Clinical Trial: Sorafenib in Treating Patients With Locally Advanced or Metastatic Kidney Cancer

Study Status: Terminated
Recruit Status: Terminated
Study Type: Interventional

Official Title: Correlation of Pathologic Findings After Neo-adjuvant Sorafenib With Results of Diffusion-Weighted Magnetic Resonance Imaging in Patients With Locally Advanced or Metastatic Clea

Brief Summary:

RATIONALE: Sorafenib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth and by blocking blood flow to the tumor. Giving sorafenib before surgery may make the tumor smaller and reduce the amount of normal tissue that needs to be removed.

PURPOSE: This clinical trial is studying how well sorafenib works in treating patients with locally advanced or metastatic kidney cancer.


Detailed Summary:

OBJECTIVES:

Primary

  • To demonstrate the feasibility and safety of sorafenib tosylate when given prior to nephrectomy or metastasectomy.
  • To evaluate the ability of diffusion-weighted magnetic resonance imaging (DW-MRI) to detect early and ongoing microstructural changes in primary and metastatic renal cell carcinoma lesions during neoadjuvant therapy with sorafenib tosylate.
  • To correlate early and ongoing microstructural changes in primary and metastatic renal cell carcinoma lesions with pathologic and clinical findings at the time of nephrectomy or metastasectomy.
  • To evaluate the ability of changes in DW-MRI to predict subsequent favorable response to treatment (complete or partial response or stable disease) after 4 weeks of therapy.

OUTLINE: Patients receive oral sorafenib tosylate twice daily on days 1-28. Patients then undergo a nephrectomy or metastasectomy in week 5. Patients with residual metastatic disease may continue sorafenib tosylate twice daily and undergo a diffusion-weighted MRI (DW-MRI) every 8 weeks in the absence of disease progression or unacceptable toxicity.

Patients undergo a DW-MRI of the abdomen and pelvis at baseline and prior to week 5 to evaluate microstructure tumor changes and to allow for prediction of sorafenib tosylate benefit. DW-MRI results are correlated with surgical and pathologic findings obtained at week 5.

Resected tumor tissue are analyzed for vascular density and to distinguish apoptotic cell death from necrotic cell death via immunohistochemistry and to measure apoptotic cell death via TUNEL a
Sponsor: Northwestern University

Current Primary Outcome:

  • MRI apparent diffusion coefficients (ADC) at baseline and week 5 [ Time Frame: Baseline and week 5 ]
    Patients will undergo a DW-MRI of the pelvis at baseline and prior to week 5 to evaluate microstructure tumor changes and to allow for prediction of sorafenib tosylate benefit
  • Tumor response during the neoadjuvant period [ Time Frame: Just prior to study week 5 ]
  • Tumor necrotic fraction and pathology [ Time Frame: At time of surgery ]
  • Time to progression [ Time Frame: At time of disease progression ]


Original Primary Outcome:

  • MRI apparent diffusion coefficients (ADC) at baseline and week 5
  • Tumor response during the neoadjuvant period
  • Tumor necrotic fraction and pathology determined at surgery
  • Time to progression


Current Secondary Outcome:

Original Secondary Outcome:

Information By: Northwestern University

Dates:
Date Received: August 1, 2008
Date Started: July 2008
Date Completion: June 2015
Last Updated: July 17, 2013
Last Verified: July 2013