Assessments during study treatment phase
- Baseline evaluations are to be conducted within 2 weeks prior to the start of protocol therapy, and comprise medical history, physical examination, toxicity assessment, hematology, serum chemistry, immune and angiogenesis monitoring, ECG, tumor biopsy (not mandatory) and, in case of female participants, urine HCG. Abdominal and chest CT scans must be done within 4 weeks prior to start of therapy.
- Patient visits will be scheduled at 2, 4 and 8 weeks and subsequently 4-weekly. At each visit medical history, physical examination, toxicity assessment, hematology and serum chemistry will be performed.
- Immune monitoring on CD4+CD25+FOXP3+ regulatory T cells, conventional T cell subsets, NK cells, invariant CD1d-restricted NKT cells, dendritic cell subsets, myeloid-derived suppressor cells and cytokine levels will be performed at baseline and subsequently at 2, 4, and 8 weeks after the start of the study treatment period.
- Angiogenesis monitoring on thrombospondin 1 (TSP-1), VEGF, circulating numbers of platelets and hematopoietic progenitor cells (HPCs) will be performed at baseline, week 4 and 8.
- Everolimus and cyclophosphamide drug levels will be measured during the phase I part of the study at week 4.
- If patients agreed on a tumor biopsy, a second biopsy will be obtained at week 4.
- CT images will be required at fixed time-points; baseline, 8 and 16 weeks, and thereafter every 8 weeks during treatment until progressive disease.
- Adverse events will be reported during the study treatment phase. Medically significant adverse events considered related to the investigational product by the investigator will be followed until resolved or considered stable.
Assessments during follow up phase
- At the end of study treatment, medical history and toxicity will be assessed, and physical examination, hematology, serum chemistry, immune and angiogenesis monitoring, abdominal and chest CT scans will be performed.
- Follow up will last till progressive disease and/or death of the patient.