Sunitinib Malate in Treating Patients With Iodine-Refractory Recurrent or Metastatic Thyroid Cancer
Condition: Recurrent Thyroid Cancer; Stage IVA Follicular Thyroid Cancer; Stage IVA Papillary Thyroid Cancer; Stage IVB Follicular Thyroid Cancer; Stage IVB Papillary Thyroid Cancer; Stage IVC Follicular Thyroid Cancer; Stage IVC Papillary Thyroid Cancer; Thyroid Gland Medullary Carcinoma
MeSH terms: Carcinoma; Thyroid Neoplasms; Thyroid Cancer, Papillary; Carcinoma, Medullary; Adenocarcinoma, Follicular; Thyroid Diseases
Intervention: sunitinib malate
Intervention description: Given PO
Intervention MeSH terms: Sunitinib
Phase: Phase 2
Study type: Interventional
Primary purpose: Treatment
Intervention model: Single Group Assignment
Masking: None (Open Label)
Enrollment: 35.0
Sex: All
Minimum age: 18 Years
Healthy volunteers: No

Summary:

      This phase II trial studies how well giving sunitinib malate works in treating patients with
      iodine-refractory recurrent or metastatic thyroid cancer. Sunitinib malate may stop the
      growth of tumor cells by blocking some of the enzymes needed for cell growth or by blocking
      blood flow to the tumor
    

Eligibility criteria:

        Inclusion Criteria:

          -  Histologically or cytologically proven metastatic WDTC or MTC

          -  Evidence of refractoriness to iodine therapy for WDTC documented by a combination of
             imaging and thyroglobulin or by biopsy

          -  Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 3

          -  Evidence of fludeoxyglucose F 18 (FDG) PET avid metastatic tumors

          -  Measurable disease by RECIST criteria

          -  Resolution of all acute toxic effects of prior systemic therapy (including iodine
             therapy or chemotherapy), radiotherapy or surgical procedure to National Cancer
             Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) Version 3.0
             grade =< 1

          -  Total serum bilirubin =< 1.5 x upper limit of normal (ULN) (patients with Gilbert's
             disease exempt)

          -  Serum transaminases =< 2.5 x ULN or =< 5.0 X ULN if secondary to liver metastases

          -  Serum creatinine =< 1.5 x ULN

          -  Absolute neutrophil count (ANC) >= 1.5 X 10^9/L

          -  Platelets >= 100,000/uL

          -  Hemoglobin >= 9.0 g/dL

          -  Willingness and ability to comply with scheduled visits, treatment plans and
             laboratory tests and other study procedures

          -  Male and female patients with reproductive potential must use an acceptable
             contraceptive method

          -  Signed and dated informed consent document indicating that the patient has been
             informed of all the pertinent aspects of the trial prior to enrollment

        Exclusion Criteria:

          -  Concomitant treatment in another therapeutic clinical trial

          -  ECOG performance status >= 3

          -  Symptomatic, untreated, brain metastasis

          -  Second primary malignancy that is clinically detectable or clinically significant at
             the time of consideration for study enrollment

          -  Full-dose anticoagulation defined as:

               -  Low molecular weight heparin use with the intent of full dose anticoagulation;
                  example: enoxaparin 1.5 mg/kg daily or equivalent

               -  Warfarin use to keep international normalized ratio (INR) greater than or equal
                  to 2

          -  History of gross hemoptysis (defined as bright red blood of at least 1/2 teaspoon or
             2.5 mL per episode) within 3 months prior to study drug administration unless
             definitively treated with surgery or radiation

          -  Any of the following within the 6 months prior to study drug administration:
             myocardial infarction, severe/unstable angina, coronary/peripheral artery bypass
             graft, symptomatic congestive heart failure, cerebrovascular accident or transient
             ischemic attack, or pulmonary embolism; ongoing cardiac dysrhythmias of NCI CTCAE
             Version 3.0 grade >= 2

          -  Type I Diabetes Mellitus; patients with Type II Diabetes Mellitus will be included as
             long as their glucose can be controlled between levels of 80 and 150 mg/dL

          -  Uncontrolled Hypertension (> 150/100 mm Hg despite optimal medical therapy)

          -  Major surgery or radiation therapy within 4 weeks of starting the study treatment

          -  Other severe acute or chronic medical or psychiatric condition, or laboratory
             abnormality that would impart, in the judgment of the investigator, excess risk
             associated with study participation or study drug administration, or which, in the
             judgment of the investigator, would make the patient inappropriate for entry into this
             study

          -  Pregnancy or breast feeding