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Imatinib Mesylate in Treating Patients With Progressive, Refractory, or Recurrent Stage II or Stage III Testicular or Ovarian Cancer

Primary Purpose

Ovarian Dysgerminoma, Recurrent Malignant Testicular Germ Cell Tumor, Recurrent Ovarian Germ Cell Tumor

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
imatinib mesylate
therapeutic conventional surgery
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 Ovarian Dysgerminoma

Eligibility Criteria

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

Inclusion Criteria: Histologically confirmed pure testicular seminoma or ovarian germ cell dysgerminoma Histologic documentation of metastatic/recurrent disease not required Alpha-fetoprotein level must be normal, unless abnormal level is explained by other conditions and approved by the study chair Clinical stage II or III Progressive, refractory, or recurrent disease, meeting at least 1 of the following criteria: Measurable progressive disease Biopsy-proven residual disease Persistently elevated or rising B-human chorionic gonadotropin (HCG) titers, defined as at least 2 values above the upper limit of normal (ULN) Cisplatin-refractory disease without option of potentially curative therapy, meeting 1 of the following criteria: Failed high-dose chemotherapy with peripheral blood stem cell transplantation (PBSCT) or autologous bone marrow transplantation (AuBMT) Ineligible for or refused PBSCT or AuBMT Unlikely to achieve long-term benefit from PBSCT or AuBMT Current evidence of metastatic disease Unidimensionally measurable target lesions At least 20 mm by conventional techniques (e.g., physical examination for clinically palpable lymph nodes and superficial skin lesions or chest x-ray for clearly defined lung lesions surrounded by aerated lung) At least 10 mm by spiral CT scan or MRI If measurable disease is confined to a solitary lesion, then its neoplastic nature must be confirmed by histology Ultrasound may not be used to measure tumor lesions that are not easily accessible clinically Non-measurable/non-target lesions, with HCG at least ULN, including the following: Bone lesions Pleural or pericardial effusions Ascites CNS lesions Leptomeningeal disease Irradiated lesions, unless progression documented after radiotherapy Performance status - ECOG 0-2 Granulocyte count at least 1,500/mm^3 Platelet count at least 100,000/mm^3 Hemoglobin at least 9 g/dL (transfusion allowed) Bilirubin no greater than 1.5 times upper limit of normal (ULN) SGOT/SGPT no greater than 2.5 times ULN Creatinine no greater than 1.5 times ULN No other severe and/or uncontrolled concurrent medical illness Not pregnant or nursing Negative pregnancy test Fertile patients must use effective barrier contraception during and for 3 months after study participation See Disease Characteristics See Disease Characteristics At least 4 weeks since prior chemotherapy No concurrent chemotherapy No concurrent hormonal therapy except steroids for adrenal failure, hormones for non-disease-related conditions (e.g., insulin for diabetes), or intermittent dexamethasone as an antiemetic See Disease Characteristics At least 4 weeks since prior radiotherapy Prior radiotherapy to a symptomatic lesion or one that may produce disability (e.g., unstable femur) allowed No concurrent palliative radiotherapy No concurrent grapefruit juice No concurrent warfarin for therapeutic anticoagulation (concurrent mini-dose warfarin [1 mg orally per day] as prophylaxis allowed)

Sites / Locations

  • Cancer and Leukemia Group B

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treatment (imatinib mesylate and surgical resection)

Arm Description

Patients receive oral imatinib mesylate once daily. Treatment continues in the absence of disease progression or unacceptable toxicity. Patients who achieve a partial response or stable disease with normalization of human chorionic gonadotropin may undergo surgical resection of residual lesions at each tumor status assessment. If residual viable germ cell tumor is present in the resected specimen, patients may resume imatinib mesylate. If no viable germ cell tumor is present in the resected specimen, then no further therapy is administered.

Outcomes

Primary Outcome Measures

Response rate defined as either a complete or partial response using RECIST criteria
Response rate (CR+PR) and exact 95% confidence interval based on the binomial distribution for the response rate will be computed.

Secondary Outcome Measures

Grade 1 or higher toxicities assessed using CTC)version 2
Toxicities will be tabulated.
Duration of response
The Kaplan-Meier product-limit method will be used.
Disease-free survival
The Kaplan-Meier product-limit method will be used.
Overall survival
The Kaplan-Meier product-limit method will be used.
Proportion of patients with mutations in the c-KIT gene
The 95% confidence interval will be estimated.

Full Information

First Posted
August 5, 2002
Last Updated
January 15, 2013
Sponsor
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00042952
Brief Title
Imatinib Mesylate in Treating Patients With Progressive, Refractory, or Recurrent Stage II or Stage III Testicular or Ovarian Cancer
Official Title
A Phase II Study Of Imatinib Mesylate (Gleevec, Formerly Known As STI571; IND 61,135, NSC #716051) In Patients With Refractory Seminoma
Study Type
Interventional

2. Study Status

Record Verification Date
January 2013
Overall Recruitment Status
Terminated
Why Stopped
Administratively complete.
Study Start Date
June 2002 (undefined)
Primary Completion Date
October 2003 (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
Imatinib mesylate may stop the growth of tumor cells by blocking the enzymes necessary for tumor cell growth. Phase II trial to study the effectiveness of imatinib mesylate in treating patients who have progressive, refractory, or recurrent stage II or stage III testicular cancer or stage II or stage III ovarian cancer following cisplatin-based chemotherapy
Detailed Description
OBJECTIVES: I. Determine the activity of imatinib mesylate in patients with progressive, refractory, or recurrent pure testicular seminoma or ovarian germ cell dysgerminoma after cisplatin-based chemotherapy. II. Determine the toxicity of this drug in this patient population. III. Determine KIT expression and identify mutations in the c-kit gene in patients treated with this drug. OUTLINE: This is a multicenter study. Patients receive oral imatinib mesylate once daily. Treatment continues in the absence of disease progression or unacceptable toxicity. Patients who achieve a partial response or stable disease with normalization of human chorionic gonadotropin may undergo surgical resection of residual lesions at each tumor status assessment. If residual viable germ cell tumor is present in the resected specimen, patients may resume imatinib mesylate. If no viable germ cell tumor is present in the resected specimen, then no further therapy is administered. Patients are followed every 3 months for 1 year and then every 6 months for 1 year. PROJECTED ACCRUAL: A total of 32 patients will be accrued for this study within 32-38 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Ovarian Dysgerminoma, Recurrent Malignant Testicular Germ Cell Tumor, Recurrent Ovarian Germ Cell Tumor, Stage II Malignant Testicular Germ Cell Tumor, Stage II Ovarian Germ Cell Tumor, Stage III Malignant Testicular Germ Cell Tumor, Stage III Ovarian Germ Cell Tumor, Testicular Seminoma

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Treatment (imatinib mesylate and surgical resection)
Arm Type
Experimental
Arm Description
Patients receive oral imatinib mesylate once daily. Treatment continues in the absence of disease progression or unacceptable toxicity. Patients who achieve a partial response or stable disease with normalization of human chorionic gonadotropin may undergo surgical resection of residual lesions at each tumor status assessment. If residual viable germ cell tumor is present in the resected specimen, patients may resume imatinib mesylate. If no viable germ cell tumor is present in the resected specimen, then no further therapy is administered.
Intervention Type
Drug
Intervention Name(s)
imatinib mesylate
Other Intervention Name(s)
CGP 57148, Gleevec, Glivec
Intervention Description
Given orally
Intervention Type
Procedure
Intervention Name(s)
therapeutic conventional surgery
Intervention Description
Undergo surgical resection
Intervention Type
Other
Intervention Name(s)
laboratory biomarker analysis
Intervention Description
Correlative studies
Primary Outcome Measure Information:
Title
Response rate defined as either a complete or partial response using RECIST criteria
Description
Response rate (CR+PR) and exact 95% confidence interval based on the binomial distribution for the response rate will be computed.
Time Frame
Up to 2 years
Secondary Outcome Measure Information:
Title
Grade 1 or higher toxicities assessed using CTC)version 2
Description
Toxicities will be tabulated.
Time Frame
Up to 2 years
Title
Duration of response
Description
The Kaplan-Meier product-limit method will be used.
Time Frame
From first response (CR or PR) to the date of disease progression or death, assessed up to 2 years
Title
Disease-free survival
Description
The Kaplan-Meier product-limit method will be used.
Time Frame
From the date of initiation of treatment to date of progression or death due to any cause, whichever occurs first, assessed up to 2 years
Title
Overall survival
Description
The Kaplan-Meier product-limit method will be used.
Time Frame
From date of initiation of treatment to date of death due to any cause, assessed up to 2 years
Title
Proportion of patients with mutations in the c-KIT gene
Description
The 95% confidence interval will be estimated.
Time Frame
Up to 2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
15 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically confirmed pure testicular seminoma or ovarian germ cell dysgerminoma Histologic documentation of metastatic/recurrent disease not required Alpha-fetoprotein level must be normal, unless abnormal level is explained by other conditions and approved by the study chair Clinical stage II or III Progressive, refractory, or recurrent disease, meeting at least 1 of the following criteria: Measurable progressive disease Biopsy-proven residual disease Persistently elevated or rising B-human chorionic gonadotropin (HCG) titers, defined as at least 2 values above the upper limit of normal (ULN) Cisplatin-refractory disease without option of potentially curative therapy, meeting 1 of the following criteria: Failed high-dose chemotherapy with peripheral blood stem cell transplantation (PBSCT) or autologous bone marrow transplantation (AuBMT) Ineligible for or refused PBSCT or AuBMT Unlikely to achieve long-term benefit from PBSCT or AuBMT Current evidence of metastatic disease Unidimensionally measurable target lesions At least 20 mm by conventional techniques (e.g., physical examination for clinically palpable lymph nodes and superficial skin lesions or chest x-ray for clearly defined lung lesions surrounded by aerated lung) At least 10 mm by spiral CT scan or MRI If measurable disease is confined to a solitary lesion, then its neoplastic nature must be confirmed by histology Ultrasound may not be used to measure tumor lesions that are not easily accessible clinically Non-measurable/non-target lesions, with HCG at least ULN, including the following: Bone lesions Pleural or pericardial effusions Ascites CNS lesions Leptomeningeal disease Irradiated lesions, unless progression documented after radiotherapy Performance status - ECOG 0-2 Granulocyte count at least 1,500/mm^3 Platelet count at least 100,000/mm^3 Hemoglobin at least 9 g/dL (transfusion allowed) Bilirubin no greater than 1.5 times upper limit of normal (ULN) SGOT/SGPT no greater than 2.5 times ULN Creatinine no greater than 1.5 times ULN No other severe and/or uncontrolled concurrent medical illness Not pregnant or nursing Negative pregnancy test Fertile patients must use effective barrier contraception during and for 3 months after study participation See Disease Characteristics See Disease Characteristics At least 4 weeks since prior chemotherapy No concurrent chemotherapy No concurrent hormonal therapy except steroids for adrenal failure, hormones for non-disease-related conditions (e.g., insulin for diabetes), or intermittent dexamethasone as an antiemetic See Disease Characteristics At least 4 weeks since prior radiotherapy Prior radiotherapy to a symptomatic lesion or one that may produce disability (e.g., unstable femur) allowed No concurrent palliative radiotherapy No concurrent grapefruit juice No concurrent warfarin for therapeutic anticoagulation (concurrent mini-dose warfarin [1 mg orally per day] as prophylaxis allowed)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Christopher Ryan
Organizational Affiliation
Cancer and Leukemia Group B
Official's Role
Principal Investigator
Facility Information:
Facility Name
Cancer and Leukemia Group B
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60606
Country
United States

12. IPD Sharing Statement

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Imatinib Mesylate in Treating Patients With Progressive, Refractory, or Recurrent Stage II or Stage III Testicular or Ovarian Cancer

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