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Phase I Study of the Combination of Axitinib (AX) Plus Everolimus (EV) in Patients With Malignant Advanced Solid Tumors

Phase 1
18 Years
Open (Enrolling)
Malignant Advanced Solid Tumors, Carcinoma, Renal Cell

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Trial Information

Phase I Study of the Combination of Axitinib (AX) Plus Everolimus (EV) in Patients With Malignant Advanced Solid Tumors

Phase I study of the combination of axitinib (AX) plus everolimus (EV) in patients with
malignant advanced solid tumors.

- To determine the recommended dose for phase II study of the combination of AX + EV

- To determine the safety profile and predictive factors for toxicity, pharmacokinetics
(PK), and efficacy in adult solid tumors.

- To assess functional vascular imaging (FVI) as surrogate marker of activity, biomarkers
predictive of activity and preliminary efficacy data in metastatic RCC, untreated with

Phase I, multicentre, open-label, non-randomized, sequential algorithm based dose-finding
(3+3), clinical study in successive cohorts of patients.

Patients will take both drugs orally, every day, without planned rest period (AX bid and EV
once a day). By convention one cycle is 28 days. At the first cycle patients will take one
week of AX single agent before starting EV. Patients will be treated at increasing dose
levels (DLs) in successive cohorts of 3-6 patients according to the number of patients with
dose limiting toxicities (DLT) until the maximum tolerated dose (MTD; i.e. the DL at which
<= 1/6 patient experiences a DLT during the first cycle). All decision concerning
qualification for DLT, dose escalation, study termination, inclusion of additional patients,
will be taken by a Trial Monitoring Committee..

The MTD will not be higher than the recommended dose of each single agent. Six additional
patients will be entered at the MTD to confirm the feasibility of the dose and preliminarily
assess the efficacy of the combination in patients with RCC untreated with antiangiogenics.

Three levels of dose will be explored.

Inclusion Criteria

Inclusion criteria

- Histologically proven advanced adult solid tumors, with the exception of Hodgkin and
non Hodgkin lymphoma. Patients with hepatocellular carcinomas (HCC) may be enrolled
without histological documentation if they meet the consensus non-invasive diagnostic

- Failure or contra-indication of all standard therapies, except for the patients with
advanced renal cell carcinoma, enrolled at the recommended dose who will be naïve of
previous lines of therapy while metastatic.

- Age > 18 years

- ECOG Performance status (PS) 0-1

- Life expectancy > 3 months

- Measurable/evaluable disease according to RECIST CRITERIA version 1.0

- Acceptable biological values: Hemoglobin > 10g /dL; neutrophils > 1.5 x 109/L;
platelets > 100 x 109/L, AST and ALT < 2.5 x the upper normal limits (UNL), or < 5 x
UNL in case of liver metastases, GGT < 3 x the upper normal limits (UNL), PAL < 2.5 x
the upper normal limits (UNL), or < 5 x UNL in case of liver metastases, serum
bilirubin < 1.5 x ULN, creatinine clearance (Cockroft & Gault formula) > 60 mL/min.

- 24 hours proteinuria ≤ 1 g/24 h

- Albumin > 30 g/l

- Amylase and lipase ≤ 1.5 UNL

- Electrolytes (calcium, sodium, potassium, chlore, magnesium, phosphate) in the normal
range. Supplementation could be possible before study entry.

- Total cholesterol ≤ 2.5 UNL

- Triglycerides ≤ 2.5 UNL

- BP < 140/90

- Washout period from last anticancer therapy, including radiation and surgery > 3
weeks and recovery of toxicities to NCI-CTC grade < 1.

- Written informed Consent.

- Use of effective contraceptive method (Intrauterine device, oral combined
contraceptive) for women of child-bearing age or whose partner is included in the

- Patient with french social security.

- Additional inclusion criteria before the association axitinib plus everolimus period

- No toxicity with NCI-CTC grade > 2 at the end of axitinib alone period just before
starting axitinib and everolimus (cycle 1)

- BP < 140/ 90

Exclusion criteria

- Brain metastasis

- Severe underlying cardiovascular disease, even medically controlled, such as angina
pectoris, myocardial infarction, cardiac insufficiency, cardiac failure, cerebral
strokes, lower limb ischemic disease, thromboembolic disease, and any patient, who,
in the investigator's opinion is at high risk for arterial or venous thromboembolism.

- Hepatitis B or C carrier or at a chronic state

- Uncontrolled hypertension, or diabetes mellitus despite medical treatment.

- Inability to swallow pills

- Unresolved pneumopathy, no need for antibiotherapy

- Any medical or social condition, which; in the investigator's opinion, would
jeopardize patient's safety, patient's compliance to the protocol, or the
interpretation of study results. These conditions include (but are not limited to):
severe infection, cardiac failure, chronic gastrointestinal disease compromising oral
drug absorption, psychiatric illnesses, foreseeable poor treatment compliance with
oral medications, patients living far away from the investigational centers, etc…

- Hypersensitivity to Axitinib or Everolimus

- Participation to another clinical trial, or use of an unapproved medication within 4
weeks prior to study treatment initiation.

- Pregnant or lactating women.

Type of Study:


Study Design:

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

Outcome Measure:

Proportion of patients with DLT (dose limiting toxicity) during the first cycle (first 28 days of the combination of both study compounds), per dose level explored

Outcome Description:

A DLT will be one of the following adverse events, with a possible relationship to the study medications Febrile, related bleeding or any grade 4 neutropenia or thrombocytopenia, grade 3 non-hematological toxicity, unless adequately treated with usual symptomatic therapy grade 4 non-hematological toxicity study treatment interruption > 2 weeks, inability to deliver at least 80% of the intended doses of axitinib and/or everolimus between day 8 and 35 due to toxicity.

Outcome Time Frame:

during cycle 1

Safety Issue:


Principal Investigator


Investigator Role:

Principal Investigator

Investigator Affiliation:

University Hospital, Bordeaux


France: Afssaps - Agence française de sécurité sanitaire des produits de santé (Saint-Denis)

Study ID:

CHUBX 2010/09



Start Date:

March 2011

Completion Date:

August 2014

Related Keywords:

  • Malignant Advanced Solid Tumors
  • Carcinoma, Renal Cell
  • Phase I
  • Axitinib
  • Everolimus
  • Maximum tolerated dose (MTD)
  • solid tumor
  • Renal cell cancer (RCC)
  • Pharmacokinetics (PK/PD)
  • Carcinoma
  • Carcinoma, Renal Cell
  • Neoplasms