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DETERMINE Trial Treatment Arm 03: Entrectinib in Adult, Teenage/Young Adults and Paediatric Patients With ROS1 Gene Fusion-positive Cancers. (DETERMINE)

Primary Purpose

Solid Tumor, Haematological Malignancy, Malignancy

Status
Recruiting
Phase
Phase 2
Locations
United Kingdom
Study Type
Interventional
Intervention
Entrectinib
Sponsored by
Cancer Research UK
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Solid Tumor focused on measuring Adult, Antineoplastic Agents, Cancer, Child, Entrectinib, Malignancy, Malignant Neoplasms, Molecular Targeted Therapy, Mutation, Neoplasms by Histologic Site, Neoplasms by Site, Oncogene, Paediatric, Protein Kinase Inhibitors, Rare, ROS1 Protein, human, Tumour-agnostic, Young adult

Eligibility Criteria

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

THE PARTICIPANT MUST FULFIL THE ELIGIBILITY CRITERIA WITHIN THE DETERMINE MASTER PROTOCOL (NCT05722886) AND WITHIN THE TREATMENT ARM 03 (ENTRECTINIB) OUTLINED BELOW* *When entrectinib-specific inclusion/exclusion criteria or precautions below differ from those specified in the Master Protocol, the entrectinib-specific criteria will take precedence. Inclusion Criteria: A. Confirmed diagnosis of a ROS1 gene fusion-positive malignancy, other than NSCLC, that has been identified using an analytically validated sequencing technique. B. Patients must be able and willing to undergo a fresh biopsy. C. Patients with a BSA of 0.43m^2 and over. D. ADULT PATIENTS: Adequate organ function as per haematological and biochemical indices within the ranges shown below. These measurements should be performed to confirm the patient's eligibility. Haemoglobin (Hb): ≥90 g/L (transfusion allowed) Absolute neutrophil count (ANC): ≥1.5×10^9/L (no granulocyte colony-stimulating factor [GCSF] support in preceding 72 hours) Platelet count: ≥100×10^9/L (unsupported for 72 hours) Bilirubin: <2.5 x upper limit of normal (ULN). Patients with known Gilbert's syndrome who have a serum bilirubin: ≤3 x ULN may be enrolled. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST): ≤2.5 x ULN or ≤5 x ULN if raised due to metastases. estimated glomerular filtration rate (eGFR): eGFR: ≥30 mL/min (uncorrected value) Coagulation - prothrombin (PT) (or international normalized ratio [INR]), and activated partial thromboplastin clotting time (aPTT): ≤1.5 x limit of normal (unless patient is on anticoagulants e.g. warfarin [INR should be stable and within indicated therapeutic range], or direct oral anticoagulants [DOAC]. E. PAEDIATRIC PATIENTS: Adequate organ function as per haematological and biochemical indices within the ranges shown below. These measurements should be performed to confirm the patient's eligibility. Haemoglobin (Hb): ≥80 g/L (transfusion allowed) ANC: ≥1.0×10^9/L (no GCSF support in preceding 72 hours) Platelet count: ≥75×10^9/L (unsupported for 72 hours) Bilirubin: ≤1.5 x ULN for age ALT and AST: ≤2.5 x ULN for age or < 5xULN if raised due to metastases. estimated glomerular filtration rate (eGFR): eGFR >70 ml/min/1.73m^2 International Normalised Ratio (INR) or Prothrombin Time (PT) and activated Partial Thromboplastin Time (aPTT): ≤1.5 x ULN for age (unless patient is on anticoagulants e.g. warfarin [INR should be stable and within indicated therapeutic range], or DOAC). F. Women of childbearing potential are eligible provided that they meet the following criteria: - Have a negative serum or urine pregnancy test before enrolment and either: • Agree to use one form of highly effective birth control method such as: I. Oral, intravaginal or transdermal combined (oestrogen and progestogen containing) hormonal contraception II. Oral, injectable or implantable progestogen-only hormonal contraception associated with inhibition of ovulation III. Intrauterine device (IUD) IV. Intrauterine hormone-releasing system (IUS) V. Bilateral tubal occlusion VI. Vasectomised partner Plus a barrier method: male or female condom with or without spermicide; cap, diaphragm or sponge with spermicide. • Sexual abstinence; Effective from the first administration of entrectinib, throughout the trial and for five weeks after the last administration of entrectinib. G. Male patients with partners who are women of childbearing potential are eligible provided that they agree to the following, from the first administration of entrectinib, throughout the trial and for three months after the last administration of entrectinib: Agree to take measures not to father children by using a barrier method of contraception (condom plus spermicide) or to sexual abstinence. Non-vasectomised male patients with partners who are women of childbearing potential must also be willing to ensure that their partner uses a highly effective method of contraception as in F above. Male patients with pregnant or lactating partners must be advised to use barrier method contraception (for example, condom plus spermicidal gel) to prevent drug exposure of the foetus or neonate. Exclusion Criteria: A. Female patients who are pregnant, breastfeeding or planning to become pregnant during the trial or within five weeks following their last dose of entrectinib. B. Diagnosis of ROS1 fusion-positive Non-Small Cell Lung Cancer (NSCLC). C. Prior treatment with the same class of drug unless genetic profile demonstrates a mechanism of resistance known to be potentially sensitive to entrectinib. D. Patients with significant cardiovascular disease are excluded as defined by: i. Current congestive heart failure requiring therapy (New York Heart Association III or IV) or known left ventricular ejection fraction (LVEF) <50% (moderate to severe) ii. History of unstable angina pectoris or myocardial infarction (MI) up to three months prior to trial entry, or current poorly controlled angina (symptoms weekly or more) iii. Presence of symptomatic or severe valvular heart disease (severe by local echo graphic criteria or American Heart Association/American Cardiac College Stage C or D) iv. History of a clinically significant cardiac arrhythmia up to three months prior to trial entry (asymptomatic atrial fibrillation or asymptomatic first-degree heart block are permitted. v. History of stroke (ischaemic or haemorrhagic) within the last three months. E. Patients with a baseline QTcF (Corrected QT interval by Fridericia formula) interval longer than 450 millisecond (ms) for male patients and 470 ms for female patients, patients with congenital long QTcF syndrome, and patients taking medicinal products that are known to prolong the QTc interval. F. History of additional risk factors for Torsades de Pointes (e.g., family history of long QT syndrome). G. Grade ≥2 peripheral neuropathy. H. Known active infections that would interfere with the assessment of safety or efficacy of entrectinib (bacterial, fungal, or viral, including HIV positive). I. Known hypersensitivity to entrectinib or any of the excipients. J. Patient unable to swallow entrectinib intact, without chewing, crushing or opening the capsules (as per the dosing schedule and suitable dosing strengths available). Any active gastrointestinal disease (e.g., Crohn's disease, ulcerative colitis, or short gut syndrome) or other malabsorption syndromes that would reasonably affect drug absorption. K. Patients with rapidly progressing or symptomatically deteriorating brain metastases. Patients with previously treated brain metastases are eligible, provided the patient has not experienced a seizure or had a clinically significant change in neurological status within the 14 days prior to the start of IMP administration. Such patients must be non-dependent on steroids or on a stable or reducing dose of steroid treatment for at least 14 days (or 7 days for paediatric patients) prior to the start of IMP administration. Primary brain or CNS malignancies are allowed providing the patient is clinically stable (if requiring corticosteroids must be at stable or decreasing doses for at least 14 days for adults and 7 days for paediatric patients prior to the start of IMP administration). Patients who have received brain irradiation must have completed whole-brain radiotherapy and/or stereotactic radiosurgery at least 14 days prior to the start of IMP administration. L. Patients with personal history of significant osteopenia (screening for osteopenia not required). M. Any clinically significant concomitant disease or condition (or its treatment) that could interfere with the conduct of the trial or absorption of oral medications that would, in the opinion of the Investigator, pose an unacceptable risk to the patient in this trial.

Sites / Locations

  • Belfast City HospitalRecruiting
  • University Hospital BirminghamRecruiting
  • Birmingham Children's Hospital
  • Bristol Royal Hospital for Children
  • Bristol Haematology and Oncology Centre
  • Addenbrooke's HospitalRecruiting
  • Velindre Cancer Centre
  • Western General HospitalRecruiting
  • The Beatson HospitalRecruiting
  • Royal Hospital for Children Glasgow
  • Leeds General Infirmary
  • Leicester Royal InfirmaryRecruiting
  • Alder Hey Hospital
  • The Royal Marsden Hospital
  • University College London Hospital
  • Guy's HospitalRecruiting
  • Great Ormond Street Hospital
  • Royal Manchester Children's Hospital
  • The Christie HospitalRecruiting
  • Great North Children's HospitalRecruiting
  • Freeman HospitalRecruiting
  • Churchill HospitalRecruiting
  • John Radcliffe HospitalRecruiting
  • Weston Park Hospital
  • Southampton General Hospital
  • Clatterbridge Cancer Centre

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treatment Arm 03

Arm Description

This entrectinib treatment arm is for adult, teenage/young adult (TYA) and paediatric participants with ROS1 gene fusion-positive malignancies.

Outcomes

Primary Outcome Measures

Objective Response (OR)
An OR is defined as the confirmed occurrence of either a Complete Response (CR) or Partial Response (PR) according to Response Evaluation Criteria in Solid Tumours (RECIST) Version 1.1 criteria (or immune related (ir)-RECIST or standard imaging criteria for specific disease e.g. Response Evaluation in Neuro Oncology criteria (RANO)). In patients with leukaemia, OR will be defined as the occurrence of CR , CRi (CR incomplete neutrophil recovery) or CRp (CR with incomplete platelet recovery). The trial will report the proportion of patients with an OR and 95% credible interval.
Durable Clinical Benefit (DCB)
DCB is defined as the absence of disease progression for at least 24 weeks from the start of trial treatment according to RECIST Version 1.1 criteria (or ir-RECIST or standard imaging criteria for specific disease e.g. RANO criteria). Alternative definitions of DCB based on different time points may be pre-specified for particular sub-cohorts if 24 weeks is not clinically relevant. The trial will report the proportion of patients with a DCB and 95% credible interval.

Secondary Outcome Measures

Duration of response (DR)
Duration of response, is defined as the time from the date of the first confirmed CR or PR according to RECIST 1.1 or ir-RECIST or standard imaging criteria for specific disease e.g. RANO criteria to the date of disease progression. The trial will report the median DR and 95% credible interval.
Best percentage change in sum of target lesion / index lesion diameters (PCSD)
PCSD is defined as the greatest decrease or least increase in the sum of target lesion diameters (RECIST) or index lesion diameters (irRECIST) as a percentage compared to the baseline measurement. The trial will report the mean PCSD and 95% credible interval.
Time to treatment discontinuation (TTD)
TTD is defined as the time from date of starting trial treatment to date of discontinuing trial treatment, in days estimated by the median of the posterior inverse gamma probability distribution. The trial will report the median TTD and 95% credible interval.
Progression-Free Survival time (PFS)
PFS is defined as the time from date of starting trial treatment to date of progression or date of death without a previous progression recorded estimated by the median of the posterior inverse gamma probability distribution.
Time to Progression (TTP)
TTP is defined as the time from date of starting trial treatment to date of progression or date of death without recorded progression censored rather than events. The trial will report the median TTP and 95% credible interval.
Growth Modulation Index (GMI)
GMI is defined as the ratio of TTP with the trial protocol treatment to TTP on the most recent prior line of therapy. The trial will report the mean GMI and 95% credible interval.
Overall Survival time (OS)
OS is defined as the time from date of starting trial treatment to date of death from any cause estimated by the median of the posterior normal probability distribution.
Occurrence of at least one Suspected Unexpected Serious Adverse Event (SUSAR)
The trial will report the number of patients who experience at least one SUSAR to entrectinib.
Occurrence of at least one Grade 3, 4 or 5 entrectinib related AE
Number of patients who experience at least one entrectinib related Grade 3, 4 or 5 AE according to NCI CTCAE Version 5.0.
EORTC-QLQ-30 Standardised Area Under Summary Score Curve (QLQSAUC) in adult participants.
For adult populations, multiple measures of QoL will be generated from patient completion of the European Organisation for Research and Treatment of Cancer QLQC30 (EORTC-QLQC30) questionnaire (30 measures). For each patient the Summary Score from the questionnaire will be generated at each time point and the area under the curve generated by these scores over time will be calculated and standardised by the time frame. The trial will report the mean QLQSAUC and 95% credible interval.
EQ-5D Standardised Area Under Index Value Curve (EQ5DSAUC) in adult participants
For adult populations, two measures of QoL will be generated from patient completion of the EQ-5D-5L questionnaire. For each measure, scores based on responses from the questionnaire will be generated at each time point and the area under the curve generated by these scores over time will be calculated and standardised by the time frame. The trial will report the mean EQ5DSAUC and 95% credible interval.
Mean change from baseline in the PedsQL 4.0 Standardised Area Under total Scale Score Curve (PedsSAUC) in paediatric participants
For paediatric populations multiple measures of QoL will be generated from patient completion of the PedsQL 4.0 (4 measures). The Summary Score from the questionnaire will be generated at each time point and the area under the curve generated by these scores over time will be calculated and standardised by the time frame. The trial will report the mean PedsSAUC and 95% credible interval.
Mean change from baseline in the PedsQL 4.0 Standardised Area Under total Scale Score Curve (PedsSAUC) in parents from paediatric participants
For paediatric populations multiple measures of QoL will be generated from patient's parent completion of the PedsQL 4.0 (4 measures). The Summary Score from the questionnaire will be generated at each time point and the area under the curve generated by these scores over time will be calculated and standardised by the time frame. The trial will report the mean PedsSAUC and 95% credible interval.

Full Information

First Posted
February 22, 2023
Last Updated
October 24, 2023
Sponsor
Cancer Research UK
Collaborators
University of Manchester, University of Birmingham, Royal Marsden NHS Foundation Trust, Hoffmann-La Roche
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1. Study Identification

Unique Protocol Identification Number
NCT05770544
Brief Title
DETERMINE Trial Treatment Arm 03: Entrectinib in Adult, Teenage/Young Adults and Paediatric Patients With ROS1 Gene Fusion-positive Cancers.
Acronym
DETERMINE
Official Title
DETERMINE (Determining Extended Therapeutic Indications for Existing Drugs in Rare Molecularly Defined Indications Using a National Evaluation Platform Trial): An Umbrella-Basket Platform Trial to Evaluate the Efficacy of Targeted Therapies in Rare Adult, Paediatric and Teenage/Young Adult (TYA) Cancers With Actionable Genomic Alterations, Including Common Cancers With Rare Actionable Alterations. Treatment Arm 03: Entrectinib in Adult, Teenage/Young Adults and Paediatric Patients With ROS1 Gene Fusion-positive Cancers.
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
December 2023 (Anticipated)
Primary Completion Date
October 2029 (Anticipated)
Study Completion Date
October 2029 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Cancer Research UK
Collaborators
University of Manchester, University of Birmingham, Royal Marsden NHS Foundation Trust, Hoffmann-La Roche

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
This clinical trial is looking at a drug called entrectinib. Entrectinib is approved as standard of care treatment for adult patients with non-small cell lung cancer (NSCLC) which have a particular molecular alteration called ROS1-positive, and patients 12 years of age or older with solid tumours which have another type of change in the cancer cells. This means it has gone through clinical trials and been approved by the Medicines and Healthcare products Regulatory Agency (MHRA) in the UK. Investigators now wish to find out if it will be useful in treating patients with other cancer types which have the same molecular alteration (ROS1-positive). If the results are positive, the study team will work with the NHS and the Cancer Drugs Fund to see if these drugs can be routinely accessed for patients in the future. This trial is part of a trial programme called DETERMINE. The programme will also look at other anti-cancer drugs in the same way, through matching the drug to rare cancer types or ones with specific mutations.
Detailed Description
DETERMINE Treatment Arm 03 (entrectinib) aims to evaluate the efficacy of entrectinib in ROS1 gene fusion-positive rare* adult, paediatric and teenage/young adult (TYA) cancers and in common cancers where a ROS1 mutation or amplification is considered to be infrequent. *Rare is defined generally as incidence less than 6 cases in 100,000 patients (includes paediatric and teenagers/young adult cancers) or common cancers with rare alterations. This treatment arm has a target sample size of 30 evaluable patients. Sub-cohorts may be defined and further expanded where promising activity is identified to a target of 30 evaluable patients each. The ultimate aim is to translate positive clinical findings to the NHS (Cancer Drugs Fund) to provide new treatment options for rare adult, paediatric and TYA cancers. OUTLINE: Pre-screening: The Molecular Tumour Board makes a treatment recommendation for the participant based on molecularly-defined cohorts. Screening: Consenting participants undergo biopsy and collection of blood samples for research purposes. Treatment: Participants will receive entrectinib until disease progression, unacceptable toxicity or withdrawal of consent. Participants will also undergo collection of blood samples at various intervals while receiving treatment and at the end of trial visit (EoT). After completion of study treatment, patients are followed up every 3 months for 2 years THE DETERMINE TRIAL MASTER (SCREENING) PROTOCOL: Please see DETERMINE Trial Master (Screening) Protocol record (NCT05722886) for information on the DETERMINE Trial Master Protocol and applicable documents.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Solid Tumor, Haematological Malignancy, Malignancy, Malignant Neoplasm, Lymphoproliferative Disorders, Neoplasms by Histologic Type, Neoplasms by Site, Cancer, Brain Neoplasms, Melanoma, Glioma
Keywords
Adult, Antineoplastic Agents, Cancer, Child, Entrectinib, Malignancy, Malignant Neoplasms, Molecular Targeted Therapy, Mutation, Neoplasms by Histologic Site, Neoplasms by Site, Oncogene, Paediatric, Protein Kinase Inhibitors, Rare, ROS1 Protein, human, Tumour-agnostic, Young adult

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2, Phase 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
30 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Treatment Arm 03
Arm Type
Experimental
Arm Description
This entrectinib treatment arm is for adult, teenage/young adult (TYA) and paediatric participants with ROS1 gene fusion-positive malignancies.
Intervention Type
Drug
Intervention Name(s)
Entrectinib
Other Intervention Name(s)
Rozlytrek
Intervention Description
Adult and paediatric participants with body surface area (BSA) ≥1.51 m^2 will receive entrectinib orally at a dose of 600 mg daily dose (three 200 mg capsules per day). Paediatric participants with BSA <1.51 m^2 will receive entrectinib at a dose of 100 mg (BSA=0.43-0.50 m^2) or 200 mg (BSA=0.51-0.80m^2) or 300 mg (BSA=0.81-1.10 m^2) or 400 mg (BSA=1.11-1.50 m^2). Each cycle of treatment will consist of 28 days and participants may continue until disease progression, unacceptable toxicity or withdrawal of consent.
Primary Outcome Measure Information:
Title
Objective Response (OR)
Description
An OR is defined as the confirmed occurrence of either a Complete Response (CR) or Partial Response (PR) according to Response Evaluation Criteria in Solid Tumours (RECIST) Version 1.1 criteria (or immune related (ir)-RECIST or standard imaging criteria for specific disease e.g. Response Evaluation in Neuro Oncology criteria (RANO)). In patients with leukaemia, OR will be defined as the occurrence of CR , CRi (CR incomplete neutrophil recovery) or CRp (CR with incomplete platelet recovery). The trial will report the proportion of patients with an OR and 95% credible interval.
Time Frame
Disease assessments to be performed up to 24 weeks from the start of trial treatment.
Title
Durable Clinical Benefit (DCB)
Description
DCB is defined as the absence of disease progression for at least 24 weeks from the start of trial treatment according to RECIST Version 1.1 criteria (or ir-RECIST or standard imaging criteria for specific disease e.g. RANO criteria). Alternative definitions of DCB based on different time points may be pre-specified for particular sub-cohorts if 24 weeks is not clinically relevant. The trial will report the proportion of patients with a DCB and 95% credible interval.
Time Frame
Disease assessments to be performed up to 24 weeks from the start of trial treatment.
Secondary Outcome Measure Information:
Title
Duration of response (DR)
Description
Duration of response, is defined as the time from the date of the first confirmed CR or PR according to RECIST 1.1 or ir-RECIST or standard imaging criteria for specific disease e.g. RANO criteria to the date of disease progression. The trial will report the median DR and 95% credible interval.
Time Frame
Disease assessment every 2 cycles of entrectinib (each cycle is 28 days) and at EoT. After 24 weeks, it can be done every 3 cycles, on discussion with Sponsor. Follow-up visits are every 12 weeks after last dose of entrectinib for up to 2 years.
Title
Best percentage change in sum of target lesion / index lesion diameters (PCSD)
Description
PCSD is defined as the greatest decrease or least increase in the sum of target lesion diameters (RECIST) or index lesion diameters (irRECIST) as a percentage compared to the baseline measurement. The trial will report the mean PCSD and 95% credible interval.
Time Frame
Disease assessment performed every 2 cycles (each cycle is 28 days). After 24 weeks, disease assessments can be repeated every 3 cycles, on discussion with Sponsor. Follow-up visits are every 12 weeks following last dose for a period of up to 2 years.
Title
Time to treatment discontinuation (TTD)
Description
TTD is defined as the time from date of starting trial treatment to date of discontinuing trial treatment, in days estimated by the median of the posterior inverse gamma probability distribution. The trial will report the median TTD and 95% credible interval.
Time Frame
From first dose of entrectinib to discontinuation of trial treatment up to 5 years.
Title
Progression-Free Survival time (PFS)
Description
PFS is defined as the time from date of starting trial treatment to date of progression or date of death without a previous progression recorded estimated by the median of the posterior inverse gamma probability distribution.
Time Frame
Disease assessment performed every 2 cycles (each cycle is 28 days). After 24 weeks, it can be done every 3 cycles, on discussion with Sponsor. Follow-up visits take place every 12 weeks following last dose of entrectinib for a period of up to 2 years.
Title
Time to Progression (TTP)
Description
TTP is defined as the time from date of starting trial treatment to date of progression or date of death without recorded progression censored rather than events. The trial will report the median TTP and 95% credible interval.
Time Frame
Disease assessment performed every 2 cycles (each cycle is 28 days). After 24 weeks, it can be done every 3 cycles, on discussion with Sponsor. Follow-up visits take place every 12 weeks following last dose of entrectinib for a period of up to 2 years.
Title
Growth Modulation Index (GMI)
Description
GMI is defined as the ratio of TTP with the trial protocol treatment to TTP on the most recent prior line of therapy. The trial will report the mean GMI and 95% credible interval.
Time Frame
Disease assessment performed every 2 cycles (each cycle is 28 days). After 24 weeks, it can be done every 3 cycles, on discussion with Sponsor. Follow-up visits take place every 12 weeks following last dose of entrectinib for a period of up to 2 years.
Title
Overall Survival time (OS)
Description
OS is defined as the time from date of starting trial treatment to date of death from any cause estimated by the median of the posterior normal probability distribution.
Time Frame
Time of death or up to 2 years after the End of Treatment (EoT) visit.
Title
Occurrence of at least one Suspected Unexpected Serious Adverse Event (SUSAR)
Description
The trial will report the number of patients who experience at least one SUSAR to entrectinib.
Time Frame
From the time of consent until 28 days after last dose of entrectinib (up to 5 years) or until patient starts another anti-cancer therapy, whichever came first. An average time frame will be presented with results entry.
Title
Occurrence of at least one Grade 3, 4 or 5 entrectinib related AE
Description
Number of patients who experience at least one entrectinib related Grade 3, 4 or 5 AE according to NCI CTCAE Version 5.0.
Time Frame
From the time of consent until 28 days after last dose of entrectinib (up to 5 years) or until patient starts another anti-cancer therapy, whichever came first. An average time frame will be presented with results entry.
Title
EORTC-QLQ-30 Standardised Area Under Summary Score Curve (QLQSAUC) in adult participants.
Description
For adult populations, multiple measures of QoL will be generated from patient completion of the European Organisation for Research and Treatment of Cancer QLQC30 (EORTC-QLQC30) questionnaire (30 measures). For each patient the Summary Score from the questionnaire will be generated at each time point and the area under the curve generated by these scores over time will be calculated and standardised by the time frame. The trial will report the mean QLQSAUC and 95% credible interval.
Time Frame
QoL surveys performed at baseline every 2 cycles (every cycle is 28 days) and after interrupting treatment (up to 5 years).
Title
EQ-5D Standardised Area Under Index Value Curve (EQ5DSAUC) in adult participants
Description
For adult populations, two measures of QoL will be generated from patient completion of the EQ-5D-5L questionnaire. For each measure, scores based on responses from the questionnaire will be generated at each time point and the area under the curve generated by these scores over time will be calculated and standardised by the time frame. The trial will report the mean EQ5DSAUC and 95% credible interval.
Time Frame
QoL surveys performed prior to inclusion, every 2 cycles (each cycle is 28 days) and at EoT visit (up to 5 years).
Title
Mean change from baseline in the PedsQL 4.0 Standardised Area Under total Scale Score Curve (PedsSAUC) in paediatric participants
Description
For paediatric populations multiple measures of QoL will be generated from patient completion of the PedsQL 4.0 (4 measures). The Summary Score from the questionnaire will be generated at each time point and the area under the curve generated by these scores over time will be calculated and standardised by the time frame. The trial will report the mean PedsSAUC and 95% credible interval.
Time Frame
QoL surveys performed prior to inclusion, every 2 cycles (each cycle is 28 days) and at EoT visit (up to 5 years).
Title
Mean change from baseline in the PedsQL 4.0 Standardised Area Under total Scale Score Curve (PedsSAUC) in parents from paediatric participants
Description
For paediatric populations multiple measures of QoL will be generated from patient's parent completion of the PedsQL 4.0 (4 measures). The Summary Score from the questionnaire will be generated at each time point and the area under the curve generated by these scores over time will be calculated and standardised by the time frame. The trial will report the mean PedsSAUC and 95% credible interval.
Time Frame
QoL surveys performed prior to inclusion, every 2 cycles (each cycle is 28 days) and at EoT visit (up to 5 years).

10. Eligibility

Sex
All
Accepts Healthy Volunteers
No
Eligibility Criteria
THE PARTICIPANT MUST FULFIL THE ELIGIBILITY CRITERIA WITHIN THE DETERMINE MASTER PROTOCOL (NCT05722886) AND WITHIN THE TREATMENT ARM 03 (ENTRECTINIB) OUTLINED BELOW* *When entrectinib-specific inclusion/exclusion criteria or precautions below differ from those specified in the Master Protocol, the entrectinib-specific criteria will take precedence. Inclusion Criteria: A. Confirmed diagnosis of a ROS1 gene fusion-positive malignancy, other than NSCLC, that has been identified using an analytically validated sequencing technique. B. Patients must be able and willing to undergo a fresh biopsy. C. Patients with a BSA of 0.43m^2 and over. D. ADULT PATIENTS: Adequate organ function as per haematological and biochemical indices within the ranges shown below. These measurements should be performed to confirm the patient's eligibility. Haemoglobin (Hb): ≥90 g/L (transfusion allowed) Absolute neutrophil count (ANC): ≥1.5×10^9/L (no granulocyte colony-stimulating factor [GCSF] support in preceding 72 hours) Platelet count: ≥100×10^9/L (unsupported for 72 hours) Bilirubin: <2.5 x upper limit of normal (ULN). Patients with known Gilbert's syndrome who have a serum bilirubin: ≤3 x ULN may be enrolled. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST): ≤2.5 x ULN or ≤5 x ULN if raised due to metastases. estimated glomerular filtration rate (eGFR): eGFR: ≥30 mL/min (uncorrected value) Coagulation - prothrombin (PT) (or international normalized ratio [INR]), and activated partial thromboplastin clotting time (aPTT): ≤1.5 x limit of normal (unless patient is on anticoagulants e.g. warfarin [INR should be stable and within indicated therapeutic range], or direct oral anticoagulants [DOAC]. E. PAEDIATRIC PATIENTS: Adequate organ function as per haematological and biochemical indices within the ranges shown below. These measurements should be performed to confirm the patient's eligibility. Haemoglobin (Hb): ≥80 g/L (transfusion allowed) ANC: ≥1.0×10^9/L (no GCSF support in preceding 72 hours) Platelet count: ≥75×10^9/L (unsupported for 72 hours) Bilirubin: ≤1.5 x ULN for age ALT and AST: ≤2.5 x ULN for age or < 5xULN if raised due to metastases. estimated glomerular filtration rate (eGFR): eGFR >70 ml/min/1.73m^2 International Normalised Ratio (INR) or Prothrombin Time (PT) and activated Partial Thromboplastin Time (aPTT): ≤1.5 x ULN for age (unless patient is on anticoagulants e.g. warfarin [INR should be stable and within indicated therapeutic range], or DOAC). F. Women of childbearing potential are eligible provided that they meet the following criteria: - Have a negative serum or urine pregnancy test before enrolment and either: • Agree to use one form of highly effective birth control method such as: I. Oral, intravaginal or transdermal combined (oestrogen and progestogen containing) hormonal contraception II. Oral, injectable or implantable progestogen-only hormonal contraception associated with inhibition of ovulation III. Intrauterine device (IUD) IV. Intrauterine hormone-releasing system (IUS) V. Bilateral tubal occlusion VI. Vasectomised partner Plus a barrier method: male or female condom with or without spermicide; cap, diaphragm or sponge with spermicide. • Sexual abstinence; Effective from the first administration of entrectinib, throughout the trial and for five weeks after the last administration of entrectinib. G. Male patients with partners who are women of childbearing potential are eligible provided that they agree to the following, from the first administration of entrectinib, throughout the trial and for three months after the last administration of entrectinib: Agree to take measures not to father children by using a barrier method of contraception (condom plus spermicide) or to sexual abstinence. Non-vasectomised male patients with partners who are women of childbearing potential must also be willing to ensure that their partner uses a highly effective method of contraception as in F above. Male patients with pregnant or lactating partners must be advised to use barrier method contraception (for example, condom plus spermicidal gel) to prevent drug exposure of the foetus or neonate. Exclusion Criteria: A. Female patients who are pregnant, breastfeeding or planning to become pregnant during the trial or within five weeks following their last dose of entrectinib. B. Diagnosis of ROS1 fusion-positive Non-Small Cell Lung Cancer (NSCLC). C. Prior treatment with the same class of drug unless genetic profile demonstrates a mechanism of resistance known to be potentially sensitive to entrectinib. D. Patients with significant cardiovascular disease are excluded as defined by: i. Current congestive heart failure requiring therapy (New York Heart Association III or IV) or known left ventricular ejection fraction (LVEF) <50% (moderate to severe) ii. History of unstable angina pectoris or myocardial infarction (MI) up to three months prior to trial entry, or current poorly controlled angina (symptoms weekly or more) iii. Presence of symptomatic or severe valvular heart disease (severe by local echo graphic criteria or American Heart Association/American Cardiac College Stage C or D) iv. History of a clinically significant cardiac arrhythmia up to three months prior to trial entry (asymptomatic atrial fibrillation or asymptomatic first-degree heart block are permitted. v. History of stroke (ischaemic or haemorrhagic) within the last three months. E. Patients with a baseline QTcF (Corrected QT interval by Fridericia formula) interval longer than 450 millisecond (ms) for male patients and 470 ms for female patients, patients with congenital long QTcF syndrome, and patients taking medicinal products that are known to prolong the QTc interval. F. History of additional risk factors for Torsades de Pointes (e.g., family history of long QT syndrome). G. Grade ≥2 peripheral neuropathy. H. Known active infections that would interfere with the assessment of safety or efficacy of entrectinib (bacterial, fungal, or viral, including HIV positive). I. Known hypersensitivity to entrectinib or any of the excipients. J. Patient unable to swallow entrectinib intact, without chewing, crushing or opening the capsules (as per the dosing schedule and suitable dosing strengths available). Any active gastrointestinal disease (e.g., Crohn's disease, ulcerative colitis, or short gut syndrome) or other malabsorption syndromes that would reasonably affect drug absorption. K. Patients with rapidly progressing or symptomatically deteriorating brain metastases. Patients with previously treated brain metastases are eligible, provided the patient has not experienced a seizure or had a clinically significant change in neurological status within the 14 days prior to the start of IMP administration. Such patients must be non-dependent on steroids or on a stable or reducing dose of steroid treatment for at least 14 days (or 7 days for paediatric patients) prior to the start of IMP administration. Primary brain or CNS malignancies are allowed providing the patient is clinically stable (if requiring corticosteroids must be at stable or decreasing doses for at least 14 days for adults and 7 days for paediatric patients prior to the start of IMP administration). Patients who have received brain irradiation must have completed whole-brain radiotherapy and/or stereotactic radiosurgery at least 14 days prior to the start of IMP administration. L. Patients with personal history of significant osteopenia (screening for osteopenia not required). M. Any clinically significant concomitant disease or condition (or its treatment) that could interfere with the conduct of the trial or absorption of oral medications that would, in the opinion of the Investigator, pose an unacceptable risk to the patient in this trial.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Aida Sarmiento Castro
Phone
+442034695101
Email
determine@cancer.org.uk
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Matthew Krebs, Prof
Organizational Affiliation
The Christie Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Belfast City Hospital
City
Belfast
ZIP/Postal Code
BT9 7AB
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Vicky Coyle, Prof
Email
V.Coyle@qub.ac.uk
First Name & Middle Initial & Last Name & Degree
Vicky Coyle, Prof
Facility Name
University Hospital Birmingham
City
Birmingham
ZIP/Postal Code
B15 2TT
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Gary Middleton, Prof
Phone
0121 371 3573
Email
G.Middleton@bham.ac.uk
First Name & Middle Initial & Last Name & Degree
Gary Middleton, Prof
Facility Name
Birmingham Children's Hospital
City
Birmingham
Country
United Kingdom
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Susanne Gatz, Dr
Phone
0121 333 9999
Email
Susanne.Gatz@nhs.net
First Name & Middle Initial & Last Name & Degree
Susanne Gatz, Dr
Facility Name
Bristol Royal Hospital for Children
City
Bristol
ZIP/Postal Code
BS2 8BJ
Country
United Kingdom
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Antony Ng, Dr
Phone
0117 342 8044
Email
Antony.Ng@uhbw.nhs.uk
First Name & Middle Initial & Last Name & Degree
Antony Ng, Dr
Facility Name
Bristol Haematology and Oncology Centre
City
Bristol
ZIP/Postal Code
BS2 8ED
Country
United Kingdom
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Antony Ng, Dr
Phone
0117 342 8044
Email
Antony.Ng@uhbw.nhs.uk
First Name & Middle Initial & Last Name & Degree
Antony Ng, Dr
Facility Name
Addenbrooke's Hospital
City
Cambridge
ZIP/Postal Code
CB2 OQQ
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Bristi Basu, Dr
Phone
01223 596105
Email
bb313@medschl.cam.ac.uk
First Name & Middle Initial & Last Name & Degree
Bristi Basu, Dr
Facility Name
Velindre Cancer Centre
City
Cardiff
ZIP/Postal Code
CF14 2TL
Country
United Kingdom
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Robert Jones, Dr
Phone
02920 615888
Ext
6327
Email
Robert.Hugh.Jones@wales.nhs.uk
First Name & Middle Initial & Last Name & Degree
Robert Jones, Dr
Facility Name
Western General Hospital
City
Edinburgh
ZIP/Postal Code
EH4 2XU
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Stefan Symeonides, Dr
First Name & Middle Initial & Last Name & Degree
Stefan Symeonides, Dr
Facility Name
The Beatson Hospital
City
Glasgow
ZIP/Postal Code
G12 OYN
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Patricia Roxburgh, Dr
Phone
0141 301 7118
Email
Patricia.Roxburgh@glasgow.ac.uk
First Name & Middle Initial & Last Name & Degree
Patricia Roxburgh, Dr
Facility Name
Royal Hospital for Children Glasgow
City
Glasgow
ZIP/Postal Code
G51 4TF
Country
United Kingdom
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Milind Ronghe, Dr
Phone
0141 452 6692
Email
Milind.Ronghe@ggc.scot.nhs.uk
First Name & Middle Initial & Last Name & Degree
Milind Ronghe, Dr
Facility Name
Leeds General Infirmary
City
Leeds
ZIP/Postal Code
LS1 3EX
Country
United Kingdom
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Martin Elliott, Dr
Phone
0113 392 8779
Email
martin.elliott1@nhs.net
First Name & Middle Initial & Last Name & Degree
Martin Elliott, Dr
Facility Name
Leicester Royal Infirmary
City
Leicester
ZIP/Postal Code
LE1 5WW
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Anne Thomas, Dr
Phone
0116 2587601
Email
at107@le.ac.uk
First Name & Middle Initial & Last Name & Degree
Anne Thomas, Dr
Facility Name
Alder Hey Hospital
City
Liverpool
ZIP/Postal Code
L14 5AB
Country
United Kingdom
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Lisa Howell, Dr
Phone
0151 293 3679
Email
Lisa.Howell@alderhey.nhs.uk
First Name & Middle Initial & Last Name & Degree
Lisa Howell, Dr
Facility Name
The Royal Marsden Hospital
City
London Borough of Sutton
ZIP/Postal Code
SM2 5PT
Country
United Kingdom
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Lynley Marshall, Dr
Phone
0208 661 3678
Email
LynleyVanessa.Marshall@icr.ac.uk
First Name & Middle Initial & Last Name & Degree
Lynley Marshall, Dr
Facility Name
University College London Hospital
City
London
ZIP/Postal Code
NW1 2BU
Country
United Kingdom
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Martin Foster, Prof
Phone
020 3447 5085
Email
M.Forster@ucl.ac.uk
First Name & Middle Initial & Last Name & Degree
Martin Foster, Prof
Facility Name
Guy's Hospital
City
London
ZIP/Postal Code
SE1 9RT
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
James Spicer, Dr
Phone
020 7188 4260
Email
james.spicer@kcl.ac.uk
First Name & Middle Initial & Last Name & Degree
James Spicer, Dr
Facility Name
Great Ormond Street Hospital
City
London
ZIP/Postal Code
WC1N 3JH
Country
United Kingdom
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Darren Hargrave, Dr
Phone
0207 813 8525
Email
Darren.hargrave@gosh.nhs.uk
First Name & Middle Initial & Last Name & Degree
Darren Hargrave, Dr
Facility Name
Royal Manchester Children's Hospital
City
Manchester
ZIP/Postal Code
M13 9WL
Country
United Kingdom
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Guy Makin, Dr
Phone
0161 701 8419
Email
Guy.Makin@mft.nhs.uk
First Name & Middle Initial & Last Name & Degree
Guy Makin, Dr
Facility Name
The Christie Hospital
City
Manchester
ZIP/Postal Code
M20 4BX
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Matthew Krebs, Prof
Phone
0161 918 7672
Email
Matthew.Krebs@nhs.net
First Name & Middle Initial & Last Name & Degree
Matthew Krebs, Prof
Facility Name
Great North Children's Hospital
City
Newcastle
ZIP/Postal Code
NE1 4LP
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Alastair Greystoke, Dr
Phone
0191 2138476
Email
Alastair.Greystoke@newcastle.ac.uk
First Name & Middle Initial & Last Name & Degree
Alastair Greystoke, Dr
Facility Name
Freeman Hospital
City
Newcastle
ZIP/Postal Code
NE7 7DN
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Alastair Greystoke, Dr
Phone
0191 2138476
Email
Greystoke@newcastle.ac.uk
First Name & Middle Initial & Last Name & Degree
Alastair Greystoke, Dr
Facility Name
Churchill Hospital
City
Oxford
ZIP/Postal Code
OX3 7LE
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Sarah Pratap, Dr
Phone
01865 235273
Email
Sarah.Pratap@ouh.nhs.uk
First Name & Middle Initial & Last Name & Degree
Sarah Pratap, Dr
Facility Name
John Radcliffe Hospital
City
Oxford
ZIP/Postal Code
OX3 9DU
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Sarah Pratap, Dr
Phone
01865 235273
Email
Sarah.Pratap@ouh.nhs.uk
First Name & Middle Initial & Last Name & Degree
Sarah Pratap, Dr
Facility Name
Weston Park Hospital
City
Sheffield
ZIP/Postal Code
S10 2SJ
Country
United Kingdom
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Sarah Danson, Dr
Phone
0114 226 5068
Email
s.danson@sheffield.ac.uk
First Name & Middle Initial & Last Name & Degree
Sarah Danson, Dr
Facility Name
Southampton General Hospital
City
Southampton
ZIP/Postal Code
SO16 6YD
Country
United Kingdom
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Juliet Gray, Prof
Phone
0238 120 6639
Email
Juliet.Gray@uhs.nhs.uk
First Name & Middle Initial & Last Name & Degree
Juliet Gray, Prof
Facility Name
Clatterbridge Cancer Centre
City
Wirral
ZIP/Postal Code
CH63 4JY
Country
United Kingdom
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Dan Palmer, Dr
Phone
0151 706 4172 / 0151 706 4177
Email
daniel.palmer@liverpool.ac.uk
First Name & Middle Initial & Last Name & Degree
Dan Palmer, Dr

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Individual de-identified patient data will be shared with researchers whose proposed use of the data is approved by a review committee of the Sponsor.
IPD Sharing Time Frame
All requests for data relating to this treatment arm that are made within 5 years from last patient last visit for the entrectinib treatment arm will be considered; requests made subsequently will be considered where possible.
IPD Sharing Access Criteria
When a request has been approved, Cancer Research UK will provide access to the de-identified individual patient-level data and appropriate supporting information. A signed Data Sharing Agreement must be in place before accessing requested information. Requests should be submitted to drugdev@cancer.org.uk.
Links:
URL
http://CRUK.org/determine
Description
Overview of the DETERMINE trial
URL
https://clinicaltrials.gov/ct2/show/NCT05722886
Description
ClinicalTrials.gov record for DETERMINE Trial Master Screening Protocol (NCT05722886).

Learn more about this trial

DETERMINE Trial Treatment Arm 03: Entrectinib in Adult, Teenage/Young Adults and Paediatric Patients With ROS1 Gene Fusion-positive Cancers.

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