Study of Axitinib in Patients With Recurred or Metastatic Adenoid Cystic Carcinoma (AxitinibACC)
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ClinicalTrials.gov Identifier: NCT02859012 |
Recruitment Status :
Completed
First Posted : August 8, 2016
Last Update Posted : March 29, 2022
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Tracking Information | ||||
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First Submitted Date ICMJE | July 28, 2016 | |||
First Posted Date ICMJE | August 8, 2016 | |||
Last Update Posted Date | March 29, 2022 | |||
Actual Study Start Date ICMJE | September 2016 | |||
Actual Primary Completion Date | December 2017 (Final data collection date for primary outcome measure) | |||
Current Primary Outcome Measures ICMJE |
Progression-free survival (PFS) rate [ Time Frame: 6 months ] | |||
Original Primary Outcome Measures ICMJE | Same as current | |||
Change History | ||||
Current Secondary Outcome Measures ICMJE |
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Original Secondary Outcome Measures ICMJE | Same as current | |||
Current Other Pre-specified Outcome Measures | Not Provided | |||
Original Other Pre-specified Outcome Measures | Not Provided | |||
Descriptive Information | ||||
Brief Title ICMJE | Study of Axitinib in Patients With Recurred or Metastatic Adenoid Cystic Carcinoma | |||
Official Title ICMJE | Randomized Phase II Study of Axitinib in Patients With Recurred or Metastatic Adenoid Cystic Carcinoma | |||
Brief Summary | To understand efficacy of axitinib in recurred or metastatic adenoid cystic carcinoma | |||
Detailed Description | Adenoid cystic carcinoma (ACC) is a rare variant of adenocarcinoma that occurs in secretory glands such as in salivary glands. Although ACC is histologically low grade and slow-growing, more than half of patients eventually have recurrent and/or metastatic disease. The natural course of metastatic disease with ACC is relatively indolent; however, most patients with metastatic disease ultimately die from their cancer. The management of recurred / metastatic ACC is a distinct therapeutic challenge because of its insidious local growth pattern, propensity for perineural involvement, tendency for distant metastasis, and pronounced ability to recur over a prolonged period. 2. Current treatment The role of systemic chemotherapy in ACC is very limited and objective response to any cytotoxic or molecular targeted agent is infrequent, and the optimum regimen is unclear. Because of the rarity of ACC, there are few clinical trials investigating the efficacy of systemic chemotherapy. Recurrent/metastatic ACC is an incurable disease with no standard treatments. VEGF is highly expressed in ACC and its expression correlates with stage, tumor size, vascular invasion, recurrence and metastasis. High expression of VEGF and Ki-67 were independent poor prognostic factors in ACC. MYB/NFIB translocation has recently identified in ACC and MYB protein over expression was found in ACC. MYB over-expression in ACC has been correlated to the increased expression of genes involved in vascular endothelial growth factor (VEGF), KIT . More than 70% of ACCs highly express the oncogenic transcription factor c-myb, which drives expression of genes that activate VEGFR and c-kit pathways. Several lines of evidence suggest a function for VEGF, PDGFR signaling in ACC progression. The expressions of NF-kappaB p65, iNOS, and VEGF were related with microvessel density. In vitro, the inhibition of VEGF expression via iNOS gene induced apoptosis of ACC cell lines. Axitinib (AG-013736; Pfizer) is a multi-targeted small-molecule inhibitor of the receptor tyrosine kinases involved in tumor proliferation and angiogenesis, including VEGFR-1, VEGFR-2 and VEGFR-3, c-kit, platelet-derived growth factor receptor (PDGFR)-α and PFGFR-β. Axitinib (AG-013736) has demonstrated a partial response lasting 4 months in one patient with ACC in a phase I trial . In that aspect, Ho et al. conducted phase II study with axitinib in ACC. Interestingly, response rate was 9.1% and tumor shrinkage was observed in 66.7% Besides of axitinib, other antiangiogenic agents such as sutene or dovitinib showed promising activity in ACC. Dovitinib, which is pan FGFR , VEGF, PDGFR inhibitor showed one confirmed partial response PR (3.1%) and three unconfirmed PR (9.3%). Interestingly, hyperphosphatemia was not observed in this study, and one PR patients showed strong PDGFR beta positivity, which suggests that antiangiogenic pathway is more important than FGFR pathway. 3. Gap, issue or problem that needs to be addressed Based on these evidences which suggest a function for VGFR, PDGFR signaling in ACC tumorigenesis and progression, the use of axitinib is reasonable and valuable. However, the huge gap in ACC trial is lack of randomization trial. Until now, there is no randomized trial in ACC because of its rarity. Hence there is no confirmatory trial in ACC. Without randomization trial, we can not say the real efficacy of axitinib. So we design multicenter randomized trial of axtinib in ACC to confirm the efficacy of axitinib in this orphan disease. |
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Study Type ICMJE | Interventional | |||
Study Phase ICMJE | Phase 2 | |||
Study Design ICMJE | Allocation: Randomized Intervention Model: Crossover Assignment Masking: None (Open Label) Primary Purpose: Treatment |
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Condition ICMJE | Recurrent ACC, metastaticACC, Unreaectable ACC | |||
Intervention ICMJE |
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Study Arms ICMJE |
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Publications * | Kang EJ, Ahn MJ, Ock CY, Lee KW, Kwon JH, Yang Y, Choi YH, Kim MK, Ji JH, Yun T, Nam BH, Kim SB, Keam B. Randomized Phase II Study of Axitinib versus Observation in Patients with Recurred or Metastatic Adenoid Cystic Carcinoma. Clin Cancer Res. 2021 Oct 1;27(19):5272-5279. doi: 10.1158/1078-0432.CCR-21-1061. | |||
* Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline. |
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Recruitment Information | ||||
Recruitment Status ICMJE | Completed | |||
Estimated Enrollment ICMJE |
60 | |||
Original Estimated Enrollment ICMJE | Same as current | |||
Actual Study Completion Date ICMJE | August 2020 | |||
Actual Primary Completion Date | December 2017 (Final data collection date for primary outcome measure) | |||
Eligibility Criteria ICMJE | Inclusion Criteria:
Exclusion Criteria:
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Sex/Gender ICMJE |
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Ages ICMJE | Child, Adult, Older Adult | |||
Accepts Healthy Volunteers ICMJE | No | |||
Contacts ICMJE | Contact information is only displayed when the study is recruiting subjects | |||
Listed Location Countries ICMJE | Korea, Republic of | |||
Removed Location Countries | ||||
Administrative Information | ||||
NCT Number ICMJE | NCT02859012 | |||
Other Study ID Numbers ICMJE | Axitinib in ACC | |||
Has Data Monitoring Committee | No | |||
U.S. FDA-regulated Product | Not Provided | |||
IPD Sharing Statement ICMJE | Not Provided | |||
Current Responsible Party | Bhumsuk Keam, Seoul National University Hospital | |||
Original Responsible Party | Same as current | |||
Current Study Sponsor ICMJE | Seoul National University Hospital | |||
Original Study Sponsor ICMJE | Same as current | |||
Collaborators ICMJE | Not Provided | |||
Investigators ICMJE |
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PRS Account | Seoul National University Hospital | |||
Verification Date | March 2022 | |||
ICMJE Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP |