Targeting ATR in Soft-tissue Sarcomas (TARSARC)
Primary Purpose
Leiomyosarcoma, Adult
Status
Recruiting
Phase
Phase 2
Locations
France
Study Type
Interventional
Intervention
Association of berzosertib with gemcitabine
Gemcitabine
Sponsored by
About this trial
This is an interventional treatment trial for Leiomyosarcoma, Adult focused on measuring ATR inhibition, soft-tissue sarcoma, advanced/metastatic
Eligibility Criteria
Inclusion Criteria:
- Histologically confirmed leiomyosarcomas.
- Metastatic or unresectable locally advanced disease,
- Documented progression according to RECIST v1.1 confirmed by central review,
- Age ≥ 18 years,
- ECOG ≤ 1,
- Life expectancy > 3 months,
- No more than 3 previous line of systemic therapy for advanced disease,
- Patients must have advanced disease and must not be a candidate for other approved therapeutic regimen known to provide significant clinical benefit based on investigator judgement,
- Patients must have measurable disease defined as per RECIST v1.1
- Patient must comply with the collection of tumor biopsies, and tumors must be accessible for biopsy,
- At least three weeks since last chemotherapy, immunotherapy or any other pharmacological treatment and/or radiotherapy,
- Adequate hematological, renal, metabolic and hepatic function
- Women of childbearing potential must have a negative serum pregnancy test within 7 days prior to randomization.
- Both women of childbearing potential and men must agree to use a highly effective method of contraception 28 days before start of first dose of study drug
- No prior or concurrent malignant disease diagnosed or treated in the last 2 years except for adequately treated in situ carcinoma of the cervix, basal or squamous skin cell carcinoma, or in situ transitional bladder cell carcinoma,
- Recovery to grade ≤ 1 from any adverse event (AE) derived from previous treatment
- Voluntarily signed and dated written informed consent prior to any study specific procedure,
- Patients with a social security in compliance with the French law.
Exclusion Criteria:
- Previous treatment with Gemcitabine, or berzosertib or other ATR inhibitor,
- Evidence of progressive or symptomatic central nervous system or leptomeningeal metastases,
- Women who are pregnant or breast feeding,
- Participation to a study involving a medical or therapeutic intervention in the last 30 days,
- Previous enrolment in the present study,
- Patient unable to follow and comply with the study procedures because of any geographical, social or psychological reasons,
- Known hypersensitivity to any involved study drug or any of its formulation components,
- Has known active hepatitis B or hepatitis C,
- Has a known history of Human Immunodeficiency Virus or known acquired immunodeficiency syndrome
Any of the following cardiac or cardiovascular criteria :
- Congestive heart failure ≥ New York Heart Association (NHYA) class 1,
- Unstable angina , new-onset angina
- Myocardial infarction less than 6 months before start of study drug
- Uncontrolled cardiac arrhythmias,
- Participants with Li Fraumeni syndrome and/or ataxia telangiectasia,
Active autoimmune disease:
- Patients with diabetes type I, vitiligo, psoriasis, hypo- or hyperthyroid disease not requiring immunosuppressive treatment are eligible,
- Patients requiring hormone replacement with corticosteroids are eligible if the steroids are administered only for the purpose of hormonal replacement and at dose ≤ 10 mg or 10 mg equivalent prednisone day,
- Administration of steroids through a route known to result in a minimal systemic exposure (topical, intranasal, intra-ocular or inhalation) are acceptable.
- Arterial or venous thrombotic or embolic events such as cerebrovascular accident , deep vein thrombosis or pulmonary embolism within 6 months before the start of study medication,
- Patients with oral anticoagulation based on Vitamine K antagonist,
- Treatment by potent inhibitors or inducers of CYP3A4
- Vaccination with yellow fever or by any other live attenuated vaccine in the last 30 days,
- Individuals deprived of liberty or placed under legual guardianship.
Sites / Locations
- Institut BergoniéRecruiting
- Centre Leon BerardRecruiting
- CHU PoitiersRecruiting
- Institut de Cancérologie de l'Ouest
- IUCT OncopôleRecruiting
- Institut Gustave RoussyRecruiting
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Other
Arm Label
Experimental Arm A: treatment by berzosertib combined with gemcitabine
Standard Arm B: treatment by gemcitabine alone
Arm Description
Patients with advanced leiomyosarcomas will be treated with berzosertib combined with gemcitabine
Patients with advanced leiomyosarcomas will be treated with with gemcitabine alone (control arm)
Outcomes
Primary Outcome Measures
Assessment of the antitumor activity of berzosertib combined with gemcitabine
Antitumor activity will be assessed in terms of 6-month progression-free rate and is defined as the rate of complete or partial response (CR, PR) or stable disease (SD), as per RECIST v1.1.
Assessment of the antitumor activity of gemcitabine
Antitumor activity will be assessed in terms of 6-month progression-free rate and is defined as the rate of complete or partial response (CR, PR) or stable disease (SD), as per RECIST v1.1.
Secondary Outcome Measures
6-month objective response rate (ORR) for patients treated by berzosertib in association with gemcitabine
Objective response is defined as complete response (CR) or partial response (PR) as per adapted RECIST v1.1.
6-month objective response rate (ORR) for patients treated by gemcitabine alone
Objective response is defined as complete response (CR) or partial response (PR) as per adapted RECIST v1.1.
Best overall response for patients treated by berzosertib in association with gemcitabine
Best overall response is defined as the best reponse across all time points (RECIST v1.1). The best overall response rate is determined once all the data for the patient is known
Best overall response for patients treated by gemcitabine alone
Best overall response is defined as the best reponse across all time points (RECIST v1.1). The best overall response rate is determined once all the data for the patient is known
1-year progression-free survival for patients treated by berzosertib in association with gemcitabine
Progression-free survival is defined as the delay between the start date of treatment and the date of progression (as per RECIST v1.1) or death (from any cause), whichever occurs first
1-year progression-free survival for patients treated by gemcitabine alone
Progression-free survival is defined as the delay between the start date of treatment and the date of progression (as per RECIST v1.1) or death (from any cause), whichever occurs first
2-year progression-free survival for patients treated by berzosertib in association with gemcitabine
Progression-free survival is defined as the delay between the start date of treatment and the date of progression (as per RECIST v1.1) or death (from any cause), whichever occurs first
2-year progression-free survival for patients treated by gemcitabine alone
Progression-free survival is defined as the delay between the start date of treatment and the date of progression (as per RECIST v1.1) or death (from any cause), whichever occurs first
1-year overall survival for patients treated by berzosertib in association with gemcitabine
Overall survival is defined as the delay between the start date of treatment and the date of death (from any cause)
1-year overall survival for patients treated by gemcitabine alone
Overall survival is defined as the delay between the start date of treatment and the date of death (from any cause)
2-year overall survival for patients treated by berzosertib in association with gemcitabine
Overall survival is defined as the delay between the start date of treatment and the date of death (from any cause)
2-year overall survival for patients treated by gemcitabine alone
Overall survival is defined as the delay between the start date of treatment and the date of death (from any cause)
6-month objective response according to CHOI criteria, independently for each arm
Objective response is defined as complete response (CR) or partial response (PR) as per CHOI criteria.
Best overall response according to CHOI criteria, independently for each arm
Best overall response is defined as the best reponse across all time points (CHOI criteria). The best overall response rate is determined once all the data for the patient is known
Safety profile independently for each arm: Common Terminology Criteria for Adverse Event version 5
Toxicity graded using the Common Terminology Criteria for Adverse Events version 5
Tumor immune cells levels
Levels of immune cells (CD4, CD8, PDL1)in tumor will be measured by immunohistochemistry
Blood cytokines levels
Levels of cytokines (tryptophane, interleukine) in blood will be measured by ELISA
Blood lymphocytes levels
Levels of fixed PBMC (peripheral blood mononucear cells) in blood will be measured by flow cytometry
Blood kynurenine levels
Levels of kynurenine in blood will be measured by ELISA
Full Information
NCT ID
NCT04807816
First Posted
March 15, 2021
Last Updated
September 27, 2023
Sponsor
Institut Bergonié
Collaborators
Merck Healthcare KGaA, Darmstadt, Germany, an affiliate of Merck KGaA, Darmstadt, Germany
1. Study Identification
Unique Protocol Identification Number
NCT04807816
Brief Title
Targeting ATR in Soft-tissue Sarcomas
Acronym
TARSARC
Official Title
Targeting ATR in Soft-tissue Sarcomas: a Randomized Phase II Study. TARSARC Study
Study Type
Interventional
2. Study Status
Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
February 9, 2022 (Actual)
Primary Completion Date
October 2024 (Anticipated)
Study Completion Date
April 2026 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Institut Bergonié
Collaborators
Merck Healthcare KGaA, Darmstadt, Germany, an affiliate of Merck KGaA, Darmstadt, Germany
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
Multicenter, prospective, open-labeled, 2-arm, non-comparative randomized phase II trial to assess the antitumor activity of berzosertib in association with gemcitabine
Detailed Description
This is a multicenter, prospective, open-labeled, 2-arm, non-comparative randomized (2:1) phase II trial. Patients will be randomized between arm A (gemcitabine + berzosertib) and arm B (gemcitabine) with two patients randomized in arm A for one patient randomized in arm B.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Leiomyosarcoma, Adult
Keywords
ATR inhibition, soft-tissue sarcoma, advanced/metastatic
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
This is a multicenter, prospective, open-labeled, 2-arm, non-comparative randomized (2:1) phase II trial. Patients will be randomized between arm A (gemcitabine + berzosertib) and arm B (gemcitabine) with two patients randomized in arm A for one patient randomized in arm B.
Masking
None (Open Label)
Allocation
Randomized
Enrollment
72 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Experimental Arm A: treatment by berzosertib combined with gemcitabine
Arm Type
Experimental
Arm Description
Patients with advanced leiomyosarcomas will be treated with berzosertib combined with gemcitabine
Arm Title
Standard Arm B: treatment by gemcitabine alone
Arm Type
Other
Arm Description
Patients with advanced leiomyosarcomas will be treated with with gemcitabine alone (control arm)
Intervention Type
Drug
Intervention Name(s)
Association of berzosertib with gemcitabine
Other Intervention Name(s)
Experimental
Intervention Description
Gemcitabine will be administered by intravenous 30-minutes infusion on days 1 and 8 every 3 weeks, at a fixed dose of 1000 mg/m².
Berzosertib will be administered intravenously on days 2 and 9 every 3 weeks (210 mg/m²).
A treatment cycle consists of 3 weeks (i.e., 21 days) and will be administered during hospitalization.
Intervention Type
Drug
Intervention Name(s)
Gemcitabine
Other Intervention Name(s)
Control
Intervention Description
Gemcitabine will be administered by intravenous 30-minutes infusion on days 1 and 8 every 3 weeks, at a fixed dose of 1000 mg/m².
A treatment cycle consists of 3 weeks (i.e., 21 days) and will be administered during hospitalization.
Primary Outcome Measure Information:
Title
Assessment of the antitumor activity of berzosertib combined with gemcitabine
Description
Antitumor activity will be assessed in terms of 6-month progression-free rate and is defined as the rate of complete or partial response (CR, PR) or stable disease (SD), as per RECIST v1.1.
Time Frame
6 months
Title
Assessment of the antitumor activity of gemcitabine
Description
Antitumor activity will be assessed in terms of 6-month progression-free rate and is defined as the rate of complete or partial response (CR, PR) or stable disease (SD), as per RECIST v1.1.
Time Frame
6 months
Secondary Outcome Measure Information:
Title
6-month objective response rate (ORR) for patients treated by berzosertib in association with gemcitabine
Description
Objective response is defined as complete response (CR) or partial response (PR) as per adapted RECIST v1.1.
Time Frame
6 months
Title
6-month objective response rate (ORR) for patients treated by gemcitabine alone
Description
Objective response is defined as complete response (CR) or partial response (PR) as per adapted RECIST v1.1.
Time Frame
6 months
Title
Best overall response for patients treated by berzosertib in association with gemcitabine
Description
Best overall response is defined as the best reponse across all time points (RECIST v1.1). The best overall response rate is determined once all the data for the patient is known
Time Frame
throughout the treatment period, an expected average of 6 months
Title
Best overall response for patients treated by gemcitabine alone
Description
Best overall response is defined as the best reponse across all time points (RECIST v1.1). The best overall response rate is determined once all the data for the patient is known
Time Frame
throughout the treatment period, an expected average of 6 months
Title
1-year progression-free survival for patients treated by berzosertib in association with gemcitabine
Description
Progression-free survival is defined as the delay between the start date of treatment and the date of progression (as per RECIST v1.1) or death (from any cause), whichever occurs first
Time Frame
1 year
Title
1-year progression-free survival for patients treated by gemcitabine alone
Description
Progression-free survival is defined as the delay between the start date of treatment and the date of progression (as per RECIST v1.1) or death (from any cause), whichever occurs first
Time Frame
1 year
Title
2-year progression-free survival for patients treated by berzosertib in association with gemcitabine
Description
Progression-free survival is defined as the delay between the start date of treatment and the date of progression (as per RECIST v1.1) or death (from any cause), whichever occurs first
Time Frame
2 years
Title
2-year progression-free survival for patients treated by gemcitabine alone
Description
Progression-free survival is defined as the delay between the start date of treatment and the date of progression (as per RECIST v1.1) or death (from any cause), whichever occurs first
Time Frame
2 years
Title
1-year overall survival for patients treated by berzosertib in association with gemcitabine
Description
Overall survival is defined as the delay between the start date of treatment and the date of death (from any cause)
Time Frame
1 year
Title
1-year overall survival for patients treated by gemcitabine alone
Description
Overall survival is defined as the delay between the start date of treatment and the date of death (from any cause)
Time Frame
1 year
Title
2-year overall survival for patients treated by berzosertib in association with gemcitabine
Description
Overall survival is defined as the delay between the start date of treatment and the date of death (from any cause)
Time Frame
2 years
Title
2-year overall survival for patients treated by gemcitabine alone
Description
Overall survival is defined as the delay between the start date of treatment and the date of death (from any cause)
Time Frame
2 years
Title
6-month objective response according to CHOI criteria, independently for each arm
Description
Objective response is defined as complete response (CR) or partial response (PR) as per CHOI criteria.
Time Frame
6 months
Title
Best overall response according to CHOI criteria, independently for each arm
Description
Best overall response is defined as the best reponse across all time points (CHOI criteria). The best overall response rate is determined once all the data for the patient is known
Time Frame
throughout the treatment period, an expected average of 6 months
Title
Safety profile independently for each arm: Common Terminology Criteria for Adverse Event version 5
Description
Toxicity graded using the Common Terminology Criteria for Adverse Events version 5
Time Frame
throughout the treatment period, an expected average of 6 months
Title
Tumor immune cells levels
Description
Levels of immune cells (CD4, CD8, PDL1)in tumor will be measured by immunohistochemistry
Time Frame
before treatment onset and cycle 2 day 1 (each cycle is 21 days)
Title
Blood cytokines levels
Description
Levels of cytokines (tryptophane, interleukine) in blood will be measured by ELISA
Time Frame
baseline, cycle 2 day 1, cycle 6 day 1 and progression (each cycle is 21 days)
Title
Blood lymphocytes levels
Description
Levels of fixed PBMC (peripheral blood mononucear cells) in blood will be measured by flow cytometry
Time Frame
baseline, cycle 2 day 1, cycle 6 day 1 and progression (each cycle is 21 days)
Title
Blood kynurenine levels
Description
Levels of kynurenine in blood will be measured by ELISA
Time Frame
baseline, cycle 2 day 1, cycle 6 day 1 and progression (each cycle is 21 days)
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Histologically confirmed leiomyosarcomas.
Metastatic or unresectable locally advanced disease,
Documented progression according to RECIST v1.1 confirmed by central review,
Age ≥ 18 years,
ECOG ≤ 1,
Life expectancy > 3 months,
No more than 3 previous line of systemic therapy for advanced disease,
Patients must have advanced disease and must not be a candidate for other approved therapeutic regimen known to provide significant clinical benefit based on investigator judgement,
Patients must have measurable disease defined as per RECIST v1.1
Patient must comply with the collection of tumor biopsies, and tumors must be accessible for biopsy,
At least three weeks since last chemotherapy, immunotherapy or any other pharmacological treatment and/or radiotherapy,
Adequate hematological, renal, metabolic and hepatic function
Women of childbearing potential must have a negative serum pregnancy test within 7 days prior to randomization.
Both women of childbearing potential and men must agree to use a highly effective method of contraception 28 days before start of first dose of study drug
No prior or concurrent malignant disease diagnosed or treated in the last 2 years except for adequately treated in situ carcinoma of the cervix, basal or squamous skin cell carcinoma, or in situ transitional bladder cell carcinoma,
Recovery to grade ≤ 1 from any adverse event (AE) derived from previous treatment
Voluntarily signed and dated written informed consent prior to any study specific procedure,
Patients with a social security in compliance with the French law.
Exclusion Criteria:
Previous treatment with Gemcitabine, or berzosertib or other ATR inhibitor,
Evidence of progressive or symptomatic central nervous system or leptomeningeal metastases,
Women who are pregnant or breast feeding,
Participation to a study involving a medical or therapeutic intervention in the last 30 days,
Previous enrolment in the present study,
Patient unable to follow and comply with the study procedures because of any geographical, social or psychological reasons,
Known hypersensitivity to any involved study drug or any of its formulation components,
Has known active hepatitis B or hepatitis C,
Has a known history of Human Immunodeficiency Virus or known acquired immunodeficiency syndrome
Any of the following cardiac or cardiovascular criteria :
Congestive heart failure ≥ New York Heart Association (NHYA) class 1,
Unstable angina , new-onset angina
Myocardial infarction less than 6 months before start of study drug
Uncontrolled cardiac arrhythmias,
Participants with Li Fraumeni syndrome and/or ataxia telangiectasia,
Active autoimmune disease:
Patients with diabetes type I, vitiligo, psoriasis, hypo- or hyperthyroid disease not requiring immunosuppressive treatment are eligible,
Patients requiring hormone replacement with corticosteroids are eligible if the steroids are administered only for the purpose of hormonal replacement and at dose ≤ 10 mg or 10 mg equivalent prednisone day,
Administration of steroids through a route known to result in a minimal systemic exposure (topical, intranasal, intra-ocular or inhalation) are acceptable.
Arterial or venous thrombotic or embolic events such as cerebrovascular accident , deep vein thrombosis or pulmonary embolism within 6 months before the start of study medication,
Patients with oral anticoagulation based on Vitamine K antagonist,
Treatment by potent inhibitors or inducers of CYP3A4
Vaccination with yellow fever or by any other live attenuated vaccine in the last 30 days,
Individuals deprived of liberty or placed under legual guardianship.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Antoine ITALIANO, MD, PhD
Phone
(0)5.56.33.33.33
Ext
+33
Email
a.italiano@bordeaux.unicancer.fr
First Name & Middle Initial & Last Name or Official Title & Degree
Simone MATHOULIN-PELISSIER, MD, PhD
Email
s.mathoulin@bordeaux.unicancer.fr
Facility Information:
Facility Name
Institut Bergonié
City
Bordeaux
ZIP/Postal Code
33076
Country
France
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Antoine ITALIANO, MD, PhD
Email
a.italiano@bordeaux.unicancer.fr
Facility Name
Centre Leon Berard
City
Lyon
ZIP/Postal Code
69008
Country
France
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Armelle DUFRESNE, MD
Email
armelle.dufresne@lyon.unicancer.fr
Facility Name
CHU Poitiers
City
Poitiers
ZIP/Postal Code
86000
Country
France
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Nicolas ISAMBERT, MD, PhD
Email
nicolas.isambert@chu-poitiers.fr
Facility Name
Institut de Cancérologie de l'Ouest
City
Saint-Herblain
ZIP/Postal Code
44805
Country
France
Individual Site Status
Withdrawn
Facility Name
IUCT Oncopôle
City
Toulouse
ZIP/Postal Code
31059
Country
France
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Thibaud VALENTIN, MD
Email
valentin.thibaud@iuct-oncopole.fr
Facility Name
Institut Gustave Roussy
City
Villejuif
ZIP/Postal Code
94805
Country
France
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Benjamin VERRET, MD
Email
benjamin.verret@gustaveroussy.fr
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Targeting ATR in Soft-tissue Sarcomas
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