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An Open-Label Phase I Study of the Safety of Perifosine in Combination With Sunitinib Malate for Patients With Advanced Cancers

Phase 1
18 Years
Not Enrolling
Renal Cancer, GIST

Thank you

Trial Information

An Open-Label Phase I Study of the Safety of Perifosine in Combination With Sunitinib Malate for Patients With Advanced Cancers

This study is a Phase I trial in two parts. In part 1, an MTD to the combination of
perifosine and sunitinib malate will be determined. In some previous trials with perifosine
and other biologic agents, doses determined in Phase I studies are not as well tolerated in
larger groups of patients when response is an endpoint. Thus in part 2, with the MTD as a
starting point, a group of patients will be accrued with the goal of ensuring that they will
be able to tolerate at least two courses of therapy, which would make them evaluable for
response in a Phase II study. As a secondary endpoint, the effects of the combination of
perifosine and sunitinib malate will be evaluated for response rate and time to progression.
The pharmacokinetics of the combination of the study drugs will be measured.

For the purposes of this study, one cycle of therapy will be defined as 6 weeks. Patients
will take one 50 mg tablet of perifosine one to three times a day and sunitinib malate once
a day for 4 out of 6 weeks. Patients may need anti-emetics and/or anti-diarrheals.
Patients will be evaluated for progression or response at 12-week intervals.

Patients who experience toxicity may continue on treatment with doses delayed or reduced.

All patients should continue therapy unless disease progression is documented on two
occasions at least four weeks apart.

Part 1 of this Phase I study will accrue from six to 24 patients depending on the number of
dose levels evaluated. Up to six patients will be treated at each dose level. A dose
limiting toxicity (DLT) will be defined as:

- Grade 3 or greater non-hematologic toxicity

- Grade 4 hematologic toxicity

Inclusion Criteria:

- Patients with a histologically or cytologically confirmed diagnosis of renal tumor or
GIST are eligible for this protocol. Patients with other solid tumor types must have
their cases reviewed by the OCOG medical monitor.

- The physician must believe that the patient's course and the growth rate of the tumor
are such that the patient would feel comfortable continuing treatment for 12 weeks
even if there is a transient period of modest tumor growth during the first weeks
following the initiation of perifosine and sunitinib malate treatment.

- Patients must have a life expectancy of more than 6 months.

- Patients may have received prior sorafenib or sunitinib malate.

- Patients may have measurable or evaluable disease.

- Patients should have a performance status of 0 to 1 according to the ECOG criteria.
However, patients with ECOG performance status of 2 may be admitted with approval
from the study chairman or medical monitor.

- Patients must have adequate organ and marrow function, unless in the opinion of the
treating investigator, the abnormality is related to tumor and the study chairman or
medical monitor agree the abnormality is unlikely to affect the safety of perifosine
and/or sunitinib use.

- Patients must have recovered from acute toxicity related to prior therapy including
surgery or radiotherapy, excluding alopecia.

- Patients must be able to ingest oral medications or to obtain them through a
gastrostomy tube.

- Patients must be at least 18 years of age.

- Patients must have ability to understand and the willingness to sign a written
informed consent document.

- LVEF greater than or equal to 50%.

Exclusion Criteria:

- Rapidly progressing disease, as defined by progression within 8 weeks of initiation
of the previous regimen

- Patients who have had more than three prior systemic therapies, including biologics,
are excluded unless prior approval is obtained from the medical monitor

- Patients receiving any other investigational agents or devices

- Patients initiating a treatment for their cancer within the last two months who will
be continued concomitantly with perifosine

- History of allergic reactions attributed to compounds of similar chemical or biologic
composition to perifosine (miltefosine or edelfosine)

- Uncontrolled intercurrent illness including, but not limited to, ongoing or active
infection and psychiatric illness/social situations that would limit compliance with
study requirements

- Patients currently taking strong inhibitors of the CYP3A4 family (e.g., ketoconazole,
itraconazole, clarithromycin, atazanavir, indinavir, nefazodone, nelfinavir,
ritonavir, saquinavir, telithromycin, voriconazole) AND inducers of the CYP3A4 family
(e.g., dexamethasone, phenytoin, carbamazepine, rifampin, rifabutin, rifapentin,
phenobarbital, St. John's Wort) because of possible pharmacokinetic interactions
with sunitinib. Patients who are no longer taking strong CYP3A4 inhibitors and/or
inducers are ineligible unless they have discontinued use 4 weeks prior to beginning

- HIV-positive patients receiving combination anti-retroviral therapy are excluded from
the study because of possible pharmacokinetic interactions with perifosine.

- Patients with a history of unstable or newly diagnosed angina pectoris, recent
myocardial infarction (within 6 months of enrollment), or New York Heart Association
class II-IV congestive heart failure

- Female patients who are pregnant or lactating are ineligible. All females of
childbearing potential must have a negative serum pregnancy test within 72 hours of
treatment. Men and women of childbearing potential must agree to employ adequate
contraception to prevent pregnancy while on therapy and for 4 weeks after the
completion of treatment.

Type of Study:


Study Design:

Allocation: Non-Randomized, Endpoint Classification: Safety Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:


Outcome Time Frame:

every 6 weeks

Safety Issue:



United States: Food and Drug Administration

Study ID:

Perifosine 125



Start Date:

October 2006

Completion Date:

October 2009

Related Keywords:

  • Renal Cancer
  • GIST
  • Perifosine
  • Sunitinib Malate
  • Renal cancer
  • GIST
  • advanced cancers
  • Carcinoma, Renal Cell
  • Kidney Neoplasms
  • Neoplasms