A Study of Olaratumab (LY3012207), Doxorubicin, and Ifosfamide in Participants With Advanced or Metastatic Soft Tissue Sarcoma
Primary Purpose
Soft Tissue Sarcoma
Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
Olaratumab
Doxorubicin
Ifosfamide
Mesna
Sponsored by
About this trial
This is an interventional treatment trial for Soft Tissue Sarcoma
Eligibility Criteria
Inclusion Criteria:
- Have a histological diagnosis of advanced STS (by local pathology review), for which treatment with doxorubicin, ifosfamide and mesna is deemed appropriate by the investigator.
- Have measurable or nonmeasurable but evaluable disease as defined by the Response Evaluation Criteria in Solid Tumors (RECIST 1.1).
- Have adequate hematologic, organ and coagulation function within 2 weeks (14 days) prior to enrollment.
- Have a performance status of 0 to 1 on the Eastern Cooperative Oncology Group scale.
- Have received no prior lines of systemic therapy and are suitable to receive doxorubicin, ifosfamide and mesna. All previous anticancer treatments must have completed ≥3 weeks (21 days) prior to the first dose of study treatment.
- Have left ventricular ejection fraction (LVEF) ≥50% assessed within 28 days prior to enrollment.
- Have resolution of Adverse Events (AEs), with the exception of alopecia, and of all clinically significant toxic effects of prior locoregional therapy, surgery or radiotherapy to ≤Grade 1, by National Cancer Institute-Common Terminology Criteria for Adverse Events (NCI-CTCAE) Version 4.0.
- Have sufficient available material from archived formalin-fixed paraffin-embedded tumor tissue for biomarker-related studies. If such tissue is not available, a newly obtained core or excisional biopsy of a tumor lesion must be performed.
- If male, must be sterile or agree to use an effective method of contraception or a highly effective method of contraception during the study and for at least 12 weeks following the last dose of study treatment.
If female and of child-bearing potential, must:
- have a negative serum pregnancy test at the time of enrollment,
- have a negative urine pregnancy test within 24 hours prior to the first dose of study treatment, and
- agree to use a highly effective method of contraception during the study and for 3 months following the last dose of study treatment.
- Have a life expectancy of at least 3 months, in the opinion of the investigator.
Exclusion Criteria:
- Are currently enrolled in a clinical trial involving an investigational product or any other type of medical research judged not to be scientifically or medically compatible with this study.
- Have participated within the past 30 days in a clinical trial involving an investigational product. If the previous investigational product has a long half-life, 3 months or 5 half-lives (whichever is longer) should have passed.
- Have previously completed or withdrawn from any study investigating olaratumab.
- Have received prior treatment with olaratumab, doxorubicin, or ifosfamide, or have participated in other trials investigating olaratumab.
- Have received prior radiotherapy of the mediastinal/pericardial area or whole pelvis radiation.
- Have known urinary outflow obstruction, or inflammation of the urinary bladder (cystitis).
- Are diagnosed with gastrointestinal stromal tumor or Kaposi sarcoma.
- Have active central nervous system (CNS) or leptomeningeal metastasis (brain metastasis) at the time of enrollment. Participants with a history of CNS metastasis (previously treated with curative intent [for example, stereotactic radiation or surgery]) that has not progressed on follow-up imaging, have been asymptomatic for at least 60 days, and are not receiving systemic corticosteroids and/or anticonvulsants are eligible. Participants with signs or symptoms of neurological compromise should have appropriate radiographic imaging performed before enrollment to rule out brain metastasis.
Have a history of another primary malignancy, with the exception of:
- curatively treated non-melanomatous skin cancer
- curatively treated cervical carcinoma in situ
- Have an active fungal, bacterial and/or known viral infection including human immunodeficiency virus or viral (A, B, or C) hepatitis (screening is not required).
- Have Grade 3 or 4 peripheral neuropathy per NCI-CTCAE Version 4.0.
- Have a serious cardiac condition.
- Have a resting heart rate of >100 beats per minute (bpm).
- Have a Fridericia's QT corrected interval (QTcF) interval of >450 milliseconds (msec) for males and >470 msec for females on screening electrocardiogram (ECG) utilizing Fridericia's correction.
- Have uncontrolled intercurrent illness including, but not limited to, an ongoing/active infection requiring parenteral antibiotics.
- Have a psychiatric illness/social situation that would limit compliance with study requirements.
- Have electively planned or will require major surgery during the course of the study.
- Are females who are pregnant or breastfeeding.
Sites / Locations
- University of Miami School of Medicine
- University of Texas MD Anderson Cancer Center
- Universitätsklinikum Essen
- HELIOS Klinikum Berlin-Buch
- Istituto Nazionale dei Tumori
- Università degli Studi di Catania - Azienda Policlinico
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Olaratumab + Doxorubicin + Ifosfamide + Mesna
Arm Description
Olaratumab 15 milligrams per kilogram (mg/kg) on Days 1 and 8 of a 21-day cycle, in combination with doxorubicin and ifosfamide was administered. When the safety of the 15-mg/kg dose of olaratumab was established, a 20-mg/kg loading dose cycle of olaratumab on Days 1 and 8 of a 21-day cycle in Cycle 1 only, followed by 15 mg/kg on Days 1 and 8 of subsequent cycles in combination with doxorubicin and ifosfamide plus mesna, was administered.
Outcomes
Primary Outcome Measures
Number of Participants With Olaratumab Dose Limiting Toxicities (DLTs)
A Dose Limiting Toxicity is defined as an Adverse Event (AE) that is likely related to the study medication or combination, and fulfills any one of the following criteria, graded according to the NCI-CTCAE Version 4.0:
Grade 3 or 4 febrile neutropenia, or sepsis., or
Grade 4 neutropenia lasting 7 days or longer.
Grade 4 thrombocytopenia, or Grade 3 thrombocytopenia complicated by hemorrhage.
Nonhematologic Grade ≥3 toxicity, except for toxicities (such as nausea, vomiting, transient electrolyte abnormalities, or diarrhoea) that can be controlled with optimal medical management within 48 hours or clinically non-significant laboratory abnormalities.
Secondary Outcome Measures
Pharmacokinetics (PK): Maximum Serum Concentration (Cmax) of Olaratumab
PK: Cmax of olaratumab.
PK: Maximum Serum Concentration (Cmax,ss) of Olaratumab at Steady-state
PK: Cmax of olaratumab at steady-state.
PK: Trough Serum Concentration (Cmin)
PK: Cmin of olaratumab.
PK: Trough Serum Concentration (Cmin,ss) of Olaratumab at Steady-state
PK: Cmin of olaratumab at steady-state.
Number of Participants With Anti-Olaratumab Antibodies
Participants with treatment-emergent anti-drug antibody (TE ADA) positive were 1) a participant with a 4-fold (2 dilutions) increase over a positive baseline antibody titer; or 2) for a negative baseline titer, a participant with an increase from the baseline to a level of 1:20.
Objective Response Rate (ORR): Number of Participants Who Achieve Best Overall Tumor Response of Complete Response (CR) or Partial Response (PR)
Objective response rate is the best overall tumor response of complete response (CR) or partial response (PR) as classified by the independent central review according to the Response Evaluation Criteria In Solid Tumors (RECIST v1.1). CR is a disappearance of all target and non-target lesions and normalization of tumor marker level. PR is an at least 30% decrease in the sum of the diameters of target lesions (taking as reference the baseline sum diameter) without progression of non-target lesions or appearance of new lesions.
Progression Free Survival (PFS)
Progression-free survival time was measured from randomization until the date of objective progression as defined by Response Evaluation Criteria in Solid Tumors v1.1 (RECIST v1.1), or death from any cause. PD is defined as at least a 20% increase in the sum of the diameters of target lesions, with reference being the smallest sum on study and an absolute increase of at least 5 mm, or unequivocal progression of non-target lesions, or 1 or more new lesions. Participants who have neither progressed nor died were censored at the day of their last radiographic tumor assessment, if available, or date of randomization if no post-baseline radiographic assessment is available.
Duration of Response (DoR)
Duration of response is defined as the time from the date measurement criteria for CR or PR (whichever is first recorded) are first met until the first date that disease is recurrent or objective progression is observed, per RECIST 1.1, or the date of death from any cause in the absence of objectively determined disease progression or recurrence. Participants known to be alive and without disease progression will be censored at the time of the last adequate tumor assessment.
Disease Control Rate (DCR): Percentage of Participants With a Best Overall Response of CR, PR, or Stable Disease (SD)
Disease control rate (DCR) is the percentage of participants with a best overall response of CR, PR or SD as defined by RECIST v1.1. CR is defined as the disappearance of all target and non-target lesions and no appearance of new lesions. PR is defined as at least a 30% decrease in the sum of the longest diameter (LD) of target lesions (taking as reference the baseline sum LD), no progression of non-target lesions, and no appearance of new lesions. SD is neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for progressive disease (PD) for target lesions, no progression of non-target lesions, and no appearance of new lesions. PD is defined as at least a 20% increase in the sum of the diameters of target lesions, with reference being the smallest sum on study and an absolute increase of at least 5 mm, or unequivocal progression of non-target lesions, or 1 or more new lesions.
Overall Survival (OS)
Overall survival is defined as the time from the date of randomization to the date of death from any cause. For each participant who is not known to have died as of the data-inclusion cut-off date for a particular analysis, overall survival duration was censored for that analysis at the date of last prior contact.
Full Information
NCT ID
NCT03283696
First Posted
September 13, 2017
Last Updated
August 22, 2020
Sponsor
Eli Lilly and Company
1. Study Identification
Unique Protocol Identification Number
NCT03283696
Brief Title
A Study of Olaratumab (LY3012207), Doxorubicin, and Ifosfamide in Participants With Advanced or Metastatic Soft Tissue Sarcoma
Official Title
A Phase 1b Study of Olaratumab, Doxorubicin and Ifosfamide in the Treatment of Patients With Advanced or Metastatic Soft Tissue Sarcoma
Study Type
Interventional
2. Study Status
Record Verification Date
April 2020
Overall Recruitment Status
Completed
Study Start Date
October 18, 2017 (Actual)
Primary Completion Date
April 29, 2019 (Actual)
Study Completion Date
August 25, 2019 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Eli Lilly and Company
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
The purpose of this study is to evaluate the safety of ifosfamide when added to the combination regimen of olaratumab and doxorubicin in participants with advanced or metastatic soft tissue sarcoma (STS).
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Soft Tissue Sarcoma
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
24 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Olaratumab + Doxorubicin + Ifosfamide + Mesna
Arm Type
Experimental
Arm Description
Olaratumab 15 milligrams per kilogram (mg/kg) on Days 1 and 8 of a 21-day cycle, in combination with doxorubicin and ifosfamide was administered. When the safety of the 15-mg/kg dose of olaratumab was established, a 20-mg/kg loading dose cycle of olaratumab on Days 1 and 8 of a 21-day cycle in Cycle 1 only, followed by 15 mg/kg on Days 1 and 8 of subsequent cycles in combination with doxorubicin and ifosfamide plus mesna, was administered.
Intervention Type
Drug
Intervention Name(s)
Olaratumab
Other Intervention Name(s)
LY3012207
Intervention Description
Administered IV
Intervention Type
Drug
Intervention Name(s)
Doxorubicin
Intervention Description
Administered IV
Intervention Type
Drug
Intervention Name(s)
Ifosfamide
Intervention Description
Administered IV
Intervention Type
Drug
Intervention Name(s)
Mesna
Intervention Description
Administered per standard of care
Primary Outcome Measure Information:
Title
Number of Participants With Olaratumab Dose Limiting Toxicities (DLTs)
Description
A Dose Limiting Toxicity is defined as an Adverse Event (AE) that is likely related to the study medication or combination, and fulfills any one of the following criteria, graded according to the NCI-CTCAE Version 4.0:
Grade 3 or 4 febrile neutropenia, or sepsis., or
Grade 4 neutropenia lasting 7 days or longer.
Grade 4 thrombocytopenia, or Grade 3 thrombocytopenia complicated by hemorrhage.
Nonhematologic Grade ≥3 toxicity, except for toxicities (such as nausea, vomiting, transient electrolyte abnormalities, or diarrhoea) that can be controlled with optimal medical management within 48 hours or clinically non-significant laboratory abnormalities.
Time Frame
Cycle 1 (Up To 24 days)
Secondary Outcome Measure Information:
Title
Pharmacokinetics (PK): Maximum Serum Concentration (Cmax) of Olaratumab
Description
PK: Cmax of olaratumab.
Time Frame
Cycle 1 - Day 1 (predose, end of infusion, 2 hours post olaratumab (olara), 6 hours post olara, 24 hours post olara, 72 hours post olara), Day 8 (predose, end of infusion, 2 hours post-olara, 6 hours post olara, 48 hours post olara, 168 hours post olara)
Title
PK: Maximum Serum Concentration (Cmax,ss) of Olaratumab at Steady-state
Description
PK: Cmax of olaratumab at steady-state.
Time Frame
Cycle 3 - Day 1 (predose, end of infusion, 2 hours post olara, 5 hours post olara, 24 hours post olara, 72 hours post olara), Day 8 (predose, end of infusion, 2 hours post-olara, 5 hours post olara, 48 hours post olara, 168 hours post olara)
Title
PK: Trough Serum Concentration (Cmin)
Description
PK: Cmin of olaratumab.
Time Frame
Cycle 1 - Day 1 (predose, end of infusion, 2 hours post olaratumab (olara), 6 hours post olara, 24 hours post olara, 72 hours post olara), Day 8 (predose, end of infusion, 2 hours post-olara, 6 hours post olara, 48 hours post olara, 168 hours post olara)
Title
PK: Trough Serum Concentration (Cmin,ss) of Olaratumab at Steady-state
Description
PK: Cmin of olaratumab at steady-state.
Time Frame
Cycle 3 - Day 1 (predose, end of infusion, 2 hours post olara, 5 hours post olara, 24 hours post olara, 72 hours post olara), Day 8 (predose, end of infusion, 2 hours post-olara, 5 hours post olara, 48 hours post olara, 168 hours post olara)
Title
Number of Participants With Anti-Olaratumab Antibodies
Description
Participants with treatment-emergent anti-drug antibody (TE ADA) positive were 1) a participant with a 4-fold (2 dilutions) increase over a positive baseline antibody titer; or 2) for a negative baseline titer, a participant with an increase from the baseline to a level of 1:20.
Time Frame
Baseline through Follow-up (Up To 21 Months)
Title
Objective Response Rate (ORR): Number of Participants Who Achieve Best Overall Tumor Response of Complete Response (CR) or Partial Response (PR)
Description
Objective response rate is the best overall tumor response of complete response (CR) or partial response (PR) as classified by the independent central review according to the Response Evaluation Criteria In Solid Tumors (RECIST v1.1). CR is a disappearance of all target and non-target lesions and normalization of tumor marker level. PR is an at least 30% decrease in the sum of the diameters of target lesions (taking as reference the baseline sum diameter) without progression of non-target lesions or appearance of new lesions.
Time Frame
Baseline up to Short-Term Follow-Up Period (Up To 21 Months)
Title
Progression Free Survival (PFS)
Description
Progression-free survival time was measured from randomization until the date of objective progression as defined by Response Evaluation Criteria in Solid Tumors v1.1 (RECIST v1.1), or death from any cause. PD is defined as at least a 20% increase in the sum of the diameters of target lesions, with reference being the smallest sum on study and an absolute increase of at least 5 mm, or unequivocal progression of non-target lesions, or 1 or more new lesions. Participants who have neither progressed nor died were censored at the day of their last radiographic tumor assessment, if available, or date of randomization if no post-baseline radiographic assessment is available.
Time Frame
Baseline to Objective Disease Progression or Death Due to Any Cause (Up To 21 Months)
Title
Duration of Response (DoR)
Description
Duration of response is defined as the time from the date measurement criteria for CR or PR (whichever is first recorded) are first met until the first date that disease is recurrent or objective progression is observed, per RECIST 1.1, or the date of death from any cause in the absence of objectively determined disease progression or recurrence. Participants known to be alive and without disease progression will be censored at the time of the last adequate tumor assessment.
Time Frame
Date of Complete Response (CR) or Partial Response (PR) to Objective Disease Progression or Death Due to Any Cause (Up To 21 Months)
Title
Disease Control Rate (DCR): Percentage of Participants With a Best Overall Response of CR, PR, or Stable Disease (SD)
Description
Disease control rate (DCR) is the percentage of participants with a best overall response of CR, PR or SD as defined by RECIST v1.1. CR is defined as the disappearance of all target and non-target lesions and no appearance of new lesions. PR is defined as at least a 30% decrease in the sum of the longest diameter (LD) of target lesions (taking as reference the baseline sum LD), no progression of non-target lesions, and no appearance of new lesions. SD is neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for progressive disease (PD) for target lesions, no progression of non-target lesions, and no appearance of new lesions. PD is defined as at least a 20% increase in the sum of the diameters of target lesions, with reference being the smallest sum on study and an absolute increase of at least 5 mm, or unequivocal progression of non-target lesions, or 1 or more new lesions.
Time Frame
Baseline until Disease Progression or Death Due to Any Cause (Up To 21 Months)
Title
Overall Survival (OS)
Description
Overall survival is defined as the time from the date of randomization to the date of death from any cause. For each participant who is not known to have died as of the data-inclusion cut-off date for a particular analysis, overall survival duration was censored for that analysis at the date of last prior contact.
Time Frame
Baseline to Date of Death Due to Any Cause (Up To 21 Months)
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Have a histological diagnosis of advanced STS (by local pathology review), for which treatment with doxorubicin, ifosfamide and mesna is deemed appropriate by the investigator.
Have measurable or nonmeasurable but evaluable disease as defined by the Response Evaluation Criteria in Solid Tumors (RECIST 1.1).
Have adequate hematologic, organ and coagulation function within 2 weeks (14 days) prior to enrollment.
Have a performance status of 0 to 1 on the Eastern Cooperative Oncology Group scale.
Have received no prior lines of systemic therapy and are suitable to receive doxorubicin, ifosfamide and mesna. All previous anticancer treatments must have completed ≥3 weeks (21 days) prior to the first dose of study treatment.
Have left ventricular ejection fraction (LVEF) ≥50% assessed within 28 days prior to enrollment.
Have resolution of Adverse Events (AEs), with the exception of alopecia, and of all clinically significant toxic effects of prior locoregional therapy, surgery or radiotherapy to ≤Grade 1, by National Cancer Institute-Common Terminology Criteria for Adverse Events (NCI-CTCAE) Version 4.0.
Have sufficient available material from archived formalin-fixed paraffin-embedded tumor tissue for biomarker-related studies. If such tissue is not available, a newly obtained core or excisional biopsy of a tumor lesion must be performed.
If male, must be sterile or agree to use an effective method of contraception or a highly effective method of contraception during the study and for at least 12 weeks following the last dose of study treatment.
If female and of child-bearing potential, must:
have a negative serum pregnancy test at the time of enrollment,
have a negative urine pregnancy test within 24 hours prior to the first dose of study treatment, and
agree to use a highly effective method of contraception during the study and for 3 months following the last dose of study treatment.
Have a life expectancy of at least 3 months, in the opinion of the investigator.
Exclusion Criteria:
Are currently enrolled in a clinical trial involving an investigational product or any other type of medical research judged not to be scientifically or medically compatible with this study.
Have participated within the past 30 days in a clinical trial involving an investigational product. If the previous investigational product has a long half-life, 3 months or 5 half-lives (whichever is longer) should have passed.
Have previously completed or withdrawn from any study investigating olaratumab.
Have received prior treatment with olaratumab, doxorubicin, or ifosfamide, or have participated in other trials investigating olaratumab.
Have received prior radiotherapy of the mediastinal/pericardial area or whole pelvis radiation.
Have known urinary outflow obstruction, or inflammation of the urinary bladder (cystitis).
Are diagnosed with gastrointestinal stromal tumor or Kaposi sarcoma.
Have active central nervous system (CNS) or leptomeningeal metastasis (brain metastasis) at the time of enrollment. Participants with a history of CNS metastasis (previously treated with curative intent [for example, stereotactic radiation or surgery]) that has not progressed on follow-up imaging, have been asymptomatic for at least 60 days, and are not receiving systemic corticosteroids and/or anticonvulsants are eligible. Participants with signs or symptoms of neurological compromise should have appropriate radiographic imaging performed before enrollment to rule out brain metastasis.
Have a history of another primary malignancy, with the exception of:
curatively treated non-melanomatous skin cancer
curatively treated cervical carcinoma in situ
Have an active fungal, bacterial and/or known viral infection including human immunodeficiency virus or viral (A, B, or C) hepatitis (screening is not required).
Have Grade 3 or 4 peripheral neuropathy per NCI-CTCAE Version 4.0.
Have a serious cardiac condition.
Have a resting heart rate of >100 beats per minute (bpm).
Have a Fridericia's QT corrected interval (QTcF) interval of >450 milliseconds (msec) for males and >470 msec for females on screening electrocardiogram (ECG) utilizing Fridericia's correction.
Have uncontrolled intercurrent illness including, but not limited to, an ongoing/active infection requiring parenteral antibiotics.
Have a psychiatric illness/social situation that would limit compliance with study requirements.
Have electively planned or will require major surgery during the course of the study.
Are females who are pregnant or breastfeeding.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Call 1-877-CTLILLY (1-877-285-4559) or 1-317-615-4559 Mon - Fri 9 AM - 5 PM Eastern time (UTC/GMT - 5 hours, EST)
Organizational Affiliation
Eli Lilly and Company
Official's Role
Study Director
Facility Information:
Facility Name
University of Miami School of Medicine
City
Miami
State/Province
Florida
ZIP/Postal Code
33136
Country
United States
Facility Name
University of Texas MD Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
Universitätsklinikum Essen
City
Essen
State/Province
Nordrhein-Westfalen
ZIP/Postal Code
45122
Country
Germany
Facility Name
HELIOS Klinikum Berlin-Buch
City
Berlin
ZIP/Postal Code
13125
Country
Germany
Facility Name
Istituto Nazionale dei Tumori
City
Milano
State/Province
Lombardie
ZIP/Postal Code
20133
Country
Italy
Facility Name
Università degli Studi di Catania - Azienda Policlinico
City
Catania
ZIP/Postal Code
95123
Country
Italy
12. IPD Sharing Statement
Plan to Share IPD
No
Links:
URL
https://www.lillytrialguide.com/en-US/studies/soft-tissue-sarcoma/JGDR#?postal=
Description
A Study of Olaratumab (LY3012207), Doxorubicin, and Ifosfamide in Participants With Advanced or Metastatic Soft Tissue Sarcoma
Learn more about this trial
A Study of Olaratumab (LY3012207), Doxorubicin, and Ifosfamide in Participants With Advanced or Metastatic Soft Tissue Sarcoma
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