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Cryoablation Versus Medical Therapy in Desmoid Tumors Progressing After Watchful Waiting (CRYODESMO-02)

Primary Purpose

Desmoid Tumor

Status
Not yet recruiting
Phase
Not Applicable
Locations
France
Study Type
Interventional
Intervention
Cryoablation
Chemotherapy drug
Sponsored by
University Hospital, Strasbourg, France
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Desmoid Tumor focused on measuring Desmoids, Cryoablation, Drug therapy, Cross-Over Studies

Eligibility Criteria

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

Inclusion Criteria: Subject (male or female) with extra-peritoneal desmoid tumor (confirmed by prior biopsy by an experienced pathologist within the RRePS network) 13 years of age or older Measurable viable tumor (according to the mRECIST criteria using MRI. The baseline MRI imaging is mandatory in the 2 months prior to treatment initiation (D0). Progressive disease (according to the mRECIST criteria) after the watchful waiting period or significant increase in symptoms requiring an active therapy, as advised in a multidisciplinary sarcoma tumor board Tumor deemed accessible for cryoablation procedure by the operator in a type I center. (In pediatric cases, a careful site tumor analysis will be performed with interventional radiologist to ensure for limited consequence of cryoablation in pediatric patients especially regarding growth plates). 100 % of destruction of the tumor achievable in one procedure of cryoablation with 1cm security margin according to assessment by referral center (type 1) for cryoablation ECOG performance status 0-2 at inclusion visit Biological and hematological parameters (neutrophils ≥ 1,5.109/L ; platelet count ≥ 100.109/L ; no significant hemostatic abnormalities) in the 4 weeks prior to treatment initiation (D0) Subject able to understand the objectives and risks of the research and to give dated and signed informed consent. For minors, the consent of the 2 parents must be obtained. Subject affiliated to a social health insurance plan For a woman of childbearing age: negative blood pregnancy test at screening/inclusion visit Subject agreeing to use a contraceptive method: Exclusion criteria: Intra-peritoneal desmoid tumor Known hypersensitivity to vinorelbine or other vinca-alkaloids, or other constituents to navelbine, to vinblastine, to methotrexate or any excipients, current or recent (within 2 weeks) severe infection, severe renal failure, severe hepatic injury, chronic respiratory failure, concomitant treatment with: yellow fever vaccine, prophylactic treatment with phenytoin, trimethoprim, probenecid, acetylsalicylic acid, phenylbutazone. Any contra-indication for the procedure as stated by the interventional radiologist in terms of tumor size, proximity to neural/vascular structures or adjacent organs at risk making the procedure at unacceptable risk Impaired hemostasis, that may interfere with the conduct of the cryoablation Concurrent participation in other experimental studies that could affect endpoints of the present study Concurrent use of any antitumor agent or NSAIDs, penicillins, PPIs, acitretin, ciprofloxacin, azote protoxide Contraindication to any form of sedation Hypersensitivity to gadoteric acid, meglumine or any drug containing gadolinium Others contra-indications to MRI Pregnancy or breastfeeding Impossibility to give the subject informed information (subject in an emergency situation, patient with comprehension difficulties ...) Psychiatric disorders Incompetent subject (subject to a legal protection measure: curatorship, guardianship, future protection mandate, family habilitation)

Sites / Locations

  • Service d'Oncologie Médicale, Service de Radiologie Interventionnelle, Institut BERGONNIE
  • Service d'Oncologie Médicale, Service de Radiologie Interventionnelle-Centre François BACLESSE
  • Service d'Oncologie Médicale -Centre Georges François LECLERC
  • Service d'Oncologie Médicale, Service de Radiologie Interventionnelle-Centre Léon BERARD
  • Service d'Oncologie Médicale, service de Radiologie Interventionnelle,CHU de Marseille, Hopital La Timone
  • Service de Radiologie-CHU de Nantes
  • Service d'Oncologie Médicale-Centre Antoine LACASSAGNE
  • Service d'Oncologie Médicale-Centre Henri BECQUEREL
  • Service d'Oncologie Médicale
  • Institut de cancérologie Strasbourg Europe (ICANS)
  • Service d'Imagerie Interventionnelle, Hôpitaux Universitaires de Strasbourg , France, 67091
  • Service d'Oncologie Médicale-Institut Claudius Régaud et Service de Radiologie Interventionnelle, CHU de Toulouse
  • Service d'Oncologie médicale, Service de Radiologie Interventionnelle- Institut Gustave ROUSSY

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Cryoablation

Medical therapy

Arm Description

One single cryoablation of the desmoid tumor at Day 0

Chemotherapy: at the investigator's discretion: either methotrexate 30mg/m² + vinblastine 6mg/m² (IV infusion) once/week for 6 months, then every other week from months 7 to 12, or vinorelbine 90mg/week (per os: 3x30mg, soft capsules) for 12 months.

Outcomes

Primary Outcome Measures

Rate of non-progressive disease
Rates of non-progressive disease (sum of complete response (CR), partial response (PR), and stable disease (SD) according to modified RECIST criteria)

Secondary Outcome Measures

Progression-free survival 1
Progression-free survival 1 (PFS1: from the beginning of cryoablation or medical therapy to first disease progression) in cryoablation and medical therapy group
Rate of patients who cross over to the other arm
Rate of complete response
Rate of complete response at 12 months in cryoablation and medical therapy group with and without a cross-over treatment
Secondary Progression-free survival 2
Secondary Progression-free survival 2 (PFS 2: from the cross-over to second disease progression) in cryoablation and medical therapy group
Incidence of Treatment-Emergent Adverse Events as assessed by NCI-CTCAE version 5.0 toxicity scale
The occurrence of complications and adverse reactions according to the classification of the NCI-CTCAE version 5.0 toxicity scale
QUALITY OF LIFE assessed by EUROQOL EQ 5D before and after treatment
EUROQOL EQ 5D will be used; score ranging from 1 (good quality of life) to 5 (poor quality of life)
PAIN assessed by brief pain inventory (BPI) before and after treatment
BPI will be used; score ranging from 0 (no pain) to 10 (high pain)
Health economics assessment
cost and incremental cost utility ratio

Full Information

First Posted
August 31, 2023
Last Updated
October 6, 2023
Sponsor
University Hospital, Strasbourg, France
Collaborators
Direction Générale de l'Offre des Soins (DGOS)
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1. Study Identification

Unique Protocol Identification Number
NCT06081400
Brief Title
Cryoablation Versus Medical Therapy in Desmoid Tumors Progressing After Watchful Waiting
Acronym
CRYODESMO-02
Official Title
A Phase II Multicentric, Randomized Trial Assessing Cryoablation Versus Medical Therapy in Desmoid Tumors Progressing After Watchful Waiting
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Not yet recruiting
Study Start Date
November 2023 (Anticipated)
Primary Completion Date
November 2026 (Anticipated)
Study Completion Date
February 2029 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University Hospital, Strasbourg, France
Collaborators
Direction Générale de l'Offre des Soins (DGOS)

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
"Wait & see" is currently the standard of care of recently diagnosed desmoid tumors (DT). In case of progression or symptomatic disease, medical therapy is nowadays widely used including chemotherapy. Cryoablation has proven to be beneficial for the treatment of large, progressive and symptomatic DT. This randomized phase II trial aims to compare cryoablation versus medical therapy in DT patients progressing after the "wait & see" period. Moreover, a cross-over design has been anticipated to allow all patients to undergo cryoablation if necessary.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Desmoid Tumor
Keywords
Desmoids, Cryoablation, Drug therapy, Cross-Over Studies

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Crossover Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
150 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Cryoablation
Arm Type
Experimental
Arm Description
One single cryoablation of the desmoid tumor at Day 0
Arm Title
Medical therapy
Arm Type
Active Comparator
Arm Description
Chemotherapy: at the investigator's discretion: either methotrexate 30mg/m² + vinblastine 6mg/m² (IV infusion) once/week for 6 months, then every other week from months 7 to 12, or vinorelbine 90mg/week (per os: 3x30mg, soft capsules) for 12 months.
Intervention Type
Procedure
Intervention Name(s)
Cryoablation
Intervention Description
Percutaneous imaging-guided cryoablation
Intervention Type
Drug
Intervention Name(s)
Chemotherapy drug
Intervention Description
Either : methotrexate 30mg/m² + vinblastine 6mg/m² (IV infusion) once/week for 6 months, then every other week from months 7 to 12, or vinorelbine 90mg/week (per os: 3x30mg, soft capsules) for 12 months.
Primary Outcome Measure Information:
Title
Rate of non-progressive disease
Description
Rates of non-progressive disease (sum of complete response (CR), partial response (PR), and stable disease (SD) according to modified RECIST criteria)
Time Frame
12 months after treatment initiation (Day 0+12months)
Secondary Outcome Measure Information:
Title
Progression-free survival 1
Description
Progression-free survival 1 (PFS1: from the beginning of cryoablation or medical therapy to first disease progression) in cryoablation and medical therapy group
Time Frame
from treatment initiation to PD or 24 months whichever comes first
Title
Rate of patients who cross over to the other arm
Time Frame
24 months after treatment initiation
Title
Rate of complete response
Description
Rate of complete response at 12 months in cryoablation and medical therapy group with and without a cross-over treatment
Time Frame
12 months after treatment initiation and 12 months after cross-over
Title
Secondary Progression-free survival 2
Description
Secondary Progression-free survival 2 (PFS 2: from the cross-over to second disease progression) in cryoablation and medical therapy group
Time Frame
Through study completion, up to 39 months
Title
Incidence of Treatment-Emergent Adverse Events as assessed by NCI-CTCAE version 5.0 toxicity scale
Description
The occurrence of complications and adverse reactions according to the classification of the NCI-CTCAE version 5.0 toxicity scale
Time Frame
Through study completion, up to 39 months
Title
QUALITY OF LIFE assessed by EUROQOL EQ 5D before and after treatment
Description
EUROQOL EQ 5D will be used; score ranging from 1 (good quality of life) to 5 (poor quality of life)
Time Frame
Screening visit, Month 1, Month 2, Month 3, Month 6, Month 9 and Month 12 after treatment initiation
Title
PAIN assessed by brief pain inventory (BPI) before and after treatment
Description
BPI will be used; score ranging from 0 (no pain) to 10 (high pain)
Time Frame
Screening visit, Day 0/Day 1, Month 1, Month 2, Month 3, Month 6, Month 9 and Month 12 after treatment initiation
Title
Health economics assessment
Description
cost and incremental cost utility ratio
Time Frame
Through study completion, up to 39 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
13 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject (male or female) with extra-peritoneal desmoid tumor (confirmed by prior biopsy by an experienced pathologist within the RRePS network) 13 years of age or older Measurable viable tumor (according to the mRECIST criteria using MRI. The baseline MRI imaging is mandatory in the 2 months prior to treatment initiation (D0). Progressive disease (according to the mRECIST criteria) after the watchful waiting period or significant increase in symptoms requiring an active therapy, as advised in a multidisciplinary sarcoma tumor board Tumor deemed accessible for cryoablation procedure by the operator in a type I center. (In pediatric cases, a careful site tumor analysis will be performed with interventional radiologist to ensure for limited consequence of cryoablation in pediatric patients especially regarding growth plates). 100 % of destruction of the tumor achievable in one procedure of cryoablation with 1cm security margin according to assessment by referral center (type 1) for cryoablation ECOG performance status 0-2 at inclusion visit Biological and hematological parameters (neutrophils ≥ 1,5.109/L ; platelet count ≥ 100.109/L ; no significant hemostatic abnormalities) in the 4 weeks prior to treatment initiation (D0) Subject able to understand the objectives and risks of the research and to give dated and signed informed consent. For minors, the consent of the 2 parents must be obtained. Subject affiliated to a social health insurance plan For a woman of childbearing age: negative blood pregnancy test at screening/inclusion visit Subject agreeing to use a contraceptive method: Exclusion criteria: Intra-peritoneal desmoid tumor Known hypersensitivity to vinorelbine or other vinca-alkaloids, or other constituents to navelbine, to vinblastine, to methotrexate or any excipients, current or recent (within 2 weeks) severe infection, severe renal failure, severe hepatic injury, chronic respiratory failure, concomitant treatment with: yellow fever vaccine, prophylactic treatment with phenytoin, trimethoprim, probenecid, acetylsalicylic acid, phenylbutazone. Any contra-indication for the procedure as stated by the interventional radiologist in terms of tumor size, proximity to neural/vascular structures or adjacent organs at risk making the procedure at unacceptable risk Impaired hemostasis, that may interfere with the conduct of the cryoablation Concurrent participation in other experimental studies that could affect endpoints of the present study Concurrent use of any antitumor agent or NSAIDs, penicillins, PPIs, acitretin, ciprofloxacin, azote protoxide Contraindication to any form of sedation Hypersensitivity to gadoteric acid, meglumine or any drug containing gadolinium Others contra-indications to MRI Pregnancy or breastfeeding Impossibility to give the subject informed information (subject in an emergency situation, patient with comprehension difficulties ...) Psychiatric disorders Incompetent subject (subject to a legal protection measure: curatorship, guardianship, future protection mandate, family habilitation)
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Afshin GANGI, MD,PhD
Phone
0369550304
Ext
33
Email
afshin.gangi@chru-strasbourg.fr
First Name & Middle Initial & Last Name or Official Title & Degree
Roberto Luigi CAZZATO, MD
Phone
0369550304
Ext
33
Email
RobertoLuigi.CAZZATO@chru-strasbourg.fr
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Afshin GANGI, MD, PhD
Organizational Affiliation
Hôpitaux Universitaires de Strasbourg
Official's Role
Principal Investigator
Facility Information:
Facility Name
Service d'Oncologie Médicale, Service de Radiologie Interventionnelle, Institut BERGONNIE
City
Bordeaux
ZIP/Postal Code
33000
Country
France
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Maud TOULMONDE, MD
First Name & Middle Initial & Last Name & Degree
Maud TOULMONDE, MD
Facility Name
Service d'Oncologie Médicale, Service de Radiologie Interventionnelle-Centre François BACLESSE
City
Caen
ZIP/Postal Code
14076
Country
France
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Marie-Aude THENINT, MD
First Name & Middle Initial & Last Name & Degree
Marie-Aude THENINT, MD
Facility Name
Service d'Oncologie Médicale -Centre Georges François LECLERC
City
Dijon
ZIP/Postal Code
21079
Country
France
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Alice HERVIEU, MD
First Name & Middle Initial & Last Name & Degree
Alice HERVIEU, MD
Facility Name
Service d'Oncologie Médicale, Service de Radiologie Interventionnelle-Centre Léon BERARD
City
Lyon
ZIP/Postal Code
69373
Country
France
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Mehdi BRAHMI, MD
First Name & Middle Initial & Last Name & Degree
Mehdi BRAHMI, MD
Facility Name
Service d'Oncologie Médicale, service de Radiologie Interventionnelle,CHU de Marseille, Hopital La Timone
City
Marseille
ZIP/Postal Code
13385
Country
France
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Florence DUFFAUD, MD, PhD
First Name & Middle Initial & Last Name & Degree
Florence DUFFAUD, MD, PhD
Facility Name
Service de Radiologie-CHU de Nantes
City
Nantes
ZIP/Postal Code
44000
Country
France
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Arthur DAVID, MD
First Name & Middle Initial & Last Name & Degree
Arthur DAVID, MD
Facility Name
Service d'Oncologie Médicale-Centre Antoine LACASSAGNE
City
Nice
ZIP/Postal Code
06189
Country
France
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Agnès DUCOULOMBIER, MD
First Name & Middle Initial & Last Name & Degree
Agnès DUCOULOMBIER
Facility Name
Service d'Oncologie Médicale-Centre Henri BECQUEREL
City
Rouen
ZIP/Postal Code
76038
Country
France
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Cécile GUILLEMET, MD
First Name & Middle Initial & Last Name & Degree
Cécile GUILLEMET, MD
Facility Name
Service d'Oncologie Médicale
City
Saint-Herblain
ZIP/Postal Code
44805
Country
France
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Emmanuelle BOMPAS, MD
First Name & Middle Initial & Last Name & Degree
Emmnauelle BOMPAS, MD
Facility Name
Institut de cancérologie Strasbourg Europe (ICANS)
City
Strasbourg
ZIP/Postal Code
67033
Country
France
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jean-Emmanuel KURTZ, MD PhD
First Name & Middle Initial & Last Name & Degree
Jean-Emmanuel KURTZ
Facility Name
Service d'Imagerie Interventionnelle, Hôpitaux Universitaires de Strasbourg , France, 67091
City
Strasbourg
ZIP/Postal Code
67091
Country
France
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Afshin GANGI, MD, PhD
First Name & Middle Initial & Last Name & Degree
Afshin GANGI, MD, PhD
First Name & Middle Initial & Last Name & Degree
Roberto Luigi CAZZATO, MD
Facility Name
Service d'Oncologie Médicale-Institut Claudius Régaud et Service de Radiologie Interventionnelle, CHU de Toulouse
City
Toulouse
ZIP/Postal Code
31059
Country
France
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Thibaud VALENTIN, MD
First Name & Middle Initial & Last Name & Degree
Thibaud VALENTIN, MD
Facility Name
Service d'Oncologie médicale, Service de Radiologie Interventionnelle- Institut Gustave ROUSSY
City
Villejuif
ZIP/Postal Code
94800
Country
France
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Frédéric DESCHAMPS, MD
First Name & Middle Initial & Last Name & Degree
Frédéric DESCHAMPS, MD

12. IPD Sharing Statement

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Cryoablation Versus Medical Therapy in Desmoid Tumors Progressing After Watchful Waiting

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