Current Clinical Trials

S0931, Everolimus in Treating Patients With Kidney Cancer Who Have Undergone Surgery
  1. Henry Tsai, MD
    Henry Tsai, MD
  2. for people 18 Years to 120 Years (full criteria)
  3. Rancho Mirage, CA
  4. study started November 2011
  5. Henry Tsai, MD
  6. Currently not accepting new patients

Description

Summary

RATIONALE: Everolimus may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth or by blocking blood flow to the tumor. PURPOSE: This phase III trial is studying everolimus to see how well it works in treating patients with kidney cancer who have undergone surgery.

Official Title

S0931 EVEREST: EVErolimus for Renal Cancer Ensuring Surgical Therapy, A Phase III Study

Detailed Description

OBJECTIVES: Primary to compare recurrence-free survival in renal carcinoma patients randomly assigned to 54 weeks of everolimus versus 54 weeks of placebo after nephrectomy or partial nephrectomy. Secondary To compare the overall survival of patients treated with everolimus vs placebo. To compare qualitative and quantitative toxicity between the two study arms. To bank tissue and biologic specimens for future study of molecular biomarkers relevant to the AKT/mTOR and other pathways implicated in... more
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OBJECTIVES: Primary to compare recurrence-free survival in renal carcinoma patients randomly assigned to 54 weeks of everolimus versus 54 weeks of placebo after nephrectomy or partial nephrectomy. Secondary To compare the overall survival of patients treated with everolimus vs placebo. To compare qualitative and quantitative toxicity between the two study arms. To bank tissue and biologic specimens for future study of molecular biomarkers relevant to the AKT/mTOR and other pathways implicated in the pathogenesis of renal carcinoma and to investigate their potential predictive and prognostic value. To bank blood specimens for the future study of the relationship between steady-state trough levels of everolimus and relevant side effects (lymphopenia, infection, hyperglycemia, hypercholesterolemia, hypertriglyceridemia) in patients treated on this study with everolimus. OUTLINE: This is a multicenter study. Patients are stratified according to pathologic stage (intermediate high-risk vs very high-risk), histologic subtype (clear cell vs non-clear cell), and performance status (0 vs 1). Patients are randomized to 1 of 2 treatment arms. Arm I: Patients receive oral everolimus once daily on days 1-42. Treatment repeats every 6 weeks for 9 courses in the absence of disease progression or unacceptable toxicity. Arm II: Patients receive oral placebo once daily on days 1-42. Treatment repeats every 6 weeks for 9 courses in the absence of disease progression or unacceptable toxicity. Archived tumor tissue, plasma, and whole blood samples may be collected periodically for biomarker analysis and other translational studies. After completion of study treatment, patients are followed up every 6 months for 2 years and then annually for 8 years.

Keywords

Kidney Cancer

Eligibility

for people 18 Years to 120 Years
DISEASE CHARACTERISTICS: Histologically or cytologically confirmed renal cell carcinoma Clear cell or non-clear cell allowed No disease of the collecting duct or medullary carcinoma Considered pathologically either intermediate high-risk or very high-risk disease No history of distant metastases Patients with microvascular invasion of the renal vein of any grade or stage (as long as M0) are eligible Have undergone a full surgical resection (radical nephrectomy or partial nephrectomy) including r... more
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DISEASE CHARACTERISTICS: Histologically or cytologically confirmed renal cell carcinoma Clear cell or non-clear cell allowed No disease of the collecting duct or medullary carcinoma Considered pathologically either intermediate high-risk or very high-risk disease No history of distant metastases Patients with microvascular invasion of the renal vein of any grade or stage (as long as M0) are eligible Have undergone a full surgical resection (radical nephrectomy or partial nephrectomy) including removal of all clinically positive nodes Surgical margins must be negative Patients with positive renal vein margins are eligible unless there is invasion of the renal vein wall at the margin (provided no other margins are positive) Patients must be registered within 84 days after the date of the first surgical resection of the first tumor No evidence of residual or metastatic renal cell cancer on CT scan of the chest, abdomen, and pelvis (all with oral and IV contrast) performed after nephrectomy and within 28 days before registration MRI scans of the abdomen and pelvis with gadolinium and a non-contrast CT scan of the chest may be substituted if the patient is not able to have CT scans with IV contrast PATIENT CHARACTERISTICS: Zubrod performance status 0-1 ANC = 1,500/mm^3 Platelet count = 100,000/mm^3 Serum creatinine = 2.0 times upper limit of normal (ULN) OR calculated creatinine clearance = 30 mL/min Bilirubin = 1.5 times ULN SGOT and SGPT = 2.5 times ULN Not pregnant or nursing Fertile patients must use effective contraception during and for up to 8 weeks after completion of study treatment Able to take oral medications Patients must not have any of the following: NYHA class III-IV cardiac disease (i.e., patients with cardiac disease resulting in marked limitation of physical activity or resulting in inability to carry on any physical activity without discomfort) Unstable angina pectoris Myocardial infarction within the past 6 months Serious uncontrolled cardiac arrhythmia Patients must NOT have liver disease such as cirrhosis or severe hepatic impairment (Child-Pugh Class C) HBV and HCV testing are required at screening for all patients with a positive medical history based on risk factors and/or confirmation of prior HBV/HCV infection Must be able to take oral medications No impairment of gastrointestinal function or gastrointestinal disease that may significantly alter the absorption of everolimus (e.g., ulcerative disease, uncontrolled nausea, vomiting, diarrhea, malabsorption syndrome, or small bowel resection) No known history of HIV seropositivity No known uncontrolled, underlying pulmonary disease (spirometry and DLCO = 50% of predicted OR oxygen saturation = 88% at rest on room air) No uncontrolled hyperlipidemia (fasting serum cholesterol > 300 mg/dL AND fasting triglycerides > 2.5 times ULN) obtained within 28 days prior to registration Optimal lipid control must be achieved before registration and monitored during protocol treatment No uncontrolled diabetes mellitus (defined by fasting serum glucose > 1.5 times ULN) obtained within 28 days prior to registration. Optimal glucose control must be achieved before registration and monitored during protocol treatment No prior malignancies except for any of the following: Adequately treated basal cell or squamous cell skin cancer In situ cervical cancer Adequately treated stage I or stage II cancer from which the patient is currently in complete remission Any other cancer from which the patient has been disease-free for 5 years No known hypersensitivity to everolimus or other rapamycins (sirolimus, temsirolimus) or to their excipients No contraindications to receiving either IV iodine-based contrast or gadolinium PRIOR CONCURRENT THERAPY: See Disease Characteristics Patients must have recovered from any surgery-related complications No prior anticancer therapy for renal cell carcinoma including systemic therapy in the adjuvant or neoadjuvant setting, immunotherapy, investigational therapy, surgical metastasectomy, or radiotherapy More than 14 days since prior and no concurrent strong CYP3A4 inhibitors (i.e., ketoconazole, itraconazole, voriconazole, posaconazole, fluvoxamine, nefazodone, nelfinavir, or ritonavir) or strong CYP3A4 inducers (i.e., phenytoin, rifampin, or rifabutin) More than 7 days since prior and no concurrent live vaccines No other concurrent anticancer agents including investigational agents No concurrent chronic treatment with systemic steroids or another immunosuppressive agent Topical or inhaled corticosteroids are allowed

Lead Scientist at Eisenhower Health

Henry Tsai, MD
For Henry Tung-Yun Tsai, MD, MA, a Board Certified Hematologist and Medical Oncologist – specializing in the treatment colon cancer and other gastrointestinal cancers, medicine has always been a part of his life. Originally from Taiwan, Dr. Tsai’s father and sisters all have careers in medicine – ranging in specialties from pharmacy to general surgery.  After having moved from Taiwan at age 14, Dr. Tsai attended the University of Calif... more
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For Henry Tung-Yun Tsai, MD, MA, a Board Certified Hematologist and Medical Oncologist – specializing in the treatment colon cancer and other gastrointestinal cancers, medicine has always been a part of his life. Originally from Taiwan, Dr. Tsai’s father and sisters all have careers in medicine – ranging in specialties from pharmacy to general surgery. 

After having moved from Taiwan at age 14, Dr. Tsai attended the University of California at Berkeley where he received his Bachelor of Arts in molecular and cell biology/neurobiology. He received a Master of Arts degree in medical sciences from Boston University and attended medical school at Wayne State University School of Medicine in Detroit, Michigan.

Upon graduating from medical school, he moved to Atlanta, Georgia for an internship, residency and a fellowship in Hematology/Oncology at Emory University. It was at Emory where Dr. Tsai grew to love his chosen specialty: cancer care.

“Yes, cancer care is one of the most difficult fields to practice,” says Dr. Tsai. “But, it is also the most stimulating and rewarding. There are days when I see my patients get better and I have experienced hope. I feel privileged to be a part of their process.”

Dr. Tsai has been a member of the American Medical Association, American College of Physicians, American Society of Clinical Oncology. He has been the local principle investigator for various clinical trials and has presented at workshops and symposiums across the United States. He has authored a book chapter and manuscript related to cancer.

Clinical Study Details

  1. Currently not accepting new patients
  2. study started November 2011
  3. Interventional
  4. August 28, 2024