapsed or Refractory AIDS-Related Kaposi Sarcoma Phase 1
Completed NCT01057121 - Lenalidomide in Treating Patients With AIDS-Associated Kaposi's Sarcoma Phase 1/Phase 2