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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 the side effects and how well sorafenib works in treating patients undergoing surgery for stage II, stage III, or stage IV kidney cancer.
- Determine the safety and feasibility of systemic sorafenib tosylate therapy when given prior to definitive nephrectomy in patients with stage II-IV renal cell carcinoma (RCC).
- Determine all levels of response in primary renal tumors of patients treated with this drug.
- Assess effects of this drug on gene expression, protein expression, and metabolic profile using tumor tissue samples from these patients.
- Identify biomarkers or biomarker patterns associated with RCC or this drug in these patients.
OUTLINE: This is a pilot, open-label, nonrandomized study.
Patients receive oral sorafenib tosylate twice daily for 4-8 weeks in the absence of disease progression or unacceptable toxicity. After completion of neoadjuvant therapy, patients undergo surgical resection of their kidney tumor.
Patients undergo blood and urine sample collection at baseline and after completion of treatment (i.e., at 4 and 8* weeks) for VEGF analysis. Samples are examined by enzyme-linked immunosorbent assay for measurement of serum and urinary VEGF levels.
NOTE: *Blood sampling at 8 weeks is only for those patients undergoing 8 weeks of study therapy.
Patients also undergo tissue sample collection at the time of nephrectomy. Tissue samples are examined by microarray analysis and IHC staining for expression of CD31/PECAM, HIF1α, and HIF2α. Immunohistochemical staining to identify biomarkers of microvessel density is also performed. Tissue samples are also examined for gene expression and metabolic profile by small molecule mass spectroscopy, as well as VHL gene mutation by VHL mutation analysis.
Patients are followed at 4-8 weeks after nephrectomy.
Allocation: Non-Randomized, Masking: Open Label, Primary Purpose: Treatment
sorafenib tosylate, microarray analysis, mutation analysis, immunoenzyme technique, immunohistochemistry staining method, conventional surgery, neoadjuvant therapy, spectroscopy
Lineberger Comprehensive Cancer Center at University of North Carolina - Chapel Hill
Active, not recruiting
National Cancer Institute (NCI)
Published on BioPortfolio: 2014-08-27T03:41:21-0400
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