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Imatinib Mesylate in Treating Patients With Gastrointestinal Stromal Tumor That Has Been Completely Removed During Surgery

Primary Purpose

Gastrointestinal Stromal Tumor

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
imatinib mesylate
laboratory biomarker analysis
Sponsored by
National Cancer Institute (NCI)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Gastrointestinal Stromal Tumor

Eligibility Criteria

16 Years - undefined (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Patient must have an ECOG/Zubrod performance status of ≤ 2 Patient must have a diagnosis of high-risk primary GIST; NOTE: High risk is defined as tumor size ≥ 10 cm in maximum dimension, or the presence of tumor rupture before or during surgery, intraperitoneal hemorrhage or multifocal (< 5) intraperitoneal tumors Patient must have undergone complete gross resection (includes R0 [negative microscopic margins] and R1 [positive microscopic margins] resections) of a primary GIST within 70 days prior to registration Patient must have a histologic diagnosis of GIST that is confirmed by central pathology review Patient's tumor must stain positive for the Kit receptor tyrosine kinase on immunohistochemistry as determined by the central pathologist using the Dako (Dako Corp., Carpinteria, CA) anti-CD 117 antibody Patient must have a chest x-ray completed within 28 days prior to registration Patient must have a post-operative CT scan with IV and PO contrast or MRI with contrast (if allergic to CT contrast) of abdomen and pelvis within 28 days prior to registration Creatinine ≤ 1.5 times the institution ULN WBC ≥ 2,000/mm^3 Platelet ≥ 100,000/mm^3 Total bilirubin ≤ 1.5 times the institution ULN AST and ALT ≤ 2.5 times the institution ULN Female of childbearing potential must have negative serum pregnancy test Patient or the patient's legally acceptable representative must provide a signed and dated written informed consent prior to registration and any study related procedures If patient is a cancer survivor, each of the following criteria must apply: Patient has undergone potentially curative therapy for all prior malignancies, No evidence of any prior malignancies for at least 5 years with no evidence of recurrence (except for effectively treated basal cell or squamous carcinoma of the skin, carcinoma in-situ of the cervix that has been effectively treated by surgery alone, or lobular carcinoma in-situ of the ipsilateral or contralateral breast treated by surgery alone) Patient is deemed by their treating physician to be at low risk for recurrence from prior malignancies Exclusion Criteria: Patient has received post-operative chemotherapy Patient has received post-operative radiation therapy Patient has received post-operative investigational treatment Patient has received prior therapy with STI571 Patient has had an active infection requiring antibiotics within 14 days prior to registration Patient has objective evidence of residual disease on the post-operative CT scan or MRI of the abdomen or pelvis Patient, if female and breastfeeding; NOTE: It is not known whether STI571 or its metabolites are excreted in human milk; however, in lactating female rats administered 100 mg/kg, a dose approximately equal to the maximum clinical dose of 800 mg/day based on body surface area, STI571 and/or its metabolites were extensively excreted in milk; it is estimated that approximately 1.5% of a maternal dose is excreted into milk, which is equivalent to a dose to the infant of 30% the maternal dose per unit body weight; because many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants, women should be advised against breastfeeding while taking STI571 Patient has New York Heart Association class 3 or 4 cardiac disease Patient is taking full dose warfarin; NOTE: The use of mini-dose warfarin (1 mg orally per day) for prevention of central line-associated deep venous thrombosis is permitted

Sites / Locations

  • American College of Surgeons Oncology Group

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treatment (imatinib mesylate)

Arm Description

Patients receive oral imatinib mesylate daily beginning within 84 days of surgical resection. Treatment continues for 1 year in the absence of disease recurrence or unacceptable toxicity.

Outcomes

Primary Outcome Measures

Determination whether patients with completely resected high-risk primary GIST who undergo adjuvant treatment with imatinib mesylate have prolonged survival compared to historical controls

Secondary Outcome Measures

Prevalence of recurrence free survival
Marginal point and two-sided 95% (pointwise) confidence bands, based on Kaplan-Meier estimator will be produced.
Prevalence of recurrence
Marginal point and two-sided 95% (pointwise) confidence bands, based on Kaplan-Meier estimator will be produced.
Overall survival
Marginal point and two-sided 95% (pointwise) confidence bands, based on Kaplan-Meier estimator will be produced.
Toxicities, graded according to the National Cancer Institute Common Toxicity Criteria

Full Information

First Posted
October 11, 2001
Last Updated
February 19, 2013
Sponsor
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00025246
Brief Title
Imatinib Mesylate in Treating Patients With Gastrointestinal Stromal Tumor That Has Been Completely Removed During Surgery
Official Title
A Phase II Study of Adjuvant STI571 (Gleevec TM) Therapy in Patients Following Completely Resected High-risk Primary GastroIntestinal Stromal Tumor (GIST)
Study Type
Interventional

2. Study Status

Record Verification Date
January 2013
Overall Recruitment Status
Completed
Study Start Date
September 2001 (undefined)
Primary Completion Date
November 2007 (Actual)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
This phase II trial is studying how well imatinib mesylate works in treating patients with gastrointestinal stromal tumor that was completely removed during surgery. Imatinib mesylate may stop the growth of cancer cells by blocking the enzymes necessary for cancer cell growth
Detailed Description
PRIMARY OBJECTIVES: I. To ascertain whether patients with completely resected high-risk primary GIST who undergo adjuvant treatment with STI571 have prolonged survival compared to historical controls. SECONDARY OBJECTIVES: I. To determine the 2 and 5-year prevalence of recurrence in patients treated with adjuvant STI571 following complete resection of high-risk primary GIST. II. To obtain from patients with GIST: tumor tissue (before therapy with STI571 and at the time of recurrence), blood specimens (before therapy with STI571), and serum specimens (before therapy with STI571, after completing therapy with STI571, and at the time of recurrence) for scientific correlative analyses. III. To assess the toxicity of oral STI571 therapy when used in the adjuvant setting. OUTLINE: Patients receive oral imatinib mesylate daily beginning within 84 days of surgical resection. Treatment continues for 1 year in the absence of disease recurrence or unacceptable toxicity. After completion of study treatment, patients are followed periodically for up to 10 years.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Gastrointestinal Stromal Tumor

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
89 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Treatment (imatinib mesylate)
Arm Type
Experimental
Arm Description
Patients receive oral imatinib mesylate daily beginning within 84 days of surgical resection. Treatment continues for 1 year in the absence of disease recurrence or unacceptable toxicity.
Intervention Type
Drug
Intervention Name(s)
imatinib mesylate
Other Intervention Name(s)
CGP 57148, Gleevec, Glivec
Intervention Description
Given orally
Intervention Type
Other
Intervention Name(s)
laboratory biomarker analysis
Intervention Description
Correlative studies
Primary Outcome Measure Information:
Title
Determination whether patients with completely resected high-risk primary GIST who undergo adjuvant treatment with imatinib mesylate have prolonged survival compared to historical controls
Time Frame
Up to 5 years
Secondary Outcome Measure Information:
Title
Prevalence of recurrence free survival
Description
Marginal point and two-sided 95% (pointwise) confidence bands, based on Kaplan-Meier estimator will be produced.
Time Frame
2 years
Title
Prevalence of recurrence
Description
Marginal point and two-sided 95% (pointwise) confidence bands, based on Kaplan-Meier estimator will be produced.
Time Frame
5 years
Title
Overall survival
Description
Marginal point and two-sided 95% (pointwise) confidence bands, based on Kaplan-Meier estimator will be produced.
Time Frame
Up to 5 years
Title
Toxicities, graded according to the National Cancer Institute Common Toxicity Criteria
Time Frame
Up to 10 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
16 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient must have an ECOG/Zubrod performance status of ≤ 2 Patient must have a diagnosis of high-risk primary GIST; NOTE: High risk is defined as tumor size ≥ 10 cm in maximum dimension, or the presence of tumor rupture before or during surgery, intraperitoneal hemorrhage or multifocal (< 5) intraperitoneal tumors Patient must have undergone complete gross resection (includes R0 [negative microscopic margins] and R1 [positive microscopic margins] resections) of a primary GIST within 70 days prior to registration Patient must have a histologic diagnosis of GIST that is confirmed by central pathology review Patient's tumor must stain positive for the Kit receptor tyrosine kinase on immunohistochemistry as determined by the central pathologist using the Dako (Dako Corp., Carpinteria, CA) anti-CD 117 antibody Patient must have a chest x-ray completed within 28 days prior to registration Patient must have a post-operative CT scan with IV and PO contrast or MRI with contrast (if allergic to CT contrast) of abdomen and pelvis within 28 days prior to registration Creatinine ≤ 1.5 times the institution ULN WBC ≥ 2,000/mm^3 Platelet ≥ 100,000/mm^3 Total bilirubin ≤ 1.5 times the institution ULN AST and ALT ≤ 2.5 times the institution ULN Female of childbearing potential must have negative serum pregnancy test Patient or the patient's legally acceptable representative must provide a signed and dated written informed consent prior to registration and any study related procedures If patient is a cancer survivor, each of the following criteria must apply: Patient has undergone potentially curative therapy for all prior malignancies, No evidence of any prior malignancies for at least 5 years with no evidence of recurrence (except for effectively treated basal cell or squamous carcinoma of the skin, carcinoma in-situ of the cervix that has been effectively treated by surgery alone, or lobular carcinoma in-situ of the ipsilateral or contralateral breast treated by surgery alone) Patient is deemed by their treating physician to be at low risk for recurrence from prior malignancies Exclusion Criteria: Patient has received post-operative chemotherapy Patient has received post-operative radiation therapy Patient has received post-operative investigational treatment Patient has received prior therapy with STI571 Patient has had an active infection requiring antibiotics within 14 days prior to registration Patient has objective evidence of residual disease on the post-operative CT scan or MRI of the abdomen or pelvis Patient, if female and breastfeeding; NOTE: It is not known whether STI571 or its metabolites are excreted in human milk; however, in lactating female rats administered 100 mg/kg, a dose approximately equal to the maximum clinical dose of 800 mg/day based on body surface area, STI571 and/or its metabolites were extensively excreted in milk; it is estimated that approximately 1.5% of a maternal dose is excreted into milk, which is equivalent to a dose to the infant of 30% the maternal dose per unit body weight; because many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants, women should be advised against breastfeeding while taking STI571 Patient has New York Heart Association class 3 or 4 cardiac disease Patient is taking full dose warfarin; NOTE: The use of mini-dose warfarin (1 mg orally per day) for prevention of central line-associated deep venous thrombosis is permitted
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ronald DeMatteo
Organizational Affiliation
American College of Surgeons
Official's Role
Principal Investigator
Facility Information:
Facility Name
American College of Surgeons Oncology Group
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27705
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
23860199
Citation
DeMatteo RP, Ballman KV, Antonescu CR, Corless C, Kolesnikova V, von Mehren M, McCarter MD, Norton J, Maki RG, Pisters PW, Demetri GD, Brennan MF, Owzar K; American College of Surgeons Oncology Group (ACOSOG) Intergroup Adjuvant GIST Study Team for the Alliance for Clinical Trials in Oncology. Long-term results of adjuvant imatinib mesylate in localized, high-risk, primary gastrointestinal stromal tumor: ACOSOG Z9000 (Alliance) intergroup phase 2 trial. Ann Surg. 2013 Sep;258(3):422-9. doi: 10.1097/SLA.0b013e3182a15eb7.
Results Reference
derived

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Imatinib Mesylate in Treating Patients With Gastrointestinal Stromal Tumor That Has Been Completely Removed During Surgery

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