IRCI Gynae Sarcomas, High Grade Uterine Sarcoma
Uterine Sarcoma
About this trial
This is an interventional treatment trial for Uterine Sarcoma focused on measuring Locally advanced, stage III, stage IV, residual disease after primary surgery, newly diagnosed HGUS, Metastatic
Eligibility Criteria
Inclusion Criteria:
Patients who are suitable for treatment with doxorubicin +/- ifosfamide and fall within one of the following patient populations:
• HGUS, HGESS, HGLMS and HG adenosarcoma
- FIGO stage II and stage III : if adjuvant chemotherapy is proposed
- FIGO stage IV: if first line chemotherapy is proposed
- Metastatic: diagnosed with disease relapse after local treatment for primary tumor
- at least 18 years old
- written informed consent
- Central pathological confirmation: Histological evidence of HGUS, HGESS, HGLMS and HG adenosarcoma
- Non-progressive patients (CR, PR, SD) at the end of the first line treatment (standard chemotherapy consisting of 4 to 6 cycles of anthracyclines alone or in combination with ifosfamide)
- WHO/ECOG performance status 0-2
- Adequate organ and bone marrow function within 3 days prior to the first dose of study treatment (Cabozantinib/placebo)
- Clinically normal cardiac function
- Women of child bearing potential must have a negative serum/urine pregnancy test within 3 days prior to the first dose of study treatment
- Adequate birth control measures
Exclusion Criteria:
- low-grade ESS, leiomyosarcoma (low or intermediate), carcinosarcoma, low-grade adenosarcoma, rhabdomyosarcoma (alveolar or embryonal) and soft tissue PNET of uterus/cervix.
- contraindications to cabozantinib
- not able to swallow and retain oral tablets
- planned use of chemotherapy, radiation therapy, radionuclide treatment, small molecule tyrosine kinase inhibitor or hormonal therapy, and any other investigational agent (Cabozantinib/placebo) during the treatment period
- concurrent uncompensated hypothyroidism or thyroid dysfunction within 7 days before the first dose of study treatment
- patient with poorly controlled hypertension defined at baseline as blood pressure >150/90
- patients who have suffered a cerebrovascular accident at any time in the past, patients who have suffered a transient ischemic attack in the past 6 months, patients who have suffered a deep venous thrombosis (DVT) or a pulmonary embolism in the past 6 months
- Gastrointestinal disorders
- patients with radiographic evidence of cavitating pulmonary lesion(s)
- patients with tumor in contact with, invading or encasing any major blood vessels
- patients evidence of tumor invading the GI tract
- evidence of active bleeding or bleeding diathesis
- hemoptysis ≥ 0.5 teaspoon (2.5ml) of red blood within 3 months before the first dose of study treatment
- signs indicative of pulmonary hemorrhage within 3 months before the first dose of study treatment
- clinically-significant gastrointestinal bleeding within 6 months before the first dose of study treatment
- prior major surgery or trauma within 6 weeks prior to first dose of study drug and any wound, fracture, or ulcer should be completely healed
- concurrent or planned treatment with strong inhibitors or inducers of cytochrome P450 3A4/5
Sites / Locations
- Institut Bergonie
- Institut Bergonie
- Centre Leon Berard
- Institut de Cancerologie de l'Ouest (ICO) - Centre Rene Gauducheau
- Fondazione IRCCS Istituto Nazionale dei Tumori
- Academisch Medisch Centrum at University of Amsterdam
- Hospital General Vall D'Hebron
- Hospital Universitario San Carlos
- Cambridge University Hospital NHS - Addenbrookes Hospital
- NHS Greater Glasgow and Clyde - Beatson West of Scotland Cancer Centre - Gartnavel General Hospital
- Leeds Teaching Hospitals NHS Trust - St. James's University Hospital
- Royal Marsden Hospital
- University College London Hospitals NHS Foundation Trust - University College Hospital
- Nottingham University Hospitals NHS Trust - City Hospital
- Oxford University Hospitals NHS Trust - Churchill Hospital
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
Cabozantinib
Placebo
Cabozantinib maintenance 60 mg daily for 2 years or until withdrawal criterion After documented disease progression (according to RECIST 1.1), the treatment will be unblinded. Subjects receiving cabozantinib shall be further treated at the investigator discretion.
Placebo daily for 2 years or until withdrawal criterion. After documented disease progression (according to RECIST 1.1), the treatment will be unblinded. Subjects receiving placebo shall be offered the option of receiving cabozantinib up to further progression. This is not mandatory and treatment is at the investigator decision.