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Combined Modality Treatment of Sarcomas of the Extremities (PASART-1)

Primary Purpose

Sarcoma,Soft Tissue

Status
Completed
Phase
Phase 1
Locations
Netherlands
Study Type
Interventional
Intervention
pazopanib
Sponsored by
The Netherlands Cancer Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Sarcoma,Soft Tissue

Eligibility Criteria

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

Inclusion Criteria:

  1. Histologically confirmed newly diagnosed intermediate to high grade soft tissue sarcoma of and localized to the extremities or head and neck area for which the treatment is a combination of both surgery and radiotherapy (deep seated, > 5cm according to the RECIST 1.1 criteria, grade II/III according to the WHO definition).
  2. Age > 18 years.
  3. Eastern Cooperative Oncology Group (ECOG) performance status of 0-1.
  4. Absence of any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule; those conditions should be discussed with the patient before registration in the trial.
  5. Before patient registration/randomization, written informed consent must be given according to ICH/GCP, and national/local regulations.

6 Able to swallow and retain oral medication. 7. A life expectancy of at least 12 weeks. 8. Adequate organ function.

-

Exclusion Criteria:

  1. Prior malignancies; except subjects who have had another malignancy and have been disease-free for 5 years, or subjects with a history of completely resected non-melanomatous skin carcinoma or successfully treated in situ carcinoma are eligible.
  2. Patients with recurrent sarcomas (even without prior radiotherapy).
  3. Ewing sarcoma and other PNET family tumours, rhabdomyosarcomas (both pediatric and adult), osteosarcomas.
  4. Clinically significant gastrointestinal abnormalities which might interfere with oral dosing diagnosed as:

    • Active peptic ulcer disease.
    • Known intraluminal metastatic lesions with suspected bleeding.
    • Inflammatory bowel disease, ulcerative colitis, or other gastrointestinal conditions with increased risk of perforation.
    • History of abdominal fistula, gastrointestinal perforation, or intra abdominal abscess within 28 days prior to beginning study treatment.
    • Major resection of the stomach or small bowel.
  5. Uncontrolled hypertension.
  6. Unstable or serious concurrent condition (e.g., active infection requiring systemic therapy).
  7. Prolongation of corrected QT interval (QTc) >480 msecs.
  8. History of any one of more of the following cardiovascular conditions within the past 6 months:

    1. Cardiac angioplasty or stenting.
    2. Myocardial infarction.
    3. Unstable angina.
    4. Symptomatic peripheral vascular disease.
    5. Coronary artery by-pass graft surgery.
    6. Class II, III or IV congestive heart failure as defined by the New York Heart Association (NYHA).
    7. History of cerebrovascular accident, pulmonary embolism or untreated deep venous thrombosis (DVT) within the past 6 months.
  9. Macroscopic hematuria
  10. Haemoptysis that is clinically relevant within 4 weeks of first dose of study drug.
  11. Evidence of active bleeding or bleeding diathesis.
  12. Prior major surgery or trauma within 28 days prior to first dose of study drug and/or presence of any non-healing wound, fracture, or ulcer.
  13. Chemotherapy or radiation therapy within 2 weeks prior to the first dose of study drug.
  14. Biological therapy or treatment with an investigational agent within 28 days or 5 half-lives, whichever is longer prior to the first dose of study drug.
  15. Prohibited medications listed in the protocol for 14 days or five half-lives of a drug (whichever is longer) prior to Visit 1 and for the duration of the study should not be taken.
  16. Known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs chemically related to pazopanib.
  17. Pregnancy or lactating.
  18. Hypothyroidism.

    -

Sites / Locations

  • The Netherlands Cancer Institute

Arms of the Study

Arm 1

Arm Type

Other

Arm Label

cohort

Arm Description

Dose level Dose of pazopanib orally, once daily, # patients -1 200 mg -- (starting) 400 mg 3 600 mg 3 (maximum) 800 mg 3

Outcomes

Primary Outcome Measures

Dose limiting toxicity
To study the safety and feasibility of adding 6 weeks of orally administered Pazopanib to 25 x 2Gy in 5 weeks preoperative radiotherapy in extremity or head and neck area soft tissue sarcoma patients (to identify the Dose Limiting Toxicity (DLT) and the Recommend Phase II Dose (RPTD) if pazopanib is added to 50 Gy pre-operatively)

Secondary Outcome Measures

the exploration/feasibility of dynamic imaging
The secondary objective is to explore the feasibility to perform perfusion weighted MRI imaging regarding tumor respons to RT and neoangio genesis inhibitor by pazopanib.

Full Information

First Posted
October 7, 2013
Last Updated
October 8, 2015
Sponsor
The Netherlands Cancer Institute
Collaborators
GlaxoSmithKline
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1. Study Identification

Unique Protocol Identification Number
NCT01985295
Brief Title
Combined Modality Treatment of Sarcomas of the Extremities
Acronym
PASART-1
Official Title
Phase I Clinical Study of a Combined Modality Treatment of Sarcomas of the Extremities With Radiotherapy (RT) and Dose-escalation of Pazopanib
Study Type
Interventional

2. Study Status

Record Verification Date
October 2015
Overall Recruitment Status
Completed
Study Start Date
June 2010 (undefined)
Primary Completion Date
August 2014 (Actual)
Study Completion Date
November 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
The Netherlands Cancer Institute
Collaborators
GlaxoSmithKline

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
In this study, we aim to define the recommended dose of a VEGFR-TKI (pazopanib) in combination with RT pre-operatively given.
Detailed Description
Study design A dose escalation trial of Pazopanib, starting at 400mg daily, orally in combination with the standard 25 x 2Gy preoperative radiotherapy in newly diagnosed extremity sarcoma patients. Dose of pazopanib will be escalated via 600mg to maximally 800mg. Overall treatment time of pazopanib is 40 days. Treatment plan: Pazopanib Dose level Dose of pazopanib orally, once daily, # patients (starting) 400 mg 3 600 mg 3 (maximum) 800 mg 3 Treatment plan: radiotherapy RT is given during 5 weeks with a once daily fraction of 2 Gray (50 Gray in 25 daily fractions) RT planning: The dose planning should be performed by CT based Intensity Modulated RT (IMRT) or 3 Dimensional Conformal RT (3D-RT) according to the local planning protocol of the participating institute. Dose specification: According to the ICRU 50/62.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Sarcoma,Soft Tissue

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
12 (Actual)

8. Arms, Groups, and Interventions

Arm Title
cohort
Arm Type
Other
Arm Description
Dose level Dose of pazopanib orally, once daily, # patients -1 200 mg -- (starting) 400 mg 3 600 mg 3 (maximum) 800 mg 3
Intervention Type
Drug
Intervention Name(s)
pazopanib
Other Intervention Name(s)
Compound Number: GW786034
Intervention Description
A dose escalation trial of Pazopanib, starting at 400mg daily, orally in combination with the standard 25 x 2Gy preoperative radiotherapy in newly diagnosed extremity sarcoma patients. Dose of pazopanib will be escalated via 600mg to maximally 800mg. Overall treatment time of pazopanib is 40 days.
Primary Outcome Measure Information:
Title
Dose limiting toxicity
Description
To study the safety and feasibility of adding 6 weeks of orally administered Pazopanib to 25 x 2Gy in 5 weeks preoperative radiotherapy in extremity or head and neck area soft tissue sarcoma patients (to identify the Dose Limiting Toxicity (DLT) and the Recommend Phase II Dose (RPTD) if pazopanib is added to 50 Gy pre-operatively)
Time Frame
14 weeks
Secondary Outcome Measure Information:
Title
the exploration/feasibility of dynamic imaging
Description
The secondary objective is to explore the feasibility to perform perfusion weighted MRI imaging regarding tumor respons to RT and neoangio genesis inhibitor by pazopanib.
Time Frame
14 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically confirmed newly diagnosed intermediate to high grade soft tissue sarcoma of and localized to the extremities or head and neck area for which the treatment is a combination of both surgery and radiotherapy (deep seated, > 5cm according to the RECIST 1.1 criteria, grade II/III according to the WHO definition). Age > 18 years. Eastern Cooperative Oncology Group (ECOG) performance status of 0-1. Absence of any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule; those conditions should be discussed with the patient before registration in the trial. Before patient registration/randomization, written informed consent must be given according to ICH/GCP, and national/local regulations. 6 Able to swallow and retain oral medication. 7. A life expectancy of at least 12 weeks. 8. Adequate organ function. - Exclusion Criteria: Prior malignancies; except subjects who have had another malignancy and have been disease-free for 5 years, or subjects with a history of completely resected non-melanomatous skin carcinoma or successfully treated in situ carcinoma are eligible. Patients with recurrent sarcomas (even without prior radiotherapy). Ewing sarcoma and other PNET family tumours, rhabdomyosarcomas (both pediatric and adult), osteosarcomas. Clinically significant gastrointestinal abnormalities which might interfere with oral dosing diagnosed as: Active peptic ulcer disease. Known intraluminal metastatic lesions with suspected bleeding. Inflammatory bowel disease, ulcerative colitis, or other gastrointestinal conditions with increased risk of perforation. History of abdominal fistula, gastrointestinal perforation, or intra abdominal abscess within 28 days prior to beginning study treatment. Major resection of the stomach or small bowel. Uncontrolled hypertension. Unstable or serious concurrent condition (e.g., active infection requiring systemic therapy). Prolongation of corrected QT interval (QTc) >480 msecs. History of any one of more of the following cardiovascular conditions within the past 6 months: Cardiac angioplasty or stenting. Myocardial infarction. Unstable angina. Symptomatic peripheral vascular disease. Coronary artery by-pass graft surgery. Class II, III or IV congestive heart failure as defined by the New York Heart Association (NYHA). History of cerebrovascular accident, pulmonary embolism or untreated deep venous thrombosis (DVT) within the past 6 months. Macroscopic hematuria Haemoptysis that is clinically relevant within 4 weeks of first dose of study drug. Evidence of active bleeding or bleeding diathesis. Prior major surgery or trauma within 28 days prior to first dose of study drug and/or presence of any non-healing wound, fracture, or ulcer. Chemotherapy or radiation therapy within 2 weeks prior to the first dose of study drug. Biological therapy or treatment with an investigational agent within 28 days or 5 half-lives, whichever is longer prior to the first dose of study drug. Prohibited medications listed in the protocol for 14 days or five half-lives of a drug (whichever is longer) prior to Visit 1 and for the duration of the study should not be taken. Known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs chemically related to pazopanib. Pregnancy or lactating. Hypothyroidism. -
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Rick Haas, MD,PhD
Organizational Affiliation
NKI
Official's Role
Principal Investigator
Facility Information:
Facility Name
The Netherlands Cancer Institute
City
Amsterdam
State/Province
Noord Holland
ZIP/Postal Code
1066CX
Country
Netherlands

12. IPD Sharing Statement

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Combined Modality Treatment of Sarcomas of the Extremities

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