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Mesylate Apatinib for Stage Ⅳ STS After Failure of Chemotherapy

Primary Purpose

Soft Tissue Sarcoma, Adult, Stage II

Status
Unknown status
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Apatinib
Sponsored by
Tianjin Medical University Cancer Institute and Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Soft Tissue Sarcoma, Adult, Stage II focused on measuring Apatinib, Soft Tissue Sarcoma

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Patients voluntarily join the study, signed informed consent, good compliance;
  • The pathology was diagnosed as stage Ⅳ soft tissue sarcoma patients, clinical staging using the American Cancer Research Joint Committee (AJCC) TNM staging criteria. According to CT or MRI at least one measurable lesion;
  • At least one chemotherapy regimen (containing anthracycline) was treated and evaluated as "disease progression" in terms of the efficacy evaluation criteria of solid tumors (RECIST 1.1).
  • 18 to 70 years old, PS score: 0 ~ 2; expected survival period of more than 3 months;
  • The laboratory check meets the following criteria:
  • Blood routine examination: HB ≥ 100g / L (14 days without blood transfusion); ANC ≥ 1.5 × 109 / L; PLT ≥ 80 × 109 / L
  • Biochemical tests: serum creatinine Cr ≤ normal upper limit (ULN), bilirubin BIL ≤ normal upper limit (ULN), ALT, AST ≤ 1.5 × normal upper limit (ULN), for liver metastases ≤ 5 × normal upper limit (ULN); fasting triglyceride ≤ 3.0mmol / L, fasting cholesterol ≤ 7.75mmol / L;
  • Doppler ultrasonography: left ventricular ejection fraction (LVEF) ≥ normal low (50%).
  • Women should agree that contraceptive measures (such as IUDs, contraceptives or condoms) must be used within six months of the study period and after the end of the study; serum or urine pregnancy studies were negative for 7 days prior to study , and must be non-lactating patients; men should agree that contraceptive measures must be used within six months of the study period and after the end of the study period.

Exclusion Criteria:

  • Patients who have received antiangiogenic therapy or other targeted treatment for no more than 3 months, such as Endostar, Erlotinib, Sunitinib, Sorafenib, Avastin, Imatinib, Famitinib, Pazopanib and other drugs.
  • Past or concurrent with other malignancies, except for cured skin basal cell carcinoma and cervical in situ cancer;
  • Participated in other drug clinical researchers within four weeks;
  • Previously received anticancer treatment patients with NCI CTC AE grade> 1 grade toxicity;
  • Have a variety of factors that affect oral medication (such as can not swallow, gastrointestinal resection, chronic diarrhea and intestinal obstruction, etc.)
  • Known brain metastases, spinal cord compression, cancerous meningitis, or screening when the CT or MRI examination found that the brain or pia mater disease;
  • Patients with any severe and / or uncontrolled disease, for example:
  • Unstable angina, symptomatic congestive heart failure, myocardial infarction within 6 months prior to randomization, severe uncontrollable arrhythmia; poor blood pressure control (systolic blood pressure> 140 mmHg, diastolic blood pressure> 90 mmHg )patient;
  • Active or uncontrollable serious infection;
  • Liver diseases such as cirrhosis, decompensated liver disease, chronic active hepatitis;
  • Poor control of diabetes (fasting blood glucose (FBG)> 10mmol / L);
  • Urinary routine urinary protein ≥ ++, and confirmed 24 hours urine protein> 1.0 g;
  • Long untreated wound or fracture;
  • Patients with bleeding tendency (such as active gastrointestinal ulcers) or treated with anticoagulants or vitamin K antagonists such as warfarin, heparin or analogues;
  • Interventional venous thrombosis events such as cerebrovascular accident (including transient ischemic attack), deep vein thrombosis, and pulmonary embolism before the first medication.
  • Have a history of psychiatric abuse and can not quit or have mental disorders;
  • Have a history of immunodeficiency, including HIV testing positive or other acquired, congenital immune deficiency disease, or a history of organ transplantation;
  • According to the researcher's judgment, there are serious illnesses that compromise the patient's safety or affect the patient's completion of the study.

Sites / Locations

  • Tianjin Medical University Cancer Hospital & InstituteRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

apatinib group

Arm Description

apatinib 500mg po qd, 28 days for a cycle.

Outcomes

Primary Outcome Measures

Progression-free survival (PFS)
PFS is defined as the length of time from random assignment to disease progression or to death resulting from any cause other than the progress.

Secondary Outcome Measures

Disease control rate(DCR)
Investigators will assess treatment response according to Response Evaluation Criteria in Solid Tumors 1.1(RECIST1.1)
Objective tumor response rate(ORR)
ORR is defined as the percentage of subjects having achieved confirmed Complete Response + Partial Response as best overall response according to radiological assessments.
Overall survival(OS)
OS is defined as the length of time from random assignment to death or to last contact.
Adverse Events(AEs)
AEs are evaluated according to National Cancer Institute Common Terminology Criteria for Adverse Events v4.0.

Full Information

First Posted
April 17, 2017
Last Updated
May 19, 2017
Sponsor
Tianjin Medical University Cancer Institute and Hospital
Collaborators
Zhejiang Cancer Hospital, Gansu Cancer Hospital, Liaoning Tumor Hospital & Institute, Fudan University
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1. Study Identification

Unique Protocol Identification Number
NCT03121846
Brief Title
Mesylate Apatinib for Stage Ⅳ STS After Failure of Chemotherapy
Official Title
Mesylate Apatinib for Stage Ⅳ Soft Tissue Sarcoma Patients After Failure of Traditional Chemotherapy: Prospective, Open-label, Single-Arm, Multi-center Phase II Clinical Trial
Study Type
Interventional

2. Study Status

Record Verification Date
March 2017
Overall Recruitment Status
Unknown status
Study Start Date
May 1, 2017 (Actual)
Primary Completion Date
November 1, 2018 (Anticipated)
Study Completion Date
May 1, 2019 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Tianjin Medical University Cancer Institute and Hospital
Collaborators
Zhejiang Cancer Hospital, Gansu Cancer Hospital, Liaoning Tumor Hospital & Institute, Fudan University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a Prospective, Open-label, Single-Arm, Multi-center phase II clinical trial evaluating the efficacy and safety of Apatinib for Chemotherapy Failure Ⅳ Stage Soft Tissue Sarcoma.
Detailed Description
The prognosis of sarcoma patients in stage IV is poor. For STS, the response rate of chemotherapy is only 20-35% and the median survival time is about 12 months. The 5 year survival rate is lower than 10% reported in several large-scale studies. Although chemotherapy plays a major role in the treatment of advanced STS, the classic chemotherapy agents are not curative. Combination chemotherapy or dose-dense regimens have largely failed to improve the response rates. Long-term using of cytotoxic drugs increased the risk of toxicity in patients. Apatinib is a small molecular inhibitor of Vascular Epithelial Growth Factor Receptor-2 (VEGFR-2). It has been approved as a second-line treatment for advanced gastric cancer. Several phase III clinical studies of non small cell lung cancer, liver cancer, colorectal cancer and other tumors also showed apatinib has less toxic side effects and better patient tolerance. However, the clinical application of apatinib in STS is still lack of evidence-based medicine. And this clinical trial is designed to prospectively investigate the efficacy and safety of apatinib in stage IV sarcoma patients who failed in chemotherapy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Soft Tissue Sarcoma, Adult, Stage II
Keywords
Apatinib, Soft Tissue Sarcoma

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
apatinib group
Arm Type
Experimental
Arm Description
apatinib 500mg po qd, 28 days for a cycle.
Intervention Type
Drug
Intervention Name(s)
Apatinib
Other Intervention Name(s)
Apatinib Mesylate Tablets
Intervention Description
Apatinib 500 mg is administered orally daily, until disease progression or untolerable toxicity.
Primary Outcome Measure Information:
Title
Progression-free survival (PFS)
Description
PFS is defined as the length of time from random assignment to disease progression or to death resulting from any cause other than the progress.
Time Frame
2 year
Secondary Outcome Measure Information:
Title
Disease control rate(DCR)
Description
Investigators will assess treatment response according to Response Evaluation Criteria in Solid Tumors 1.1(RECIST1.1)
Time Frame
2 year
Title
Objective tumor response rate(ORR)
Description
ORR is defined as the percentage of subjects having achieved confirmed Complete Response + Partial Response as best overall response according to radiological assessments.
Time Frame
2 year
Title
Overall survival(OS)
Description
OS is defined as the length of time from random assignment to death or to last contact.
Time Frame
3 year
Title
Adverse Events(AEs)
Description
AEs are evaluated according to National Cancer Institute Common Terminology Criteria for Adverse Events v4.0.
Time Frame
2 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients voluntarily join the study, signed informed consent, good compliance; The pathology was diagnosed as stage Ⅳ soft tissue sarcoma patients, clinical staging using the American Cancer Research Joint Committee (AJCC) TNM staging criteria. According to CT or MRI at least one measurable lesion; At least one chemotherapy regimen (containing anthracycline) was treated and evaluated as "disease progression" in terms of the efficacy evaluation criteria of solid tumors (RECIST 1.1). 18 to 70 years old, PS score: 0 ~ 2; expected survival period of more than 3 months; The laboratory check meets the following criteria: Blood routine examination: HB ≥ 100g / L (14 days without blood transfusion); ANC ≥ 1.5 × 109 / L; PLT ≥ 80 × 109 / L Biochemical tests: serum creatinine Cr ≤ normal upper limit (ULN), bilirubin BIL ≤ normal upper limit (ULN), ALT, AST ≤ 1.5 × normal upper limit (ULN), for liver metastases ≤ 5 × normal upper limit (ULN); fasting triglyceride ≤ 3.0mmol / L, fasting cholesterol ≤ 7.75mmol / L; Doppler ultrasonography: left ventricular ejection fraction (LVEF) ≥ normal low (50%). Women should agree that contraceptive measures (such as IUDs, contraceptives or condoms) must be used within six months of the study period and after the end of the study; serum or urine pregnancy studies were negative for 7 days prior to study , and must be non-lactating patients; men should agree that contraceptive measures must be used within six months of the study period and after the end of the study period. Exclusion Criteria: Patients who have received antiangiogenic therapy or other targeted treatment for no more than 3 months, such as Endostar, Erlotinib, Sunitinib, Sorafenib, Avastin, Imatinib, Famitinib, Pazopanib and other drugs. Past or concurrent with other malignancies, except for cured skin basal cell carcinoma and cervical in situ cancer; Participated in other drug clinical researchers within four weeks; Previously received anticancer treatment patients with NCI CTC AE grade> 1 grade toxicity; Have a variety of factors that affect oral medication (such as can not swallow, gastrointestinal resection, chronic diarrhea and intestinal obstruction, etc.) Known brain metastases, spinal cord compression, cancerous meningitis, or screening when the CT or MRI examination found that the brain or pia mater disease; Patients with any severe and / or uncontrolled disease, for example: Unstable angina, symptomatic congestive heart failure, myocardial infarction within 6 months prior to randomization, severe uncontrollable arrhythmia; poor blood pressure control (systolic blood pressure> 140 mmHg, diastolic blood pressure> 90 mmHg )patient; Active or uncontrollable serious infection; Liver diseases such as cirrhosis, decompensated liver disease, chronic active hepatitis; Poor control of diabetes (fasting blood glucose (FBG)> 10mmol / L); Urinary routine urinary protein ≥ ++, and confirmed 24 hours urine protein> 1.0 g; Long untreated wound or fracture; Patients with bleeding tendency (such as active gastrointestinal ulcers) or treated with anticoagulants or vitamin K antagonists such as warfarin, heparin or analogues; Interventional venous thrombosis events such as cerebrovascular accident (including transient ischemic attack), deep vein thrombosis, and pulmonary embolism before the first medication. Have a history of psychiatric abuse and can not quit or have mental disorders; Have a history of immunodeficiency, including HIV testing positive or other acquired, congenital immune deficiency disease, or a history of organ transplantation; According to the researcher's judgment, there are serious illnesses that compromise the patient's safety or affect the patient's completion of the study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Jilong Yang, M.D., Ph.D.
Phone
+8618622221626
Email
yangjilong@tjmuch.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jilong Yang, M.D., Ph.D.
Organizational Affiliation
Tianjin Medical University Cancer Institute and Hospital
Official's Role
Study Chair
Facility Information:
Facility Name
Tianjin Medical University Cancer Hospital & Institute
City
Tianjin
State/Province
Tianjin
ZIP/Postal Code
300060
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jilong Yang, M.D., Ph.D.
Phone
+8618622221626
Email
yangjilong@tjmuch.com

12. IPD Sharing Statement

Plan to Share IPD
No

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Mesylate Apatinib for Stage Ⅳ STS After Failure of Chemotherapy

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