Phase 1
Completed N=13
Safety Study of Sirolimus and Hydroxychloroquine in Women With Lymphangioleiomyomatosis
Source: ClinicalTrials.gov NCT01687179 ↗Enrolled (actual)
13
Serious AEs
7.7%
Results posted
Oct 2018
Primary outcomePrimary: Safety of Combination Therapy With Sirolimus and Hydroxychloroquine in LAM Patients — 2.27; 1.11; 0; 1.11 Percentage of adverse events
Summary
Specific Aim 1: To investigate whether, in Lymphangioleiomyomatosis (LAM) patients, the combination of sirolimus and hydroxychloroquine is safe and well tolerated
Specific Aim 2: To investigate whether, in LAM patients, 6 months of combination therapy with sirolimus and hydroxychloroquine results in improvement of indicators of disease, and whether the gains are sustained after stopping therapy.
Specific Aim 3: To investigate the potential role of a LAM-specific peripheral blood signature to predict rates of disease progression and determine responsiveness to combination therapy.
This will be a phase I dose escalation study of the combination of sirolimus (2 mg adjusted to keep trough levels between 5-15 ng/ml) and hydroxychloroquine (200 mg or 400 mg) taken orally daily. Up to 18 adult women with LAM will be enrolled.
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Safety of Combination Therapy With Sirolimus and Hydroxychloroquine in LAM Patients |
2.27; 1.11; 0; 1.11; 18.18; 22.22 | — |
Eligibility Criteria
Inclusion Criteria
- Female age 18 or older
- Ability to give informed consent
- Diagnosis of LAM as defined as typical cystic change on CT plus:
- biopsy or cytology of any tissue demonstrating LAM
- angiomyolipoma, chylothorax, lymphangioleiomyoma, or tuberous sclerosis
- serum VEGFD greater or equal to 800pg/ml
- Post-bronchodilator FEV1 equal or less than 80% of predicted or DLCO equal equal or less than 70% of predicted, or RV > 120% of predicted at baseline
- Women of childbearing potential must agree to use 2 forms of barrier contraception during and for 8 weeks after the last dose of medication.
Exclusion Criteria
- History of intolerance of mTOR inhibitors
- History of intolerance to hydroxychloroquine
- History of severe psoriasis
- History of porphyria cutanea tarda
- Uncontrolled intercurrent illness
- Pregnant, breast feeding, or plan to become pregnant in the next year
- Inadequate contraception
- Significant hematological or hepatic abnormalities
- Use of an investigational drug within 30 days of study start
- Inability to attend scheduled clinic visits
- Inability to perform PFTs
- Creatinine > 2.5mg/dL
- Recent pneumothorax within 8 weeks of screening
- History of malignancy in the last 2 years other than basal cell skin cancer
- Use of estrogen containing medication within 30 days of screening
- Abnormal G6PD levels at baseline
- Preexisting maculopathy or retinopathy
- Preexisting myopathy
- Currently taking doxycycline, metformin, lupron, simvastatin
- Unable to undergo CT or MRI
- History of seizure within last year
- Hepatitis B, C, HIV positive serology
- Use of alternative medical therapies for LAM for at least 6 weeks prior to study participation
- History of myocardial infarct, angina, or stroke related to atherosclerosis
- History of cardiomyopathy
- Previous lung transplant
- Surgery (involving entry into a body cavity or requiring 3 or more stitches) within 2 months of initiation of study drug
- Uncontrolled cholesterol > 350mg/dL, triglycerides > 400mg/dL
Data sourced from ClinicalTrials.gov (NCT01687179). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication. Informational only — not medical advice.