A Phase 1 interventional study of Cixutumumab and Everolimus in Gastrin-Producing Neuroendocrine Tumor, Lung Carcinoid Tumor and Metastatic Digestive System Neuroendocrine Tumor G1, sponsored by National Cancer Institute (NCI). Completed at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2016-07-15.
Sponsored by National Cancer Institute (NCI) · Phase 1, Interventional, and Treatment
This phase I trial studies the side effects and best dose of cixutumumab when given together with everolimus and octreotide acetate in treating patients with advanced low- or intermediate-grade neuroendocrine cancer. Monoclonal antibodies, such as cixutumumab, may find tumor cells and help carry tumor-killing substances to them. Everolimus may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Octreotide acetate may interfere with the growth of tumor cells and slow the growth of neuroendocrine cancer. Giving cixutumumab together with everolimus and octreotide acetate may be a better treatment for neuroendocrine cancer.
PRIMARY OBJECTIVES:
I. To recommend a phase 2 dose for the combination of IMC-A12 (cixutumumab) and everolimus, given with octreotide long-acting release (LAR) (octreotide acetate), in patients with advanced neuroendocrine tumors.
II. To describe the pharmacokinetics of IMC-A12 given once every 21 days in combination with everolimus and octreotide LAR.
III. To evaluate pharmacodynamic markers in blood, and tumor tissue.
SECONDARY OBJECTIVES:
I. To evaluate the safety profile of IMC-A12 and everolimus with octreotide LAR.
II. To explore the anti-tumor activity of the combination of IMC-A12 and everolimus as defined by Response Evaluation Criteria in Solid Tumors (RECIST) response rate and progression-free survival (PFS).
TERTIARY OBJECTIVES:
I. To explore baseline molecular marker and drug-induced molecular marker changes that may predict clinical outcome.
OUTLINE: This is a dose-escalation study of cixutumumab.
Patients receive cixutumumab intravenously (IV) over 60-90 minutes and octreotide acetate intramuscularly (IM) on day 1 and everolimus orally (PO) once daily (QD) on days 1-21. Treatment repeats every 21 days for up to 18 courses in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed up for 30 days.
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Patients not on anticoagulation must have international normalized ratio (INR) =\< 1.5; patients on full-dose anticoagulation (warfarin or low molecular weight heparin) are eligible provided that both of the following criteria are met:
Exclusion Criteria:
Uncontrolled intercurrent illness including, but not limited to:
Patients receive cixutumumab IV over 60-90 minutes and octreotide acetate IM on day 1 and everolimus PO QD on days 1-21. Treatment repeats every 21 days for up to 18 courses in the absence of disease progression or unacceptable toxicity.
Biological: Cixutumumab · Drug: Everolimus · Other: Laboratory Biomarker Analysis · Drug: Octreotide Acetate · Other: Pharmacological Study
Given IV
Also known as: Anti-IGF-1R Recombinant Monoclonal Antibody IMC-A12, IMC-A12
Given PO
Also known as: 42-O-(2-Hydroxy)ethyl Rapamycin, Afinitor, Certican, RAD 001, RAD001
Correlative studies
Given IM
Also known as: D-Phenylalanyl-L-cysteinyl-L-phenylalanyl-D-tryptophyl-L-lysyl-L-threonyl-N-[(1R,2R)-2-hydroxy-1-(hyroxymethyl)propyl]-L-cysteinamide, Cyclic (2->7)-disulfide, Acetate (Salt), Longastatin, Longastatina, Samilstin, Sandostatin, Sandostatin Lar Depot, Sandostatina, Sandostatine, SMS 201-995, SMS 201-995 AC
Correlative studies
Incidence of dose-limiting toxicities (DLTs) for the combination of cixutumumab and everolimus with octreotide acetate
Analysis will be performed using a patient summary of the number of cycles of study drug administered by initial dose level, and will be presented including a flag for DLTs which occurred during course 1. The recommended Phase II dose will also be presented.
Time frame: 21 days
Pharmacodynamic markers in blood and tumor tissue
Descriptive statistics for the changes from baseline in blood and tissue biomarkers will be presented by response category in an attempt to characterize these changes with respect to efficacy.
Time frame: Up to day 1 of course 4
Pharmacokinetic parameters
Descriptive statistics will be used for plasma drug concentration data. Calculated parameters will include maximum concentration and minimum concentration.
Time frame: Pre-dose and day 1 of courses 1-7
Safety profile of cixutumumab and everolimus with octreotide acetate among patients with advanced neuroendocrine tumors, defined by the incidence of adverse events
Safety data will be tabulated for all patients who receive any amount of study medication. These data will include adverse events and laboratory parameters. Adverse events will be tabulated by body system, preferred term, severity and relation to treatment. The tabulation of adverse events will be done using the CTCAE version 4.0.
Time frame: Up to 30 days after completion of study treatment
Anti-tumor activity as determined by RECIST
Time frame: Up to 30 days after completion of study treatment
Changes in drug-induced molecular markers
Time frame: Baseline to up to day 1 of course 4
Changes in molecular markers
Time frame: Baseline to up to day 1 of course 4
This study is completed, as verified in Jul 2016. You cannot join it, but the record below documents what was studied.
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National Cancer Institute (NCI)