Phase 3 Study to Treat Patients With Soft Tissue Sarcomas
Metastatic, Locally Advanced or Unresectable Soft Tissue Sarcoma
About this trial
This is an interventional treatment trial for Metastatic, Locally Advanced or Unresectable Soft Tissue Sarcoma focused on measuring soft tissue sarcoma, unresectable, metastatic, locally advanced, sarcoma
Eligibility Criteria
Inclusion Criteria:
- Has provided written informed consent prior to any study related activities.
- Age ≥15 years (US only), and 18-80 (rest of world (ROW)), male or female.
- Histological confirmation of intermediate or high grade soft-tissue sarcoma. Tissue must be sent to a central pathology lab for review but will not preclude entry onto the study. Final assignment of tumor grade and histology will be based on the designation provided by the central pathology review.
- An adequate tumor specimen obtained by either excisional biopsy, incisional biopsy or core needle biopsy must be sent to the central pathology lab for evaluation. The material must measure at least 0.8 × 0.1 cm in size or contain at least 50 tumor cells.
- Locally advanced, unresectable, and/or metastatic soft-tissue sarcoma of intermediate or high grade with evidence of disease progression by either computed tomography (CT) or magnetic resonance imaging (MRI) scan, or clinical judgment on or after the last cancer therapy within 6 months prior to randomization.
- Relapsed or refractory (lack of response) to ≥1 course of systemic therapy regimen(s), excluding adjuvant or neoadjuvant chemotherapy, and is incurable by either surgery or radiation.
- Capable of providing informed consent and complying with trial procedures.
- ECOG PS 0-2.
- Life expectancy >12 weeks.
- Measurable tumor lesions according to RECIST 1.1 criteria.[50]
- Women must not be able to become pregnant (e.g., post-menopausal for at least 1 year, surgically sterile, or practicing adequate birth control methods) for the duration of the study. (Adequate contraception includes: oral contraception, implanted contraception, intrauterine device implanted for at least 3 months, or barrier method in conjunction with spermicide.)
- Males and their female partner(s) of child-bearing potential must use 2 forms of effective contraception (see Inclusion 11 plus condom or vasectomy for males) from the last menstrual period of the female partner during the study treatment and agree to continue use for 6 months after the final dose of study treatment.
- Women of child bearing potential must have a negative serum or urine pregnancy test at the Screening Visit and be non-lactating.
- Accessibility to the site that optimizes the subject's ability to keep all study-related appointments.
Exclusion Criteria:
- Prior exposure to >375 mg/m2 of doxorubicin or liposomal doxorubicin.
- Palliative surgery and/or radiation treatment within 30 days prior to date of randomization.
- Exposure to any investigational agent within 30 days of date of randomization.
- Exposure to any systemic chemotherapy within 30 days of date of randomization.
- An inadequate tumor specimen as defined by the central pathologist.
- Current evidence/diagnosis of alveolar soft part sarcoma, extraskeletal myxoid chondrosarcoma, rhabdomyosarcoma, osteosarcoma, gastrointestinal stromal tumor (GIST), dermatofibrosarcoma (unless transformed to fibrosarcoma), Ewing's sarcoma, Kaposi's sarcoma, mixed mesodermal tumor, clear cell sarcomas.
- Evidence of central nervous system (CNS) metastasis who have not received prior definitive therapy for their lesions.
- History of other malignancies except cured basal cell carcinoma, cutaneous squamous cell carcinoma, melanoma in situ, superficial bladder cancer or carcinoma in situ of the cervix unless documented free of cancer for ≥5 years.
- Laboratory values: Screening serum creatinine >1.5 x upper limit of normal (ULN), alanine aminotransferase (ALT) >3×ULN or >5×ULN if liver metastases are present, total bilirubin >2×ULN, absolute neutrophil count (ANC) <1,500/mm3, platelet concentration <100,000/mm3, hemoglobin <9g/dL.
- Clinically evident congestive heart failure (CHF) > class II of the New York Heart Association (NYHA) guidelines.
- Current, serious, clinically significant cardiac arrhythmias, defined as the existence of an absolute arrhythmia or ventricular arrhythmias classified as Lown III, IV or V.
- Baseline QTc >470 msec and/or previous history of QT prolongation while taking other medications.
- Concomitant use of medications associated with a high incidence of QT prolongation is not allowed.
- History or signs of active coronary artery disease with or without angina pectoris within the last 6 months.
- Serious myocardial dysfunction defined by ECHO as absolute left ventricular ejection fraction (LVEF) below the institution's lower limit of predicted normal.
- Known history of HIV infection.
- Active, clinically significant serious infection requiring treatment with antibiotics, anti-virals or anti-fungals. The Medical Monitor should be contacted for any uncertainties.
- Major surgery within 30 days prior to date of randomization.
- Current or past substance abuse or any condition that might interfere with the subject's participation in the study or in the evaluation of the study results.
- Any condition that is unstable and could jeopardize the subject's participation in the study.
Sites / Locations
- University of Alabama at Birmingham
- Arizona Oncology Associates, PC
- The University of Arizona
- City of Hope Medical Group
- Samuel Oschin Cancer Center
- UCLA Medical Center
- Sarcoma Oncology Center
- Stanford University Medical Center
- U of CO Health Sciences Center
- Rocky Mountain Cancer Centers
- Mayo Clinic
- Moffitt Cancer Center
- Georgia Cancer Specialists
- Northwestern Medical Faculty Foundation
- Edward Cancer Center
- Oncology Specialists, SC
- Kansas City Cancer Center
- Massachusetts General Hospital
- Dana Farber Cancer Institute
- University of Michigan
- University of Minnesota
- Mayo Clinic
- Washington University
- Nebraska Methodist Hospital
- Roswell Park Cancer Institute
- Levine Cancer Institute
- Wake Forest University Baptist Medical Center
- University Hospitals Case Medical Center
- Cleveland Clinic
- The James Cancer Hospital and Solove Research Institute
- Center for Health and Healing
- Jefferson Medical College
- U of Pittsburgh Cancer Institute
- Vanderbilt University
- Fletcher Allen Health Care
- Medical College of Wisconsin
- Royal North Shore Hospital
- Westmead Hospital
- Cross Cancer Institute
- Juravinski Cancer Center
- McGill University
- Instituto Clinico Oncologica del Sur (ICOS)
- Herlev Hospital
- Institut Bergonie
- Centre Georges Francois Leclerc
- Centre Hospitalier Regional et Universitaire - Hospital Bretonneau
- Hopital Rene Huguenin - Institut Curie
- Institut Gustave Roussy
- Centre Leon Berard
- Magyar Honvedseg Egeszsegugyi Kozpont
- Rambam Medical Center
- Sharet Institute of Oncology Hadassah Ein Karem Medical Center
- Chaim Sheba Medical Center
- Tel Aviv Sourasky Medical Center
- Fondazione del Piemonte per l'Oncologia
- Azienda Ospedaliero-Universitaria di Bologna-Policlinico S Orsola-Malpighi
- IRCCS Instituto Ortopedico Rizzoli
- Istituto Europeo di Oncologia Milano
- Istituto Oncologico Veneto
- Leiden Universitair Medisch Centrum
- Instytut im.Marii Sklodowskiej-Curie
- State Institution "Blokhin Cancer Research Centre RAMS"
- City Oncology Hospital #2
- Republican Clinical Oncologic Dispensary of Ministry of Health Republic Tatarstan
- Hospital Universitario Son Espases
- Consorcio Hospitalario Provincial de Castellon
- Hospital Puerta de Hierro Majadahonda
- Complejo Hospitalario de Navarra
- Hospital Santa Creu i Sant Pau
- Inst Catala D'Oncologia
- Hospital Universitario La Paz
- Centro Integral Oncologico Clara Campal, Hospital de Madrid Norte-San Chinarro
- Hospital San Carlos Madrid
- Hospital Universitario Miguel Servet
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Aldoxorubicin
Investigator's Choice of Treatment
Aldoxorubicin is administered at 350 mg/m2 (260 mg/m2 doxorubicin equivalent) intravenously on Day 1 every 21-day cycles until tumor progression or unacceptable toxicity occurs.
These treatments include: Dacarbazine administered at 1000 mg/m2 by intravenous infusion (IVI), over 90±15 minutes on Day 1 every 21 days until tumor progression or unacceptable toxicity occurs; Pazopanib, 800 mg orally each day until tumor progression or unacceptable toxicity occurs; Gemcitabine, 900 mg/m2 by IVI over 90 minutes on Days 1 and 8, plus docetaxel, 100 mg/m2 by IVI over 1 hour on Day 8 of a 28 day cycle until tumor progression or unacceptable toxicity occurs; Doxorubicin, 75 mg/m2 by IVI over 5 to 30 minutes every 21 days for a maximum cumulative dose of 550 mg/m2 or unacceptable toxicity occurs; or Ifosfamide 2.0 g/m2 administered over 2 to 4 hours on Days 1-4 of a 21 day cycle + mesna per standard site administration regimen until tumor progression or unacceptable toxicity occurs.