OlaReDo - Olaratumab and Rechallenge With Doxorubicin in Soft Tissue Sarcoma Patients
Primary Purpose
Advanced Soft Tissue Sarcoma
Status
Terminated
Phase
Phase 2
Locations
Germany
Study Type
Interventional
Intervention
Olaratumab
Dexrazoxane
Doxorubicin
Sponsored by
About this trial
This is an interventional treatment trial for Advanced Soft Tissue Sarcoma focused on measuring Soft tissue sarcoma
Eligibility Criteria
Inclusion Criteria:
- Patients must have histologically confirmed soft tissue sarcoma (STS) Note: Evidence of disease progression at study entry is required.
- Treated in any order (neoadjuvant, adjuvant or for metastatic disease) with an anthracycline containing chemotherapy (The participant may have had any number of prior systemic cytotoxic therapies for advanced/metastatic disease. All previous anticancer treatments must be completed ≥ 3 weeks (21 days) prior to first dose of study drug.)
- No progression on prior therapy with anthracyclines or within three months after stopping this therapy
- Signed written informed consent
- Men and women aged ≥ 18 years
- Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
- Locally advanced (unresectable) or metastatic disease
- Presence of measurable or non-measurable but evaluable disease as defined by the Response Evaluation Criteria in Solid Tumors (RECIST 1.1, Eisenhauer et al. 2009)
Adequate haematologic, organ, and coagulation function within 2 weeks (14 days) prior to enrollment:
- Absolute neutrophil count (ANC) ≥ 1,500/mm3; G-CSF is not permitted within 2 weeks (14 days) prior to enrollment
- Platelet count ≥ 100,000/mm3
- Creatinine clearance ≥ 45 mL/min (calculated by using the Cockcroft-Gault formula (refer to study protocol Appendix 4)
- Total bilirubin ≤ upper limit of normal (ULN). In patients with Gilbert's Syndrome, total bilirubin should be < 3 mg/dL
- AST/ALT ≤ 3.0 x upper limit of normal (ULN); in case of liver involvement, AST/ALT ≤ 5.0 x are acceptable
- Haemoglobin ≥ 9 g/dl. If haemoglobin <9 g/dl, blood transfusion is permitted. If haemoglobin cannot be enhanced to ≥ 9 g/dl, patient cannot be included into the study
- International Normalized Ration (INR) ≤ 1.5 or prothrombin time (PT) ≤ 1.5 x ULN
- Partial thromboplastin time (PTT or aPTT) ≤ 1.5 x ULN if not on anticoagulant therapy. For patients receiving anticoagulants, coagulation parameters within the intended or expected range for their therapeutic use are allowed. Patients must have no history of active bleeding (defined as within 14 days of first dose of study drug) or pathological condition that carries a high risk of bleeding (for example, tumor involving major vessels or known esophageal varices)
- If routine urinalysis ≥2+ proteinuria, patient must have ≤1000 mg protein on a 24-hour urine, or urine protein/creatinine ratio ≤1 on spot urine
- Left ventricular ejection fraction (LVEF) ≥50% assessed within 28 days prior to enrollment
- Females of child-bearing potential must have a negative serum pregnancy test within 7 days prior to enrollment (refer to study protocol Appendix 3)
- Females of child-bearing potential and males and must agree to use highly effective contraceptive precautions during the trial and up to 6 months following the last dose of study drug (refer to study protocol Appendix 3)
- The participant has, in the opinion of the investigator, a life expectancy of at least 3 months
Exclusion Criteria:
- Diagnosis of GIST or Kaposi sarcoma
- Active central nervous system (CNS) or leptomeningeal metastasis (brain metastasis) at the time of enrollment. Participants with a history of a CNS metastasis previously treated with curative intent (for example, stereotactic radiation or surgery) that have not progressed on follow-up imaging, have been asymptomatic for at least 60 days and are not receiving systemic corticosteroids and/or anticonvulsants, are eligible. Participants with signs or symptoms of neurological compromise should have appropriate radiographic imaging performed before enrollment to rule out brain metastasis
- Prior radiotherapy of the mediastinal/pericardial area or whole pelvis radiation
- The participant has symptomatic congestive heart failure (CHF), or severe cardiac arrhythmia
- The participant has unstable angina pectoris, angioplasty, cardiac stenting, or myocardial infarction within 6 months of enrollment
- The participant has a QTcB interval calculated using Bazett's formula interval of >450 milliseconds (msec) for males and >470 msec for females on screening electrocardiogram (ECG)
- Females who are pregnant or breastfeeding
- Known allergy to any of the treatment components including a history of allergic reactions attributed to compounds of chemical or biological composition similar to olaratumab, dexrazoxane or doxorubicin
- The participant has a known active fungal, bacterial, or viral infection including human immunodeficiency virus (HIV) or viral (A, B, or C) hepatitis (screening is not required)
- Known history of active bleeding (defined as within 14 days of first dose of study drug) or pathological condition that carries a high risk of bleeding (for example, tumor involving major vessels or known esophageal varices)
- History of another primary cancer, with the exception of i) curatively treated non-melanomatous skin cancer or ii) curatively treated cervical carcinoma in situ or iii) other primary non-haematologic malignancies or solid tumor treated with curative intent, no known active disease and no treatment administered during the last 3 years prior to enrollment
- Electively planned or required major surgery during the course of the clinical trial
- Any condition that, in the opinion of the investigator, would compromise the well-being of the participant or the study or prevent the participant from meeting or performing study requirements
- On-treatment participation in another clinical study in the period 30 days prior to start of study treatment and during the study
- Legal incapacity or limited legal capacity
- Any condition that requires concomitant vaccination with yellow fever vaccine
Sites / Locations
- Helios Klinikum Bad Saarow
- Helios Klinikum Berlin-Buch Klinik für Onkologie und Palliativmedizin
- Charité Universitätsmedizin Berlin Medizinische Klinik m. S. Hämatologie, Onkologie und Tumorimmunologie Campus Virchow Kliniken
- Medizinische Fakultät Carl Gustav Carus Medizinische Klinik I Internistische Onkologie
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Study treatment
Arm Description
Olaratumab 20 mg/kg IV on day 1 and day 8 of cycle 1 and 15 mg/kg olaratumab IV on day 1 and day 8 of cycles 2-8. Plus dexrazoxane at a dose equal to 10 times the doxorubicin dose (mg/m2) IV on day 1 of each 21 day cycle for 8 cycles Plus doxorubicin 75 mg/m2 IV on day 1 of each 21 day cycle for 8 cycles Beginning with cycle 9, olaratumab maintenance monotherapy at 15 mg/kg IV on day 1 and day 8 of each subsequent 21 day cycle
Outcomes
Primary Outcome Measures
Progression-free survival rate after 3 months (PFSR3), assessed by applying RECIST 1.1
number of patients proven progression-free and alive after 3 months divided through the total number of patients in the all-treated-subjects population
Secondary Outcome Measures
Progression free survival (PFS)
Time from the first dosing date of any study medication to the date of the first Objectively documented tumor progression, as determined by investigators (per RECIST v1.1), or death due to any cause.
Objective response rate (ORR) (i.e. CR or PR)
Number and percentage of participants with a best overall response (BOR) of complete response (CR) or partial response (PR)
Disease control rate (DCR) (i.e. CR, PR or SD)
Number and percentage of participants with complete response (CR) or partial response (PR) or stable disease (SD)
Overall survival (OS)
Time from date of the first dosing date of any study medication to the date of death (due to any cause)
Assessment of adverse events
Type, incidence and severity of AEs, SAEs
Study therapy discontinuation rate due to cardiac toxicity
Number of patients proven study therapy discontinuation due to cardiac toxicity (i.e. due to LVEF reduction by more than 20% or LVEF <45%) divided through the total number of patients in the all-treated-subjects population
Full Information
NCT ID
NCT03698227
First Posted
October 1, 2018
Last Updated
July 13, 2020
Sponsor
Institut für Klinische Krebsforschung IKF GmbH at Krankenhaus Nordwest
1. Study Identification
Unique Protocol Identification Number
NCT03698227
Brief Title
OlaReDo - Olaratumab and Rechallenge With Doxorubicin in Soft Tissue Sarcoma Patients
Official Title
Efficacy of Olaratumab and Rechallenge With Doxorubicin in Anthracycline Pretreated, Advanced Soft Tissue Sarcoma Patients. An Exploratory Phase-II Study
Study Type
Interventional
2. Study Status
Record Verification Date
July 2020
Overall Recruitment Status
Terminated
Why Stopped
Lack of efficacy on olaratumab
Study Start Date
November 12, 2018 (Actual)
Primary Completion Date
June 25, 2020 (Actual)
Study Completion Date
June 25, 2020 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Institut für Klinische Krebsforschung IKF GmbH at Krankenhaus Nordwest
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 an exploratory, prospective, open label, single arm, phase II-study for the evaluation of efficacy and feasibility (as determined by safety and tolerability) of olaratumab and doxorubicin rechallenge in anthracycline pretreated locally advanced (unresectable) or metastatic soft tissue sarcoma patients.
Detailed Description
Until now, rechallenge with anthracyclines in patients with metastatic STS which had a benefit from prior anthracycline containing therapy was never investigated in a prospective study.
Due to the very promising effect of olaratumab and doxorubicin in anthracycline-naïve patients and further taking into consideration the results of the retrospective anthracycline rechallenge study, there is a clear rationale to evaluate the effects of olaratumab and doxorubicin also in anthracycline pretreated patients by conducting a prospective clinical trial.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Advanced Soft Tissue Sarcoma
Keywords
Soft tissue sarcoma
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Model Description
Olaratumab and doxorubicin rechallenge in anthracycline pretreated, advanced soft tissue sarcoma patients
Masking
None (Open Label)
Allocation
N/A
Enrollment
2 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Study treatment
Arm Type
Experimental
Arm Description
Olaratumab 20 mg/kg IV on day 1 and day 8 of cycle 1 and 15 mg/kg olaratumab IV on day 1 and day 8 of cycles 2-8.
Plus dexrazoxane at a dose equal to 10 times the doxorubicin dose (mg/m2) IV on day 1 of each 21 day cycle for 8 cycles
Plus doxorubicin 75 mg/m2 IV on day 1 of each 21 day cycle for 8 cycles
Beginning with cycle 9, olaratumab maintenance monotherapy at 15 mg/kg IV on day 1 and day 8 of each subsequent 21 day cycle
Intervention Type
Drug
Intervention Name(s)
Olaratumab
Other Intervention Name(s)
Study treatment
Intervention Description
iv infusion
Intervention Type
Drug
Intervention Name(s)
Dexrazoxane
Other Intervention Name(s)
Study treatment
Intervention Description
iv infusion
Intervention Type
Drug
Intervention Name(s)
Doxorubicin
Other Intervention Name(s)
Study treatment
Intervention Description
iv infusion
Primary Outcome Measure Information:
Title
Progression-free survival rate after 3 months (PFSR3), assessed by applying RECIST 1.1
Description
number of patients proven progression-free and alive after 3 months divided through the total number of patients in the all-treated-subjects population
Time Frame
After 3 months treatment
Secondary Outcome Measure Information:
Title
Progression free survival (PFS)
Description
Time from the first dosing date of any study medication to the date of the first Objectively documented tumor progression, as determined by investigators (per RECIST v1.1), or death due to any cause.
Time Frame
6 months of Follow Up
Title
Objective response rate (ORR) (i.e. CR or PR)
Description
Number and percentage of participants with a best overall response (BOR) of complete response (CR) or partial response (PR)
Time Frame
6 months of Follow Up
Title
Disease control rate (DCR) (i.e. CR, PR or SD)
Description
Number and percentage of participants with complete response (CR) or partial response (PR) or stable disease (SD)
Time Frame
6 months of Follow Up
Title
Overall survival (OS)
Description
Time from date of the first dosing date of any study medication to the date of death (due to any cause)
Time Frame
6 months of Follow Up
Title
Assessment of adverse events
Description
Type, incidence and severity of AEs, SAEs
Time Frame
During study conduct up to a maximum of 18 months (EOT)
Title
Study therapy discontinuation rate due to cardiac toxicity
Description
Number of patients proven study therapy discontinuation due to cardiac toxicity (i.e. due to LVEF reduction by more than 20% or LVEF <45%) divided through the total number of patients in the all-treated-subjects population
Time Frame
After treatment discontinuation up to a maximum of 18 months (EOS)
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patients must have histologically confirmed soft tissue sarcoma (STS) Note: Evidence of disease progression at study entry is required.
Treated in any order (neoadjuvant, adjuvant or for metastatic disease) with an anthracycline containing chemotherapy (The participant may have had any number of prior systemic cytotoxic therapies for advanced/metastatic disease. All previous anticancer treatments must be completed ≥ 3 weeks (21 days) prior to first dose of study drug.)
No progression on prior therapy with anthracyclines or within three months after stopping this therapy
Signed written informed consent
Men and women aged ≥ 18 years
Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
Locally advanced (unresectable) or metastatic disease
Presence of measurable or non-measurable but evaluable disease as defined by the Response Evaluation Criteria in Solid Tumors (RECIST 1.1, Eisenhauer et al. 2009)
Adequate haematologic, organ, and coagulation function within 2 weeks (14 days) prior to enrollment:
Absolute neutrophil count (ANC) ≥ 1,500/mm3; G-CSF is not permitted within 2 weeks (14 days) prior to enrollment
Platelet count ≥ 100,000/mm3
Creatinine clearance ≥ 45 mL/min (calculated by using the Cockcroft-Gault formula (refer to study protocol Appendix 4)
Total bilirubin ≤ upper limit of normal (ULN). In patients with Gilbert's Syndrome, total bilirubin should be < 3 mg/dL
AST/ALT ≤ 3.0 x upper limit of normal (ULN); in case of liver involvement, AST/ALT ≤ 5.0 x are acceptable
Haemoglobin ≥ 9 g/dl. If haemoglobin <9 g/dl, blood transfusion is permitted. If haemoglobin cannot be enhanced to ≥ 9 g/dl, patient cannot be included into the study
International Normalized Ration (INR) ≤ 1.5 or prothrombin time (PT) ≤ 1.5 x ULN
Partial thromboplastin time (PTT or aPTT) ≤ 1.5 x ULN if not on anticoagulant therapy. For patients receiving anticoagulants, coagulation parameters within the intended or expected range for their therapeutic use are allowed. Patients must have no history of active bleeding (defined as within 14 days of first dose of study drug) or pathological condition that carries a high risk of bleeding (for example, tumor involving major vessels or known esophageal varices)
If routine urinalysis ≥2+ proteinuria, patient must have ≤1000 mg protein on a 24-hour urine, or urine protein/creatinine ratio ≤1 on spot urine
Left ventricular ejection fraction (LVEF) ≥50% assessed within 28 days prior to enrollment
Females of child-bearing potential must have a negative serum pregnancy test within 7 days prior to enrollment (refer to study protocol Appendix 3)
Females of child-bearing potential and males and must agree to use highly effective contraceptive precautions during the trial and up to 6 months following the last dose of study drug (refer to study protocol Appendix 3)
The participant has, in the opinion of the investigator, a life expectancy of at least 3 months
Exclusion Criteria:
Diagnosis of GIST or Kaposi sarcoma
Active central nervous system (CNS) or leptomeningeal metastasis (brain metastasis) at the time of enrollment. Participants with a history of a CNS metastasis previously treated with curative intent (for example, stereotactic radiation or surgery) that have not progressed on follow-up imaging, have been asymptomatic for at least 60 days and are not receiving systemic corticosteroids and/or anticonvulsants, are eligible. Participants with signs or symptoms of neurological compromise should have appropriate radiographic imaging performed before enrollment to rule out brain metastasis
Prior radiotherapy of the mediastinal/pericardial area or whole pelvis radiation
The participant has symptomatic congestive heart failure (CHF), or severe cardiac arrhythmia
The participant has unstable angina pectoris, angioplasty, cardiac stenting, or myocardial infarction within 6 months of enrollment
The participant has a QTcB interval calculated using Bazett's formula interval of >450 milliseconds (msec) for males and >470 msec for females on screening electrocardiogram (ECG)
Females who are pregnant or breastfeeding
Known allergy to any of the treatment components including a history of allergic reactions attributed to compounds of chemical or biological composition similar to olaratumab, dexrazoxane or doxorubicin
The participant has a known active fungal, bacterial, or viral infection including human immunodeficiency virus (HIV) or viral (A, B, or C) hepatitis (screening is not required)
Known history of active bleeding (defined as within 14 days of first dose of study drug) or pathological condition that carries a high risk of bleeding (for example, tumor involving major vessels or known esophageal varices)
History of another primary cancer, with the exception of i) curatively treated non-melanomatous skin cancer or ii) curatively treated cervical carcinoma in situ or iii) other primary non-haematologic malignancies or solid tumor treated with curative intent, no known active disease and no treatment administered during the last 3 years prior to enrollment
Electively planned or required major surgery during the course of the clinical trial
Any condition that, in the opinion of the investigator, would compromise the well-being of the participant or the study or prevent the participant from meeting or performing study requirements
On-treatment participation in another clinical study in the period 30 days prior to start of study treatment and during the study
Legal incapacity or limited legal capacity
Any condition that requires concomitant vaccination with yellow fever vaccine
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Salah-Eddin Al-Batran, Prof. Dr.
Organizational Affiliation
Institut für Klinische Krebsforschung IKF GmbH at Krankenhaus Nordwest
Official's Role
Study Director
Facility Information:
Facility Name
Helios Klinikum Bad Saarow
City
Bad Saarow
ZIP/Postal Code
15526
Country
Germany
Facility Name
Helios Klinikum Berlin-Buch Klinik für Onkologie und Palliativmedizin
City
Berlin
ZIP/Postal Code
13125
Country
Germany
Facility Name
Charité Universitätsmedizin Berlin Medizinische Klinik m. S. Hämatologie, Onkologie und Tumorimmunologie Campus Virchow Kliniken
City
Berlin
ZIP/Postal Code
13353
Country
Germany
Facility Name
Medizinische Fakultät Carl Gustav Carus Medizinische Klinik I Internistische Onkologie
City
Dresden
ZIP/Postal Code
01307
Country
Germany
12. IPD Sharing Statement
Plan to Share IPD
No
IPD Sharing Plan Description
No IPD will be shared
Learn more about this trial
OlaReDo - Olaratumab and Rechallenge With Doxorubicin in Soft Tissue Sarcoma Patients
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