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Phase II Study Assessing the Efficacy and Safety of Lenvatinib for Anaplastic Thyroid Cancer (HOPE)

Primary Purpose

Anaplastic Thyroid Cancer

Status
Completed
Phase
Phase 2
Locations
Japan
Study Type
Interventional
Intervention
Lenvatinib
Sponsored by
Translational Research Center for Medical Innovation, Kobe, Hyogo, Japan
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Anaplastic Thyroid Cancer focused on measuring anaplastic thyroid cancer, lenvatinib

Eligibility Criteria

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

Inclusion Criteria:

  1. Histologically confirmed as anaplastic thyroid cancer
  2. Unresectable disease
  3. Have measurable lesion defined by the RECIST version 1.1
  4. Have adequate organ function and meet following laboratory value:

    1. Bone marrow function test within 14 days prior to enrollment:

      neutrophil count>=1.5 x 103/microL blood platelet count>=10.0 x 104/microL hemoglobin amount>=9.0 g/dL

    2. Liver function test within 14 days prior to enrollment:

      AST,ALT<=3.0 x ULN(without liver metastatic) AST,ALT<=5.0 x ULN(with liver metastatic) bilirubin<=2.0 mg/dL

    3. Kidney function test within 14 days prior to enrollment:

      GFR estimation>=50 ml/min/1.73 m2 GFR estimation calculated by following formula. Male:194 x(serum creatinine concentration)-1.094 x(Age)-0.287 Female:Male GFR estimation x 0.739

    4. Cardiac function test within 28 days prior to enrollment: 12-lead electrocardiogram: no clinically important abnormality as shown below: heart disease, severe arrhythmia etc.
  5. Regardless of usage of antihypertensive drug, systolic blood pressure <=140 mm Hg and diastolic blood pressure <=90 mm Hg (If already taking antihypertensive drug, must have capacity of further antihypertensive therapy.)
  6. ECOG performance status 0-2
  7. Ability to swallow oral medications
  8. Life expectancy greater than 8 weeks
  9. Have signed written informed consent to participate in this study

Exclusion Criteria:

  1. Have complications or medical history of

    1. Complication of brain metastasis (Exclude if cured and in clinically stable condition for more than 1 month prior to screening.)
    2. Treatment required complication of systemic infectious disease
    3. Complication of pulmonary fibrosis or interstitial pneumonitis
    4. Medical history of clinically significant cardiovascular disease within 6 months of initial dose as: NYHA class above 2 leveled congestive heart failure, unstable angina, cardiac infarction or cardiac arrhythmia with paroxysmal or required treatment e) Uncontrollable complication of diabetes mellitus f) hemoptysis within 3 weeks of enrollment (blood volume of more than half of teaspoon) g) Medical history of hemorrhagic or thrombotic disease within 6 months of enrollment h) If proteinuria values above 2+ by urinary protein qualitative test, conduct 24-hour urine collection and the urine protein determined as 1g/24 hours or more. (can substitute to the ratio of proteinuria in morning urine/creatinine) i) Malabsorption at gastrointestinal tract and any of the complication diseases that investigator considers that will be affected to lenvatinib absorption j) Recent major surgery within 2 weeks (if needle biopsy within 1 week) of enrollment k) Drainage required celomic fluid stagnation
  2. Have history of lenvatinib administration
  3. Confirmed tumor invasion to the carotid arteries
  4. Have history of high dose external radiation therapy to cervical region, and irradiated tumor location close to the carotid arteries.
  5. Have any unresolved toxicity greater than 1 by CTCAE v4.0.
  6. Have active double cancer
  7. Female patients who are pregnant, lactating, breast feeding or have childbearing potential
  8. Psychiatric disorder and regarded by the investigator as inadequate for this study enrollment
  9. Confirmed as no resistance to any component of this drug
  10. Currently receiving other interventional clinical study treatment

Sites / Locations

  • Nagoya University Hospital
  • Fujita Health University Hospital
  • IUHW Ichikawa Hospital
  • National Cancer Center Hospital East
  • Japanese Red Cross Narita Hospital
  • Kuma Hospital
  • Kobe Univbersity Hospital
  • University of Tsukuba Hospital
  • Iwate Medical University Hospital
  • Kitasato University Hospital
  • Showa University Northern Yokohama Hospital
  • Kanagawa Cancer Center
  • Miyaghi Cancer Center
  • Tohoku University Hospital
  • Shinsyu University School of Medicine Department of Surgery
  • Nara Hospital Kinki University Faculty of Medicine
  • Nara Medical University
  • Osaka Police Hospital
  • Osaka City University Graduate School of Medicine and Faculty of Medicine
  • Nippon Medical School Hospital
  • The Cancer Institute Hospital of JFCR
  • Ito Hospital
  • Tokyo Medical University Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treatment Arm

Arm Description

Outcomes

Primary Outcome Measures

Overall Survival (OS)
OS is defined as time frame from date of initial dose until date of death from any cause. Or until the last confirmed survival date, study cut-off date which ever comes first.

Secondary Outcome Measures

Progression-Free Survival (PFS)
PFS is defined as time frame from date of initial dose until the date of first confirmed disease progression, until date of death from any cause or the last tumor evaluating date whichever comes first.
Best Overall Response (BOR)
BOR is defined as the best total efficacy record during the date of initial dose to the date of study completion, by which evaluated with following index. Complete Response (CR), Partial Response (PR), Stable Disease (SD is defined as ≧3 weeks),Pharmacodynamics/Progressive Disease (PD) or Not Evaluable (NE).
Objective Response Rate (ORR)
ORR is defined as the ratio of patients who are evaluated as CR or PR in Best Overall Response (BOR).
Disease Control Rate (DCR)
DCR is defined as the ratio of patients who are evaluated as CR, PR or SD in Best Overall Response (BOR).
Clinical Benefit Rate (CBR)
CBR is defined as the ratio of patients who are evaluated as CR, PR or durable SD (dSD is defined as ≧11 weeks SD) in Best Overall Response (BOR).
Safety assessment on the incidence ratio of adverse events
Safety assessment will be assessed by the ratio of adverse event

Full Information

First Posted
March 29, 2016
Last Updated
June 16, 2020
Sponsor
Translational Research Center for Medical Innovation, Kobe, Hyogo, Japan
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1. Study Identification

Unique Protocol Identification Number
NCT02726503
Brief Title
Phase II Study Assessing the Efficacy and Safety of Lenvatinib for Anaplastic Thyroid Cancer
Acronym
HOPE
Official Title
Phase II Study Assessing the Efficacy and Safety of Lenvatinib for Anaplastic Thyroid Cancer (HOPE)
Study Type
Interventional

2. Study Status

Record Verification Date
June 2020
Overall Recruitment Status
Completed
Study Start Date
April 4, 2016 (Actual)
Primary Completion Date
February 25, 2020 (Actual)
Study Completion Date
March 20, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Translational Research Center for Medical Innovation, Kobe, Hyogo, Japan

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this phase Ⅱ study is to assess the efficacy and safety of lenvatinib for anaplastic thyroid cancer patients who are diagnosed as unresectable. The total duration of the study will be 30 months. All patients will start administration of lenvatinib within 1 week of enrollment and receive the study drug 24mg orally once daily at almost the same time. 1 cycle consists of 4 weeks. Treatment term starts on the day 1st of drug administration of cycle 1 and administration will be continued until patients meet withdrawal criteria. Safety and efficacy assesment will be conducted on a regular basis during the trial. Tumor evaluation will be conducted at 4weeks, 8 weeks, 12 weeks, 16 weeks and at every 8 weeks after the 16th week since initial administration. When study drug administration terminated,tests of the drug termination will be conducted within 7 days of withdrawal and final observation will be conducted at 30 days after the last dose. Survival survey will be conducted at follow-up term. After the termination of the study drug, survival follow up survey will be conducted every 12 weeks unless patients withdraw enrollment of this study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Anaplastic Thyroid Cancer
Keywords
anaplastic thyroid cancer, lenvatinib

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Treatment Arm
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Lenvatinib
Intervention Description
All patients will receive lenvatinib 24 mg orally once daily at almost the same time. The treatment will be started within 1 week after enrollment. 1 cycle consists of 4 weeks. The administration will be continued until patients meet withdrawal criteria. If any toxicity manifested that cannot be ruled out causal association with the study drug, drug withdrawal or dosage reduction will be conducted in accordance with drug withdrawal/dosage reduction criteria.
Primary Outcome Measure Information:
Title
Overall Survival (OS)
Description
OS is defined as time frame from date of initial dose until date of death from any cause. Or until the last confirmed survival date, study cut-off date which ever comes first.
Time Frame
up to 30 months
Secondary Outcome Measure Information:
Title
Progression-Free Survival (PFS)
Description
PFS is defined as time frame from date of initial dose until the date of first confirmed disease progression, until date of death from any cause or the last tumor evaluating date whichever comes first.
Time Frame
up to 30 months
Title
Best Overall Response (BOR)
Description
BOR is defined as the best total efficacy record during the date of initial dose to the date of study completion, by which evaluated with following index. Complete Response (CR), Partial Response (PR), Stable Disease (SD is defined as ≧3 weeks),Pharmacodynamics/Progressive Disease (PD) or Not Evaluable (NE).
Time Frame
up to 30 months
Title
Objective Response Rate (ORR)
Description
ORR is defined as the ratio of patients who are evaluated as CR or PR in Best Overall Response (BOR).
Time Frame
up to 30 months
Title
Disease Control Rate (DCR)
Description
DCR is defined as the ratio of patients who are evaluated as CR, PR or SD in Best Overall Response (BOR).
Time Frame
up to 30 months
Title
Clinical Benefit Rate (CBR)
Description
CBR is defined as the ratio of patients who are evaluated as CR, PR or durable SD (dSD is defined as ≧11 weeks SD) in Best Overall Response (BOR).
Time Frame
up to 30 months
Title
Safety assessment on the incidence ratio of adverse events
Description
Safety assessment will be assessed by the ratio of adverse event
Time Frame
up to 30 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
20 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically confirmed as anaplastic thyroid cancer Unresectable disease Have measurable lesion defined by the RECIST version 1.1 Have adequate organ function and meet following laboratory value: Bone marrow function test within 14 days prior to enrollment: neutrophil count>=1.5 x 103/microL blood platelet count>=10.0 x 104/microL hemoglobin amount>=9.0 g/dL Liver function test within 14 days prior to enrollment: AST,ALT<=3.0 x ULN(without liver metastatic) AST,ALT<=5.0 x ULN(with liver metastatic) bilirubin<=2.0 mg/dL Kidney function test within 14 days prior to enrollment: GFR estimation>=50 ml/min/1.73 m2 GFR estimation calculated by following formula. Male:194 x(serum creatinine concentration)-1.094 x(Age)-0.287 Female:Male GFR estimation x 0.739 Cardiac function test within 28 days prior to enrollment: 12-lead electrocardiogram: no clinically important abnormality as shown below: heart disease, severe arrhythmia etc. Regardless of usage of antihypertensive drug, systolic blood pressure <=140 mm Hg and diastolic blood pressure <=90 mm Hg (If already taking antihypertensive drug, must have capacity of further antihypertensive therapy.) ECOG performance status 0-2 Ability to swallow oral medications Life expectancy greater than 8 weeks Have signed written informed consent to participate in this study Exclusion Criteria: Have complications or medical history of Complication of brain metastasis (Exclude if cured and in clinically stable condition for more than 1 month prior to screening.) Treatment required complication of systemic infectious disease Complication of pulmonary fibrosis or interstitial pneumonitis Medical history of clinically significant cardiovascular disease within 6 months of initial dose as: NYHA class above 2 leveled congestive heart failure, unstable angina, cardiac infarction or cardiac arrhythmia with paroxysmal or required treatment e) Uncontrollable complication of diabetes mellitus f) hemoptysis within 3 weeks of enrollment (blood volume of more than half of teaspoon) g) Medical history of hemorrhagic or thrombotic disease within 6 months of enrollment h) If proteinuria values above 2+ by urinary protein qualitative test, conduct 24-hour urine collection and the urine protein determined as 1g/24 hours or more. (can substitute to the ratio of proteinuria in morning urine/creatinine) i) Malabsorption at gastrointestinal tract and any of the complication diseases that investigator considers that will be affected to lenvatinib absorption j) Recent major surgery within 2 weeks (if needle biopsy within 1 week) of enrollment k) Drainage required celomic fluid stagnation Have history of lenvatinib administration Confirmed tumor invasion to the carotid arteries Have history of high dose external radiation therapy to cervical region, and irradiated tumor location close to the carotid arteries. Have any unresolved toxicity greater than 1 by CTCAE v4.0. Have active double cancer Female patients who are pregnant, lactating, breast feeding or have childbearing potential Psychiatric disorder and regarded by the investigator as inadequate for this study enrollment Confirmed as no resistance to any component of this drug Currently receiving other interventional clinical study treatment
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Iwao Sugitani, M.D., Ph.D
Organizational Affiliation
Graduate School of Medicine Nippon Medical School
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Makoto Tahara, M.D., Ph.D
Organizational Affiliation
National Cancer Center Hospital East
Official's Role
Study Director
Facility Information:
Facility Name
Nagoya University Hospital
City
Nagoya-city
State/Province
Aichi-prefecture
ZIP/Postal Code
466-8560
Country
Japan
Facility Name
Fujita Health University Hospital
City
Toyoake-city
State/Province
Aichi-prefecture
ZIP/Postal Code
470-1192
Country
Japan
Facility Name
IUHW Ichikawa Hospital
City
Ichikawa-city
State/Province
Chiba-prefecture
ZIP/Postal Code
272-0827
Country
Japan
Facility Name
National Cancer Center Hospital East
City
Kashiwa-city
State/Province
Chiba-prefecture
ZIP/Postal Code
277-8577
Country
Japan
Facility Name
Japanese Red Cross Narita Hospital
City
Narita-city
State/Province
Chiba-prefecture
ZIP/Postal Code
286-8523
Country
Japan
Facility Name
Kuma Hospital
City
Kobe-city
State/Province
Hyogo-prefecture
ZIP/Postal Code
650-0011
Country
Japan
Facility Name
Kobe Univbersity Hospital
City
Kobe-city
State/Province
Hyogo-prefecture
ZIP/Postal Code
650-0017
Country
Japan
Facility Name
University of Tsukuba Hospital
City
Tsukuba-city
State/Province
Ibaraki-prefecture
ZIP/Postal Code
305-8576
Country
Japan
Facility Name
Iwate Medical University Hospital
City
Morioka-city
State/Province
Iwate-prefecture
ZIP/Postal Code
020-8505
Country
Japan
Facility Name
Kitasato University Hospital
City
Sagamihara-city
State/Province
Kanagawa-prefecture
ZIP/Postal Code
252-0375
Country
Japan
Facility Name
Showa University Northern Yokohama Hospital
City
Yokohama-city
State/Province
Kanagawa-prefecture
ZIP/Postal Code
224-8503
Country
Japan
Facility Name
Kanagawa Cancer Center
City
Yokohama-city
State/Province
Kanagawa-prefecture
ZIP/Postal Code
241-8515
Country
Japan
Facility Name
Miyaghi Cancer Center
City
Natori-city
State/Province
Miyagi-prefecture
ZIP/Postal Code
981-1293
Country
Japan
Facility Name
Tohoku University Hospital
City
Sendai-city
State/Province
Miyagi-prefecture
ZIP/Postal Code
980-8574
Country
Japan
Facility Name
Shinsyu University School of Medicine Department of Surgery
City
Matsumoto-city
State/Province
Nagano-prefecture
ZIP/Postal Code
390-8621
Country
Japan
Facility Name
Nara Hospital Kinki University Faculty of Medicine
City
Ikoma-city
State/Province
Nara-prefecture
ZIP/Postal Code
630-0293
Country
Japan
Facility Name
Nara Medical University
City
Kashihara-city
State/Province
Nara-prefecture
ZIP/Postal Code
634-8522
Country
Japan
Facility Name
Osaka Police Hospital
City
Osaka-city
State/Province
Osaka-prefecture
ZIP/Postal Code
543-0035
Country
Japan
Facility Name
Osaka City University Graduate School of Medicine and Faculty of Medicine
City
Osaka-city
State/Province
Osaka-prefecture
ZIP/Postal Code
545-8585
Country
Japan
Facility Name
Nippon Medical School Hospital
City
Bunkyo-ku
State/Province
Tokyo-metropolis
ZIP/Postal Code
113-8603
Country
Japan
Facility Name
The Cancer Institute Hospital of JFCR
City
Koto-ku
State/Province
Tokyo-metropolis
ZIP/Postal Code
135-8550
Country
Japan
Facility Name
Ito Hospital
City
Shibuya-ku
State/Province
Tokyo-metropolis
ZIP/Postal Code
150-8308
Country
Japan
Facility Name
Tokyo Medical University Hospital
City
Shinjuku-ku
State/Province
Tokyo-metropolis
ZIP/Postal Code
160-0023
Country
Japan

12. IPD Sharing Statement

Learn more about this trial

Phase II Study Assessing the Efficacy and Safety of Lenvatinib for Anaplastic Thyroid Cancer

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