RATIONALE: Vatalanib and everolimus may stop the growth of tumor cells by blocking blood flow to the tumor and by blocking some of the enzymes needed for cell growth. PURPOSE: This phase I trial is studying the side effects and best dose of vatalanib and everolimus and to see how well they work in treating patients with advanced solid tumors.
OBJECTIVES: Primary * Determine the maximum tolerated dose (MTD) of vatalanib and everolimus in patients with advanced solid tumors. * Determine the safety and tolerability of vatalanib and everolimus in patients with advanced solid tumors. * Evaluate the safety and tolerability of vatalanib and everolimus at the MTD in patients with metastatic renal cell carcinoma (RCC). Secondary * Describe the non dose-limiting toxic effects associated with vatalanib and everolimus. * Describe the pharmacokinetics of vatalanib and everolimus in patients with advanced solid tumors. * Determine the functional extent of mTOR inhibition by changes in the phosphorylation status of S6K protein in peripheral blood mononuclear cells in patients treated with vatalanib and everolimus. * Describe any clinical responses seen in patients with metastatic RCC in a dose-expansion cohort treated at the MTD. * Observe overall survival of RCC patients treated with vatalanib and everolimus. * Determine the time to progression of patients with RCC treated with vatalanib and everolimus. OUTLINE: This is a phase I dose-escalation study followed by a phase Ib study. * Phase I (solid tumors): Patients receive oral vatalanib on days 1-28 and oral everolimus on days 15-28 during course 1 and on days 1-28 during all subsequent courses. Treatment repeats every 28 days for up to 12 courses in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of vatalanib and everolimus until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. * Phase Ib (renal cell carcinoma only): Patients receive oral vatalanib and oral everolimus at the MTD on days 1-28. Treatment repeats every 28 days for up to 12 courses in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed every 6 months. PROJECTED ACCRUAL: A total of 44 patients will be accrued for this study.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
37
Duke Comprehensive Cancer Center
Durham, North Carolina, United States
Maximum tolerated dose (MTD) of vatalanib and everolimus
Patients were evaluated on Day 1,14 and 28 for dose limiting toxicities
Time frame: Day 1 - 28
Safety and tolerability
Adverse events were assessed every 14 days for the length of the treatment period.
Time frame: Duration of study treatment
Safety and tolerability at the MTD in patients with metastatic renal cell carcinoma (RCC)
Patients were assessed for adverse events every 14 days while on study treatment
Time frame: Duration of study treatment
Non dose-limiting toxicity
Patients were assessed every 14 days for non dose-limiting toxicity while on study treatment
Time frame: Duration of study treatment
Pharmacokinetics
Blood was drawn for PK assessment on Day 14 of Cycle 1 and Day 1 of Cycle 2
Time frame: Day 14 Cycle 1, Day 1 Cycle 2
Changes in the phosphorylation status of S6K protein in peripheral blood mononuclear cells
Samples were collected on Day 1 and at Day 28 of Cycle 1
Time frame: Day 1 and 28
Clinical response in patients with metastatic RCC
patients underwent restaging studies every 2 cycles while on treatment for evidence of disease response
Time frame: Duration of treatment
Overall survival of patients with RCC
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Time frame: Until death
Time to progression of patients with RCC
Patients were followed for evidence of disease progression as long as they remained on study drug.
Time frame: Duration of study treatment