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Breast CancerPhase 2NCT00722072

Sorafenib and Fulvestrant in Treating Patients With Locally Advanced or Metastatic Breast Cancer That Did Not Respond to Aromatase Inhibitor Therapy

A Phase 2 study testing fulvestrant and sorafenib tosylate in people with Breast Cancer, run by OHSU Knight Cancer Institute at 1 site in United States.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

RATIONALE: Sorafenib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth and by blocking blood flow to the tumor. Estrogen can cause the growth of breast cancer cells. Hormone therapy using fulvestrant may fight breast cancer by blocking the use of estrogen by the tumor cells. Read more about this study

Who is it for?
Ages 18 to 120 years
Conditions the study is for
Breast Cancer
What is being tested?
fulvestrant and sorafenib tosylate
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
12 participants
Where
1 siteUnited States
Study dates
Jul 2008to Jul 2012
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 120 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

DISEASE CHARACTERISTICS:

  • Diagnosis of incurable breast cancer
  • Locally advanced or metastatic disease
  • Measurable or evaluable disease
  • Measurable disease is defined as ≥ 1 uni-dimensionally measurable lesion ≥ 20 mm by conventional techniques or ≥ 10 mm by spiral computed tomography(CT) scan
  • Bone-only metastases that can be imaged with bone scan AND magnetic resonance imaging (MRI) or bone scan AND plain x-ray is considered measurable disease
  • Tumor lesions that are situated in a previously irradiated area are considered measurable only if they are progressing at the time of study entry
  • Evaluable disease includes unresectable skin/chest wall metastases that can be photographed and whose size can be measured with a ruler
  • Bone-only metastases that can only be imaged using bone scan or malignant pleural effusion(s) only are not considered evaluable disease
  • Previously treated with a third-generation aromatase inhibitor (e.g., letrozole, anastrazole, or exemestane) AND meets one of the following criteria:
  • Progressed during palliative aromatase inhibitor therapy
  • Recurred during adjuvant aromatase inhibitor therapy
  • Recurred within 12 months of completing adjuvant aromatase inhibitor therapy
  • Human Epidermal growth factor Receptor 2(HER2/neu)-negative tumor
  • No Human Epidermal growth factor Receptor 2(HER2/neu) overexpression (i.e., tumor staining 3+ by immunohistochemistry [IHC] or gene amplified by Fluorescence In Situ Hybridization [FISH])
  • Hormone receptor status:
  • Estrogen receptor and/or progesterone receptor positive, defined as ≥ 10% of malignant cells with positive nuclear staining

PATIENT CHARACTERISTICS:

  • Postmenopausal
  • Eastern Cooperative Group(ECOG) performance status 0-1
  • Life expectancy ≥ 16 weeks
  • Neutrophil count ≥ 1,500/mm^³
  • Platelet count ≥ 100,000/mm^³
  • Hemoglobin ≥ 9.0 g/dL
  • Creatinine < 2 mg/dL
  • Total bilirubin ≤ 1.5 times upper limit of normal (ULN)
  • Alanine aminotransferase (ALT) and aspartate aminotransferase(AST) ≤ 2.5 times ULN (≤ 5 times ULN for patients with liver involvement)
  • International Normalized Ratio(INR) < 1.5 OR Prothrombin time/ partial thromboplastin time (PT/PTT) normal
  • Left ventricular ejection fraction(LVEF) normal by Multiple Gated Acquisition(MUGA) or ECHO
  • No known allergy to sorafenib tosylate or fulvestrant
  • No cardiac disease, including any of the following:
  • New York Heart Association(NYHA) class III-IV congestive heart failure
  • Unstable angina (anginal symptoms at rest) or new-onset angina (within the past 3 months)
  • Myocardial infarction within the past 6 months
  • Cardiac ventricular arrhythmias requiring anti-arrhythmic therapy
  • No uncontrolled hypertension, defined as systolic blood pressure > 150 mm Hg or diastolic blood pressure > 90 mm Hg despite optimal medical management
  • No thrombotic or embolic events, such as cerebrovascular accident (including transient ischemic attacks), within the past 6 months
  • No known HIV infection or chronic hepatitis B or C infection
  • No infection that requires IV antibiotics or produces a fever > 100°F within the past 72 hours
  • No pulmonary hemorrhage/bleeding event ≥ Common terminology criteria for adverse events(CTCAE) grade 2 within the past 4 weeks
  • No other hemorrhage/bleeding event ≥ CTCAE grade 3 within the past 4 weeks
  • No evidence or history of bleeding diathesis or coagulopathy
  • No significant traumatic injury within the past 2 weeks
  • No serious, nonhealing wound, ulcer, or bone fracture
  • No condition that impairs the patient's ability to swallow whole pills
  • No malabsorption problem
  • No second malignancy within the past 5 years, except adequately treated and cured basal cell or squamous cell skin cancer or carcinoma in situ of the cervix
  • No underlying medical condition that, in the principal investigator's opinion, will make the administration of study drug hazardous or would obscure the interpretation of adverse events

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • No prior chemotherapy for metastatic or unresectable locally advanced breast cancer
  • No prior sorafenib tosylate or other Vascular endothelial growth factor(VEGF)-targeting therapies
  • More than 2 weeks since prior major surgery or open biopsy
  • No concurrent anticoagulation with warfarin or heparin
  • No concurrent Hypericum perforatum (St. John wort) or rifampin
  • No other concurrent anticancer agents, including chemotherapy or biological therapy
  • No other concurrent investigational drugs
  • Concurrent bisphosphonates allowed

Trial locations and contacts

1 site in 1 country.

United States1 site
  • OHSU Knight Cancer Institute

    Portland, Oregon, 97239-3098

Other trials in United States

About this study

Official title: A Phase II Open-Label Study of Sorafenib Plus Fulvestrant as Salvage Therapy for Hormone Receptor Positive Metastatic Breast Cancer Failing Prior Aromatase Inhibitor Treatment

RATIONALE: Sorafenib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth and by blocking blood flow to the tumor. Estrogen can cause the growth of breast cancer cells. Hormone therapy using fulvestrant may fight breast cancer by blocking the use of estrogen by the tumor cells. Giving sorafenib together with fulvestrant may kill more tumor cells.

PURPOSE: This phase II trial is studying how well giving sorafenib together with fulvestrant works in treating patients with locally advanced or metastatic breast cancer that did not respond to aromatase inhibitor therapy.

Read the detailed description

OBJECTIVES:

Primary

  • To investigate the clinical activity of sorafenib tosylate and fulvestrant, as determined by a 4-month progression-free survival rate, in patients with hormone receptor-positive locally advanced or metastatic breast cancer that progressed after prior treatment with an aromatase inhibitor.

Secondary

  • To determine the objective response rate in patients treated with this regimen.
  • To determine the median time to progression in patients treated with this regimen.
  • To determine the progression-free survival of patients treated with this regimen.
  • To determine the overall survival of patients treated with this regimen.
  • To establish the safety and tolerability profile of this regimen in these patients.

OUTLINE: Patients receive oral sorafenib tosylate twice daily on days 1-28. Patients also receive fulvestrant intramuscularly on days 1 and 15 of course 1 and on day 1 of all subsequent courses. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed at 28-56 days.

Conditions
Breast Cancer
Being tested
fulvestrant, sorafenib tosylate
Keywords
male breast cancer, stage IIIA breast cancer, stage IIIB breast cancer, stage IIIC breast cancer, stage IV breast cancer, recurrent breast cancer
Medical subject headings
Breast Neoplasms, Breast Neoplasms, Male

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • fulvestrantDrug

    Loading dose for cycle 1: 500 mg intramuscular(IM) on Day 1;250 mg IM on Day 15 Upon completion of the loading dose, a fixed dose of fulvestrant 250 mg IM will be administered on day 1 of the next 28 day cycle and every consecutive cycle until tumor progression or until unacceptable toxicity occurs requiring discontinuation of study therapy

  • sorafenib tosylateDrug

    Subjects will take sorafenib 800 mg/day administered as 400 mg bid (twice daily) each morning and evening approximately 12 hours apart. Treatment will begin on Day 1 of the study and continue daily until tumor progression or until an unacceptable toxicity occurs which would require delay, modification or discontinuation of study therapy

Study groups in NCT00722072
Study groupRoleWhat they receive
Fulvestrant/ SorafenibExperimentalFulvestrant: A loading dose will be administered intramuscularly to all subjects during cycle 1 of treatment as follows: * 500 mg IM on Day 1 * 250 mg IM on Day 15 Upon completion of the loading dose, a fixed dose of Fulvestrant 250 mg IM will be administered on day 1 of the next 28 day cycle and every consecutive cycle until tumor progression or unacceptable toxicity occurs requiring discontinuation. Sorafenib: Subjects will take Sorafenib 800 mg/day administered as 400 mg bid (twice daily)each morning and evening approximately 12 hours apart. Treatment will begin on Day 1 of the study and continue daily until tumor progression or until unacceptable toxicity occurs.
Receives: Drug: fulvestrant; Drug: sorafenib tosylate

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of Participants With Progression-free Survival at 4 Months

    Progression-free survival rate is defined as the proportion of subjects who are progression free (CR, PR and SD) at 4 months after initiating treatment with sorafenib plus fulvestrant. Complete Response (CR):Disappearance of all target (both measurable and evaluable)lesions. Partial Response (PR):At least a 30% decrease in the sum of the longest diameter (LD) of both measurable and evaluable target lesions. Stable Disease (SD):Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for progressive disease(PD).

    Measured: 4 months after initiating treatment with sorafenib plus fulvestrant.

Secondary outcomes (4)
  1. Objective Response Rate

    Measured: Every 8 weeks (two cycles) while receiving study therapy.

  2. Time to Progression

    Measured: Start of treatment to time of progression.

  3. Progression-free Survival

    Measured: Start of treatment to time of progression or death, whichever comes first.

  4. Overall Survival

    Measured: 28 to 56 days after discontinuation of study therapy

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted25 Jul 2008 (estimated)
  2. Study startJul 2008
  3. Primary completionJul 2010
  4. Study completionJul 2012

Why it stopped: Sponsor pulled funding and low accrual

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
12 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00722072
Sponsor's protocol ID
IRB00004318
Other IDs
P30CA069533, OHSU-4318, BAYER-OHSU-4318, CDR0000601002
Status last verified
Jan 2018
First submitted
24 Jul 2008
Last updated
26 Feb 2018

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing fulvestrant and sorafenib tosylate in people with Breast Cancer, run by OHSU Knight Cancer Institute at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 26 Feb 2018. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 5 Sep 2011). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of Participants With Progression-free Survival at 4 Months (time frame: 4 months after initiating treatment with sorafenib plus fulvestrant.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 26 Feb 2018.

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