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Doxorubicin and Gemcitabine in Treating Patients With Locally Recurrent or Metastatic Unresectable Renal Cell Carcinoma

Phase 2
Completed
Conditions
Metastatic Renal Cell Carcinoma
Renal Cell Carcinoma With Sarcomatoid Features
Interventions
Registration Number
NCT00068393
Lead Sponsor
Eastern Cooperative Oncology Group
Brief Summary

RATIONALE: Drugs used in chemotherapy, such as doxorubicin and gemcitabine, use different ways to stop tumor cells from dividing so they stop growing or die. Combining more than one drug may kill more tumor cells.

PURPOSE: This phase II trial is studying how well giving doxorubicin together with gemcitabine works in treating patients with locally recurrent or metastatic unresectable renal cell carcinoma (kidney cancer).

Detailed Description

OBJECTIVES:

* Determine the response rate of patients with locally recurrent or metastatic unresectable renal cell cancer with sarcomatoid features treated with doxorubicin and gemcitabine.

* Determine the progression-free survival and overall survival of patients treated with this regimen.

* Determine the toxic effects of this regimen in these patients.

OUTLINE: This is a multicenter study.

Patients receive doxorubicin intravenously (IV) and gemcitabine IV over 30 minutes on day 1. Patients also receive filgrastim (G-CSF) subcutaneously (SC) on days 2- or 3-10 or pegfilgrastim SC on day 2. Courses repeat every 2 weeks in the absence of disease progression or unacceptable toxicity.

After 6 courses, patients undergo a MUGA scan. Patients with a stable\* left ventricular ejection fraction (LVEF) continue therapy as above. Patients who reach a total doxorubicin dose of 450 mg/m\^2 and are found to have unstable cardiac function or who have an abnormal LVEF continue therapy with gemcitabine alone.

NOTE: \*Stable cardiac function is defined as no decrease more than 15% of LVEF in absolute number and LVEF at least 35% in total function by MUGA.

Patients are followed every 3 months for 2 years and then every 6 months for 1 year.

ACTUAL ACCRUAL: A total of 39 patients were accrued for this study.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
39
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Doxorubicin/GemcitabineNeulastaDoxorubicin was given at 50 mg/m² by IV slow push, followed by gemcitabine 1500 mg/m² IV infusion over 30 minutes on day 1. Patients will receive G-CSF at a subcutaneous dose of 5mcg/kg/day on days 2 or 3 to 10 or neulasta at a dose of 6mg on day 2. Growth factor must be administered as close as possible to 24 hours after the completion of chemotherapy. It is recommended that neulasta be administered only on day 2 due to its prolonged half-life. Cycles were repeated every 2 weeks.
Doxorubicin/GemcitabineG-CSF (granulocyte-colony stimulating factor)Doxorubicin was given at 50 mg/m² by IV slow push, followed by gemcitabine 1500 mg/m² IV infusion over 30 minutes on day 1. Patients will receive G-CSF at a subcutaneous dose of 5mcg/kg/day on days 2 or 3 to 10 or neulasta at a dose of 6mg on day 2. Growth factor must be administered as close as possible to 24 hours after the completion of chemotherapy. It is recommended that neulasta be administered only on day 2 due to its prolonged half-life. Cycles were repeated every 2 weeks.
Doxorubicin/GemcitabineDoxorubicinDoxorubicin was given at 50 mg/m² by IV slow push, followed by gemcitabine 1500 mg/m² IV infusion over 30 minutes on day 1. Patients will receive G-CSF at a subcutaneous dose of 5mcg/kg/day on days 2 or 3 to 10 or neulasta at a dose of 6mg on day 2. Growth factor must be administered as close as possible to 24 hours after the completion of chemotherapy. It is recommended that neulasta be administered only on day 2 due to its prolonged half-life. Cycles were repeated every 2 weeks.
Doxorubicin/GemcitabineGemcitabineDoxorubicin was given at 50 mg/m² by IV slow push, followed by gemcitabine 1500 mg/m² IV infusion over 30 minutes on day 1. Patients will receive G-CSF at a subcutaneous dose of 5mcg/kg/day on days 2 or 3 to 10 or neulasta at a dose of 6mg on day 2. Growth factor must be administered as close as possible to 24 hours after the completion of chemotherapy. It is recommended that neulasta be administered only on day 2 due to its prolonged half-life. Cycles were repeated every 2 weeks.
Primary Outcome Measures
NameTimeMethod
Response Rate by Solid Tumor Response Criteria (RECIST)Every 8 weeks during treatment; then every 3 months if <2 years from study entry; then every 6 months if 2-3 years from study entry

Per RECIST criteria, Complete response (CR)= disappearance of all target and nontarget lesions Partial response (PR)= \>=30% decrease in the sum of the longest diameters of target lesions from baseline, and persistence of one or more non-target lesion(s) and/or the maintenance of tumor marker level above the normal limits. Objective response = CR + PR

Secondary Outcome Measures
NameTimeMethod
Progression-free SurvivalEvery 8 weeks during treatment; then every 3 months if <2 years from study entry; then every 6 months if 2-3 years from study entry

Progression-free survival is defined as time from study entry until disease progression or death from any cause, whichever occurs first. Progression is defined as at least a 20% increase in the sum of the longest diameters of target lesions, taking as reference the smallest sum longest diameter recorded since the baseline measurements, or the appearance of one or more new lesion(s) or unequivocal progression of existing nontarget lesions.

Overall SurvivalEvery 2 weeks during treatment; then every 3 months if <2 years from study entry; then every 6 months if 2-3 years from study entry

Overall survival is defined as the time from study entry until death from any cause.

Trial Locations

Locations (91)

Hematology and Oncology Associates

🇺🇸

Chicago, Illinois, United States

Mercy Hospital and Medical Center

🇺🇸

Chicago, Illinois, United States

University of Chicago Cancer Research Center

🇺🇸

Chicago, Illinois, United States

Cancer Research Center at Boston Medical Center

🇺🇸

Boston, Massachusetts, United States

Beth Israel Deaconess Medical Center

🇺🇸

Boston, Massachusetts, United States

William N. Wishard Memorial Hospital

🇺🇸

Indianapolis, Indiana, United States

Barbara Ann Karmanos Cancer Institute

🇺🇸

Detroit, Michigan, United States

Mayo Clinic Cancer Center

🇺🇸

Rochester, Minnesota, United States

Aurora Sinai Medical Center

🇺🇸

Milwaukee, Wisconsin, United States

Medical Consultants, Limited

🇺🇸

Milwaukee, Wisconsin, United States

Roswell Park Cancer Institute

🇺🇸

Buffalo, New York, United States

CCOP - Hematology-Oncology Associates of Central New York

🇺🇸

Syracuse, New York, United States

Welch Cancer Center at Sheridan Memorial Hospital

🇺🇸

Sheridan, Wyoming, United States

Central Pennsylvania Hematology and Medical Oncology Associates, PC

🇺🇸

Lemoyne, Pennsylvania, United States

Cancer Institute of New Jersey at UMDNJ - Robert Wood Johnson Medical School

🇺🇸

New Brunswick, New Jersey, United States

Marshfield Clinic - Marshfield Center

🇺🇸

Marshfield, Wisconsin, United States

St. Rita's Medical Center

🇺🇸

Lima, Ohio, United States

Penn State Cancer Institute at Milton S. Hershey Medical Center

🇺🇸

Hershey, Pennsylvania, United States

Gundersen Lutheran Cancer Center at Gundersen Lutheran Medical Center

🇺🇸

La Crosse, Wisconsin, United States

University of Colorado Cancer Center at UC Health Sciences Center

🇺🇸

Aurora, Colorado, United States

Lewistown Hospital

🇺🇸

Lewistown, Pennsylvania, United States

Mount Nittany Medical Center

🇺🇸

State College, Pennsylvania, United States

Fox Chase Cancer Center - Philadelphia

🇺🇸

Philadelphia, Pennsylvania, United States

USC/Norris Comprehensive Cancer Center and Hospital

🇺🇸

Los Angeles, California, United States

Robert H. Lurie Comprehensive Cancer Center at Northwestern University

🇺🇸

Chicago, Illinois, United States

Veterans Affairs Medical Center - Lakeside Chicago

🇺🇸

Chicago, Illinois, United States

Midwest Center for Hematology/Oncology

🇺🇸

Joliet, Illinois, United States

Joliet Oncology-Hematology Associates, Limited - West

🇺🇸

Joliet, Illinois, United States

North Shore Oncology and Hematology Associates, Limited - Libertyville

🇺🇸

Libertyville, Illinois, United States

Hematology Oncology Associates - Skokie

🇺🇸

Skokie, Illinois, United States

Cancer Care and Hematology Specialists of Chicagoland - Niles

🇺🇸

Niles, Illinois, United States

CCOP - Carle Cancer Center

🇺🇸

Urbana, Illinois, United States

Elkhart General Hospital

🇺🇸

Elkhart, Indiana, United States

Hematology/Oncology of the North Shore at Gross Point Medical Center

🇺🇸

Skokie, Illinois, United States

Indiana University Cancer Center

🇺🇸

Indianapolis, Indiana, United States

Saint Anthony Memorial Health Centers

🇺🇸

Michigan City, Indiana, United States

Center for Cancer Therapy at LaPorte Hospital and Health Services

🇺🇸

La Porte, Indiana, United States

Howard Community Hospital at Howard Regional Health System

🇺🇸

Kokomo, Indiana, United States

CCOP - Northern Indiana CR Consortium

🇺🇸

South Bend, Indiana, United States

Memorial Hospital of South Bend

🇺🇸

South Bend, Indiana, United States

McFarland Clinic, PC

🇺🇸

Ames, Iowa, United States

Saint Joseph Regional Medical Center

🇺🇸

South Bend, Indiana, United States

Cedar Rapids Oncology Associates

🇺🇸

Cedar Rapids, Iowa, United States

Siouxland Regional Cancer Center

🇺🇸

Sioux City, Iowa, United States

St. Luke's Regional Medical Center

🇺🇸

Sioux City, Iowa, United States

Oakwood Cancer Center at Oakwood Hospital and Medical Center

🇺🇸

Dearborn, Michigan, United States

Genesys Hurley Cancer Institute

🇺🇸

Flint, Michigan, United States

Hurley Medical Center

🇺🇸

Flint, Michigan, United States

Foote Hospital

🇺🇸

Jackson, Michigan, United States

Van Elslander Cancer Center at St. John Hospital and Medical Center

🇺🇸

Grosse Pointe Woods, Michigan, United States

Borgess Medical Center

🇺🇸

Kalamazoo, Michigan, United States

Lakeland Cancer Care Center at Lakeland Hospital - St. Joseph

🇺🇸

Saint Joseph, Michigan, United States

Bronson Methodist Hospital

🇺🇸

Kalamazoo, Michigan, United States

Miller-Dwan Medical Center

🇺🇸

Duluth, Minnesota, United States

St. John Macomb Hospital

🇺🇸

Warren, Michigan, United States

Hematology-Oncology Centers of the Northern Rockies - Billings

🇺🇸

Billings, Montana, United States

St. Mary's - Duluth Clinic Cancer Center

🇺🇸

Duluth, Minnesota, United States

St. Peter's Hospital

🇺🇸

Helena, Montana, United States

CCOP - Montana Cancer Consortium

🇺🇸

Billings, Montana, United States

St. Vincent Healthcare

🇺🇸

Billings, Montana, United States

Bozeman Deaconess Cancer Center

🇺🇸

Bozeman, Montana, United States

St. James Community Hospital

🇺🇸

Butte, Montana, United States

Kalispell Medical Oncology

🇺🇸

Kalispell, Montana, United States

Kalispell Regional Medical Center

🇺🇸

Kalispell, Montana, United States

Community Medical Center

🇺🇸

Missoula, Montana, United States

Guardian Oncology and Center for Wellness

🇺🇸

Missoula, Montana, United States

Montana Cancer Specialists at Montana Cancer Center

🇺🇸

Missoula, Montana, United States

Montana Cancer Center at St. Patrick Hospital and Health Sciences Center

🇺🇸

Missoula, Montana, United States

Marshfield Clinic - Indianhead Center

🇺🇸

Rice Lake, Wisconsin, United States

CCOP - Duluth

🇺🇸

Duluth, Minnesota, United States

Carle Cancer Center at Carle Foundation Hospital

🇺🇸

Urbana, Illinois, United States

Sparrow Regional Cancer Center

🇺🇸

Lansing, Michigan, United States

Rush-Copley Cancer Care Center

🇺🇸

Aurora, Illinois, United States

Siouxland Hematology-Oncology Associates, LLP

🇺🇸

Sioux City, Iowa, United States

Glacier Oncology, PLLC

🇺🇸

Kalispell, Montana, United States

West Michigan Cancer Center

🇺🇸

Kalamazoo, Michigan, United States

Medical X-Ray Center, PC

🇺🇸

Sioux Falls, South Dakota, United States

Community Comprehensive Cancer Center at Camden-Clark Memorial Hospital

🇺🇸

Parkersburg, West Virginia, United States

Billings Clinic Cancer Center

🇺🇸

Billings, Montana, United States

Great Falls Clinic

🇺🇸

Great Falls, Montana, United States

CCOP - Northern New Jersey

🇺🇸

Hackensack, New Jersey, United States

Avera Cancer Institute

🇺🇸

Sioux Falls, South Dakota, United States

Sioux Valley Hospital and University of South Dakota Medical Center

🇺🇸

Sioux Falls, South Dakota, United States

University of Wisconsin Paul P. Carbone Comprehensive Cancer Center

🇺🇸

Madison, Wisconsin, United States

Saint Joseph Mercy Cancer Center

🇺🇸

Ann Arbor, Michigan, United States

CCOP - Michigan Cancer Research Consortium

🇺🇸

Ann Arbor, Michigan, United States

Our Lady of Mercy Medical Center Comprehensive Cancer Center

🇺🇸

Bronx, New York, United States

Northern Rockies Radiation Oncology Center

🇺🇸

Billings, Montana, United States

Seton Cancer Institute - Saginaw

🇺🇸

Saginaw, Michigan, United States

Deaconess Billings Clinic - Downtown

🇺🇸

Billings, Montana, United States

Hunterdon Regional Cancer Center at Hunterdon Medical Center

🇺🇸

Flemington, New Jersey, United States

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