Brain and Central Nervous System Tumors Clinical Trial
Official title:
Rosiglitazone (Peroxisome Proliferating Activating Receptor-gamma {PPAR-y} Ligand) Treatment of Pituitary Tumors
RATIONALE: Rosiglitazone may help pituitary adenoma cells become more like normal cells, and
grow and spread more slowly.
PURPOSE: This phase II trial is studying how well rosiglitazone works in treating patients
with newly diagnosed or residual or recurrent pituitary adenoma.
OBJECTIVES:
- To assess the effect of rosiglitazone maleate on the core biochemical parameter, 24-hour
urinary free cortisol levels, in patients with recurrent or uncured pituitary-dependent
Cushing disease. (Group 1)
- To assess the effect of this drug on corticotropin-releasing hormone-stimulated
pituitary tumor ACTH secretion in patients with recurrent or uncured pituitary-dependent
Cushing disease. (Group 1)
- To assess the effect of this drug on tumor growth in patients with non-secreting
pituitary macroadenoma (> 10 mm) using RECIST criteria. (Group 2)
- To assess the effect of this drug on pituitary tumor gonadotropin (i.e.,
follicle-stimulating hormone, leuteinizing hormone, and alpha-subunit) secretion in
patients with non-secreting macroadenoma. (Group 2)
- To assess the overall safety and tolerability of this drug in both cohorts of patients.
- To assess the overall quality of life, in terms of performance status during treatment,
of both cohorts of patients using the Karnofsky performance index.
OUTLINE: Patients are grouped according to adrenocorticotropic hormone (ACTH)-secreting
status (yes [Group 1] vs no [Group 2]).
- Group 1 (ACTH-secreting adenomas): Patients receive 4 mg oral rosiglitazone maleate once
daily in week 1 and then 8 mg once daily beginning in week 2 and continuing for up to 6
months in the absence of disease progression or unacceptable toxicity.
- Group 2 (non-secreting macroadenomas): Patients receive 4 mg oral rosiglitazone maleate
once daily in week 1 and then 8 mg once daily beginning in week 2 and continuing for up
to 12 months in the absence of disease progression or unacceptable toxicity.
Patients undergo collection of blood and urine samples at baseline and after completion of
study therapy to assess pituitary function, thyroid function, and 24-hour urinary free
cortisol levels. Additional assessments include corticotrophin-stimulation testing, dynamic
pituitary function testing (i.e., arginine/growth-hormone releasing-hormone testing) to
measure growth hormone secretion, and overnight 1 mg dexamethasone suppression testing to
measure 8 a.m. serum cortisol levels. Patients also undergo MRI at baseline and after
completion of study therapy to examine the effects of rosiglitazone maleate treatment on
pituitary tumor size.
Patients complete a questionnaire at baseline and monthly during study for evaluation of
headaches.
PROJECTED ACCRUAL: A total of 15 patients with ACTH-secreting pituitary tumor and 15 patients
with non-secreting pituitary macroadenomas will be accrued for this study.
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