Targeted Therapy Selection Based on Tumor Tissue Kinase Activity Profiles for Patients With Advanced Solid Malignancies, an Exploratory Study (TSAP)
Primary Purpose
Advanced Solid Tumors, Inoperable, Metastasis
Status
Terminated
Phase
Not Applicable
Locations
Netherlands
Study Type
Interventional
Intervention
desatinib or sunitinib or erlotinib or everolimus or lapatinib or sorafenib
Sponsored by
About this trial
This is an interventional treatment trial for Advanced Solid Tumors focused on measuring targeted therapy, individualized medicine, tyrosine kinase inhibitor, kinome profiling, Metastasized
Eligibility Criteria
Inclusion Criteria:
- Patients presenting with an advanced (unresectable and/or metastatic) solid malignancy for whom no standard treatment is available.
- Patients should have received at least one prior standard medical treatment regimen for their advanced disease.
- Patients with progressive disease within 12 weeks prior to the start of study medication based on radiological assessment.
- At least one tumor lesion should be assessable for biopsy to perform kinase activity analysis.
- Age ≥ 18 years.
- Histological or cytological documentation of cancer is required.
- Patients with at least one measurable lesion. Lesions must be evaluated by CT-scan or MRI according to Response Evaluation Criteria in Solid Tumors (RECIST).
- WHO performance status 0 - 2
- Life expectancy of at least 12 weeks
Adequate bone marrow, liver and renal function as assessed by the following laboratory requirements to be conducted within 7 days prior to screening:
- Hemoglobin ≥ 5.6 mmol/L
- Absolute neutrophil count (ANC) ≥ 1,500/mm3
- Platelet count ≥ 100x10*9/l
- Total bilirubin ≤ 1.5 times the upper limit of normal (ULN) 22 of 59
- ALT and AST ≤ 2.5 x ULN (≤ 5 x ULN for subjects with liver involvement of their cancer)
- Serum creatinine ≤ 1.5 x ULN or a calculated creatinine clearance ¡Ý 50 ml/min
- Activated partial thromboplastin time < 1.25 x ULN
- Prothrombin time or INR < 1.25 x ULN
- Patients should be able to swallow oral medication.
- Written informed consent
Exclusion Criteria:
History of cardiac disease:
- Congestive heart failure >NYHA class 2.
- Active Coronary Artery Disease (myocardial infarction more than 6 months prior to screening is allowed).
- Cardiac arrhythmias requiring anti-arrhythmic therapy (beta blockers or digoxin are permitted).
- Uncontrolled hypertension. Blood pressure must be ≤ 160/95 mmHg at the time of screening on a stable antihypertensive regimen. Blood pressure must be stable on at least 3 separate measurements on at least 2 separate days.
- Uncontrolled infections (> grade 2 NCI-CTC version 3.0).
- Subjects with serious non-healing wound, ulcer, or bone fracture.
- History or clinical evidence of central nervous system (CNS) disease, including primary brain tumor and brain metastases.
- Clinical findings associated, in the judgment of the investigator, with an unacceptably high tumor biopsy risk
- Pregnant or breast-feeding subjects.
- Concurrent anticancer chemotherapy, immunotherapy or investigational drug therapy during the study or within 4 weeks of the start of study drug.
- Radiotherapy on target lesions during study or within 4 weeks of the start of study drug. Palliative radiotherapy will be allowed.
- Concomitant use of dexamethasone, anti-convulsants and anti-arrhythmic drugs other than digoxin or beta blockers.
- Major surgery within 28 days of start of treatment. The surgical wound should be fully healed prior to the start of study drug. In subjects who experienced wound healing complications during therapy, treatment should be withheld until the wound is fully healed.
- Substance abuse, medical, psychological or social conditions that may interfere with the subject¡-s participation in the study or evaluation of the study results.
- Any condition that is unstable or could jeopardize the safety of the subject and their compliance in the study.
Sites / Locations
- Medical Center Alkmaar
- VU University Medical Center
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Targeted treatment
Arm Description
Targeted treatment with desatinib or sunitinib or erlotinib or everolimus or lapatinib or sorafenib
Outcomes
Primary Outcome Measures
The clinical benefit rate (CBR) of this therapy selection approach.
The clinical benefit rate (CBR) is defined by the number of patients demonstrating either a complete or partial response or stable disease after 12 weeks of treatment.
Secondary Outcome Measures
Full Information
NCT ID
NCT01190241
First Posted
August 26, 2010
Last Updated
November 18, 2020
Sponsor
Amsterdam UMC, location VUmc
Collaborators
VitrOmics BV
1. Study Identification
Unique Protocol Identification Number
NCT01190241
Brief Title
Targeted Therapy Selection Based on Tumor Tissue Kinase Activity Profiles for Patients With Advanced Solid Malignancies, an Exploratory Study
Acronym
TSAP
Official Title
Targeted Therapy Selection Based on Tumor Tissue Kinase Activity Profiles for Patients With Advanced Solid Malignancies, an Exploratory Study
Study Type
Interventional
2. Study Status
Record Verification Date
November 2020
Overall Recruitment Status
Terminated
Study Start Date
August 2010 (undefined)
Primary Completion Date
December 2017 (Actual)
Study Completion Date
December 2017 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Amsterdam UMC, location VUmc
Collaborators
VitrOmics BV
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
The purpose of this study is to select targeted treatment based on ex vivo kinase activity inhibition profiles to targeted agents of tumor tissue from patients with advanced cancer for whom no standard treatment is available.
Detailed Description
Specific signalling proteins that are important for tumor growth can be targeted by agents. These are called targeted agents or targeted treatment. Thus far, it is unclear which patients will respond to these targeted agents. It is assumed that responses to these agents depend on specific receptor and protein signalling activities in tumor tissues. The investigators propose that kinase activity profiling may be a potential clinical diagnostic tool to predict tumor response to targeted treatment with tyrosine kinase inhibitors.
The investigators will determine ex vivo kinase activity inhibition profiles of tumor tissue to different targeted agents. Tumor tissue from patients with advanced cancer for whom no standard treatment is available will be used.
Patients will be treated with the selected targeted agent and the clinical benefit will be determined.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Advanced Solid Tumors, Inoperable, Metastasis
Keywords
targeted therapy, individualized medicine, tyrosine kinase inhibitor, kinome profiling, Metastasized
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
45 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Targeted treatment
Arm Type
Experimental
Arm Description
Targeted treatment with desatinib or sunitinib or erlotinib or everolimus or lapatinib or sorafenib
Intervention Type
Drug
Intervention Name(s)
desatinib or sunitinib or erlotinib or everolimus or lapatinib or sorafenib
Intervention Description
The drug will be selected based on ex vivo test on the tumor tissue. The patients will be treated with the selected drug until disease progression.
Primary Outcome Measure Information:
Title
The clinical benefit rate (CBR) of this therapy selection approach.
Description
The clinical benefit rate (CBR) is defined by the number of patients demonstrating either a complete or partial response or stable disease after 12 weeks of treatment.
Time Frame
12 weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patients presenting with an advanced (unresectable and/or metastatic) solid malignancy for whom no standard treatment is available.
Patients should have received at least one prior standard medical treatment regimen for their advanced disease.
Patients with progressive disease within 12 weeks prior to the start of study medication based on radiological assessment.
At least one tumor lesion should be assessable for biopsy to perform kinase activity analysis.
Age ≥ 18 years.
Histological or cytological documentation of cancer is required.
Patients with at least one measurable lesion. Lesions must be evaluated by CT-scan or MRI according to Response Evaluation Criteria in Solid Tumors (RECIST).
WHO performance status 0 - 2
Life expectancy of at least 12 weeks
Adequate bone marrow, liver and renal function as assessed by the following laboratory requirements to be conducted within 7 days prior to screening:
Hemoglobin ≥ 5.6 mmol/L
Absolute neutrophil count (ANC) ≥ 1,500/mm3
Platelet count ≥ 100x10*9/l
Total bilirubin ≤ 1.5 times the upper limit of normal (ULN) 22 of 59
ALT and AST ≤ 2.5 x ULN (≤ 5 x ULN for subjects with liver involvement of their cancer)
Serum creatinine ≤ 1.5 x ULN or a calculated creatinine clearance ¡Ý 50 ml/min
Activated partial thromboplastin time < 1.25 x ULN
Prothrombin time or INR < 1.25 x ULN
Patients should be able to swallow oral medication.
Written informed consent
Exclusion Criteria:
History of cardiac disease:
Congestive heart failure >NYHA class 2.
Active Coronary Artery Disease (myocardial infarction more than 6 months prior to screening is allowed).
Cardiac arrhythmias requiring anti-arrhythmic therapy (beta blockers or digoxin are permitted).
Uncontrolled hypertension. Blood pressure must be ≤ 160/95 mmHg at the time of screening on a stable antihypertensive regimen. Blood pressure must be stable on at least 3 separate measurements on at least 2 separate days.
Uncontrolled infections (> grade 2 NCI-CTC version 3.0).
Subjects with serious non-healing wound, ulcer, or bone fracture.
History or clinical evidence of central nervous system (CNS) disease, including primary brain tumor and brain metastases.
Clinical findings associated, in the judgment of the investigator, with an unacceptably high tumor biopsy risk
Pregnant or breast-feeding subjects.
Concurrent anticancer chemotherapy, immunotherapy or investigational drug therapy during the study or within 4 weeks of the start of study drug.
Radiotherapy on target lesions during study or within 4 weeks of the start of study drug. Palliative radiotherapy will be allowed.
Concomitant use of dexamethasone, anti-convulsants and anti-arrhythmic drugs other than digoxin or beta blockers.
Major surgery within 28 days of start of treatment. The surgical wound should be fully healed prior to the start of study drug. In subjects who experienced wound healing complications during therapy, treatment should be withheld until the wound is fully healed.
Substance abuse, medical, psychological or social conditions that may interfere with the subject¡-s participation in the study or evaluation of the study results.
Any condition that is unstable or could jeopardize the safety of the subject and their compliance in the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Henk Verheul, M.D., PhD
Organizational Affiliation
Amsterdam UMC, location VUmc
Official's Role
Principal Investigator
Facility Information:
Facility Name
Medical Center Alkmaar
City
Alkmaar
ZIP/Postal Code
1815 JD
Country
Netherlands
Facility Name
VU University Medical Center
City
Amsterdam
ZIP/Postal Code
1081 HV
Country
Netherlands
12. IPD Sharing Statement
Citations:
PubMed Identifier
30018133
Citation
Labots M, Van der Mijn JC, Dekker H, Ruijter R, Pham TV, Van der Vliet HJ, Van der Hoeven JJM, Meijer GA, Verheul HMW. Selection of Protein Kinase Inhibitors Based on Tumor Tissue Kinase Activity Profiles in Patients with Refractory Solid Malignancies: An Interventional Molecular Profiling Study. Oncologist. 2018 Oct;23(10):1135-e118. doi: 10.1634/theoncologist.2018-0263. Epub 2018 Jul 17.
Results Reference
derived
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Targeted Therapy Selection Based on Tumor Tissue Kinase Activity Profiles for Patients With Advanced Solid Malignancies, an Exploratory Study
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