A Phase IV Study of Safety and Efficacy of Everolimus in Taiwanese Patients With Tuberous Sclerosis Complex Who Have Renal Angiomyolipoma (TSC-AML)
The purpose of this prospective study is to assess the safety and efficacy of everolimus in Taiwanese patients with renal angiomyolipoma (AML) associated with tuberous sclerosis complex (TSC) . Only patients who fulfil the local reimbursement criteria of everolimus for TSC-AML will be included in this study.
This open-label, prospective, single-arm, multicenter Phase IV post approval commitment (PAC) study is planned to be conducted in approximately 10 patients with confirmed diagnosis of TSC-AML and who fulfil the local reimbursement criteria of everolimus for TSC-AML treatment.
The study will have a 30-day screening phase, and each patient will be on treatment up to 52 weeks. Enrollment will end at the latest within 52 weeks from Day 1 of the study, regardless of the number of patients actually recruited. After completion of the treatment phase/end of treatment (EOT), eligible patients will enter a 4-week safety follow up (FU) phase. Patients who continue to be on treatment beyond 52 weeks, based on the investigator's judgment will not be included in the 4-week safety FU phase.
Arms and Interventions
Participants with confirmed diagnosis of TSC-AML and who fulfil the local (Taiwan) reimbursement criteria of everolimus for TSC-AML treatment
Everolimus tablets for oral use. The recommended everolimus starting dose will be 10 mg orally taken once daily for all patients, except for those with impaired liver function, for whom the everolimus dose will be: Child-Pugh grade A: 7.5 mg once daily (for patients with mild hepatic impairment) Child-Pugh grade B: 5.0 mg once daily (for patients with moderate hepatic impairment)
Primary Outcome Measures
- Percentage of participants with adverse events (AEs), Serious AEs (SAEs) and AEs of special interest (AESI) [From first dose of study treatment up to 56 weeks]
Percentage of participants with AEs, SAEs and AESIs.
Secondary Outcome Measures
- Angiomyolipoma (AML) response rate [Up to 52 weeks]
AML response rate is defined as the percentage of patients with an AML response. AML response will be defined as: A reduction in AML volume of at least 50% relative to screening, where AML volume is the sum of the volumes of all target AML identified at screening. In addition, AML response have to satisfy: no new AML ≥ 1 cm in longest diameter are identified, neither kidney increases in volume by more than 20% from nadir (where nadir is the lowest kidney volume at the screening), the participant does not have any angiomyolipoma-related bleeding of grade equal or over 2 (as defined by NCI CTCAE, version 5).
- AML progression rate [Up to 52 weeks]
AML progression rate is defined as the percentage of patients with an AML progression. AML progression status is defined as one or more of the following: an increase from nadir of 25% or more in AML volume to a value greater than screening AML (where nadir is the lowest AML volume obtained for the participant previously in the trial), the appearance of a new AML ≥ 1.0 cm in longest diameter, an increase from nadir of 20% or more in the volume of either kidney to a value greater than screening (where nadir is the lowest kidney volume obtained for the participant previously in the trial), angiomyolipoma-related bleeding grade ≥2 (as defined by NCI CTCAE, version 5)
- Percentage of participants with laboratory abnormalities [From screening up to 56 weeks]
The laboratory assessment (including hematology, coagulation, biochemistry, and urinalysis) will be recorded at baseline and during the study based on changes in grade of laboratory abnormality.
Signed informed consent must be obtained prior to participation in the study.
With TSC associated with renal AML which is eligible for treatment with everolimus per locally approved label (at least one of below):
Tumor size of ≥ 4 cm with history of clinically meaningful hemorrhage.
Aneurysm lesion ≥ 5 mm, ineligible for trans-arterioemolization or surgery.
More than one lesion.
Recurrence after/refractory to trans-arterioemolization or surgery.
- Presence of at least one AML lesion ≥ 1 cm in its longest diameter via CT or MRI imaging.
Patients with severe hepatic impairment (Child-Pugh class C)
Prior therapy with systemic mTOR inhibitors (sirolimus, temsirolimus, everolimus).
Any severe and/or uncontrolled medical conditions.
Pregnant or breast-feeding females.
Patients with hypersensitivity to the active substance, to other rapamycin derivatives, or to any of the excipients.
Contacts and Locations
LocationsNo locations specified.
Sponsors and Collaborators
- Novartis Pharmaceuticals
- Study Director: Novartis Pharmaceuticals, Novartis Pharmaceuticals
Study Documents (Full-Text)None provided.