Efficacy and Safety Study of RAD001 in the Growth of the Vestibular Schwannoma(s) in Neurofibromatosis 2 (NF2) Patients

Neurofibromatosis 2 Clinical Trial

— AFINF2  

Official title:

A Single Arm, Single Center, Phase II Trial of RAD001 as Monotherapy in the Treatment of Neurofibromatosis Type 2 - Related Vestibular Schwannoma

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01490476
• Other study ID #: P101202
• Secondary ID: 2011-002228-42
• Status: Completed
• Phase: Phase 2
• First received: November 30, 2011
• Last updated: May 22, 2017
• Start date: January 2012
• Est. completion date: January 2017

Study information

• Verified date: May 2017
• Source: Assistance Publique - Hôpitaux de Paris
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of the study is to determine if RAD001 treatment will shrink or slow the growth of the vestibular schwannoma(s) in Neurofibromatosis 2 (NF2) patients.

Description:

This protocol is a Phase II, open-label, efficacy and safety study of single-agent RAD001 in patients with NF2. During the study, subjects will receive continuous daily oral treatment with RAD001 for up to 4 years or until tumor progression.

Primary Objective: To determine whether RAD001 has an effect on the VS growth in patients with NF2 at a rate sufficient to submit the drug for further testing.

Secondary Objectives: To determine whether RAD001 has an effect on the volume of other intracranial tumors; to assess the effect of RAD001 on hearing function in patients with NF2 (when applicable); to determine whether RAD001 modulates signaling pathways in intracranial NF2 tumors removed during the course of the study. And determine the long term safety.

All patients will be treated with RAD001 10 mg p.o. daily dose (5mg if 15-17 years old with cutaneous surface area <1.5m2) for one year except in case of unacceptable toxicity, death, or discontinuation from the study for any other reason.

At 12 months an extension for another one year of RAD001 treatment will be discussed in case of response.

If the patient is stable (decrease or increase lower than 20%), treatment should be stopped and the patient should be kept under quarterly continuous surveillance. Resumption of treatment will be discussed case by case basis if tumor regrowth over 20% relative to the tumor volume at the end of treatment.

All patients will have a follow-up visit (including MRI) scheduled at 24 months after enrollment.

We modify the protocol to extend the treatment by RAD001 for a period of two additional years for stable patients still on treatment two years after enrollment.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 10
• Est. completion date: January 2017
• Est. primary completion date: April 2016
• Accepts healthy volunteers: No
• Gender: All
• Age group: 15 Years and older

Eligibility

Inclusion Criteria:

• Diagnosis of NF2 by National Institutes of Health (NIH) criteria

• Age = 15 years

• Progressive VS growth during the previous 12 months. Evidence of disease progression defined by progressive VS during the previous 12 months (>20% increase in volume) in subjects who are at elevated risk for surgical complications (eg, deafness, lower cranial nerve injury, facial weakness) or who refuse surgery

• Adequate bone marrow, liver and renal function.

• For women of childbearing potential, no pregnancy or breast-feeding

• Willingness and ability to comply with scheduled visits, drug administration plan, laboratory tests, other study procedures, and study restrictions.

• Willingness to provide informed consent

Exclusion Criteria:

• Inability to tolerate periodic MRI scans or gadolinium contrast.

• Inability to tolerate periodic audiologic testing or to understand a language with established scoring for word recognition testing.

• Inability to adequately perform volumetric measurement of at least 1 target lesionNote: Patients with cochlear or auditory brainstem implants may participate if a target lesion can be accurately assessed.

• Radiation therapy for the target lesion in the 60 months preceding inclusion in the study.

• Patients currently receiving anticancer therapies or who have received anticancer therapies within 4 weeks of the start of study drug.

• Immunization with attenuated live vaccines within one week of study entry or during study period.

• Patients receiving chronic, systemic treatment with corticosteroids or another immunosuppressive agent. Topical or inhaled corticosteroids are allowed.

• Other malignancies within the past 3 years except for adequately treated carcinoma of the cervix or basal or squamous cell carcinomas of the skin.

• Patients who have any severe and/or uncontrolled medical conditions.

• Patients with a known hypersensitivity to everolimus or other types of rapamycin or to its excipients.

• Patients unwilling to or unable to comply with the protocol

Related Conditions & MeSH terms

• Neurilemmoma
• Neurofibroma
• Neurofibromatoses
• Neurofibromatosis 2
• Neuroma, Acoustic

Intervention

Drug:
• RAD001
10 mg per os / day or 05mg per os / day with 12 month

Locations

Country	Name	City	State
France	Hôpital Beaujon, 100 boulevard du Général Leclerc	Clichy

Sponsors (1)

Lead Sponsor	Collaborator
Assistance Publique - Hôpitaux de Paris

Country where clinical trial is conducted

France, 

References & Publications (1)

Goutagny S, Raymond E, Esposito-Farese M, Trunet S, Mawrin C, Bernardeschi D, Larroque B, Sterkers O, Giovannini M, Kalamarides M. Phase II study of mTORC1 inhibition by everolimus in neurofibromatosis type 2 patients with growing vestibular schwannomas. J Neurooncol. 2015 Apr;122(2):313-20. doi: 10.1007/s11060-014-1710-0. Epub 2015 Jan 8. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	effect of RAD001 on the VS growth by MRI	To determine whether RAD001 has an effect on the VS growth in patients with NF2 at a rate sufficient to submit the drug for further testing	1 year
Secondary	Effect of RAD001 on the volume of other intracranial tumors (MRI) and on hearing function (audiogram)	To determine if RAD001 has an effect on the volume of other intracranial tumors, to assess efficacy of RAD001 on hearing function, to determine whether RAD001 modulates signaling pathways in tumors removed during the course of the study and to determine long term safety	1, 2 and 4 years after inclusion in the study