Propranolol for Kaposi Sarcoma

Recruiting in Palo Alto (17 mi)

+2 other locations

Overseen by Lee Ratner, MD

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Phase 2

Waitlist Available

Sponsor: Washington University School of Medicine

No Placebo Group

Prior Safety Data

Approved in 3 Jurisdictions

Trial Summary

What is the purpose of this trial?

Kaposi sarcoma (KS) lesions are initiated by endothelial cells infected with KS herpesvirus (KSHV), also known as human herpesvirus 8 (HHV-8). Lesion progression is driven by abnormal angiogenesis, chronic inflammation, and uncontrolled cell proliferation. KS remains one of the most commonly diagnosed cancers in many African countries where economic constraints prevent successful treatment in most patients. Treatment outcomes in developed countries are also often unsatisfactory in HIV positive patients despite good virological and immunological responses to antiretroviral therapy. Therefore, identification of new oral, safe treatment options for treatment of KS remains a research priority. Given the known anti-angiogenic properties and based on the treatment response with other benign vascular lesions such as infantile hemangioma, propranolol is a good candidate for the treatment of KS. The hypothesis of this study is that treating patients with Kaposi sarcoma with propranolol will result in an overall response rate (complete response rate plus partial response rate) of at least 45%, and that propranolol will be safe and well tolerated in this patient population.

Research Team

Lee Ratner, MD

Principal Investigator

Washington University School of Medicine

Eligibility Criteria

This trial is for adults with Kaposi Sarcoma, a cancer caused by the KS herpesvirus. It's looking for participants who need new treatment options, including those in countries with limited access to current treatments or HIV positive patients not responding well despite antiretroviral therapy.

Inclusion Criteria

I can swallow pills.

My Kaposi's sarcoma has worsened on ART after 12-24 weeks, needing more treatment.

I weigh more than 40 kg.

Exclusion Criteria

I have asthma or another obstructive airway disease.

I have hepatitis C that is either not cured or still detectable.

I don't have another cancer that could affect this treatment's study.

Treatment Details

Interventions

• Propranolol (Beta-blocker)

Trial Overview The study tests Propranolol Hydrochloride, known for blocking blood vessel growth and inflammation. The goal is to see if it can treat Kaposi Sarcoma effectively. Researchers hope at least 45% of patients will show major improvement.

Participant Groups

Group I: Propranolol Experimental Treatment 1 Intervention

Begin at 1/2 the target dose for 7 days (14 doses), followed by a tolerability assessment. Patients who tolerate the 1/2 dose will begin the full/target dose for 7 days (14 doses), after which tolerability will be assessed. Patients who do not tolerate the full/target dose will decrease to a 1/2 dose for 2 days and then discontinue treatment; these patients will be withdrawn from the study and replaced. Those who continue will take the target dose for 12 weeks. At 12-week time point, one of the following paths will be taken: * Complete response or partial response: continue taking propranolol at the target dose for another 8 weeks, followed by a reduced dose (1/2 the target) for 7 days, then discontinue treatment * No response (stable disease/disease progression):reduced dose (1/2 the target) for 7 days, then discontinue treatment

Propranolol is already approved in Canada for the following indications:

Approved in Canada as Propranolol for:

• Hypertension
• Angina pectoris
• Arrhythmias
• Migraine prophylaxis
• Essential tremor
• Anxiety

Who Is Running the Clinical Trial?

Washington University School of Medicine

Lead Sponsor

Trials

2,027

Recruited

2,353,000+

David H. Perlmutter

Washington University School of Medicine

Chief Executive Officer since 2015

MD from Washington University School of Medicine

Paul Scheel

Washington University School of Medicine

Chief Medical Officer since 2022

MD from Washington University School of Medicine