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临床试验/NCT00873236
NCT00873236Unknown2 期

Dynamic Contrast Enhanced MRI (DCE-MRI) Assessment of the Vascular Changes Induced With Bevacizumab Alone and in Combination With Interferon-α in Patients With Advanced Renal Cell Carcinoma

Mount Vernon Cancer Centre at Mount Vernon Hospital10 个研究点 分布在 1 个国家目标入组 30 人开始时间: 2008年4月1日最近更新:
适应症

试验速览

阶段
2 期
发起方
入组人数
30
试验地点
10
主要终点
Dynamic contrast-enhanced MRI defined changes in K-trans after 6 weeks of bevacizumab monotherapy or bevacizumab and low- or standard-dose recombinant interferon alpha-2a

研究概览

简要总结

RATIONALE: Comparing results of MRI scans done after bevacizumab may help doctors predict a patient's response to treatment and help plan the best treatment. It is not yet known whether giving bevacizumab alone is more effective than giving bevacizumab together with interferon alpha-2a in detecting kidney cancer.

PURPOSE: This randomized phase II trial is studying MRI scans of blood vessel changes caused by bevacizumab to see how well it works compared with bevacizumab given together with interferon alpha-2a in treating patients with stage III or stage IV kidney cancer.

详细描述

OBJECTIVES:

Primary

  • To establish whether bevacizumab-induced changes in dynamic contrast-enhanced (DCE)-MRI vascular parameters are significantly enhanced by recombinant interferon alpha-2a.
  • To establish whether there is an interferon alpha-2a dose response in potentiating bevacizumab-induced changes in DCE-MRI vascular parameters.

Secondary

  • To correlate changes in DCE-MRI vascular parameters for each treatment group with progression-free survival.
  • To correlate changes in DCE-MRI vascular parameters for each treatment group with tumor response and changes in tumor size.
  • To correlate changes in DCE-MRI vascular parameters for each treatment group with other surrogate biomarkers.
  • To assess the degree of change in baseline K^trans within each arm of treatment.
  • To investigate changes in diffusion and blood oxygen-level dependent MRI and their correlation with other pharmacodynamic endpoints.
  • To assess the efficacy and safety profile of bevacizumab monotherapy or in combination with low or standard doses of recombinant interferon alpha-2a.

研究设计

研究类型
Interventional
分配方式
Randomized
主要目的
Diagnostic
盲法
None

入排标准

年龄范围
18 Years 至 —(Adult, Older Adult)
性别
All
接受健康志愿者

入选标准

  • DISEASE CHARACTERISTICS:
  • Histologically or cytologically confirmed advanced renal cell carcinoma
  • Metastatic (stage IV) disease
  • Locally advanced (unresectable stage III) disease
  • Previously untreated disease
  • Majority component of conventional clear-cell type is mandatory (tumors of mixed histology should be categorized by the predominant cell type)
  • Good- or intermediate-prognosis disease as defined by Motzer score
  • Lesions measurable by RECIST criteria and amenable to dynamic contrast-enhanced MRI scanning
  • No brain metastasis
  • PATIENT CHARACTERISTICS:
  • ECOG performance status 0-2
  • Life expectancy ≥ 12 weeks
  • ANC ≥ 1,500/mm^3
  • Platelet count ≥ 100,000/mm^3
  • Hemoglobin ≥ 8 g/dL (may be transfused to maintain or exceed this level)
  • Total bilirubin < 1.5 times upper limit of normal (ULN)
  • AST and ALT < 2.5 times ULN (< 5 times ULN in patients with liver metastases)
  • Serum creatinine ≤ 1.5 times ULN
  • Urine dipstick for proteinuria < 2+ OR < 1 g of protein in 24-hour urine collection
  • INR ≤ 1.5
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile women must use effective contraception during and for 9 months after completion of study treatment
  • No significant cardiovascular disease, defined as any of the following, within the past 6 months:
  • NYHA class II-IV congestive heart failure
  • Unstable angina pectoris
  • Myocardial infarction
  • No significant vascular disease (e.g., aortic aneurysm, aortic dissection) or symptomatic peripheral vacular disease
  • No evidence or history of recurrent thromboembolism (> 1 episode of deep venous thrombosis/pulmonary embolism) within the past 6 months, bleeding diathesis, or coagulopathy
  • No inadequately controlled hypertension (defined as a BP of > 150 mm Hg systolic and/or > 100 mm Hg diastolic on medication)
  • No history of hypertensive crisis or hypertensive encephalopathy
  • No stroke or transient ischemic attack within the past 6 months
  • No abdominal or tracheoesophageal fistula, gastrointestinal perforation, or intra-abdominal abscess within the past 6 months
  • No HIV or hepatitis B or C infection
  • No active clinically serious bacterial or fungal infections (> CTCAE grade 2)
  • No other infection > CTCAE grade 2
  • No concurrent active second malignancy within the past 3 years other than nonmelanoma skin cancers or post-treatment for localized prostate cancer
  • No gross ascites
  • No seizure disorder requiring medication
  • No serious non-healing wound, ulcer, or bone fracture
  • No contraindications to MRI scanning (e.g., history of claustrophobia or metal fragment implantation)
  • No history of allergic reactions to contrast agents
  • No other significant medical illness or medically significant abnormal laboratory finding that would, in the investigator's opinion, make the patient inappropriate for this study, or would increase the risk associated with the patient's participation in the study
  • PRIOR CONCURRENT THERAPY:
  • More than 28 days since prior major surgery (including open biopsy) or radiotherapy and recovered
  • More than 14 days since prior palliative radiotherapy to painful bone lesions and recovered
  • Concurrent palliative radiotherapy for local pain control allowed
  • More than 7 days since prior core biopsy or other minor surgical procedure, excluding placement of a vascular access device
  • More than 30 days since prior and no other concurrent investigational agents
  • No concurrent chronic daily intake of aspirin ≥ 325 mg/day or clopidogrel > 75 mg/day, or steroids (prednisone > 12.5 mg/day or dexamethasone > 2 mg/day), excluding inhaled steroids
  • 另有 2 项未显示

排除标准

  • 未提供

结局指标

主要结局

Dynamic contrast-enhanced MRI defined changes in K-trans after 6 weeks of bevacizumab monotherapy or bevacizumab and low- or standard-dose recombinant interferon alpha-2a

次要结局

  • Change in vascular permeability (K-trans) and tumor hypoxia at 2 and 6 weeks post-commencement of treatment
  • Best overall response
  • Progression-free survival
  • Time to progression
  • Treatment duration of bevacizumab and recombinant interferon alpha-2a
  • Treatment withdrawal
  • Dose modification
  • Incidence of adverse events
  • Number of circulating endothelial cells, circulating endothelial progenitors, and proangiogenic monocytic cells
  • Angiogenic factors (e.g., VEGF) and hypoxia-regulated markers
  • Correlation of DCE-MRI defined changes in K-trans with clinical response
  • Correlation of DCE-MRI defined changes in K-trans with surrogate biomarkers
  • Analysis of diffusion MRI and blood oxygen-level dependent MRI changes and comparison with other pharmacodynamic markers

研究者

发起方
Mount Vernon Cancer Centre at Mount Vernon Hospital
申办方类型
Other

研究点 (10)

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