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A Phase II Evaluation of Cediranib (Recentin; AZD2171, IND# 72740, NSC# 732208) 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, Endometrial Papillary Serous Carcinoma, Recurrent Endometrial Carcinoma

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Trial Information

A Phase II Evaluation of Cediranib (Recentin; AZD2171, IND# 72740, NSC# 732208) in the Treatment of Recurrent or Persistent Endometrial Carcinoma


PRIMARY OBJECTIVES:

I. To determine the response at 6 months of patients with persistent or recurrent
endometrial carcinoma treated with cediranib maleate.

II. To determine the progression-free survival at 6 months of patients treated with this
regimen.

III. To determine the frequency and degree of toxicity of this regimen in these patients.

SECONDARY OBJECTIVES:

I. To determine the duration of progression-free survival of patients treated with this
regimen.

II. To determine the duration of overall survival of patients treated with this regimen.

III. To estimate the probability of response without restriction on the duration of response
documentation of these patients since study enrollment.

TERTIARY OBJECTIVES:

I. To determine whether the response to cediranib maleate correlates with high-expression of
its receptor targets (e.g., VEGFR [1, 2, 3] and PDGFR).

II. To determine whether the response to cediranib maleate correlates with high endogenous
circulating plasma levels of VEGFA, low-levels of its endogenous inhibitor, sFlt-1 (the
truncated, circulating portion of VEGFR-1), or circulating Tissue Factor (TF) or circulating
Par-4, both potential markers of tumor progression.

III. To determine whether a high-expression of VEGFA on pre-treatment tumor specimens
correlates with response to this regimen.

IV. To determine whether expression of phosphorylated ERK1 and 2, c-Jun, Stat3, PKC, and
p70S6 kinase correlates with resistance or sensitivity to cediranib maleate.

OUTLINE: This is a multicenter study.

Patients receive oral cediranib maleate once daily on days 1-28. Treatment repeats every 28
days in the absence of disease progression or unacceptable toxicity.

Patients undergo tumor tissue and blood sample collection at baseline and periodically
during study for biomarker and other analysis.

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 primary endometrial carcinoma including any of the following
epithelial 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

- Recurrent or persistent disease

- Refractory to curative therapy or established treatments

- Measurable disease defined as >= 1 lesion that can be accurately measured in >= 1
dimension (longest diameter to be recorded)

- Lesion must be >= 10 mm by CT scan, MRI, or caliper measurement by clinical exam
OR >= 20 mm by chest x-ray

- Lymph nodes must be > 15 mm in short axis by CT scan or MRI

- Patient must have >= 1 "target lesion" to assess response as defined by RECIST v. 1.1

- Tumors within a previous irradiated field are designated as non-target lesions
unless progression is documented OR a biopsy is obtained to confirm persistence
of disease >= 90 days after completion of radiotherapy

- Patient must not be eligible for a higher priority GOG protocol, if one exists

- Must have had 1 prior chemotherapeutic regimen for management of endometrial cancer
that may include 1 of the following:

- Chemotherapy

- Chemotherapy and radiotherapy

- Chemotherapy in conjunction with primary radiotherapy as a radio-sensitizer
will be counted as a systemic chemotherapy regimen

- Consolidation and/or maintenance therapy

- No CNS disease, including primary brain tumor or brain metastases

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

- ANC >= 1,500/mm^3

- Platelet count >= 100,000/mm^3

- Creatinine =< 1.5 times upper limit of normal (ULN) OR creatinine clearance >= 60
mL/min

- Urine protein: creatinine (UPC) ratio < 1.0 g

- Bilirubin =< 1.5 times ULN

- AST =< 2.5 times ULN

- Alkaline phosphatase =< 2.5 times ULN

- INR =< 1.5 times ULN (between 2 and 3 for patients on stable dose of therapeutic
warfarin)

- PTT =< 1.5 times ULN

- Amylase and lipase normal

- Thyroid stimulation hormone (TSH) and free thyroxine (Free T4) normal

- Peripheral neuropathy (sensory and motor) =< grade 1

- Negative pregnancy test

- Not pregnant or nursing

- Fertile patients must use effective contraception

- No active infection requiring antibiotics

- Uncomplicated urinary tract infection allowed

- No invasive malignancies within the past 3 years except nonmelanoma skin cancer or
curatively treated localized cancer of the breast, head and neck, or skin

- No serious non-healing wound, ulcer, or bone fracture, including the following:

- History of abdominal fistula, gastrointestinal perforation, or intra-abdominal
abscess within the past 28 days

- No active bleeding or pathological conditions that carry high-risk of bleeding,
including the following:

- Known bleeding disorder

- Coagulopathy disorder

- Tumor involving major vessels

- No uncontrolled seizures with standard medical therapy

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

- Uncontrolled hypertension (defined as systolic blood pressure (BP) > 150 mm Hg
or diastolic BP > 100 mm Hg despite optimized antihypertensive therapy)

- Myocardial infarction or unstable angina within the past 6 months

- New York Heart Association (NYHA) grade II-IV congestive heart failure or
serious cardiac arrhythmia requiring medication

- Patients who received prior anthracycline treatment, including doxorubicin
hydrochloride and/or liposomal doxorubicin, and have an ejection fraction <
normal are not eligible for this study

- Peripheral vascular disease >= grade 2 as assessed by NCI CTCAE

- History of cerebrovascular accident (CVA, stroke), transient ischemic attack, or
subarachnoid hemorrhage within the past 6 months

- Mean QTc > 500 msec or history of familial long QT syndrome

- No known hypersensitivity to Chinese hamster ovary cell products or other recombinant
human or humanized antibodies

- No concurrent amifostine or other protective reagents

- Recovered from recent surgery, radiotherapy, or chemotherapy

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

- At least 3 weeks since any other prior anticancer therapy

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

- Cytotoxic regimens include any agent that targets the genetic and/or mitotic
apparatus of dividing cells, resulting in dose-limiting toxicity to the bone
marrow and/or gastrointestinal mucosa

- No prior non-cytotoxic chemotherapy for management of recurrent or persistent disease

- Prior hormonal therapy allowed

- No prior cediranib maleate or other VEGF pathway-targeted therapy

- No prior cancer treatment that contraindicates this protocol therapy

- No prior radiotherapy to any portion of the abdominal cavity or pelvis within the
past 3 years other than treatment for endometrial cancer

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

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

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

- No major surgical procedure, open biopsy, or significant traumatic injury within the
past 28 days

- No anticipation of major surgical procedure during the course of the study

- No minor surgical procedures, fine needle aspirates, or core biopsies within the past
7 days

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 (PFS) according to Response Evaluation Criteria in Solid Tumors (RECIST) v. 1.1

Outcome Time Frame:

At 6 months

Safety Issue:

No

Principal Investigator

David Bender

Investigator Role:

Principal Investigator

Investigator Affiliation:

Gynecologic Oncology Group

Authority:

United States: Food and Drug Administration

Study ID:

NCI-2011-02043

NCT ID:

NCT01132820

Start Date:

June 2010

Completion Date:

Related Keywords:

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

Name

Location

University of Iowa Hospitals and Clinics Iowa City, Iowa  52242
University of Mississippi Medical Center Jackson, Mississippi  39216-4505
Abington Memorial Hospital Abington, Pennsylvania  19001
University of Washington Medical Center Seattle, Washington  98195-6043
Tacoma General Hospital Tacoma, Washington  98405
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
Sarasota Memorial Hospital Sarasota, Florida  34239
Franklin Square Hospital Center Baltimore, Maryland  21237
Via Christi Regional Medical Center Wichita, Kansas  67214
Carolinas Medical Center Charlotte, North Carolina  28232-2861
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
Group Health Cooperative Seattle, Washington  98112
Fred Hutchinson Cancer Research Center/University of Washington Cancer Consortium Seattle, Washington  98109
Cancer Center of Kansas - Chanute Chanute, Kansas  66720
Cancer Center of Kansas - Dodge City Dodge City, Kansas  67801
Cancer Center of Kansas - Newton Newton, Kansas  67114
Cancer Center of Kansas - Salina Salina, Kansas  67042
Cancer Center of Kansas - Wellington Wellington, Kansas  67152
Associates in Womens Health Wichita, Kansas  67203
Cancer Center of Kansas - Winfield Winfield, Kansas  67156
Cancer Care Northwest - Spokane South Spokane, Washington  99202
Methodist Estabrook Cancer Center Omaha, Nebraska  68114-4199
Medical Oncology and Hematology Associates Des Moines, Iowa  50309
Cancer Center of Kansas - Fort Scott Fort Scott, Kansas  66701
Cancer Center of Kansas-Independence Independence, Kansas  67301
Lawrence Memorial Hospital Lawrence, Kansas  66044
Wenatchee Valley Medical Center Wenatchee, Washington  98801-2028
Seattle Cancer Care Alliance Seattle, Washington  98109
Greater Baltimore Medical Center Baltimore, Maryland  21204
Pacific Gynecology Specialists Seattle, Washington  98104
Duke University Medical Center Durham, North Carolina  27710
Case Western Reserve University Cleveland, Ohio  44106
Riverside Methodist Hospital Columbus, Ohio  43214
Wichita CCOP Wichita, Kansas  67214-3882
Northwest Hospital Seattle, Washington  98133
Virginia Commonwealth University Richmond, Virginia  
Central Georgia Gynecologic Oncology Macon, Georgia  31201
Providence Saint Joseph Medical Center Burbank, California  91505-4866
Harrison Medical Center Bremerton, Washington  98310
University of Chicago Comprehensive Cancer Center Chicago, Illinois  60637-1470
University of Cincinnati Cincinnati, Ohio  45267-0502
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
Cancer Center of Kansas - El Dorado El Dorado, Kansas  67042
Cancer Center of Kansas-Kingman Kingman, Kansas  67068
Cancer Center of Kansas - Parsons Parsons, Kansas  67357
Cancer Center of Kansas - Pratt Pratt, Kansas  67124
Cancer Center of Kansas-Wichita Medical Arts Tower Wichita, Kansas  67208
Cancer Center of Kansas - Main Office Wichita, Kansas  67214
Ozark Health Ventures LLC dba Cancer Research for The Ozarks Springfield Springfield, Missouri  65802
Saint John's Hospital Springfield, Missouri  65804
Cox Medical Center Springfield, Missouri  65807
Cooper Hospital University Medical Center Camden, New Jersey  08103
Kettering Medical Center Kettering, Ohio  45429
Harrison Bremerton Hematology and Oncology Bremerton, Washington  98310
Swedish Medical Center-First Hill Seattle, Washington  98122-4307
Saint Joseph Medical Center Tacoma, Washington  98405
Cancer Care Associates-Yale Tulsa, Oklahoma  74136-1929
Women and Infants Hospital Providence, Rhode Island  02905
Lake University Ireland Cancer Center Mentor, Ohio  44060
Cancer Center of Kansas-Liberal Liberal, Kansas  67901
University of Missouri - Ellis Fischel Columbia, Missouri  65203
Maine Medical Center-Bramhall Campus Portland, Maine  04102
Women's Cancer Center of Nevada Las Vegas, Nevada  89109
Providence Regional Cancer Partnership Everett, Washington  98201
Palo Alto Medical Foundation-Gynecologic Oncology Mountain View, California  94040
Sudarshan K Sharma MD Limted-Gynecologic Oncology Hinsdale, Illinois  60521
Saint Vincent Oncology Center Indianapolis, Indiana  46260
The Women's Institute for Gynecologic Cancer and Special Pelvic Surgery Phillipsburg, New Jersey  08865
PeaceHealth Medical Group PC Bellingham, Washington  98226
Skagit Valley Hospital Regional Cancer Care Center Mount Vernon, Washington  98274
Olympic Medical Cancer Care Center Sequim, Washington  98384
Rockwood Cancer Treatment Center Spokane, Washington  99204
Providence Saint Mary Regional Cancer Center Walla Walla, Washington  99362
Methodist West Hospital West Des Moines, Iowa  50266-7700
Harrison Poulsbo Hematology and Oncology Poulsbo, Washington  98370
Mercy Cancer Center-West Lakes Clive, Iowa  50325
Mercy Medical Center-West Lakes West Des Moines, Iowa  50266