Azacitidine and Entinostat in Treating Patients With Metastatic Colorectal Cancer
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ClinicalTrials.gov Identifier: NCT01105377 |
Recruitment Status :
Completed
First Posted : April 16, 2010
Results First Posted : November 1, 2013
Last Update Posted : August 1, 2014
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Condition or disease | Intervention/treatment | Phase |
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Recurrent Colon Cancer Recurrent Rectal Cancer Stage IV Colon Cancer Stage IV Rectal Cancer | Drug: entinostat Drug: azacitidine Other: laboratory biomarker analysis | Phase 2 |
PRIMARY OBJECTIVES:
I. To determine the preliminary efficacy via Response Evaluation Criteria In Solid Tumors (RECIST) response rate of the combination of azacitidine and entinostat in patients with metastatic colorectal cancer.
SECONDARY OBJECTIVES:
I. Explore the effects of azacitidine and entinostat on time to progression in patients with metastatic colorectal cancer.
II. To assess the toxicity for combination azacitidine and entinostat therapy.
TERTIARY OBJECTIVES:
I. Evaluate changes in promoter methylation of selected genes from DNA in circulating serum samples.
II. To determine changes in histone deacetylase activity and acetylation of H3 and H4 histones in pre- and post-treatment tumor biopsies.
III. To evaluate correlations between these molecular effects and clinical outcomes (response, time to progression).
IV. To correlate response rates by RECIST criteria versus response rates determined be EASL (change in tumor enhancement).
OUTLINE: This is a multicenter study.
Patients receive azacitidine subcutaneously on days 1-5 and 8-10 and oral entinostat on days 3 and 10. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
Blood and tumor tissue samples are collected at baseline and periodically during courses 1-3 for DNA methylation, histone deacetylation activity, and acetylation of H3 and H4 histones analysis by PCR, western blot, and RT-PCR assays. Pharmacogenomic studies may also be conducted.
After completion of study therapy, patients are followed up every 3-6 months for up to 3 years.
Study Type : | Interventional (Clinical Trial) |
Actual Enrollment : | 47 participants |
Allocation: | N/A |
Intervention Model: | Single Group Assignment |
Masking: | None (Open Label) |
Primary Purpose: | Treatment |
Official Title: | Phase II Study of Azacitadine and Entinostat in Patients With Metastatic Colorectal Cancer |
Study Start Date : | April 2010 |
Actual Primary Completion Date : | March 2012 |
Actual Study Completion Date : | May 2014 |
Arm | Intervention/treatment |
---|---|
Experimental: Treatment (entinostat, azacitidine)
Patients receive azacitidine subcutaneously on days 1-5 and 8-10 and oral entinostat on days 3 and 10. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
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Drug: entinostat
Given orally
Other Names:
Drug: azacitidine Given SC
Other Names:
Other: laboratory biomarker analysis Correlative studies |
- Confirmed Tumor Response [ Time Frame: At 6 month evaluation ]Each evaluable patient is classified as having a confirmed tumor response if they have either a complete response (CR) or partial response (PR) lasts at least 4 weeks. Tumor response is measured by using RECIST v1.1 (Response Evaluation Criteria in Solid Tumors). A CR is defined as a disappearance of all target lesions, and each target lymph node must have reduction in short axis to <1.0 cm. A PR is defined as a 30% decrease in the sum of the longest diameter for all target lesions plus the sum of the short axis of all the target lymph nodes at current evaluation, compared to pre-treatment measurements. The confirmed response rate is calculated as the number of confirmed CR+PR, divided by the total number of evaluable patients, with 95% confidence intervals estimated using the approach of Duffy and Santner.
- Time to Progression [ Time Frame: From the start of treatment to the earliest of the date documenting disease progression, assessed up to 3 years ]Time to disease progression (TTP) is defined as the time from the start of treatment to the earliest of the date documenting disease progression or most recent assessment for patients having no progression. The distribution of TTP is estimated using the method of Kaplan-Meier.
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Histologically confirmed metastatic colorectal cancer
- Measurable disease
- Patient has failed ≥ 2 prior chemotherapy regimens
- Not a candidate for curative resection
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No CNS metastases within ≤ 2 years
- Treatment for brain metastasis and whole brain disease that has remained stable for > 3 months allowed
- Patients who have not been treated with steroid therapy may be allowed
- ECOG performance status 0-1
- Life expectancy ≥ 12 weeks
- Leukocytes ≥ 3,000/mm^3
- ANC ≥ 1,500/mm^3
- Platelet count ≥ 100,000/mm^3
- Total bilirubin ≤ 1.5 times upper limit of normal (ULN)
- AST and ALT ≤ 2.5 times ULN
- Creatinine normal OR creatinine clearance ≥ 60 mL/min
- Negative pregnancy test
- Not pregnant or nursing
- Fertile patients must use effective contraception
- Sensory neuropathy ≤ grade 2 allowed
- Willing to provide tissue and blood samples
- No history of allergic reactions attributed to compounds of similar chemical or biologic composition to entinostat, azacitidine, mannitol, or other agents used in the study
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No uncontrolled intercurrent illness including, but not limited to, any of the following:
- Ongoing or active infection
- NYHA class II-IV symptomatic congestive heart failure
- Unstable angina pectoris
- Cardiac arrhythmia
- Psychiatric illness and/or social situations that would limit compliance with study requirements
- No history of severe bleeding without thrombocytopenia
- No concurrent radiotherapy including palliative treatment
- Toxicities from prior therapy have resolved to ≤ grade 1
- More than 4 weeks since prior chemotherapy (> 6 weeks for nitrosoureas or mitomycin C)
- More than 4 weeks since prior major surgical procedure
- No prior histone deacetylase inhibitors (including valproic acid) or demethylating agents
- No concurrent investigational agents
- No concurrent combination antiretroviral therapy in HIV-positive patients
- No concurrent investigational or commercial anticancer agents or therapies
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01105377
United States, Arizona | |
Mayo Clinic in Arizona | |
Scottsdale, Arizona, United States, 85259 | |
United States, California | |
University of Southern California/Norris Cancer Center | |
Los Angeles, California, United States, 90033 | |
United States, Florida | |
Mayo Clinic in Florida | |
Jacksonville, Florida, United States, 32224-9980 | |
United States, Maryland | |
Johns Hopkins University/Sidney Kimmel Comprehensive Cancer Center | |
Baltimore, Maryland, United States, 21287 | |
United States, Michigan | |
Wayne State University/Karmanos Cancer Institute | |
Detroit, Michigan, United States, 48201 | |
United States, Minnesota | |
Minnesota Oncology Hematology PA-Maplewood | |
Maplewood, Minnesota, United States, 55109 | |
Mayo Clinic | |
Rochester, Minnesota, United States, 55905 | |
Metro-Minnesota CCOP | |
Saint Louis Park, Minnesota, United States, 55416 | |
United Hospital | |
Saint Paul, Minnesota, United States, 55102 | |
Lakeview Hospital | |
Stillwater, Minnesota, United States, 55082 | |
United States, Missouri | |
Washington University School of Medicine | |
Saint Louis, Missouri, United States, 63110 | |
United States, Pennsylvania | |
University of Pittsburgh Cancer Institute | |
Pittsburgh, Pennsylvania, United States, 15232 | |
University of Pittsburgh | |
Pittsburgh, Pennsylvania, United States, 15232 | |
United States, Wisconsin | |
University of Wisconsin Hospital and Clinics | |
Madison, Wisconsin, United States, 53792 |
Principal Investigator: | Nilofer Azad | Mayo Clinic |
Responsible Party: | National Cancer Institute (NCI) |
ClinicalTrials.gov Identifier: | NCT01105377 |
Other Study ID Numbers: |
NCI-2010-02024 NCI-2010-02024 ( Registry Identifier: CTRP (Clinical Trial Reporting Program) ) CDR0000670136 MC084B ( Other Identifier: Mayo Clinic ) 8341 ( Other Identifier: CTEP ) N01CM00099 ( U.S. NIH Grant/Contract ) P30CA015083 ( U.S. NIH Grant/Contract ) N01CM00038 ( U.S. NIH Grant/Contract ) |
First Posted: | April 16, 2010 Key Record Dates |
Results First Posted: | November 1, 2013 |
Last Update Posted: | August 1, 2014 |
Last Verified: | July 2014 |
Rectal Neoplasms Colonic Neoplasms Recurrence Disease Attributes Pathologic Processes Colorectal Neoplasms Intestinal Neoplasms Gastrointestinal Neoplasms Digestive System Neoplasms Neoplasms by Site Neoplasms Digestive System Diseases |
Gastrointestinal Diseases Colonic Diseases Intestinal Diseases Rectal Diseases Azacitidine Entinostat Histone Deacetylase Inhibitors Antimetabolites, Antineoplastic Antimetabolites Molecular Mechanisms of Pharmacological Action Antineoplastic Agents Enzyme Inhibitors |