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A Phase II Evaluation of AZD6244 (NSC #748727, IND #77782) in the Treatment of Recurrent or Persistent Endometrial Carcinoma


Phase 2
18 Years
N/A
Open (Enrolling)
Female
Endometrial Adenocarcinoma, Endometrial Adenosquamous Cell Carcinoma, Endometrial Clear Cell Carcinoma, Recurrent Endometrial Carcinoma

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Trial Information

A Phase II Evaluation of AZD6244 (NSC #748727, IND #77782) in the Treatment of Recurrent or Persistent Endometrial Carcinoma


PRIMARY OBJECTIVES:

I. To assess the activity of AZD6244 (selumetinib) for patients with recurrent or persistent
endometrial cancer with the frequency of patients who survive progression-free for at least
6 months after initiating therapy or have objective tumor response.

II. To determine the nature and degree of toxicity of AZD6244 as assessed by CTCAE v3.0 in
this cohort of patients.

SECONDARY OBJECTIVE:

I. To determine the duration of progression-free survival and overall survival.

EXPLORATORY OBJECTIVES:

I. To explore the associations between select biomarkers and response to AZD6244
(progression-free survival status >6 months and objective tumor response), measures of
clinical outcome (progression-free survival and overall survival) or disease status
including histologic cell type.

II. Mutations and single nucleotide polymorphisms in BRAF, KRAS2, FGFR2, PI3KCA, AKT1, AKT2,
AKT3 and PTEN in DNA from formalin-fixed and paraffin-embedded (FFPE) tumor and/or normal
blood cells.

III. Immunohistochemical expression of ERK, pERK, GSK3betta, pGSK3betta, PR-A, PR-B, pPR,
ER-alpha, ER-beta, BRAF, KRAS, PTEN, EGFR, pEGFR, EGF, PELP1 and MTA1s in FFPE tumor.

IV. To explore the relationship among the panel of biomarkers evaluated in this cohort
including mutations and single nucleotide polymorphisms in BRAF, KRAS2, FGFR2, PI3KCA, AKT1,
AKT2, AKT3 and PTEN as well as immunohistochemical expression of ERK, pERK, GSK3betta,
pGSK3betta, PR-A, PR-B, pPR, ER-alpha, ER-beta, BRAF, KRAS, PTEN, EGFR, pEGFR, EGF, PELP1
and MTA1s.

OUTLINE: This is a multicenter study.

Patients receive selumetinib orally (PO) twice daily on days 1-28. Courses repeat every 28
days in the absence of disease progression or unacceptable toxicity. Blood and archived
tumor tissue samples are collected for biomarker studies.

After completion of study therapy, patients are followed up every 3 months for 2 years and
then every 6 months for 3 years.


Inclusion Criteria:



- Histologically confirmed* endometrial epithelial carcinoma, including any of the
following cell types:

- Endometrioid adenocarcinoma

- Serous adenocarcinoma

- Undifferentiated carcinoma

- Clear cell adenocarcinoma

- Mixed epithelial carcinoma

- Adenocarcinoma not otherwise specified

- Mucinous adenocarcinoma

- Squamous cell carcinoma

- Transitional cell carcinoma

- Mesonephric carcinoma

- Recurrent or persistent disease that is refractory to curative therapy or established
treatments

- Measurable disease, defined as ≥ 1 lesion that can be measured in ≥ 1 dimension
(longest dimension to be recorded)

- Each lesion must be ≥ 20 mm when measured by conventional techniques (palpation,
plain x-ray, CT scan, or MRI) OR ≥ 10 mm when measured by spiral CT scan

- Must have ≥ 1 target lesion to be used to assess response, as defined by RECIST
criteria

- Tumors within a previously irradiated field are designated as "non-target"
lesions unless progression is documented or a biopsy is obtained to confirm
persistence ≥ 90 days following completion of radiotherapy

- Must have received 1 prior chemotherapeutic regimen for the management of endometrial
carcinoma

- Chemotherapy administered as a radiosensitizer in conjunction with primary
radiotherapy is considered a systemic chemotherapy regimen

- Not eligible for a higher priority GOG protocol, if one exists (e.g., any active
phase III GOG protocol for the same patient population)

- No prior or concurrent CNS disease (treated or untreated) by physical examination,
including primary brain tumor or brain metastases

- GOG performance status (PS) 0-2 (for patients who received 1 prior treatment regimen)

- GOG PS 0-1 (for patients who received 2 prior treatment regimens)

- ANC ≥ 1,500/mm^3

- Platelet count ≥ 100,000/mm^3

- Creatinine ≤ 1.5 times upper limit of normal (ULN)

- Bilirubin ≤ 1.5 times ULN

- SGOT ≤ 2.5 times ULN

- Alkaline phosphatase ≤ 2.5 times ULN

- PT/INR ≤ 1.5 OR in-range INR (between 2 and 3) if patient is on a stable dose of
therapeutic warfarin

- PTT ≤ 1.5 times ULN

- Oxygen saturation ≥ 88% on room air

- QTc < 450 msec by EKG

- LVEF normal

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception during and for ≥ 6 months after
completion of study therapy

- No neuropathy (sensory or motor) > grade 1

- No active infection requiring antibiotics

- Uncomplicated urinary tract infection allowed

- No other invasive malignancy within the past 5 years except for nonmelanoma skin
cancer

- No serious, non-healing wound, ulcer, or bone fracture

- No history of abdominal fistula or gastrointestinal perforation

- No intra-abdominal abscess within the past 28 days

- No active bleeding or pathological condition that would carry a high risk of bleeding
(e.g., bleeding disorder, coagulopathy, or tumor involving major vessels)

- No seizures not controlled with standard medical therapy

- No clinically significant cardiovascular disease including, but not limited to, any
of the following:

- Uncontrolled hypertension, defined as systolic BP > 140 mm Hg or diastolic BP >
90 mm Hg

- Myocardial infarction or unstable angina within the past 6 months

- NYHA class II-IV congestive heart failure

- Serious cardiac arrhythmia requiring medication, including atrial fibrillation
requiring rate-controlling medication

- Peripheral vascular disease ≥ grade 2

- Cerebrovascular accident (i.e., CVA, stroke), transient ischemic attack, or
subarachnoidal hemorrhage within the past 6 months

- No evidence of serious ventricular arrhythmia (i.e., ventricular tachycardia or
ventricular fibrillation ≥ 3 beats in a row) by EKG

- Concurrent low molecular weight heparin for treatment of venous thromboembolic
disease allowed provided patient is considered clinically stable on this regimen

- Recovered from prior surgery, radiotherapy, or chemotherapy

- At least 1 week since prior hormonal therapy directed at the malignant tumor

- At least 3 weeks since prior radiotherapy or chemotherapy (6 weeks for nitrosoureas
or mitomycin C)

- At least 3 weeks since other prior therapy directed at the malignant tumor, including
immunologic agents

- One prior cytotoxic regimen for the management of recurrent or persistent endometrial
disease allowed

- No prior non-cytotoxic chemotherapy for the management of endometrial cancer, except
hormonal therapy

- No prior anticancer therapy that contraindicates study therapy

- No prior MEK inhibitor AZD6244 or other specific MEK/ERK/MAPK pathway targeted
therapy

- No prior chemotherapy for any abdominal or pelvic tumor other than for the treatment
for endometrial cancer within the past 5 years

- Prior adjuvant chemotherapy for localized breast cancer allowed provided it was
completed > 3 years ago AND the patient remains free of recurrent or metastatic
disease

- No prior radiotherapy to any portion of the abdominal cavity or pelvis other than for
the treatment of endometrial cancer within the past 5 years

- Prior radiotherapy for localized cancer of the breast, head and neck, or skin is
allowed provided it was completed > 3 years ago AND the patient remains free of
recurrent or metastatic disease

- No concurrent medication that may prolong the QTc interval

- No other concurrent investigational therapy

- No concurrent combination antiretroviral therapy for HIV-positive patients

Type of Study:

Interventional

Study Design:

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

Outcome Measure:

Progression-free survival assessed by Response Evaluation Criteria for Solid Tumors (RECIST)

Outcome Time Frame:

6 months

Safety Issue:

No

Principal Investigator

Robert Coleman

Investigator Role:

Principal Investigator

Investigator Affiliation:

Gynecologic Oncology Group

Authority:

United States: Food and Drug Administration

Study ID:

NCI-2011-01958

NCT ID:

NCT01011933

Start Date:

September 2009

Completion Date:

Related Keywords:

  • Endometrial Adenocarcinoma
  • Endometrial Adenosquamous Cell Carcinoma
  • Endometrial Clear Cell Carcinoma
  • Recurrent Endometrial Carcinoma
  • Adenocarcinoma
  • Adenocarcinoma, Mucinous
  • Carcinoma
  • Carcinoma, Adenosquamous
  • Adenocarcinoma, Clear Cell
  • Adenomyoepithelioma
  • Adenoma
  • Endometrial Neoplasms

Name

Location

University of Iowa Hospitals and Clinics Iowa City, Iowa  52242
University of Mississippi Medical Center Jackson, Mississippi  39216-4505
Washington University School of Medicine Saint Louis, Missouri  63110
Abington Memorial Hospital Abington, Pennsylvania  19001
Hurley Medical Center Flint, Michigan  48503
Bronson Methodist Hospital Kalamazoo, Michigan  49007
West Michigan Cancer Center Kalamazoo, Michigan  49007-3731
Borgess Medical Center Kalamazooaa, Michigan  49001
Rush University Medical Center Chicago, Illinois  60612-3824
Hartford Hospital Hartford, Connecticut  06102-5037
Franklin Square Hospital Center Baltimore, Maryland  21237
University of Oklahoma Health Sciences Center Oklahoma City, Oklahoma  73104
Iowa Methodist Medical Center Des Moines, Iowa  50309
Iowa Lutheran Hospital Des Moines, Iowa  50316-2301
Paoli Memorial Hospital Paoli, Pennsylvania  19301-1792
Bryn Mawr Hospital Bryn Mawr, Pennsylvania  19010
Medical Oncology and Hematology Associates Des Moines, Iowa  50309
Saint Joseph Mercy Hospital Ann Arbor, Michigan  48106
Menorah Medical Center Overland Park, Kansas  66209
North Kansas City Hospital Kansas City, Missouri  64116
Research Medical Center Kansas City, Missouri  64132
Saint Luke's East - Lee's Summit Lee's Summit, Missouri  64086
Liberty Hospital Liberty, Missouri  64068
Heartland Regional Medical Center Saint Joseph, Missouri  64506
Memorial Medical Center Springfield, Illinois  62781
Riverside Methodist Hospital Columbus, Ohio  43214
Indiana University Medical Center Indianapolis, Indiana  46202
Lankenau Hospital Wynnewood, Pennsylvania  19096
University of Chicago Comprehensive Cancer Center Chicago, Illinois  60637-1470
M D Anderson Cancer Center Houston, Texas  77030
University of Southern California Los Angeles, California  90033
University of Cincinnati Cincinnati, Ohio  45267-0502
Saint Francis Hospital and Medical Center Hartford, Connecticut  06105
The Hospital of Central Connecticut New Britain, Connecticut  06050
Medical Oncology and Hematology Associates-West Des Moines Clive, Iowa  50325
Iowa Oncology Research Association CCOP Des Moines, Iowa  50309
Mercy Medical Center - Des Moines Des Moines, Iowa  50314
Medical Oncology and Hematology Associates-Des Moines Des Moines, Iowa  50309
Michigan Cancer Research Consortium Community Clinical Oncology Program Ann Arbor, Michigan  48106
Oakwood Hospital Dearborn, Michigan  48123
Saint John Hospital and Medical Center Detroit, Michigan  48236
Allegiance Health Jackson, Michigan  49201
Sparrow Hospital Lansing, Michigan  48912
Saint Mary Mercy Hospital Livonia, Michigan  48154
Saint Joseph Mercy Oakland Pontiac, Michigan  48341-2985
Saint Joseph Mercy Port Huron Port Huron, Michigan  48060
Saint Mary's of Michigan Saginaw, Michigan  48601
Saint John Macomb-Oakland Hospital Warren, Michigan  48093
Saint Luke's Hospital of Kansas City Kansas City, Missouri  64111
Saint Joseph Health Center Kansas City, Missouri  64114
Truman Medical Center Kansas City, Missouri  64108
Ozark Health Ventures LLC dba Cancer Research for The Ozarks Springfield Springfield, Missouri  65802
Cox Medical Center Springfield, Missouri  65807
Mainline Health CCOP Wynnewood, Pennsylvania  19096
Cancer Care Associates-Yale Tulsa, Oklahoma  74136-1929
Women and Infants Hospital Providence, Rhode Island  02905
Lyndon Baines Johnson General Hospital Houston, Texas  77030
University of Colorado Cancer Center - Anschutz Cancer Pavilion Aurora, Colorado  80045
State University of New York Downstate Medical Center Brooklyn, New York  11203
Women's Cancer Center of Nevada Las Vegas, Nevada  89109
Saint Luke's South Hospital Overland Park, Kansas  66213
Kansas City CCOP Prairie Village, Kansas  66208
Heartland Hematology and Oncology Associates Incorporated Kansas City, Missouri  64118
Saint Joseph Oncology Inc Saint Joseph, Missouri  64507
Los Angeles County-USC Medical Center Los Angeles, California  90033
Sudarshan K Sharma MD Limted-Gynecologic Oncology Hinsdale, Illinois  60521
Saint Vincent Oncology Center Indianapolis, Indiana  46260
Methodist West Hospital West Des Moines, Iowa  50266-7700
Genesys Regional Medical Center-West Flint Campus Flint, Michigan  48532
Mercy Cancer Center-West Lakes Clive, Iowa  50325
Mercy Medical Center-West Lakes West Des Moines, Iowa  50266