Efficacy and Safety of the Mammalian Target of Rapamycin (mTor Rapamycin) Inhibitor in Vascular Malformations (vasca-LM)

Cliniques universitaires Saint-Luc- Université Catholique de Louvain

Status and phase

Completed

Phase 3

Conditions

Cardiovascular Abnormalities

Treatments

Drug: Sirolimus

Study type

Interventional

Funder types

Other

Identifiers

NCT01811667

vasca-LM

Details and patient eligibility

About

The phosphatidylinositol 3-kinase (PI3Kinase)/Protein Kinase B (AKT)/mammalian target of rapamycin (mTor) pathway plays a role on the development and the lymphatic-vascular organisations.

The investigators want to study the efficacy and the safety of Rapamycin, an mTor inhibitor.

Full description

The complex vascular malformations induce chronical pains and organic dysfunctions causing significant morbidity and mortality. Therefore, the investigators need to establish guidelines in order to treat these pathologies. Standard treatments such as surgery or interventional radiology are of limited efficacy and related to a high level of recurrences as well as complications. Recent preclinical studies have shown the important role of the PI3Kinase/AKT/mTor pathway on the development and the lymphatic-vascular organisations suggesting an appealing therapeutic target to treat patients with complex vascular malformations.

The aim of this clinical study is to prospectively evaluate the efficacy and the safety of the Rapamycin, an mTOR inhibitor, to treat children and adults with microcystic lymphatic malformations, general lymphatics abnormalities (GLA) or complex vascular malformations for which conventional therapies as surgery or sclerotherapy are ineffective or associated with high risk of important complications.

Enrollment

19 patients

Sex

All

Ages

Under 70 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Patients with complex vascular abnormalities to be threat by a systemic therapy
Patients must have adequate liver function (LDL-cholesterol, triglycerides,...)
Patients must have adequate organ function: neutrophils >1500/mm³, Hb > 8,0 g et platelets> 50.000/mm³ (no platelets limits for the Kasabach Merritt syndrome)
Patients must have adequate renal function(normal creatinin depending on the age), clearance > 70 ml/min/1.73m² and Urin Protein Creatinine ratio <0.3 g.
Karnofsky or Landry > 50

Exclusion criteria

Dental equipments or prosthesis interfering onto a radiological examen
Other uncontrolled medical condition (uncontrolled diabetes, hypertension...)
Concomitant drugs such as inhibitors/inducers of cytochrome P450 3A4 (CYP3A4)
Immunocompromised patients, including known seropositivity for HIV
Digestive problems modifying the absorption of Rapamycin (gastric tube feeding accepted)
Pregnant or nursing (lactating) women
Prior treatment with phosphatidylinositol 3-kinase (PI3K) and/or mTOR inhibitors