Everolimus (RAD001) Therapy of Giant Cell Astrocytoma in Patients With Tuberous Sclerosis Complex

Tuberous Sclerosis Complex (TSC)is a genetic disorder with a birth incidence of approximately one in six thousand. Five to twenty percent of patients with TSC will develop astrocytoma, a slowly progressive tumor. They grow and cause damage to surrounding brain tissue, blockage of spinal fluid (hydrocephalus), blindness, trouble walking, seizures, and brain damage. If untreated, they can be fatal. Standard treatment involves surgery to remove the tumor; however surgery may itself cause brain damage, bleeding, or infection, as well as other complications. Studies have shown that everolimus suppresses the chemicals that cause tumors to grow in tuberous sclerosis, and may cause them to shrink.

The primary objective of this study is to find out the effects of everolimus on astrocytomas in a six month trial in patients with Tuberous Sclerosis who have been diagnosed with an astrocytoma

Inclusion criteria

• Age three years and older
• If female and of child bearing potential, documentation of negative pregnancy test prior to enrollment. In the extension phase, all females of child bearing potential will be required to take monthly home pregnancy tests and record results on a provided diary card.
• Clinically definite diagnosis of tuberous sclerosis (modified Gomez criteria or positive genetic test)
• Presence of giant cell astrocytoma as defined by imaging characteristics and serial increase in size of lesion on 2 or more MRI scans
• Adequate renal function (creatinine < 1.5 mg/dl)

Exclusion criteria

• Serious intercurrent medical illness or other uncontrolled medical disease which could compromise participation in the study
• Significant hematologic or hepatic abnormality
• Continuous requirement for supplemental oxygen
• Intercurrent infection at initiation of everolimus
• Embolization of angiomyolipoma within one month; any other recent surgery within 2 months of initiation of everolimus
• Pregnant or lactating women
• Use of an investigational drug within the last 30 days
• Must be adequately recovered from the acute toxicities of any prior therapy
• Clinical evidence of impending herniation or focal neurologic deficit related to the subject's astrocytoma
• Unwilling or unable to use highly effective contraception