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Doxorubicin vs. Trabectedin Plus Doxorubicin in Non Operable and/or Metastatic STS

Primary Purpose

Sarcoma

Status
Terminated
Phase
Phase 2
Locations
Spain
Study Type
Interventional
Intervention
Doxorubicin
Trabectedin
Sponsored by
Grupo Espanol de Investigacion en Sarcomas
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Sarcoma focused on measuring metastatic STS, Trabectedin, doxorrubicin, soft tissue sarcoma, non operable sarcoma

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • The patient must sign voluntarily the informed consent from before any study test is conducted that is not part of routine patient care, with the knowledge that he/she can abandon the study at any time without this affecting his/her previous care.
  • Aged between 18 and 70.
  • Pathological diagnosis of non operable and/or metastatic soft tissue sarcoma.
  • The following histological subtypes can be included:

    • Undifferentiated pleomorphic sarcoma (previously,malignant fibrous istiocytoma)
    • Leiomyosarcoma
    • Angiosarcoma
    • Liposarcoma
    • Synovial sarcoma
    • Fibrosarcoma
    • Hemangiopericytoma
    • Neurofibrosarcoma
    • Mixofibrosarcoma
    • Unclassified sarcoma
  • Measurable disease, according to RECIST criteria
  • Performance status 0-2 Eastern Cooperative Oncology Group(ECOG).
  • Adequate bone marrow function (hemoglobin > 10 g/dL, leukocytes ≥ 3.000/mm3, neutrophils ≥1.500/mm3, platelets ≥ 100.000/mm3). Patients with plasma creatinine ≤ 1,6 mg/dL, transaminases ≤2.5 times the upper limit of normal (ULN), total bilirubin ≤ upper limit of normal (ULN), CPK ≤ 2.5 times upper limit of normal (ULN), alkaline phosphatase ≤ 2.5 times the upper limit of normal (ULN) are acceptable. If the increase of alkaline phosphatase is > 2.5 times the upper limit of normal (ULN), then the alkaline phosphatase liver fraction and/or 5' nucleotidase and/or GGT must be ≤ upper limit of normal (ULN).
  • Men or women of child bearing potential should be using an effective method of contraception before entry into the study and throughout the same and for 6 months after ending the study. Women of childbearing potential must have a negative urine pregnancy test before study entry.
  • Normal cardiac function with a Left ventricular ejection fraction (LVEF) ≥ 50% by echocardiogram or Multiple Uptake Gated Acquisition Scan (MUGA).

Exclusion Criteria:

  • Previous chemotherapy treatment.
  • Previous radiotherapy involving the only localization(s) of measurable tumoral disease.
  • Performance status> 2 Eastern Cooperative Oncology Group(ECOG).
  • Central Nervous System (CNS) metastases.
  • Plasma bilirubin > upper limit of normal(ULN).
  • Creatinine > 1.6 mg/dL.
  • History of other neoplastic disease with the exception of basalioma or in situ cervical cancer adequately treated.
  • Significant cardiovascular disease (for example, dyspnea > 2 NYHA)
  • Significant systemic diseases grade 3 or higher on the NCI-CTC version 3.0 scale, that limit patient availability, or according to investigator judgment may contribute significantly to treatment toxicity.
  • Uncontrolled bacterial, mycotic or viral infections.
  • Women who are pregnant or breast-feeding
  • Psychological, familial, social or geographic circumstances that limit the patient's ability to comply with the protocol or informed consent.
  • Patients participating in another clinical trial or receiving any other investigational product.
  • Patients who had participated in another clinical trial and/or had received any other investigational product in the last 30 days prior to inclusion.
  • The following histologic subtypes are excluded:

    • Rhabdomyosarcoma
    • Ewing's family of tumors
    • Desmoplastic small round cell tumor
    • Clear cell sarcoma
    • Alveolar sarcoma

Sites / Locations

  • Ico Hospitalet
  • ICO Badalona
  • H. Clinic Barcelona
  • H. Sant Pau
  • H. Provincial Castellón
  • ICO Girona
  • H. Xeral Cies
  • Clinica Puerta Hierro
  • H. Clínico. San Carlos
  • H. U. La Paz
  • H.U. Gregorio Marañon
  • H.U. Ramon Y Cajal
  • H.U. Clinico de Malaga
  • H. de Navarra
  • H. C. Asturias
  • H. Son Dureta
  • H. Univ. Canarias
  • H.U. Virgen Del Rocio
  • Instituto Valenciano de Oncología
  • H. Miguel Servet

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Experimental

Arm Label

Arm A

Arm B

Arm Description

Classic Doxorubicin (Adriamycin - Doxorubicin hydrochloride) Presentation: Solution with 10, 20, or 50 mg Doxorubicin Hydrochloride. Excipients: hydrochloric acid and sodium chloride 0.9%, q.s. 25 ml. Pharmaceutical form: concentrate for solution for infusion. Route of administration: Intravenous

Trabectedin Presentation: vials with trabectedin 1 mg and sucrose 400 mg. Pharmaceutical form: A white or whitish lyophilized powder as concentrate for solution for injection. Route of administration: for intravenous use after reconstitution and further dilution. Classic Doxorubicin (Adriamycin - Doxorubicin hydrochloride) Presentation: Solution with 10, 20, or 50 mg Doxorubicin Hydrochloride. Excipients: hydrochloric acid and sodium chloride 0.9%, q.s. 25 ml. Pharmaceutical form: concentrate for solution for infusion. Route of administration: Intravenous

Outcomes

Primary Outcome Measures

To determine the efficacy of the combination of trabectedin and doxorubicin in comparison with doxorubicin alone in patients with advanced non operable and/or metastatic Soft Tissue Sarcomas (STS)
To determine the efficacy of the combination of trabectedin and doxorubicin in comparison with doxorubicin alone in patients with advanced non operable and/or metastatic Soft Tissue Sarcomas (STS). To this end, progression free survival will be compared between both groups of treatment.

Secondary Outcome Measures

To determine activity by means of RECIST objective responses in both study arms, trabectedin/doxorubicin combination and the control arm.
To determine activity by means of RECIST objective responses in both study arms, trabectedin/doxorubicin combination and the control arm.
To determine the tumor control (response rates plus stabilizations) in both arms of treatment.
To determine the tumor control (response rates plus stabilizations) in both arms of treatment.
Overall survival.
Overall survival.
To determine activity by tissue changes applying the Choi criteria to Soft Tissue Sarcomas (STS)(see radiological review sub study).
To determine activity by tissue changes applying the Choi criteria to Soft Tissue Sarcomas (STS)(see radiological review sub study).
To determine toxicity of trabectedin/doxorubicin combination and the control arm.
To determine toxicity of trabectedin/doxorubicin combination and the control arm.
To determine protein and mRNA expression of genes possibly involved in a potential profile of more favorable response or resistance to study drugs and to analyze the prognostic impact of them on predefined efficacy parameters.
To determine protein and mRNA expression of genes possibly involved in a potential profile of more favorable response or resistance to study drugs and to analyze the prognostic impact of them on predefined efficacy parameters.
To evaluate genomic instability, as well as protein expression that could influence response/resistance to the study drugs and make a correlation with efficacy endpoints.
To evaluate genomic instability, as well as protein expression that could influence response/resistance to the study drugs and make a correlation with efficacy endpoints.

Full Information

First Posted
April 13, 2010
Last Updated
October 26, 2015
Sponsor
Grupo Espanol de Investigacion en Sarcomas
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1. Study Identification

Unique Protocol Identification Number
NCT01104298
Brief Title
Doxorubicin vs. Trabectedin Plus Doxorubicin in Non Operable and/or Metastatic STS
Official Title
Randomized, Open, Multicenter, Prospective, Phase II Clinical Trial of Doxorubicin vs. Trabectedin Plus Doxorubicin in the First Line Treatment of Patients With Advanced Non Operable and/or Metastatic Soft Tissue Sarcomas
Study Type
Interventional

2. Study Status

Record Verification Date
October 2015
Overall Recruitment Status
Terminated
Why Stopped
Interim analysis did not show good results for main objective
Study Start Date
November 2009 (undefined)
Primary Completion Date
December 2012 (Actual)
Study Completion Date
May 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Grupo Espanol de Investigacion en Sarcomas

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The proposed investigation intends to explore if the combination of trabectedin and doxorubicin in the first line of treatment of advanced sarcomas obtains better results than doxorubicin monotherapy
Detailed Description
The proposed investigation intends to explore if the combination of trabectedin and doxorubicin in the first line of treatment of advanced sarcomas obtains better results than doxorubicin monotherapy. This proposal arises from the need to bring to the first line of treatment of advanced STS agents that have shown activity in second line. The goal is to improve available standard treatments. Tumors in patients not previously exposed to chemotherapy have not been selected in their biological behavior and they are the best scenario to test antitumor activity of a new anticancer drug. The combination of drugs with different mechanisms of action may be a clear advantage to obtain better results and potential synergy. On the other hand, the toxicity profiles of both study drugs are different and worsening or summative of adverse effects is not expected. The purpose of this study is to determine the efficacy of the combination of trabectedin and doxorubicin in comparison with doxorubicin alone in patients with advanced non operable and/or metastatic Soft Tissue Sarcomas (STS).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Sarcoma
Keywords
metastatic STS, Trabectedin, doxorrubicin, soft tissue sarcoma, non operable sarcoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
115 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm A
Arm Type
Active Comparator
Arm Description
Classic Doxorubicin (Adriamycin - Doxorubicin hydrochloride) Presentation: Solution with 10, 20, or 50 mg Doxorubicin Hydrochloride. Excipients: hydrochloric acid and sodium chloride 0.9%, q.s. 25 ml. Pharmaceutical form: concentrate for solution for infusion. Route of administration: Intravenous
Arm Title
Arm B
Arm Type
Experimental
Arm Description
Trabectedin Presentation: vials with trabectedin 1 mg and sucrose 400 mg. Pharmaceutical form: A white or whitish lyophilized powder as concentrate for solution for injection. Route of administration: for intravenous use after reconstitution and further dilution. Classic Doxorubicin (Adriamycin - Doxorubicin hydrochloride) Presentation: Solution with 10, 20, or 50 mg Doxorubicin Hydrochloride. Excipients: hydrochloric acid and sodium chloride 0.9%, q.s. 25 ml. Pharmaceutical form: concentrate for solution for infusion. Route of administration: Intravenous
Intervention Type
Drug
Intervention Name(s)
Doxorubicin
Other Intervention Name(s)
Adriamycin
Intervention Description
A maximum of 6 cycles every 3 weeks of doxorubicin monotherapy 75 mg/square meter will be given in the absence of progression or not acceptable toxicity.
Intervention Type
Drug
Intervention Name(s)
Trabectedin
Other Intervention Name(s)
Yondelis
Intervention Description
A maximum of 6 cycles every 3 weeks of the combination (Trabectedin 1,1 mg/square meter + doxorubicin 60 mg/square meter) will be given in the absence of progression or not acceptable toxicity.
Primary Outcome Measure Information:
Title
To determine the efficacy of the combination of trabectedin and doxorubicin in comparison with doxorubicin alone in patients with advanced non operable and/or metastatic Soft Tissue Sarcomas (STS)
Description
To determine the efficacy of the combination of trabectedin and doxorubicin in comparison with doxorubicin alone in patients with advanced non operable and/or metastatic Soft Tissue Sarcomas (STS). To this end, progression free survival will be compared between both groups of treatment.
Time Frame
2012
Secondary Outcome Measure Information:
Title
To determine activity by means of RECIST objective responses in both study arms, trabectedin/doxorubicin combination and the control arm.
Description
To determine activity by means of RECIST objective responses in both study arms, trabectedin/doxorubicin combination and the control arm.
Time Frame
2012
Title
To determine the tumor control (response rates plus stabilizations) in both arms of treatment.
Description
To determine the tumor control (response rates plus stabilizations) in both arms of treatment.
Time Frame
2012
Title
Overall survival.
Description
Overall survival.
Time Frame
2012
Title
To determine activity by tissue changes applying the Choi criteria to Soft Tissue Sarcomas (STS)(see radiological review sub study).
Description
To determine activity by tissue changes applying the Choi criteria to Soft Tissue Sarcomas (STS)(see radiological review sub study).
Time Frame
2012
Title
To determine toxicity of trabectedin/doxorubicin combination and the control arm.
Description
To determine toxicity of trabectedin/doxorubicin combination and the control arm.
Time Frame
2012
Title
To determine protein and mRNA expression of genes possibly involved in a potential profile of more favorable response or resistance to study drugs and to analyze the prognostic impact of them on predefined efficacy parameters.
Description
To determine protein and mRNA expression of genes possibly involved in a potential profile of more favorable response or resistance to study drugs and to analyze the prognostic impact of them on predefined efficacy parameters.
Time Frame
2012
Title
To evaluate genomic instability, as well as protein expression that could influence response/resistance to the study drugs and make a correlation with efficacy endpoints.
Description
To evaluate genomic instability, as well as protein expression that could influence response/resistance to the study drugs and make a correlation with efficacy endpoints.
Time Frame
2012

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: The patient must sign voluntarily the informed consent from before any study test is conducted that is not part of routine patient care, with the knowledge that he/she can abandon the study at any time without this affecting his/her previous care. Aged between 18 and 70. Pathological diagnosis of non operable and/or metastatic soft tissue sarcoma. The following histological subtypes can be included: Undifferentiated pleomorphic sarcoma (previously,malignant fibrous istiocytoma) Leiomyosarcoma Angiosarcoma Liposarcoma Synovial sarcoma Fibrosarcoma Hemangiopericytoma Neurofibrosarcoma Mixofibrosarcoma Unclassified sarcoma Measurable disease, according to RECIST criteria Performance status 0-2 Eastern Cooperative Oncology Group(ECOG). Adequate bone marrow function (hemoglobin > 10 g/dL, leukocytes ≥ 3.000/mm3, neutrophils ≥1.500/mm3, platelets ≥ 100.000/mm3). Patients with plasma creatinine ≤ 1,6 mg/dL, transaminases ≤2.5 times the upper limit of normal (ULN), total bilirubin ≤ upper limit of normal (ULN), CPK ≤ 2.5 times upper limit of normal (ULN), alkaline phosphatase ≤ 2.5 times the upper limit of normal (ULN) are acceptable. If the increase of alkaline phosphatase is > 2.5 times the upper limit of normal (ULN), then the alkaline phosphatase liver fraction and/or 5' nucleotidase and/or GGT must be ≤ upper limit of normal (ULN). Men or women of child bearing potential should be using an effective method of contraception before entry into the study and throughout the same and for 6 months after ending the study. Women of childbearing potential must have a negative urine pregnancy test before study entry. Normal cardiac function with a Left ventricular ejection fraction (LVEF) ≥ 50% by echocardiogram or Multiple Uptake Gated Acquisition Scan (MUGA). Exclusion Criteria: Previous chemotherapy treatment. Previous radiotherapy involving the only localization(s) of measurable tumoral disease. Performance status> 2 Eastern Cooperative Oncology Group(ECOG). Central Nervous System (CNS) metastases. Plasma bilirubin > upper limit of normal(ULN). Creatinine > 1.6 mg/dL. History of other neoplastic disease with the exception of basalioma or in situ cervical cancer adequately treated. Significant cardiovascular disease (for example, dyspnea > 2 NYHA) Significant systemic diseases grade 3 or higher on the NCI-CTC version 3.0 scale, that limit patient availability, or according to investigator judgment may contribute significantly to treatment toxicity. Uncontrolled bacterial, mycotic or viral infections. Women who are pregnant or breast-feeding Psychological, familial, social or geographic circumstances that limit the patient's ability to comply with the protocol or informed consent. Patients participating in another clinical trial or receiving any other investigational product. Patients who had participated in another clinical trial and/or had received any other investigational product in the last 30 days prior to inclusion. The following histologic subtypes are excluded: Rhabdomyosarcoma Ewing's family of tumors Desmoplastic small round cell tumor Clear cell sarcoma Alveolar sarcoma
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Javier Martin Broto, PhM
Organizational Affiliation
GEIS
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Andres Poveda, Ph.M.
Organizational Affiliation
GEIS
Official's Role
Principal Investigator
Facility Information:
Facility Name
Ico Hospitalet
City
L'Hospitalet
State/Province
Barcelona
Country
Spain
Facility Name
ICO Badalona
City
Badalona
Country
Spain
Facility Name
H. Clinic Barcelona
City
Barcelona
Country
Spain
Facility Name
H. Sant Pau
City
Barcelona
Country
Spain
Facility Name
H. Provincial Castellón
City
Castellón
Country
Spain
Facility Name
ICO Girona
City
Girona
Country
Spain
Facility Name
H. Xeral Cies
City
Lugo
Country
Spain
Facility Name
Clinica Puerta Hierro
City
Madrid
Country
Spain
Facility Name
H. Clínico. San Carlos
City
Madrid
Country
Spain
Facility Name
H. U. La Paz
City
Madrid
Country
Spain
Facility Name
H.U. Gregorio Marañon
City
Madrid
Country
Spain
Facility Name
H.U. Ramon Y Cajal
City
Madrid
Country
Spain
Facility Name
H.U. Clinico de Malaga
City
Málaga
Country
Spain
Facility Name
H. de Navarra
City
Navarra
Country
Spain
Facility Name
H. C. Asturias
City
Oviedo
Country
Spain
Facility Name
H. Son Dureta
City
Palma de Mallorca
Country
Spain
Facility Name
H. Univ. Canarias
City
Santa Cruz de Tenerife
Country
Spain
Facility Name
H.U. Virgen Del Rocio
City
Sevilla
Country
Spain
Facility Name
Instituto Valenciano de Oncología
City
Valencia
Country
Spain
Facility Name
H. Miguel Servet
City
Zaragoza
Country
Spain

12. IPD Sharing Statement

Learn more about this trial

Doxorubicin vs. Trabectedin Plus Doxorubicin in Non Operable and/or Metastatic STS

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