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A Study of Nab-paclitaxel-based Doublet as First Line Therapy in Patients With Cancer of Unknown Primary (CUP) (AGNOSTOS)

Primary Purpose

Unknown Primary Tumors

Status
Unknown status
Phase
Phase 2
Locations
Italy
Study Type
Interventional
Intervention
nab-paclitaxel
Carboplatin
Gemcitabine
Sponsored by
Fondazione del Piemonte per l'Oncologia
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Unknown Primary Tumors

Eligibility Criteria

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

Inclusion Criteria:

  • Provision of written informed consent.
  • Patients must be ≥ 18 years of age.
  • Diagnosis of CUP according to CUP Diagnostic Guidelines derived from ESMO 2011 and NCCN 2015 guidelines.
  • Sufficient archived biopsy tissue from a surgical or core needle biopsy required to perform the CUP multiplex assay.
  • Eastern Cooperative Oncology Group performance status ≤ 2.
  • No previous systemic therapy.
  • At least one measurable lesion by RECIST Criteria.
  • Good liver, cardiac, lung and marrow bone function.
  • Evidence of non-childbearing status for female patients: negative urine or serum pregnancy test within 21 days of study treatment for women of childbearing potential, or postmenopausal status.
  • Patients of child bearing potential and their partners, who are sexually active, must agree to the use of highly effective forms of contraception throughout their participation in the study.
  • Patient is willing and able to comply with the protocol for the duration of the study, including undergoing treatment and scheduled visits and examinations.

Exclusion Criteria:

  • Patients with second primary cancer, except: adequately treated non-melanoma skin cancer, curatively treated in-situ cancer of the cervix, breast Ductal Carcinoma in Situ (DCIS), stage 1 grade 1 endometrial carcinoma.
  • Specific treatable CUP syndromes including: extragonadal germ cell syndrome; neuroendocrine carcinoma; adenocarcinoma isolated to axillary lymph nodes (women cancer); peritoneal carcinomatosis (women - ovarian cancer); squamous carcinoma limited to cervical, supraclavicular, or inguinal lymph nodes; single resectable metastasis.
  • Patients receiving any radiotherapy (except for palliative reasons), within 2 weeks from the last dose prior to study entry.
  • Patients with symptomatic uncontrolled brain metastases.
  • Major surgery within 2 weeks of starting the study and patients must have recovered from any effects of any major surgery.
  • Patients considered a poor medical risk due to a serious, uncontrolled medical disorder, non-malignant systemic disease or active, uncontrolled infection. Examples include, but are not limited to, uncontrolled ventricular arrhythmia, recent (within 6 months) myocardial infarction, uncontrolled major seizure disorder, unstable spinal cord compression, superior vena cava syndrome, or any psychiatric disorder that prohibits obtaining informed consent.
  • Pregnant or breast feeding women.
  • Immunocompromised patients, eg, patients who are known to be serologically positive for human immunodeficiency virus (HIV).
  • Patients with known hepatic disease (eg, Hepatitis B or C).
  • Previous cancer treatment.
  • Patients currently enrolled in another clinical tria, except AGNOSTOS PROFILING.
  • Patients that are receiving chemotherapy, hormonal therapy (HRT is acceptable) or other novel agents.
  • Patients receiving live virus and bacterial vaccines.

Sites / Locations

  • Investigative Clinical Oncology (Oncologia Medica 2)Recruiting
  • AOU Policlinoco S Orsola - Malpighi
  • Ospedali Galliera
  • Istituto Europeo di Oncologia - IEO
  • Istituto Nazionale dei Tumori
  • Ospedale Niguarda Cà Granda
  • Istituto Oncologico Veneto - IOV
  • Fondazione IRCCS Policlinico San Matteo
  • Policlinico Universitario Campus Biomedico
  • A.O.U S.Giovanni Battista

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Arm A

Arm B

Arm Description

nab-paclitaxel 125 mg/m2 on Days 1 and 8 by IV administration over 30 minutes without premedication, followed by gemcitabine 1000 mg/m2 on Days 1 and 8 by IV administration over 30 minutes. Treatment to be repeated Q21 days.

nab-paclitaxel 125 mg/m2 on Days 1 and 8 by IV administration over 30 minutes without premedication, followed by carboplatin AUC 2 on Day 1 and 8 by IV administration over 60 minutes. Treatment to be repeated Q21 days.

Outcomes

Primary Outcome Measures

Objective response rate (ORR) as evaluated according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 guidelines.

Secondary Outcome Measures

duration of response according to RECIST version 1.1.
time to progression
overall survival
toxicity according to Common Terminology Criteria for Adverse Events - CTCAE version 4.03.

Full Information

First Posted
November 16, 2015
Last Updated
September 1, 2017
Sponsor
Fondazione del Piemonte per l'Oncologia
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1. Study Identification

Unique Protocol Identification Number
NCT02607202
Brief Title
A Study of Nab-paclitaxel-based Doublet as First Line Therapy in Patients With Cancer of Unknown Primary (CUP)
Acronym
AGNOSTOS
Official Title
A Phase II, Randomized, Multicenter Study to Assess the Efficacy of Nab-paclitaxel-based Doublet as First Line Therapy in Patients With Cancer of Unknown Primary (CUP): The AGNOSTOS Trial
Study Type
Interventional

2. Study Status

Record Verification Date
August 2017
Overall Recruitment Status
Unknown status
Study Start Date
March 2015 (undefined)
Primary Completion Date
September 2018 (Anticipated)
Study Completion Date
December 2018 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Fondazione del Piemonte per l'Oncologia

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Agnostos Trial is a multicentric phase 2 randomized trial with a 'pick-the-winner design' in chemonaive patients with cancer of unknown primary. It will assess the efficacy of the two best active single agent - carboplatin or gemcitabine - added to an innovative taxane back bone (nab-Paclitaxel). Agnostos trial is a part of a larger clinical and translational initiative to improve the outlook of patients with cancer of unknown primary through evaluation of novel chemotherapeutic regimens.
Detailed Description
Treatment-naïve patients with CUP diagnosis confirmed according to CUP Diagnostic Guidelines, will be enrolled into AGNOSTOS trial. Patients will be randomized upfront to receive a nab-paclitaxel-based duplet adding either carboplatin or gemcitabine until progression or unacceptable toxicity (randomization 1:1, n= 120; 60 per arm).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Unknown Primary Tumors

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
120 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Arm A
Arm Type
Experimental
Arm Description
nab-paclitaxel 125 mg/m2 on Days 1 and 8 by IV administration over 30 minutes without premedication, followed by gemcitabine 1000 mg/m2 on Days 1 and 8 by IV administration over 30 minutes. Treatment to be repeated Q21 days.
Arm Title
Arm B
Arm Type
Experimental
Arm Description
nab-paclitaxel 125 mg/m2 on Days 1 and 8 by IV administration over 30 minutes without premedication, followed by carboplatin AUC 2 on Day 1 and 8 by IV administration over 60 minutes. Treatment to be repeated Q21 days.
Intervention Type
Drug
Intervention Name(s)
nab-paclitaxel
Other Intervention Name(s)
Abraxane
Intervention Type
Drug
Intervention Name(s)
Carboplatin
Intervention Type
Drug
Intervention Name(s)
Gemcitabine
Primary Outcome Measure Information:
Title
Objective response rate (ORR) as evaluated according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 guidelines.
Time Frame
42 months
Secondary Outcome Measure Information:
Title
duration of response according to RECIST version 1.1.
Time Frame
42 months
Title
time to progression
Time Frame
42 months
Title
overall survival
Time Frame
42 months
Title
toxicity according to Common Terminology Criteria for Adverse Events - CTCAE version 4.03.
Time Frame
42 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Provision of written informed consent. Patients must be ≥ 18 years of age. Diagnosis of CUP according to CUP Diagnostic Guidelines derived from ESMO 2011 and NCCN 2015 guidelines. Sufficient archived biopsy tissue from a surgical or core needle biopsy required to perform the CUP multiplex assay. Eastern Cooperative Oncology Group performance status ≤ 2. No previous systemic therapy. At least one measurable lesion by RECIST Criteria. Good liver, cardiac, lung and marrow bone function. Evidence of non-childbearing status for female patients: negative urine or serum pregnancy test within 21 days of study treatment for women of childbearing potential, or postmenopausal status. Patients of child bearing potential and their partners, who are sexually active, must agree to the use of highly effective forms of contraception throughout their participation in the study. Patient is willing and able to comply with the protocol for the duration of the study, including undergoing treatment and scheduled visits and examinations. Exclusion Criteria: Patients with second primary cancer, except: adequately treated non-melanoma skin cancer, curatively treated in-situ cancer of the cervix, breast Ductal Carcinoma in Situ (DCIS), stage 1 grade 1 endometrial carcinoma. Specific treatable CUP syndromes including: extragonadal germ cell syndrome; neuroendocrine carcinoma; adenocarcinoma isolated to axillary lymph nodes (women cancer); peritoneal carcinomatosis (women - ovarian cancer); squamous carcinoma limited to cervical, supraclavicular, or inguinal lymph nodes; single resectable metastasis. Patients receiving any radiotherapy (except for palliative reasons), within 2 weeks from the last dose prior to study entry. Patients with symptomatic uncontrolled brain metastases. Major surgery within 2 weeks of starting the study and patients must have recovered from any effects of any major surgery. Patients considered a poor medical risk due to a serious, uncontrolled medical disorder, non-malignant systemic disease or active, uncontrolled infection. Examples include, but are not limited to, uncontrolled ventricular arrhythmia, recent (within 6 months) myocardial infarction, uncontrolled major seizure disorder, unstable spinal cord compression, superior vena cava syndrome, or any psychiatric disorder that prohibits obtaining informed consent. Pregnant or breast feeding women. Immunocompromised patients, eg, patients who are known to be serologically positive for human immunodeficiency virus (HIV). Patients with known hepatic disease (eg, Hepatitis B or C). Previous cancer treatment. Patients currently enrolled in another clinical tria, except AGNOSTOS PROFILING. Patients that are receiving chemotherapy, hormonal therapy (HRT is acceptable) or other novel agents. Patients receiving live virus and bacterial vaccines.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Filippo MONTEMURRO, MD
Phone
011 993
Ext
3250
Email
filippo.montemurro@ircc.it
First Name & Middle Initial & Last Name or Official Title & Degree
Elena Geuna, MD
Phone
011 993
Ext
3250
Email
elena.geuna@ircc.it
Facility Information:
Facility Name
Investigative Clinical Oncology (Oncologia Medica 2)
City
Candiolo
State/Province
Turin
ZIP/Postal Code
10060
Country
Italy
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Filippo Montemurro, MD
Phone
011993
Ext
3250
Email
filippo.montemurro@ircc.it
First Name & Middle Initial & Last Name & Degree
Elena Geuna, MD
Phone
011993
Ext
3250
Email
elena.geuna@ircc.it
Facility Name
AOU Policlinoco S Orsola - Malpighi
City
Bologna
Country
Italy
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Andrea Ardizzoni, MD
Facility Name
Ospedali Galliera
City
Genova
Country
Italy
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Alessandra Gennari, MD
Facility Name
Istituto Europeo di Oncologia - IEO
City
Milano
Country
Italy
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Giuseppe Curigliano, MD
Facility Name
Istituto Nazionale dei Tumori
City
Milano
Country
Italy
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Filippo De Braud, MD
Facility Name
Ospedale Niguarda Cà Granda
City
Milano
Country
Italy
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Salvatore Siena, MD
Facility Name
Istituto Oncologico Veneto - IOV
City
Padova
Country
Italy
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Vittorina Zagonel, MD
Facility Name
Fondazione IRCCS Policlinico San Matteo
City
Pavia
Country
Italy
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Giulia Stella, MD
Facility Name
Policlinico Universitario Campus Biomedico
City
Roma
Country
Italy
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Giuseppe Tonini, MD
Facility Name
A.O.U S.Giovanni Battista
City
Torino
ZIP/Postal Code
10126
Country
Italy
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Libero Ciuffreda, MD
First Name & Middle Initial & Last Name & Degree
Libero Ciuffreda, MD

12. IPD Sharing Statement

Learn more about this trial

A Study of Nab-paclitaxel-based Doublet as First Line Therapy in Patients With Cancer of Unknown Primary (CUP)

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