Clinical Trial Finder

Whole Brain Radiotherapy (WBRT) With Sorafenib for Breast Cancer Brain Metastases (BCBM)

Study Purpose

Sorafenib is a new type of anti-cancer drug. It belongs to a new class of medications known as tyrosine kinase inhibitors. Sorafenib is thought to work against cancer in many ways. It helps decrease blood supply to the tumor. It also blocks some proteins that help the tumor cells to grow." Sorafenib is approved by the Food and Drug administration (FDA) for treatment for other cancers like liver and kidney cancer. Sorafenib has also been studied in the treatment of breast cancer that has spread but is not specifically approved for the treatment of breast cancer. It has been studied both as a single agent and also in combination with other anti-cancer therapies for breast cancer. In laboratory models and in some patients with other cancers, sorafenib has been studied in tumors in the brain. In this study, sorafenib will be given together with whole brain radiation therapy (WBRT). Overall this research study is designed to answer 2 main questions: 1. What dose of sorafenib should be used together with WBRT? 2. What are the side effects of sorafenib and WBRT when given together?

Recruitment Criteria

Healthy volunteers are participants who do not have a disease or condition, or related conditions or symptoms

Accepts Healthy Volunteers
No

An interventional clinical study is where participants are assigned to receive one or more interventions (or no intervention) so that researchers can evaluate the effects of the interventions on biomedical or health-related outcomes.


An observational clinical study is where participants identified as belonging to study groups are assessed for biomedical or health outcomes.


Searching Both is inclusive of interventional and observational studies.

Study Type
Interventional
Eligible Ages 18 Years and Over
Gender All
More Inclusion & Exclusion Criteria

Inclusion Criteria:

  • - Histologically-confirmed metastatic adenocarcinoma of the breast (Confirmation will be done at MSKCC) - Age ≥18 years.
  • - Radiologic evidence of new and/or progressive brain metastasis (≥10 mm in longest dimension) by MR imaging of the Brain - Life expectancy of >12 weeks.
  • - Karnofsky Performance Status (KPS) of ≥70% - If a patient is on corticosteroids, he/she must be on a non-escalating corticosteroid dose (not exceeding more than 16 mg daily of Dexamethasone oral) for ≥ 5 days.
  • - No limit to prior therapies with last anti-cancer treatment ≥ 2 weeks from initiation of protocol based therapy provided all toxicities (other than alopecia) have resolved to ≤Grade 1 or baseline.
  • - Planned WBRT based on number (≥ 3 lesions) and/or size (≥ 1 cm) of BMs (SRS) in addition to WBRT will also be eligible.
  • - Patients with prior SRS will also be eligible, provided that there are new, non-irradiated measurable brain lesions.
  • - No limit to prior therapies with last anti-cancer treatment ≥2 weeks from initiation of WBRT.
Please note: there is no washout period required for trastuzumab and pertuzumab.
  • - Prior hormonal therapy for locally advanced or metastatic disease is allowed but this must have been discontinued prior to enrollment.
No washout period will be required.
  • - Continuation of trastuzumab and pertuzumab are allowed for those patients already on trastuzumab and pertuzumab therapy.
  • - Adequate bone marrow, liver, and renal function as assessed by the following: - Granulocyte count ≥ 1,000/μL, platelet count ≥ 100,000/μL, and hemoglobin ≥ 10 g/dL (hematologic parameters must be assessed at least 14 days after a prior transfusion, if any) - Serum bilirubin ≤ 1.5 mg/dL; AST, ALT, and alkaline phosphatase ≤ 2.5 × ULN except for: Patients with hepatic metastases: ALT and AST ≤ 5 × ULN; patients with hepatic and/or bone metastases: - alkaline phosphatase ≤ 5 × ULN and patients with Gilbert's disease: serum bilirubin < 5 mg/dL - Serum creatinine ≤ 1.5 mg/dL or creatinine clearance of ≥ 60 mL/min based on a 24-hour urine collection - Women of childbearing potential must have a negative serum pregnancy test performed within 7 days prior to enrollment and must agree to use adequate contraception prior to enrollment and for the duration of study participation.
Subjects (men and women) of childbearing potential must agree to use adequate contraception beginning at the signing of the ICF until at least 30 days after the last dose of study drug.
  • - Patients must be able to swallow and retain oral medication.

Exclusion Criteria:

  • - Leptomeningeal metastases, hemorrhagic metastases, presence of midline shift Please note: leptomeningeal metastases may be allowed if it is limited to cranial metastasis (MRI spine should be completed, within 4 weeks of enrollment, to show that no other leptomeningeal metastases is present) and is not the only metastasis present in the brain.
'
  • - Contraindications to sorafenib - Prior treatment with any agent that targets vascular endothelial growth factor (VEGF) or VEGF receptors (VEGFR) (licensed or investigational including sorafenib), except bevacizumab.
  • - Craniotomy or any other major surgery, open biopsy, or significant traumatic injury within 4 weeks of enrollment.
  • - Serious, non-healing wound, ulcer, or bone fracture.
  • - Uncontrolled seizures - Use of cytochrome P450 enzyme-inducing anti-epileptic drugs (such as phenytoin, carbamazepine, or phenobarbital) is not allowed.
  • - Cardiac disease: - Congestive heart failure >class II New York Heart Association (NYHA) (See Appendix B, or - Unstable angina (anginal symptoms at rest), or new-onset angina (begun within the last 3 months), or myocardial infarction within the 6 months prior to enrollment, or - Cardiac ventricular arrhythmias requiring anti-arrhythmic therapy.
  • - Congenital long QT syndrome or taking drugs known to prolong the QT interval ( See Appendix D or http://www.
Azcert.org )
  • - Subjects taking any drugs with a known risk of causing torsades de pointes.
  • - Grade 3 hypertension ( SBP ≥ 160 mm Hg and/or DBP ≥ 100 mm Hg despite maximal medical therapy) - ≥ Grade 2 Lipase increased (>1.5 x ULN), - Thrombolic, embolic, venous, or arterial events such as a cerebrovascular accident including transient ischemic attacks within the past 6 months.
  • - Evidence or history of bleeding diathesis or coagulopathy at the time of enrollment.
  • - Pulmonary hemorrhage/bleeding event >National Cancer Institute Common Terminology for Adverse Events (NCI-CTCAE, version 4.0) Grade 2 within 4 weeks of enrollment.
  • - Any other hemorrhage/bleeding event ≥NCI-CTCAE Grade 3 within 4 weeks of enrollment.
  • - Therapeutic anticoagulation with Vitamin-K antagonists (e.g., warfarin) or with heparins and heparinoids.
However, prophylactic anticoagulation as described below is allowed:
  • - Low dose warfarin (1 mg orally, once daily) with PT-INR ≤ 1.5 x ULN is permitted.
Infrequent bleeding or elevations in PT-INR have been reported in some subjects taking warfarin while on sorafenib or capecitabine therapy. Therefore, subjects taking concomitant warfarin should be monitored regularly for changes in PT, PT-INR or clinical bleeding episodes.
  • - Low dose aspirin (≤ 100 mg daily).
  • - Active clinically serious infection >NCI-CTCAE Grade 2.
  • - Known human immunodeficiency virus (HIV) infection or chronic hepatitis B or C (the safety and effectiveness of sorafenib in this patient population have not been studied).
  • - Previous or concurrent cancer that is distinct in primary site or histology from breast cancer within 5 years prior to enrollment EXCEPT cervical cancer in situ, treated basal cell carcinoma, squamous cell carcinoma (SCC), as long as it is other than SCC involving skin of the head and/or neck, and superficial bladder tumors [Ta and Tis].
  • - Subjects who have used strong CYP3A4 inducers (eg, phenytoin, carbamazepine, phenobarbital, St. John's Wort [Hypericum perforatum], dexamethasone at a dose of greater than 16 mg daily for more than one day, or rifampin [rifampicin], and/or rifabutin) within 28 days before randomization.
  • - Concurrent anti-cancer therapy (chemotherapy, hormonal therapy, radiation therapy (other than that specified by the protocol), surgery, immunotherapy, biologic therapy including trastuzumab, lapatinib, bevacizumab, tyrosine kinase inhibitors other than sorafenib or tumor embolization - Women who are pregnant or breast-feeding.
  • - Use of any investigational drug within 28 days or 5 half-lives, whichever is longer, preceding enrollment.
For the purposes of this study, bevacizumab will not be considered investigational therapy.
  • - Inability to comply with protocol and /or not willing or not available for follow-up assessments.
  • - Any condition which in the investigator's opinion makes the patient unsuitable for the study participation.

Trial Details

This trial id was obtained from ClinicalTrials.gov, a service of the U.S. National Institutes of Health, providing information on publicly and privately supported clinical studies of human participants with locations in all 50 States and in 196 countries.

Trial ID:
NCT01724606

Phase 1: Studies that emphasize safety and how the drug is metabolized and excreted in humans.

Phase 2: Studies that gather preliminary data on effectiveness (whether the drug works in people who have a certain disease or condition) and additional safety data.

Phase 3: Studies that gather more information about safety and effectiveness by studying different populations and different dosages and by using the drug in combination with other drugs.

Phase 4: Studies occurring after FDA has approved a drug for marketing, efficacy, or optimal use.

Phase
Phase 1

The sponsor is the organization or person who oversees the clinical study and is responsible for analyzing the study data.

Lead Sponsor
Memorial Sloan Kettering Cancer Center

The person who is responsible for the scientific and technical direction of the entire clinical study.

Principal Investigator
Andrew Seidman, MD
Principal Investigator Affiliation Memorial Sloan Kettering Cancer Center

Category of organization(s) involved as sponsor (and collaborator) supporting the trial.

Agency Class
OtherIndustry
Overall Status Recruiting
Countries United States

The disease, disorder, syndrome, illness, or injury that is being studied.

Conditions
Breast Cancer, Brain Metastases
Study Website: View Trial Website

Contact a Trial Team

If you are interested in learning more about this trial, find the trial site nearest to your location and contact the site coordinator via email or phone. We also strongly recommend that you consult with your healthcare provider about the trials that may interest you and refer to our terms of service below.

Memoral Sloan Kettering Cancer Center, Basking Ridge, New Jersey

Status

Recruiting

Address

Memoral Sloan Kettering Cancer Center

Basking Ridge, New Jersey,

Site Contact

Andrew Seidman, MD

646-888-5445

Memorial Sloan Kettering Monmouth, Middletown, New Jersey

Status

Recruiting

Address

Memorial Sloan Kettering Monmouth

Middletown, New Jersey, 07748

Site Contact

Andrew Seidman, MD

646-888-5445

Commack, New York

Status

Recruiting

Address

Memorial Sloan Kettering Cancer Center @ Suffolk

Commack, New York, 11725

Site Contact

Andrew Seidman, MD

646-422-4333

Memorial Sloan Kettering Westchester, Harrison, New York

Status

Recruiting

Address

Memorial Sloan Kettering Westchester

Harrison, New York, 10604

Site Contact

Andrew Seidman, MD

646-888-5445

Memorial Sloan Kettering Cancer Center, New York, New York

Status

Recruiting

Address

Memorial Sloan Kettering Cancer Center

New York, New York, 10065

Site Contact

Andrew Seidman, MD

646-888-5445

Rockville Centre, New York

Status

Recruiting

Address

Memorial Sloan Kettering at Mercy Medical Center

Rockville Centre, New York,

Site Contact

Andrew Seidman, MD

646-888-5445

The content provided by NBTS on clinical trials is for informational purposes only and is not a substitute for medical consultation with your healthcare provider. We do not recommend or endorse any specific study and you are advised to discuss the information shown with your healthcare provider. While we believe the information presented on this website to be accurate at the time of writing, we do not guarantee that its contents are correct, complete, or applicable to any particular individual situation. We strongly encourage individuals to seek out appropriate medical advice and treatment from their physicians. We cannot guarantee the availability of any clinical trial listed and will not be responsible if you are considered ineligible to participate in a given clinical trial. We are also not liable for any injury arising as a result of participation. For a full description of terms please refer to: Terms, Conditions & Privacy