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A Phase II Multi-Strata Study of PM01183 as a Single Agent or in Combination With Conventional Chemotherapy in Metastatic and/or Unresectable Sarcomas

Primary Purpose

Metastatic Sarcoma

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
PM01183
Doxorubicin
Gemcitabine
Sponsored by
Massachusetts General Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Metastatic Sarcoma focused on measuring Metastatic Sarcoma, Unresectable Sarcoma, PM01183

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Participants must have pathologically confirmed soft-tissue sarcoma, which is metastatic or unresectable, sarcoma with no curative multimodality options
  • Participants must have measurable disease by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1.
  • No more than two prior lines of chemotherapy for metastatic sarcoma are allowed; Neo-adjuvant/adjuvant chemotherapy with definitive therapy (radiation, surgery or radiation and surgery) will not be counted as one of these prior lines of therapy.
  • Age ≥ 18 and ≤ 75 years.
  • Eastern Cooperative Oncology Group performance status ≤1 (see Appendix A)
  • Life expectancy of greater than 3 months
  • Participants must have normal organ and marrow function as defined below:

    • Hemoglobin ≥ 9 g/dl
    • absolute neutrophil count ≥ 1,500/mcL
    • platelets ≥ 100,000/mcL
    • total bilirubin ≤ 1.5 X ULN
    • AST(SGOT)/ALT(SGPT) ≤3 X ULN (including patients with liver metastases)
    • creatinine ≤1.5 X ULN
    • CPK < 2.5 X ULN
    • Albumin ≥ 3 g/dl
  • Women of childbearing potential must have a negative serum or urine pregnancy test within 7 days prior to receiving study agents.
  • For patients in stratum A, an echocardiogram or multiple gated acquisition scan (MUGA) demonstrating left ventricular ejection fraction > 50% is required within 30 days prior to study drug administration.
  • Participants must be willing and able to comply with the study scheduled visits, laboratory tests, and other procedures outlined in the protocol.
  • Pre-menopausal women must have a negative pregnancy test before study entry. Both women and men must agree to use a medically acceptable method of contraception throughout the treatment period and for at least six weeks after treatment discontinuation. Acceptable methods of contraception include intrauterine device (IUD), oral contraceptive, subdermal implant, double barrier and/or complete abstinence (non-periodic).
  • Washout period prior to Day 1 Cycle 1:

    • ≥ 3 weeks since last chemotherapy or therapeutic radiation therapy (RT)
    • ≥ 4 weeks or 3 half-lives since prior antibody-based therapy, whichever is shorter
    • ≥ 2 weeks since any oral anti-neoplastic or oral investigational agent
    • Resolution of treatment-related toxicity to ≤ grade 1; alopecia and cutaneous toxicity are allowed ≤ grade 2.
    • ≥1 week since palliative RT
  • Ability to understand and the willingness to sign a written informed consent document.

Exclusion Criteria:

  • Prior exposure to PM01183
  • Patients who have received trabectedin (Yondelis, ET-743) or participated in the phase III clinical study of trabectedin NCT01343277 previously will not be eligible.
  • For stratum A, patients must not have received prior anthracycline-based therapy (prior treatment with non-anthracyclines is permitted).
  • For stratum B patients must have received prior anthracycline-based therapy (or have a contraindication to receiving this treatment) and must not have received prior gemcitabine
  • For stratum C, patients must have received prior anthracycline or gemcitabine-based therapy, or had a contraindication to either or both
  • Prior radiation treatment of >45 Gy to the pelvis
  • Previously untreated Ewing Sarcoma and rhabdomyosarcoma
  • Non-soft tissue sarcomas, such as osteosarcoma and chondrosarcoma are excluded
  • Participants who are receiving any other investigational agents.
  • Active hepatopathy of any origin including active hepatitis B and hepatitis C
  • Participants with known uncontrolled brain metastases will be excluded from this clinical.
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to PM01183 or trabectedin (Yondelis, ET-743).
  • Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, chronic indwelling drains, history of interstitial pneumonitis or pulmonary fibrosis or psychiatric illness/social situations that would limit compliance with study requirements.
  • Actively breastfeeding women unless it is interrupted during treatment and at least 6 weeks after treatment discontinuation.
  • Known myopathy or persistent CPK elevations >2.5 ULN in two different determinations performed one week apart.
  • Immunocompromised patients, including those with HIV.

Sites / Locations

  • Massachusetts General Hospital
  • Dana Farber Cancer Institute

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

PM01183 and Doxorubicin

PM01183 and Gemcitabine

Single Agent PM01183

Arm Description

Anthracycline-naïve patients will receive combination of PM01183 and Doxorubicin per cycle. PM01183 predetermined dose daily via IV per cycle Doxorubicin predetermined dose daily via IV per cycle

Prior anthracycline exposure and without prior gemcitabine exposure PM01183 predetermined dose given twice via IV per cycle Gemcitabine predetermined dose given twice via IV per cycle

Patients who have received at least both prior anthracycline and prior gemcitabine -PM01183 predetermined dose once via IV per cycle

Outcomes

Primary Outcome Measures

Disease Control Rate
The number of participants that achieved either Stable Disease (SD) or a Partial Response (PR) as assessed by Response Evaluation Criteria in Solid Tumors (RECIST v1.1) at 24 weeks. Partial Response (PR): At least a 30% decrease in the sum of the diameters of target lesions, taking as reference the baseline sum diameters. Stable Disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study.

Secondary Outcome Measures

Overall Response Rate
The overall response rate is the number of participants that achieved either Stable Disease (SD), a Partial Response (PR), or a Complete Response (CR) as assessed by Response Evaluation Criteria in Solid Tumors (RECIST v1.1). The overall response rate is the best response recorded from the start of treatment until disease progression/recurrence. Complete Response (CR): Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to <10 mm. Partial Response (PR): At least a 30% decrease in the sum of the diameters of target lesions, taking as reference the baseline sum diameters. Stable Disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study.
Treatment Related Serious Adverse Events
Summary of the serious adverse events (SAE) experienced by participants that were deemed to be at least possibly related to PM01183 when administered alone or with Doxorubicin or Gemcitabine. Adverse events were assessed using Common Terminology Criteria for Adverse Events (CTCAE v4).

Full Information

First Posted
May 15, 2015
Last Updated
February 9, 2021
Sponsor
Massachusetts General Hospital
Collaborators
Dana-Farber Cancer Institute, PharmaMar
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1. Study Identification

Unique Protocol Identification Number
NCT02448537
Brief Title
A Phase II Multi-Strata Study of PM01183 as a Single Agent or in Combination With Conventional Chemotherapy in Metastatic and/or Unresectable Sarcomas
Official Title
A Phase II Multi-Strata Study of PM01183 as a Single Agent or in Combination With Conventional Chemotherapy in Metastatic and/or Unresectable Sarcomas
Study Type
Interventional

2. Study Status

Record Verification Date
February 2021
Overall Recruitment Status
Completed
Study Start Date
August 2015 (Actual)
Primary Completion Date
February 2017 (Actual)
Study Completion Date
April 1, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Massachusetts General Hospital
Collaborators
Dana-Farber Cancer Institute, PharmaMar

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This research study is investigating a drug called PM01183 alone and in combination with chemotherapy drugs called gemcitabine or doxorubicin as a possible treatment for metastatic or unresectable Sarcoma.
Detailed Description
This research study is a Phase II clinical trial. Phase II clinical trials test the safety and effectiveness of an investigational intervention to learn whether the intervention works in treating a specific disease. "Investigational" means that the intervention is being studied. PM01183 is a new drug that is believed to bind DNA cause double strands of DNA to break. This drug has been studied in previous research studies, and these suggest that it may slow or stop the growth of cancers. The FDA (the U.S. Food and Drug Administration) has not approved PM01183 as a treatment for any disease. In this research study, the investigators are trying to assess the effects, good or bad, that PM01183, administered either alone or in combination with gemcitabine or doxorubicin has on metastatic or unresectable sarcoma.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metastatic Sarcoma
Keywords
Metastatic Sarcoma, Unresectable Sarcoma, PM01183

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
42 (Actual)

8. Arms, Groups, and Interventions

Arm Title
PM01183 and Doxorubicin
Arm Type
Experimental
Arm Description
Anthracycline-naïve patients will receive combination of PM01183 and Doxorubicin per cycle. PM01183 predetermined dose daily via IV per cycle Doxorubicin predetermined dose daily via IV per cycle
Arm Title
PM01183 and Gemcitabine
Arm Type
Experimental
Arm Description
Prior anthracycline exposure and without prior gemcitabine exposure PM01183 predetermined dose given twice via IV per cycle Gemcitabine predetermined dose given twice via IV per cycle
Arm Title
Single Agent PM01183
Arm Type
Experimental
Arm Description
Patients who have received at least both prior anthracycline and prior gemcitabine -PM01183 predetermined dose once via IV per cycle
Intervention Type
Drug
Intervention Name(s)
PM01183
Other Intervention Name(s)
lurbinectedin
Intervention Type
Drug
Intervention Name(s)
Doxorubicin
Other Intervention Name(s)
Hydroxydaunomycin Hydrochloride, Adriamycin, Hydroxydoxorubicin Hydrochloride
Intervention Type
Drug
Intervention Name(s)
Gemcitabine
Other Intervention Name(s)
Gemzar
Primary Outcome Measure Information:
Title
Disease Control Rate
Description
The number of participants that achieved either Stable Disease (SD) or a Partial Response (PR) as assessed by Response Evaluation Criteria in Solid Tumors (RECIST v1.1) at 24 weeks. Partial Response (PR): At least a 30% decrease in the sum of the diameters of target lesions, taking as reference the baseline sum diameters. Stable Disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study.
Time Frame
24 Weeks
Secondary Outcome Measure Information:
Title
Overall Response Rate
Description
The overall response rate is the number of participants that achieved either Stable Disease (SD), a Partial Response (PR), or a Complete Response (CR) as assessed by Response Evaluation Criteria in Solid Tumors (RECIST v1.1). The overall response rate is the best response recorded from the start of treatment until disease progression/recurrence. Complete Response (CR): Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to <10 mm. Partial Response (PR): At least a 30% decrease in the sum of the diameters of target lesions, taking as reference the baseline sum diameters. Stable Disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study.
Time Frame
Every 6 weeks for the first 8 cycles (cycle is 21 days) and then every 9 weeks thereafter until disease progression
Title
Treatment Related Serious Adverse Events
Description
Summary of the serious adverse events (SAE) experienced by participants that were deemed to be at least possibly related to PM01183 when administered alone or with Doxorubicin or Gemcitabine. Adverse events were assessed using Common Terminology Criteria for Adverse Events (CTCAE v4).
Time Frame
From the start of treatment until 30 days after the end of treatment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Participants must have pathologically confirmed soft-tissue sarcoma, which is metastatic or unresectable, sarcoma with no curative multimodality options Participants must have measurable disease by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1. No more than two prior lines of chemotherapy for metastatic sarcoma are allowed; Neo-adjuvant/adjuvant chemotherapy with definitive therapy (radiation, surgery or radiation and surgery) will not be counted as one of these prior lines of therapy. Age ≥ 18 and ≤ 75 years. Eastern Cooperative Oncology Group performance status ≤1 (see Appendix A) Life expectancy of greater than 3 months Participants must have normal organ and marrow function as defined below: Hemoglobin ≥ 9 g/dl absolute neutrophil count ≥ 1,500/mcL platelets ≥ 100,000/mcL total bilirubin ≤ 1.5 X ULN AST(SGOT)/ALT(SGPT) ≤3 X ULN (including patients with liver metastases) creatinine ≤1.5 X ULN CPK < 2.5 X ULN Albumin ≥ 3 g/dl Women of childbearing potential must have a negative serum or urine pregnancy test within 7 days prior to receiving study agents. For patients in stratum A, an echocardiogram or multiple gated acquisition scan (MUGA) demonstrating left ventricular ejection fraction > 50% is required within 30 days prior to study drug administration. Participants must be willing and able to comply with the study scheduled visits, laboratory tests, and other procedures outlined in the protocol. Pre-menopausal women must have a negative pregnancy test before study entry. Both women and men must agree to use a medically acceptable method of contraception throughout the treatment period and for at least six weeks after treatment discontinuation. Acceptable methods of contraception include intrauterine device (IUD), oral contraceptive, subdermal implant, double barrier and/or complete abstinence (non-periodic). Washout period prior to Day 1 Cycle 1: ≥ 3 weeks since last chemotherapy or therapeutic radiation therapy (RT) ≥ 4 weeks or 3 half-lives since prior antibody-based therapy, whichever is shorter ≥ 2 weeks since any oral anti-neoplastic or oral investigational agent Resolution of treatment-related toxicity to ≤ grade 1; alopecia and cutaneous toxicity are allowed ≤ grade 2. ≥1 week since palliative RT Ability to understand and the willingness to sign a written informed consent document. Exclusion Criteria: Prior exposure to PM01183 Patients who have received trabectedin (Yondelis, ET-743) or participated in the phase III clinical study of trabectedin NCT01343277 previously will not be eligible. For stratum A, patients must not have received prior anthracycline-based therapy (prior treatment with non-anthracyclines is permitted). For stratum B patients must have received prior anthracycline-based therapy (or have a contraindication to receiving this treatment) and must not have received prior gemcitabine For stratum C, patients must have received prior anthracycline or gemcitabine-based therapy, or had a contraindication to either or both Prior radiation treatment of >45 Gy to the pelvis Previously untreated Ewing Sarcoma and rhabdomyosarcoma Non-soft tissue sarcomas, such as osteosarcoma and chondrosarcoma are excluded Participants who are receiving any other investigational agents. Active hepatopathy of any origin including active hepatitis B and hepatitis C Participants with known uncontrolled brain metastases will be excluded from this clinical. History of allergic reactions attributed to compounds of similar chemical or biologic composition to PM01183 or trabectedin (Yondelis, ET-743). Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, chronic indwelling drains, history of interstitial pneumonitis or pulmonary fibrosis or psychiatric illness/social situations that would limit compliance with study requirements. Actively breastfeeding women unless it is interrupted during treatment and at least 6 weeks after treatment discontinuation. Known myopathy or persistent CPK elevations >2.5 ULN in two different determinations performed one week apart. Immunocompromised patients, including those with HIV.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gregory Cote, MD PhD
Organizational Affiliation
Massachusetts General Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Facility Name
Dana Farber Cancer Institute
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
31896519
Citation
Cote GM, Choy E, Chen T, Marino-Enriquez A, Morgan J, Merriam P, Thornton K, Wagner AJ, Nathenson MJ, Demetri G, George S. A phase II multi-strata study of lurbinectedin as a single agent or in combination with conventional chemotherapy in metastatic and/or unresectable sarcomas. Eur J Cancer. 2020 Feb;126:21-32. doi: 10.1016/j.ejca.2019.10.021. Epub 2019 Dec 31.
Results Reference
derived

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A Phase II Multi-Strata Study of PM01183 as a Single Agent or in Combination With Conventional Chemotherapy in Metastatic and/or Unresectable Sarcomas

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