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Efficacy of Medical Treatment With SOM230 LAR in Patients With Primary Inoperable Thymoma and/or With Local Recurrent Thymoma to Reduce Tumor Size

Primary Purpose

Primary Inoperable Thymoma, Local Recurrent Thymoma

Status
Completed
Phase
Phase 2
Locations
Germany
Study Type
Interventional
Intervention
SOM230 LAR
Sponsored by
Prof. Dr. Berthold Schalke
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Primary Inoperable Thymoma focused on measuring primary inoperable thymoma, local recurrent thymoma, reduction of tumor size, SOM230 LAR

Eligibility Criteria

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

Inclusion Criteria:

  • Male or female patients aged ≥18 years
  • Diagnosis of thymoma as assessed by biopsy and/or szintigraphy
  • Inoperability of thymoma or loco-regional metastases. Inoperability is defined as at least adherence of the tumor to the neighbored organs, suspicious to infiltrate neighbored organs or local metastasis so that R0 resection can not be expected and /or local recurrence of thymic tumor
  • Tumor stage: Thymomas of all WHO based histological subtypes (WHO A, AB, B1, B2, B3) (Rosai, 1999; Travis 2004) at Masaoka stage II to IVa based on histological examination of resection specimens or core biopsies.
  • Patients with and without thymoma associated paraneoplastic syndrome.
  • Performance status 0,1, or 2 (ECOG)
  • Patients for whom written informed consent to participate in the study has been obtained

Exclusion Criteria:

  • Patients having received radiolabeled somatostatin analogue therapy within the 6 months or any cytotoxic chemotherapy or interferon therapy within the 2 months prior to recording baseline symptoms
  • Patients who have undergone major surgery/surgical therapy for any cause within 1 month or surgical therapy of loco-regional metastases within the last 3 months before recording baseline symptoms
  • Patients who have received radiotherapy for any reason within the last 4 weeks and must have recovered from any side effects of radiotherapy before recording baseline symptoms
  • Patients who are not biochemically euthyroid
  • Diabetic patients on antidiabetic medications whose fasting blood glucose is poorly controlled as indicated by HbA1C > 8%
  • Patients with symptomatic cholelithiasis
  • Patients who have congestive heart failure (NYHA Class III or IV), unstable angina, sustained ventricular tachycardia, ventricular fibrillation, clinically significant bradycardia, advanced heart block or a history of acute myocardial infarction within the six months preceding enrollment
  • Patients with QT related risk factor: QTcF at screening > 450 msec
  • Patients with QT related risk factor: History of syncope or family history of idiopathic sudden death
  • Patients with QT related risk factor:Sudden or clinically significant cardiac arrhythmias
  • Patients with QT related risk factor: Risk factors for Torsades de Pointes such as hypokalemia, hypomagnesemia, cardiac failure, clinically significant / symptomatic bradycardia, or high-grade AV block
  • Patients with QT related risk factor: Concomitant disease(s) that could prolong QT such as autonomic neuropathy (caused by diabetes or Parkinson's disease), HIV, cirrhosis, uncontrolled hypothyroidism or cardiac failure
  • Patients with QT related risk factor: Concomitant medication(s) known to increase the QT interval
  • Patients with potassium <3.0 mmol/L at study entry, magnesium <0.4 mmol/L at study entry, calcium <1.75 mmol/L at study entry, family history of long QT syndrome, and concomitant medications known to prolong the QT interval. If the electrolyte abnormalities are corrected prior to study commencement, the patient may become eligible for the trial.
  • Patients with liver disease such as cirrhosis, chronic active hepatitis or chronic persistent hepatitis with serum bilirubin > 1.5 X ULN, serum albumin < 0.67 X LLN, and/or ALT or AST more than 2 X ULN for patients without liver Confidential - 20 - Amended Clinical Study Protocol v01 / Track Changes Study No. CSOM230CIC01T metastases or ALT or AST more than 5X ULN for patients with documented liver metastases
  • Patients with additional active malignant disease within the last five years (with the exception of basal cell carcinoma or carcinoma in situ of the cervix)
  • Patients with the presence of active or suspected acute or chronic uncontrolled infection or with a history of immunocompromise, including a positive HIV test result (ELISA and Western blot). A HIV test will not be required; however, previous medical history will be reviewed
  • Patients with abnormal coagulation (PT or APTT elevated by 30% above normal limits)
  • Patients with WBC <2.5 X 109/L; Hgb <10 g/dL; PLT <100 X 109/L (patients with paraneoplastic pan-, leuco-, erythro- or thrombopenia can be included if this seems to be the only reason for pan-, leuco-, erythro- or thrombopenia)
  • Known hypersensitivity to somatostatin analogues or any component of the pasireotide or octreotide LAR or s.c. formulations
  • Patients who have any current or prior medical condition that may interfere with the conduct of the study or the evaluation of its results in the opinion of the investigator
  • Female patients who are pregnant or lactating, or are of childbearing potential and not practicing a medically acceptable method of birth control. Female patients must use a secure method of contraception if sexually active and the partner should use a condom. If oral contraception is used, the patient must have been practicing this method for at least two months prior to enrollment and must agree to continue the oral contraceptive throughout the course of the study, and for three months after the study has ended. Male patients who are sexually active are required to use condoms during the study and for three months afterwards as a precautionary measure (available data do not suggest any increased reproductive risk with the study drugs). Female partners of these male patients should use a secondary barrier contraception.
  • Patients who are currently part of or have participated in any clinical investigation with an investigational drug within 1 month prior to dosing
  • Patients with a history of non-compliance to medical regimens or who are considered potentially unreliable or will not be able to complete the entire study
  • Patient has received any other investigational agents within 28 days of first day of study drug dosing
  • Abnormal clinical laboratory values considered by the investigator to be clinically significant and which could affect the interpretation of the study results

Sites / Locations

  • Klinik und Poliklinik für Neurologie der Universität Regensburg

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

SOM230 LAR

Arm Description

SOM230 LAR in a dosage of 60 mg i.m. once every 4 weeks

Outcomes

Primary Outcome Measures

Percent Change in Tumor Volume From Baseline to EOS
To evaluate whether SOM230 LAR is effective in patients with inoperable thymoma with respect to shrinkage of tumor volume. Response is defined as the decrease in tumor volume of 20 % at EOS as compared to baseline. Tumor shrinkage is assessed by CT or MRI.

Secondary Outcome Measures

Tumor Resection Status
To evaluate the resection status based on the categories R0, R1 and ≥ R2 at EOS using CT or MRI imaging. R0 resection means no residual tumor tissue (best status); R1 indicates microscopic residual tumor tissue and R2 indicates macroscopic residual tumor tissue (worst status).
Assessment of Tumor Operability
Assessment if patients reaching operability at the EOS.

Full Information

First Posted
December 20, 2013
Last Updated
July 19, 2017
Sponsor
Prof. Dr. Berthold Schalke
Collaborators
Crolll Gmbh
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1. Study Identification

Unique Protocol Identification Number
NCT02021942
Brief Title
Efficacy of Medical Treatment With SOM230 LAR in Patients With Primary Inoperable Thymoma and/or With Local Recurrent Thymoma to Reduce Tumor Size
Official Title
Efficacy of Medical Treatment With SOM230 LAR in Patients With Primary Inoperable Thymoma and/or With Local Recurrent Thymoma to Reduce Tumor Size
Study Type
Interventional

2. Study Status

Record Verification Date
July 2017
Overall Recruitment Status
Completed
Study Start Date
March 2012 (undefined)
Primary Completion Date
October 2015 (Actual)
Study Completion Date
October 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Prof. Dr. Berthold Schalke
Collaborators
Crolll Gmbh

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a monocenter, single-arm, open label phase II trial evaluating the effect of SOM230 LAR in adult patients with inoperable primary thymoma and thymoma metastasis (Masaoka II-IVa). SOM230 LAR in a dosage of 60 mg is administered i.m. once every 4 weeks. The purpose of this trial is a proof of concept.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Primary Inoperable Thymoma, Local Recurrent Thymoma
Keywords
primary inoperable thymoma, local recurrent thymoma, reduction of tumor size, SOM230 LAR

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
SOM230 LAR
Arm Type
Experimental
Arm Description
SOM230 LAR in a dosage of 60 mg i.m. once every 4 weeks
Intervention Type
Drug
Intervention Name(s)
SOM230 LAR
Other Intervention Name(s)
Pasireotide, Sandostatin®
Intervention Description
SOM230 LAR in a dosage of 60 mg is administered i.m. once every 4 weeks.
Primary Outcome Measure Information:
Title
Percent Change in Tumor Volume From Baseline to EOS
Description
To evaluate whether SOM230 LAR is effective in patients with inoperable thymoma with respect to shrinkage of tumor volume. Response is defined as the decrease in tumor volume of 20 % at EOS as compared to baseline. Tumor shrinkage is assessed by CT or MRI.
Time Frame
at least 6 months
Secondary Outcome Measure Information:
Title
Tumor Resection Status
Description
To evaluate the resection status based on the categories R0, R1 and ≥ R2 at EOS using CT or MRI imaging. R0 resection means no residual tumor tissue (best status); R1 indicates microscopic residual tumor tissue and R2 indicates macroscopic residual tumor tissue (worst status).
Time Frame
at least 6 months
Title
Assessment of Tumor Operability
Description
Assessment if patients reaching operability at the EOS.
Time Frame
at least 6 months
Other Pre-specified Outcome Measures:
Title
Safety: Number of Participants With Adverse Events (AE) and Serious Adverse Events (SAE)
Time Frame
at least 6 months
Title
Assessment of Myasthenia Gravis (MG) Status by Determining Titin-antibody Status
Description
MG severity status is assessed by determining Titin-antibody status at Baseline and EOS.
Time Frame
at least 6 months
Title
Assessment of Myasthenia Gravis (MG) Status by Measuring ACHR-antibody Concentrations
Description
MG severity status is assessed by measuring ACHR-antibody concentrations at Baseline and EOS.
Time Frame
at least 6 months
Title
Health Related Quality of Life
Description
Health related quality of life information was collected at Baseline and EOS using SF-36 questionnaire. Questionnaires had to be completed by the patients. All questions are scored on a scale from 0 to 100, with 100 representing the highest level of functioning possible. Patient reported answers were transformed into domain scores according to the guidelines provided by RAND/MOS. Statistical significance of the result was tested with a paired Wilcoxon rang sum test with a significance level of 0.05 considering only paired values (n=11) using PSPP Version 0.10.1.
Time Frame
at least 6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female patients aged ≥18 years Diagnosis of thymoma as assessed by biopsy and/or szintigraphy Inoperability of thymoma or loco-regional metastases. Inoperability is defined as at least adherence of the tumor to the neighbored organs, suspicious to infiltrate neighbored organs or local metastasis so that R0 resection can not be expected and /or local recurrence of thymic tumor Tumor stage: Thymomas of all WHO based histological subtypes (WHO A, AB, B1, B2, B3) (Rosai, 1999; Travis 2004) at Masaoka stage II to IVa based on histological examination of resection specimens or core biopsies. Patients with and without thymoma associated paraneoplastic syndrome. Performance status 0,1, or 2 (ECOG) Patients for whom written informed consent to participate in the study has been obtained Exclusion Criteria: Patients having received radiolabeled somatostatin analogue therapy within the 6 months or any cytotoxic chemotherapy or interferon therapy within the 2 months prior to recording baseline symptoms Patients who have undergone major surgery/surgical therapy for any cause within 1 month or surgical therapy of loco-regional metastases within the last 3 months before recording baseline symptoms Patients who have received radiotherapy for any reason within the last 4 weeks and must have recovered from any side effects of radiotherapy before recording baseline symptoms Patients who are not biochemically euthyroid Diabetic patients on antidiabetic medications whose fasting blood glucose is poorly controlled as indicated by HbA1C > 8% Patients with symptomatic cholelithiasis Patients who have congestive heart failure (NYHA Class III or IV), unstable angina, sustained ventricular tachycardia, ventricular fibrillation, clinically significant bradycardia, advanced heart block or a history of acute myocardial infarction within the six months preceding enrollment Patients with QT related risk factor: QTcF at screening > 450 msec Patients with QT related risk factor: History of syncope or family history of idiopathic sudden death Patients with QT related risk factor:Sudden or clinically significant cardiac arrhythmias Patients with QT related risk factor: Risk factors for Torsades de Pointes such as hypokalemia, hypomagnesemia, cardiac failure, clinically significant / symptomatic bradycardia, or high-grade AV block Patients with QT related risk factor: Concomitant disease(s) that could prolong QT such as autonomic neuropathy (caused by diabetes or Parkinson's disease), HIV, cirrhosis, uncontrolled hypothyroidism or cardiac failure Patients with QT related risk factor: Concomitant medication(s) known to increase the QT interval Patients with potassium <3.0 mmol/L at study entry, magnesium <0.4 mmol/L at study entry, calcium <1.75 mmol/L at study entry, family history of long QT syndrome, and concomitant medications known to prolong the QT interval. If the electrolyte abnormalities are corrected prior to study commencement, the patient may become eligible for the trial. Patients with liver disease such as cirrhosis, chronic active hepatitis or chronic persistent hepatitis with serum bilirubin > 1.5 X ULN, serum albumin < 0.67 X LLN, and/or ALT or AST more than 2 X ULN for patients without liver Confidential - 20 - Amended Clinical Study Protocol v01 / Track Changes Study No. CSOM230CIC01T metastases or ALT or AST more than 5X ULN for patients with documented liver metastases Patients with additional active malignant disease within the last five years (with the exception of basal cell carcinoma or carcinoma in situ of the cervix) Patients with the presence of active or suspected acute or chronic uncontrolled infection or with a history of immunocompromise, including a positive HIV test result (ELISA and Western blot). A HIV test will not be required; however, previous medical history will be reviewed Patients with abnormal coagulation (PT or APTT elevated by 30% above normal limits) Patients with WBC <2.5 X 109/L; Hgb <10 g/dL; PLT <100 X 109/L (patients with paraneoplastic pan-, leuco-, erythro- or thrombopenia can be included if this seems to be the only reason for pan-, leuco-, erythro- or thrombopenia) Known hypersensitivity to somatostatin analogues or any component of the pasireotide or octreotide LAR or s.c. formulations Patients who have any current or prior medical condition that may interfere with the conduct of the study or the evaluation of its results in the opinion of the investigator Female patients who are pregnant or lactating, or are of childbearing potential and not practicing a medically acceptable method of birth control. Female patients must use a secure method of contraception if sexually active and the partner should use a condom. If oral contraception is used, the patient must have been practicing this method for at least two months prior to enrollment and must agree to continue the oral contraceptive throughout the course of the study, and for three months after the study has ended. Male patients who are sexually active are required to use condoms during the study and for three months afterwards as a precautionary measure (available data do not suggest any increased reproductive risk with the study drugs). Female partners of these male patients should use a secondary barrier contraception. Patients who are currently part of or have participated in any clinical investigation with an investigational drug within 1 month prior to dosing Patients with a history of non-compliance to medical regimens or who are considered potentially unreliable or will not be able to complete the entire study Patient has received any other investigational agents within 28 days of first day of study drug dosing Abnormal clinical laboratory values considered by the investigator to be clinically significant and which could affect the interpretation of the study results
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Berthold Schalke, Prof. Dr.
Organizational Affiliation
Professor
Official's Role
Principal Investigator
Facility Information:
Facility Name
Klinik und Poliklinik für Neurologie der Universität Regensburg
City
Regensburg
State/Province
Bavaria
ZIP/Postal Code
93053
Country
Germany

12. IPD Sharing Statement

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Efficacy of Medical Treatment With SOM230 LAR in Patients With Primary Inoperable Thymoma and/or With Local Recurrent Thymoma to Reduce Tumor Size

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