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TARGETed Therapy Drug MONITOring in DIGestive Oncology (TARGETMONITO)

Primary Purpose

Digestive Cancer, Metastatic Colorectal Cancer, Hepatocellular Carcinoma

Status
Recruiting
Phase
Not Applicable
Locations
France
Study Type
Interventional
Intervention
Blood sampling to build population pharmacokinetics model
Sponsored by
UNICANCER
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Digestive Cancer focused on measuring multi kinases inhibitors, therapeutic drug monitoring, pharmacokinetics, pharmacodynamics, advanced digestive cancers

Eligibility Criteria

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

Inclusion Criteria:

  1. Patient aged 18 years or over
  2. Advanced digestive cancer (histologically confirmed or confirmed by imaging for HCC) for which a standard treatment (according to each drug SmPC and as per standard of care) planned with:

    • Regorafenib for GIST, mCRC, and HCC,
    • Everolimus for gepNET,
    • Sunitinib for pNET or GIST,
    • Cabozantinib for HCC,
    • Encorafenib - cetuximab for mCRC
  3. Life expectancy of greater than 3 months - at the discretion of the investigator
  4. Measurable disease according to tumor evaluation criteria as per local practice (Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1, etc.)
  5. Patients must be affiliated to a Social Security System (or equivalent)
  6. Patient must have signed a written informed consent form prior to any trial specific procedures. When the patient is physically unable to give their written consent, a trusted person of their choice, independent from the investigator or the sponsor, can confirm in writing the patient's consent.

Exclusion Criteria:

  1. Other concomitant anticancer systemic treatment (chronic chemotherapy, antitumor hormone therapy or immunotherapy) than the one studied
  2. Unresolved toxicity higher than NCI-CTCAE v5.0 Grade 1 attributed to any prior therapy/procedure excluding alopecia and peripheral neuropathy
  3. Prior treatment with the same MKI molecule(s) planned to be given in the cohort. If different MKI molecules (from the one(s) planned in the study) have been previously taken, a wash out period of 2 weeks before treatment should be observed.
  4. Other invasive malignancies either currently active or active in the last 3 years, except adequately treated in situ carcinoma of the cervix and basal or squamous cell carcinoma of the skin
  5. Any condition that may jeopardize patient participation in the study as well as non contraception for male and female with child-bearing potential, pregnancy or breast feeding.
  6. Patient unwilling or unable to comply with the medical follow-up required by the standard treatment taken (including PK sampling during treatment phase and vital status collection during follow-up phase) because of psychosocial, familial, social or geographical reasons
  7. Participation in another clinical study with an investigational medicinal product during the last 30 days prior to inclusion and during the present study (except if patient is included in the control arm, with placebo or with a product which have a marketed authorisation, used as per the SmPC for the given indication)
  8. Patient deprived of their liberty or under protective custody or guardianship

Sites / Locations

  • CH d'Auxerre
  • Institut du Cancer Avignon - Institut Sainte Catherine
  • CH de Bayeux - Onconormandie
  • Centre Jean Perrin
  • Hôpital Beaujon APHP
  • Centre Georges Francois Leclerc
  • Centre Oscar Lambret
  • Groupement des hôpitaux de l'Institut Catholique de Lille - Hôpital Saint Vincent de Paul
  • Centre Léon Bérard
  • Hôpital Européen Marseille
  • CHRU de Nancy - Hôpital de Brabois Adulte
  • CHU de Nantes - Hôtel Dieu
  • Centre Antoine Lacassagne
  • APHP Pitié Salpétrière
  • Hôpital Saint Joseph
  • Hôpital Privé des Côtes d'Armor - SAS
  • CHU de Poitiers
  • CHU de Reims - Hôpital Robert Debré
  • Institut Jean GodinotRecruiting
  • Centre Eugène Marquis
  • CHU Rouen - Hôpital Charles Nicolle
  • CH Saint Malo - Hôpital Broussais
  • ICANS
  • Gustave Roussy

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Arm Label

Regorafenib - mCRC, GIST, HCC

Everolimus - gepNET

Sunitinib - pNET, GIST

Cabozantinib - HCC

Encorafenib - Cetuximab - mCRC

Arm Description

3 x 30 = 90 patients Patients with mCRC, GIST or HCC treated with Regorafenib

60 patients Patients with gepNET treated with Everolimus

2 x 30 = 60 patients Patients with pNET and GIST, treated with Sunitinib

60 patients Patients with HCC treated with Cabozantinib

60 patients Patients with mCRC treated with the association Encorafenib - Cetuximab

Outcomes

Primary Outcome Measures

Trough concentration (Ctrough)
Trough concentration (Ctrough) shows the blood concentration reached by a drug immediately before the next dose is administered, once steady state has been attained. It can also be defined as the minimal drug concentration in the patient's body. Plasmatic measures will be performed by liquid chromatography with tandem mass spectrometry after protein precipitation by acetonitrile.

Secondary Outcome Measures

Progression-free survival
Progression-free survival (PFS) is the lenght of the time between inclusion and the first event of disease progression or death whatever the cause.
Overall survival
Overall survival (OS) is the lenght of time between inclusion and death whatever the cause.
Objective response rate
Objective response rate (ORR) is the percentage of patients with a best response during treatment being either complete response (CR) or partial response (PR).
Disease control rate
Disease control rate (DCR) is defined as the percentage of patients with a best response during treatment being either CR, PR, or Stable Disease (SD).
Safety: drug toxicity
Drug toxicity occurrence related to standard treatment will be graded according to the National Cancer Institute-Common Terminology Criteria for Adverse Events version 5.0. NCI-CTCAE is widely accepted in the community of oncology research as the leading rating scale for adverse events. This scale, divided into 5 grades (1 = "mild", 2 = "moderate", 3 = "severe", 4 = "life-threatening", and 5 = "death") determined by the investigator, will make it possible to assess the severity of the disorders. Only AE of Specific Interest (AESI) will be collected. An AESI is an AE related to treatment that is: G3 or G4 according to NCI-CTCAE version 5.0, or Leading to treatment modification (dose reduction or treatment interruption), or Categorized as serious adverse event (SAE) by the investigator, or Considered as clinically significant by the investigator.

Full Information

First Posted
June 23, 2022
Last Updated
August 30, 2022
Sponsor
UNICANCER
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1. Study Identification

Unique Protocol Identification Number
NCT05443087
Brief Title
TARGETed Therapy Drug MONITOring in DIGestive Oncology
Acronym
TARGETMONITO
Official Title
Dosing of Various Multi Kinases Inhibitors Plasma Concentrations for Patients Treated for Their Advanced Digestive Cancer, With the Aim to Determine the Best Optimal Dose for Each Treatment, in the Future
Study Type
Interventional

2. Study Status

Record Verification Date
August 2022
Overall Recruitment Status
Recruiting
Study Start Date
August 29, 2022 (Actual)
Primary Completion Date
August 2026 (Anticipated)
Study Completion Date
June 2027 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
UNICANCER

4. Oversight

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

5. Study Description

Brief Summary
Targeted therapy drug monitoring in digestive oncology: Dosage of plasma levels of various multikinase inhibitors (MKI) in patients treated for advanced digestive cancer (gastrointestinal stromal tumor (GIST), metastatic colorectal cancer (mCRC), hepatocellular carcinoma (HCC), gastroenteropancreatic neuroendocrine tumor (gepNET), or pancreatic neuroendocrine tumor (pNET)), with the aim of determine the optimal dose adapted for each patient, in the future.
Detailed Description
Phase IV, national, multicenter, open, multi-cohort interventional study: Regorafenib - mCRC, GIST, and HCC = 3x30 = 90 patients Everolimus - gepNET = 60 patients Sunitinib - pNET and GIST = 60 patients Cabozantinib - HCC = 60 patients Encorafenib-cetuximab - mCRC = 60 patients The patients included will be treated and followed according to standard practice (national recommendations and according to the summary of product characteristics (SmPC) of each molecule). According to the cohort, a maximum of 1 to 2 blood tubes will be taken at different times during the study: at baseline, then 1 month after the start of treatment, then 2 months after the start of treatment, if an adverse event of specific interest (AESI) occurs, and in case of progressive disease.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Digestive Cancer, Metastatic Colorectal Cancer, Hepatocellular Carcinoma, GIST, Neuroendocrine Tumors
Keywords
multi kinases inhibitors, therapeutic drug monitoring, pharmacokinetics, pharmacodynamics, advanced digestive cancers

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
330 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Regorafenib - mCRC, GIST, HCC
Arm Type
Experimental
Arm Description
3 x 30 = 90 patients Patients with mCRC, GIST or HCC treated with Regorafenib
Arm Title
Everolimus - gepNET
Arm Type
Experimental
Arm Description
60 patients Patients with gepNET treated with Everolimus
Arm Title
Sunitinib - pNET, GIST
Arm Type
Experimental
Arm Description
2 x 30 = 60 patients Patients with pNET and GIST, treated with Sunitinib
Arm Title
Cabozantinib - HCC
Arm Type
Experimental
Arm Description
60 patients Patients with HCC treated with Cabozantinib
Arm Title
Encorafenib - Cetuximab - mCRC
Arm Type
Experimental
Arm Description
60 patients Patients with mCRC treated with the association Encorafenib - Cetuximab
Intervention Type
Other
Intervention Name(s)
Blood sampling to build population pharmacokinetics model
Intervention Description
Determine for each drug plasmatic exposure (Css, trough) through the PopPK model. Concentrations measured at the following time points: 1 month after the first treatment administration 2 months after the first treatment administration In case of progression In case of severe toxicities (AESI) related to the drug received
Primary Outcome Measure Information:
Title
Trough concentration (Ctrough)
Description
Trough concentration (Ctrough) shows the blood concentration reached by a drug immediately before the next dose is administered, once steady state has been attained. It can also be defined as the minimal drug concentration in the patient's body. Plasmatic measures will be performed by liquid chromatography with tandem mass spectrometry after protein precipitation by acetonitrile.
Time Frame
From inclusion untill the end of treatment up to 4 years
Secondary Outcome Measure Information:
Title
Progression-free survival
Description
Progression-free survival (PFS) is the lenght of the time between inclusion and the first event of disease progression or death whatever the cause.
Time Frame
4 years
Title
Overall survival
Description
Overall survival (OS) is the lenght of time between inclusion and death whatever the cause.
Time Frame
4 years
Title
Objective response rate
Description
Objective response rate (ORR) is the percentage of patients with a best response during treatment being either complete response (CR) or partial response (PR).
Time Frame
4 years
Title
Disease control rate
Description
Disease control rate (DCR) is defined as the percentage of patients with a best response during treatment being either CR, PR, or Stable Disease (SD).
Time Frame
4 years
Title
Safety: drug toxicity
Description
Drug toxicity occurrence related to standard treatment will be graded according to the National Cancer Institute-Common Terminology Criteria for Adverse Events version 5.0. NCI-CTCAE is widely accepted in the community of oncology research as the leading rating scale for adverse events. This scale, divided into 5 grades (1 = "mild", 2 = "moderate", 3 = "severe", 4 = "life-threatening", and 5 = "death") determined by the investigator, will make it possible to assess the severity of the disorders. Only AE of Specific Interest (AESI) will be collected. An AESI is an AE related to treatment that is: G3 or G4 according to NCI-CTCAE version 5.0, or Leading to treatment modification (dose reduction or treatment interruption), or Categorized as serious adverse event (SAE) by the investigator, or Considered as clinically significant by the investigator.
Time Frame
Throughout study completion, up to 4 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient aged 18 years or over Advanced digestive cancer (histologically confirmed or confirmed by imaging for HCC) for which a standard treatment (according to each drug SmPC and as per standard of care) planned with: Regorafenib for GIST, mCRC, and HCC, Everolimus for gepNET, Sunitinib for pNET or GIST, Cabozantinib for HCC, Encorafenib - cetuximab for mCRC Life expectancy of greater than 3 months - at the discretion of the investigator Measurable disease according to tumor evaluation criteria as per local practice (Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1, etc.) Patients must be affiliated to a Social Security System (or equivalent) Patient must have signed a written informed consent form prior to any trial specific procedures. When the patient is physically unable to give their written consent, a trusted person of their choice, independent from the investigator or the sponsor, can confirm in writing the patient's consent. Exclusion Criteria: Other concomitant anticancer systemic treatment (chronic chemotherapy, antitumor hormone therapy or immunotherapy) than the one studied Unresolved toxicity higher than NCI-CTCAE v5.0 Grade 1 attributed to any prior therapy/procedure excluding alopecia and peripheral neuropathy Prior treatment with the same MKI molecule(s) planned to be given in the cohort. If different MKI molecules (from the one(s) planned in the study) have been previously taken, a wash out period of 2 weeks before treatment should be observed. Other invasive malignancies either currently active or active in the last 3 years, except adequately treated in situ carcinoma of the cervix and basal or squamous cell carcinoma of the skin Any condition that may jeopardize patient participation in the study as well as non contraception for male and female with child-bearing potential, pregnancy or breast feeding. Patient unwilling or unable to comply with the medical follow-up required by the standard treatment taken (including PK sampling during treatment phase and vital status collection during follow-up phase) because of psychosocial, familial, social or geographical reasons Participation in another clinical study with an investigational medicinal product during the last 30 days prior to inclusion and during the present study (except if patient is included in the control arm, with placebo or with a product which have a marketed authorisation, used as per the SmPC for the given indication) Patient deprived of their liberty or under protective custody or guardianship
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Florence GARIC
Phone
+33 (0) 1 71 93 67 07
Email
f-garic@unicancer.fr
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
David MALKA, Dr
Organizational Affiliation
Gustave ROUSSY - VILLEJUIF
Official's Role
Principal Investigator
Facility Information:
Facility Name
CH d'Auxerre
City
Auxerre
Country
France
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Anne-Laure VILLING, Dr
Email
alvilling@ch-auxerre.fr
Facility Name
Institut du Cancer Avignon - Institut Sainte Catherine
City
Avignon
Country
France
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Laurent MINEUR, Dr
Email
l.mineur@isc84.org
Facility Name
CH de Bayeux - Onconormandie
City
Bayeux
Country
France
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Annie PEYTIER, Dr
Email
a.peytier@ch-ab.fr
Facility Name
Centre Jean Perrin
City
Clermont-Ferrand
Country
France
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Hervé DEVAUD, Dr
Email
herve.devaud@clermont.unicancer.fr
Facility Name
Hôpital Beaujon APHP
City
Clichy
Country
France
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Mohamed BOUATTOUR, Dr
Email
mohamed.bouattour@aphp.fr
Facility Name
Centre Georges Francois Leclerc
City
Dijon
Country
France
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Julie VINCENT, Dr
Email
jvincent@cgfl.fr
Facility Name
Centre Oscar Lambret
City
Lille
Country
France
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Aurélien CARNOT, Dr
Email
a-carnot@o-lambret.fr
Facility Name
Groupement des hôpitaux de l'Institut Catholique de Lille - Hôpital Saint Vincent de Paul
City
Lille
Country
France
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Sophie DOMINGUEZ, Dr
Email
dominguez.sophie@ghicl.net
Facility Name
Centre Léon Bérard
City
Lyon
Country
France
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Pauline ROCHEFORT, Dr
Email
pauline.rochefort@lyon.unicancer.fr
Facility Name
Hôpital Européen Marseille
City
Marseille
Country
France
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yves RINALDI, Dr
Email
y.rinaldi@hopital-europeen.fr
Facility Name
CHRU de Nancy - Hôpital de Brabois Adulte
City
Nancy
Country
France
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Anthony LOPEZ, Dr
Email
a.lopez@chru-nancy.fr
Facility Name
CHU de Nantes - Hôtel Dieu
City
Nantes
Country
France
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yann TOUCHEFEU, Dr
Email
yann.touchefeu@chu-nantes.fr
Facility Name
Centre Antoine Lacassagne
City
Nice
Country
France
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Angélique SAINT, Dr
Email
angelique.saint@nice.unicancer.fr
Facility Name
APHP Pitié Salpétrière
City
Paris
Country
France
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jean Baptiste BACHET, Dr
Email
jean-baptiste.bachet@aphp.fr
Facility Name
Hôpital Saint Joseph
City
Paris
Country
France
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Xavier ADHOUTE, Dr
Email
xadhoute@hopital-saint-joseph.fr
Facility Name
Hôpital Privé des Côtes d'Armor - SAS
City
Plérin
Country
France
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jérôme MARTIN-BABAU, Dr
Email
j.martin@cario-sante.fr
Facility Name
CHU de Poitiers
City
Poitiers
Country
France
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
David TOUGERON, Dr
Email
david.tougeron@chu-poitiers.fr
Facility Name
CHU de Reims - Hôpital Robert Debré
City
Reims
Country
France
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Olivier BOUCHE, Pr
Email
obouche@chu-reims.fr
Facility Name
Institut Jean Godinot
City
Reims
Country
France
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Damien BOTSEN, Dr
Email
damien.botsen@reims.unicancer.fr
Facility Name
Centre Eugène Marquis
City
Rennes
Country
France
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Julien EDELINE, Dr
Email
j.edeline@rennes.unicancer.fr
Facility Name
CHU Rouen - Hôpital Charles Nicolle
City
Rouen
Country
France
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Frédéric DI FIORE, Dr
Email
frederic.di-fiore@chu-rouen.fr
Facility Name
CH Saint Malo - Hôpital Broussais
City
Saint-Malo
Country
France
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Romain DESGRIPPES, Dr
Email
r.desgrippes@ch-stmalo.fr
Facility Name
ICANS
City
Strasbourg
Country
France
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Meher BEN ABDELGHANI, Dr
Email
m.ben-abdelghani@icans.eu
Facility Name
Gustave Roussy
City
Villejuif
Country
France
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Audrey PERRET, Dr
Email
audrey.perret@gustaveroussy.fr

12. IPD Sharing Statement

Learn more about this trial

TARGETed Therapy Drug MONITOring in DIGestive Oncology

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