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NCT01010126

Temsirolimus and Bevacizumab in Treating Patients With Advanced Endometrial, Ovarian, Liver, Carcinoid, or Islet Cell Cancer

Completed Phase 2 Results posted Last updated 25 January 2019
What this trial tests

Phase 2 trial testing Bevacizumab in Adult Hepatocellular Carcinoma in 252 participants. Completed in 13 March 2017.

Timeline
8 September 2009
Primary endpoint
13 March 2017
13 March 2017

Quick facts

Lead sponsorNational Cancer Institute (NCI)
PhasePhase 2
StatusCompleted
Study typeINTERVENTIONAL
Allocationna
Designsingle group
Maskingnone
Primary purposetreatment
Enrollment252
Start date8 September 2009
Primary completion13 March 2017
Estimated completion13 March 2017
Sites61 locations across Canada, United States

Drugs / interventions tested

Conditions studied

Sponsor

National Cancer Institute (NCI)

Who can join

18 and older, any sex, with Adult Hepatocellular Carcinoma or Advanced Adult Hepatocellular Carcinoma. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Progression Free Survival Rate Primary · 6 months

Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions. The 6-month progression free survival rate is the proportion of evaluable patients progression-free 6 months from registration. The 6-month progression-free rate is defined as the total number of efficacy evaluable patients on study without documentation of disease progression 6 months from registration divided by the total number of evaluable p

GroupValue95% CI
Endometrial Cohort0.520.35 – 0.77
Ovarian Cohort0.400.29 – 0.55
Hepatocellular Cohort0.710.54 – 0.94
Carcinoid Cohort0.840.75 – 0.95
Islet Cell (Double Agent) Cohort0.850.75 – 0.95
Islet Cell (Bevacizumab-only) Cohort0.870.74 – 1.00
Tumor Response Rate Primary · Up to 3 years

Tumor response rate defined as the total number of efficacy-evaluable patients who achieved a complete or partial response according to the RECIST criteria divided by the total number of efficacy evaluable patients enrolled on study. Patients were evaluated using the Response Evaluation Criteria In Solid Tumors (RECIST) v1.1. In brief, a Complete Response (CR) means the complete disappearance of all target lesions and a reduction in each lymph node to \<1 cm. A Partial Response (PR) is defined as a 30% decrease in the sum of the longest diameter of the non-nodal target lesion from baseline. Ea

GroupValue95% CI
Endometrial Cohort0.310.14 – 0.52
Ovarian Cohort0.310.20 – 0.45
Hepatocellular Cohort0.190.06 – 0.38
Carcinoid Cohort0.120.05 – 0.24
Islet Cell (Double Agent) Cohort0.400.27 – 0.53
Islet Cell (Bevacizumab-only) Cohort0.170.05 – 0.37
Duration of Response Secondary · Time from date at which the patient's objective status is first noted to be either a complete response (CR) or partial response (PR) to the date progression is documented, assessed up to 3 years

Duration of response is defined for all evaluable patients who have achieved a response as the date at which the patient's objective status is first noted to be either a CR or PR to the date progression is documented. Objective response was assessed using Response Evaluation Criteria In Solid Tumors (RECIST) as described in Primary Objective 2 in this report. Median duration of response and the confidence interval for the median duration will be computed.

GroupValue95% CI
Endometrial Cohort25.10 – 35.5
Ovarian Cohort6.43.7 – 10.8
Hepatocellular Cohort6.40 – 11.1
Carcinoid Cohort15.00 – 18.8
Islet Cell (Double Agent) Cohort11.38.8 – 21.2
Islet Cell (Bevacizumab-only) Cohort10.93.7 – 34.1
Incidence of Adverse Events Secondary · Every cycle of treatment, up to 3 years

Adverse events are defined as events that are classified as either possibly, probably, or definitely related to study treatment, graded per National Cancer Institute Common Terminology Criteria for Adverse Events Version 3.0. The number of patients reporting grade 3 or higher adverse events at least possibly related to treatment are reported here. For a complete list of all reported adverse events, please see the adverse events section of this report.

Grade 3 Adverse Event
GroupValue95% CI
Endometrial Cohort17
Ovarian Cohort32
Hepatocellular Cohort24
Carcinoid Cohort32
Islet Cell (Double Agent) Cohort36
Islet Cell (Bevacizumab-only) Cohort13
Grade 4 Adverse Event
GroupValue95% CI
Endometrial Cohort1
Ovarian Cohort6
Hepatocellular Cohort0
Carcinoid Cohort6
Islet Cell (Double Agent) Cohort8
Islet Cell (Bevacizumab-only) Cohort0
Grade 5 Adverse Event
GroupValue95% CI
Endometrial Cohort1
Ovarian Cohort0
Hepatocellular Cohort1
Carcinoid Cohort2
Islet Cell (Double Agent) Cohort0
Islet Cell (Bevacizumab-only) Cohort0
Overall Survival Secondary · Time from registration to death, assessed up to 3 years

Survival time will be defined as the time from registration to death. Time to event distributions will be estimated using the Kaplan-Meier method.

GroupValue95% CI
Endometrial Cohort11.56.5 – NA
Ovarian Cohort16.311.1 – 21.9
Hepatocellular Cohort14.89.7 – 18.1
Carcinoid Cohort32.725.2 – 38.3
Islet Cell (Double Agent) Cohort35.014.6 – NA
Islet Cell (Bevacizumab-only) CohortNA30.6 – NA
Time to Disease Progression Secondary · Time from registration to disease progression, assessed up to 3 years

Time to progression is defined as the time from registration to disease progression. Patients who died without documentation of progression will be considered to have progressed on the date of their death. If a patient starts treatment and fails to return for evaluation, that patient will be censored for progression of disease at day one post-registration.

GroupValue95% CI
Endometrial Cohort6.02.5 – 9.8
Ovarian Cohort5.64.3 – 6.4
Hepatocellular Cohort8.05.8 – 10.9
Carcinoid Cohort15.211.4 – 24.2
Islet Cell (Double Agent) Cohort13.111.2 – 16.6
Islet Cell (Bevacizumab-only) Cohort18.010.6 – 37.0
Time to Treatment Failure Secondary · Time from study entry to the date patients end treatment, assessed up to 3 years

Time to treatment failure is defined as the time from study entry to the date patients end treatment.Time to treatment failure will be evaluated using the method of Kaplan-Meier.

GroupValue95% CI
Endometrial Cohort3.82.3 – 6.4
Ovarian Cohort4.52.7 – 5.6
Hepatocellular Cohort6.52.3 – 8.0
Carcinoid Cohort5.54.4 – 8.1
Islet Cell (Double Agent) Cohort11.38.6 – 13.3
Islet Cell (Bevacizumab-only) Cohort11.85.8 – 18.0

Adverse events — posted to ClinicalTrials.gov

Time frame: Adverse events were collected at the end of each 28 day cycle for a maximum of 58 cycles.. Reporting threshold: 0%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Endometrial Cohort
Serious: 16/26 (62%)
Deaths: 2/26
Ovarian Cohort
Serious: 34/58 (59%)
Deaths: 1/58
Hepatocellular Cohort
Serious: 13/27 (48%)
Deaths: 3/27
Carcinoid Cohort
Serious: 36/57 (63%)
Deaths: 3/57
Islet Cell (Double Agent) Cohort
Serious: 27/55 (49%)
Deaths: 0/55
Islet Cell (Bevacizumab-only) Cohort
Serious: 6/24 (25%)
Deaths: 0/24

Serious adverse events (141 terms)

ReactionSystemEndometrial CohortOvarian CohortHepatocellular CohortCarcinoid CohortIslet Cell (Double Agent) …Islet Cell (Bevacizumab-on…
Abdominal painGastrointestinal disorders
DehydrationMetabolism and nutrition disorders
Hemoglobin decreasedBlood and lymphatic system disorders
NauseaGastrointestinal disorders
Small intestinal obstructionGastrointestinal disorders
VomitingGastrointestinal disorders
FatigueGeneral disorders
HypertensionVascular disorders
Colonic perforationGastrointestinal disorders
ConstipationGastrointestinal disorders
Gastrointestinal disorderGastrointestinal disorders
FeverGeneral disorders
PneumoniaInfections and infestations
Platelet count decreasedInvestigations
Blood glucose increasedMetabolism and nutrition disorders
Serum potassium decreasedMetabolism and nutrition disorders
Serum sodium decreasedMetabolism and nutrition disorders
Muscle weaknessMusculoskeletal and connective tissue disorders
ConfusionPsychiatric disorders
Vaginal fistulaReproductive system and breast disorders
Cardiac disorderCardiac disorders
Myocardial ischemiaCardiac disorders
Ear, nose and throat examination abnormalGastrointestinal disorders
HemorrhoidsGastrointestinal disorders
Lower gastrointestinal hemorrhageGastrointestinal disorders
Other adverse events (238 terms — click to expand)

ReactionSystemEndometrial CohortOvarian CohortHepatocellular CohortCarcinoid CohortIslet Cell (Double Agent) …Islet Cell (Bevacizumab-on…
Platelet count decreasedInvestigations
Hemoglobin decreasedBlood and lymphatic system disorders
FatigueGeneral disorders
Serum cholesterol increasedInvestigations
HypertensionVascular disorders
Leukocyte count decreasedInvestigations
Protein urine positiveRenal and urinary disorders
DiarrheaGastrointestinal disorders
Ear, nose and throat examination abnormalGastrointestinal disorders
Serum triglycerides increasedMetabolism and nutrition disorders
Aspartate aminotransferase increasedInvestigations
Blood glucose increasedMetabolism and nutrition disorders
AnorexiaMetabolism and nutrition disorders
Neutrophil count decreasedInvestigations
Mucositis oralGastrointestinal disorders
Alanine aminotransferase increasedInvestigations
Serum potassium decreasedMetabolism and nutrition disorders
HeadacheNervous system disorders
Rash desquamatingSkin and subcutaneous tissue disorders
NauseaGastrointestinal disorders
Hemorrhage nasalRespiratory, thoracic and mediastinal disorders
Rash acneiformSkin and subcutaneous tissue disorders
Alkaline phosphatase increasedInvestigations
Weight lossInvestigations
Lymphocyte count decreasedInvestigations
Creatinine increasedInvestigations
VomitingGastrointestinal disorders
Edema limbsGeneral disorders
Bilirubin increasedInvestigations
Serum sodium decreasedMetabolism and nutrition disorders
PruritusSkin and subcutaneous tissue disorders
Abdominal painGastrointestinal disorders
Serum albumin decreasedMetabolism and nutrition disorders
Taste alterationNervous system disorders
Skin disorderSkin and subcutaneous tissue disorders
ConstipationGastrointestinal disorders
PainGeneral disorders
Serum calcium decreasedMetabolism and nutrition disorders
Dry skinSkin and subcutaneous tissue disorders
HemorrhoidsGastrointestinal disorders

Most-reported serious reactions: Abdominal pain, Dehydration, Hemoglobin decreased, Nausea, Small intestinal obstruction, Vomiting, Fatigue, Hypertension.

Data from ClinicalTrials.gov NCT01010126 adverse events section.

Sponsor's own description

This phase II trial studies how well temsirolimus and bevacizumab work in treating patients with advanced endometrial, ovarian, liver, carcinoid, or islet cell cancer. Temsirolimus may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Monoclonal antibodies, such as bevacizumab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Bevacizumab may also stop the growth of cancer by blocking blood flow to the tumor. Giving temsirolimus together with bevacizumab may kill more tumor cells.

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Role of lysosomes in physiological activities, diseases, and therapy.
    Zhang Z, Yue P, Lu T, Wang Y, et al · · 2021 · cited 238× · PMID 33990205 · DOI 10.1186/s13045-021-01087-1
  2. Targeting the PI3K/Akt/mTOR Pathway in Hepatocellular Carcinoma.
    Sun EJ, Wankell M, Palamuthusingam P, McFarlane C, et al · · 2021 · cited 199× · PMID 34829868 · DOI 10.3390/biomedicines9111639
  3. Therapeutic targeting of autophagy in disease: biology and pharmacology.
    Cheng Y, Ren X, Hait WN, Yang JM. · · 2013 · cited 188× · PMID 23943849 · DOI 10.1124/pr.112.007120
  4. Tumor Microenvironment in Ovarian Cancer: Function and Therapeutic Strategy.
    Yang Y, Yang Y, Yang J, Zhao X, et al · · 2020 · cited 168× · PMID 32850861 · DOI 10.3389/fcell.2020.00758
  5. Targeted therapies in gynecological cancers: a comprehensive review of clinical evidence.
    Wang Q, Peng H, Qi X, Wu M, et al · · 2020 · cited 114× · PMID 32728057 · DOI 10.1038/s41392-020-0199-6
  6. Role of the Mammalian Target of Rapamycin Pathway in Liver Cancer: From Molecular Genetics to Targeted Therapies.
    Lu X, Paliogiannis P, Calvisi DF, Chen X. · · 2021 · cited 104× · PMID 32394479 · DOI 10.1002/hep.31310
  7. PI3K/AKT/mTOR Pathway in Ovarian Cancer Treatment: Are We on the Right Track?
    Gasparri ML, Bardhi E, Ruscito I, Papadia A, et al · · 2017 · cited 92× · PMID 29093603 · DOI 10.1055/s-0043-118907
  8. Multicenter Phase II Trial of Temsirolimus and Bevacizumab in Pancreatic Neuroendocrine Tumors.
    Hobday TJ, Qin R, Reidy-Lagunes D, Moore MJ, et al · · 2015 · cited 88× · PMID 25488966 · DOI 10.1200/jco.2014.56.2082

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