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Clinical Study of Concurrent Pazopanib and Radiotherapy for Non-metastatic Sarcoma Patients (PASART-2)

Primary Purpose

Sarcoma, Soft Tissue Sarcomas

Status
Terminated
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
external beam radiotherapy
pazopanib
Sponsored by
The Netherlands Cancer Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Sarcoma focused on measuring pazopanib, radiotherapy

Eligibility Criteria

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

Inclusion Criteria:

  • Histologically confirmed newly diagnosed intermediate to high grade soft tissue sarcoma localized to the extremities, trunk and chest wall or the head and neck area, for which the standard treatment is a combination of and radiotherapy and surgery(deep seated and/or > 5cm according to the RECIST 1.1 criteria and/or an anticipated close resection margin and/or grade II/III according to the WHO definition)
  • Age ≥ 18 years
  • WHO performance status of ≤ 1
  • Able and willing to undergo blood sampling for PK and PD analysis
  • Able to swallow and retain oral medication
  • Able and willing to undergo MRI scanning
  • Able and willing to undergo tumor biopsies
  • Adequate organ functions as described by the laboratory findings in the table 1. For thyroid function, the T4 and TSH values must be within normal values of the range of the participating centers
  • Written informed consent prior to performance of study-specific procedures or assessments and must be willing to comply with treatment and follow up.

Exclusion Criteria

  • Prior malignancies; except another malignancy and disease-free for ≥ 5 years, or completely resected non-melanomatous skin carcinoma or successfully treated in situ carcinoma.
  • Patients with recurrent sarcomas (even without prior radiotherapy)
  • Ewing sarcoma and other PNET family tumors, rhabdomyosarcomas (both pediatric and adult), osteosarcomas
  • Clinically significant gastrointestinal abnormalities which might interfere with oral dosing diagnosed
  • Poorly controlled hypertension [defined as systolic blood pressure (SBP) of ≥140 mmHg or diastolic blood pressure (DBP) of ≥ 90mmHg]
  • Unstable or serious concurrent condition (e.g., active infection requiring systemic therapy)
  • Prolongation of corrected QT interval (QTc) > 480 msecs on ECG
  • History of any of more of the following cardiovascular conditions within the past 6 months:
  • Cardiac angioplasty or stenting
  • Myocardial infarction
  • Unstable angina
  • Symptomatic peripheral vascular disease
  • Coronary artery by-pass graft surgery
  • Class II, III or IV congestive heart failure as defined by the New York Heart Association (NYHA)
  • History of cerebrovascular accident, pulmonary embolism or untreated deep venous thrombosis (DVT) within the past 6 months
  • Macroscopic hematuria
  • Hemoptysis that is clinically relevant within 4 weeks of first dose of pazopanib
  • Evidence of active bleeding or bleeding diathesis
  • Prior major surgery or trauma within 28 days prior to first dose of study medication and/or presence of any non-healing wound, fracture, or ulcer
  • Chemotherapy or radiation therapy within 2 weeks prior to the first dose of study medication
  • Biological therapy or treatment with an investigational agent within 28 days or five half-lives, whichever is longer prior to the first dose of study medication
  • Prohibited medications listed in the protocol for 14 days or five half-lives of a drug (whichever is longer) prior to visit 1 and for the duration of the study
  • Known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs chemically related to pazopanib
  • Any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule; those conditions should be discussed with the patient before registration in the trial
  • Female patients who are pregnant, breast-feeding or male or female patients of reproductive potential who are not employing an effective method of birth control

Sites / Locations

  • Antoni van Leeuwenhoek
  • Leids Universitair Medisch Centrum
  • Royal Marsden Hospital

Arms of the Study

Arm 1

Arm Type

Other

Arm Label

radiotherapy combined with pazopanib

Arm Description

patients during the first part of the study received concurrent radiotherapy (25x2Gy) and pazopanib (QD 800 mg). The patients of the second part of the study will receive concurrent radiotherapy (18x2Gy) and pazopanib (QD 800 mg).

Outcomes

Primary Outcome Measures

pathological near complete remission of the resected specimen which has been treated with radiotherapy
Proportion of patients with resection specimens demonstrating induction of a pathological (near) complete remission (≥ 95% tumor regression). Pathological (near) complete remission is defined as ≥ 95% replacement of tumor with other tissue, usually fibrosis and) in the resection specimen post combined pazopanib and radiotherapy treatment

Secondary Outcome Measures

Incidence toxicities measured by NCI-CTCAE v4.0 (radiotherapy alone, pazopanib alone or both) measured from start of treatment until 6 weeks post-treatment
Rate of response as measured by RECIST v 1.1 at 4 weeks after completing radiotherapy
Incidence of acute post-operative wound complications up to 3 weeks (+/- 1 week) after surgery as defined in section 6.1.3 and reference 29 (see also appendix XII)

Full Information

First Posted
September 16, 2015
Last Updated
June 26, 2019
Sponsor
The Netherlands Cancer Institute
Collaborators
Royal Marsden NHS Foundation Trust
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1. Study Identification

Unique Protocol Identification Number
NCT02575066
Brief Title
Clinical Study of Concurrent Pazopanib and Radiotherapy for Non-metastatic Sarcoma Patients
Acronym
PASART-2
Official Title
Phase II Clinical Study of Concurrent Pazopanib for Non-metastatic Sarcoma Patients to be Treated With Radiotherapy, Localized in the Extremities, Trunk and Chest Wall or the Head and Neck Region (PASART-2)
Study Type
Interventional

2. Study Status

Record Verification Date
June 2019
Overall Recruitment Status
Terminated
Why Stopped
stopping rule
Study Start Date
March 17, 2016 (Actual)
Primary Completion Date
March 20, 2019 (Actual)
Study Completion Date
March 20, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
The Netherlands Cancer Institute
Collaborators
Royal Marsden NHS Foundation Trust

4. Oversight

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

5. Study Description

Brief Summary
Radiotherapy (RT) alone is able to induce a clinically significant effect with a variable pathologic response (a pathological complete remission, pCR, defined as ≥ 95%, or ≤ 5% remaining visible tumour cells) in only about 10% of cases. A prior phase I study (PASART-1; NCT01985295) suggested that 25 x 2 Gy preoperative RT in combination with once daily 800mg oral pazopanib is feasible, while inducing tissue replacing tumor that can consist of fibrosis and necrosis in 40% of thus treated patients. During this study, the interim analysis showed that the combination treatment of preoperative radiation with orally pazopanib is more effective than was anticipated. For this reason, the pazopanib dose of 800 mg once daily is maintained but the RT dose is reduced to 18x2Gy instead of 25x2Gy. Predominant aim of this RT dose reduction is lowering the wound complication risk after preoperative radiotherapy.
Detailed Description
Patients of the first part of the study received radiotherapy (25x2Gy) and pazopanib (QD 800 mg). Patients of the second part of the study received/ will receive radiotherapy (18x2Gy) and pazopanib (QD 800 mg).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Sarcoma, Soft Tissue Sarcomas
Keywords
pazopanib, radiotherapy

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
25 (Actual)

8. Arms, Groups, and Interventions

Arm Title
radiotherapy combined with pazopanib
Arm Type
Other
Arm Description
patients during the first part of the study received concurrent radiotherapy (25x2Gy) and pazopanib (QD 800 mg). The patients of the second part of the study will receive concurrent radiotherapy (18x2Gy) and pazopanib (QD 800 mg).
Intervention Type
Radiation
Intervention Name(s)
external beam radiotherapy
Other Intervention Name(s)
radiotherapy
Intervention Description
external beam radiotherapy 25 x 2 Gy / 18 x 2 Gy
Intervention Type
Drug
Intervention Name(s)
pazopanib
Intervention Description
pazopanib QD 800 mg
Primary Outcome Measure Information:
Title
pathological near complete remission of the resected specimen which has been treated with radiotherapy
Description
Proportion of patients with resection specimens demonstrating induction of a pathological (near) complete remission (≥ 95% tumor regression). Pathological (near) complete remission is defined as ≥ 95% replacement of tumor with other tissue, usually fibrosis and) in the resection specimen post combined pazopanib and radiotherapy treatment
Time Frame
6 weeks post treatment
Secondary Outcome Measure Information:
Title
Incidence toxicities measured by NCI-CTCAE v4.0 (radiotherapy alone, pazopanib alone or both) measured from start of treatment until 6 weeks post-treatment
Time Frame
during treatment and up to 6 weeks post treatment
Title
Rate of response as measured by RECIST v 1.1 at 4 weeks after completing radiotherapy
Time Frame
4 weeks post treatment
Title
Incidence of acute post-operative wound complications up to 3 weeks (+/- 1 week) after surgery as defined in section 6.1.3 and reference 29 (see also appendix XII)
Time Frame
up to 3 weeks post surgery

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically confirmed newly diagnosed intermediate to high grade soft tissue sarcoma localized to the extremities, trunk and chest wall or the head and neck area, for which the standard treatment is a combination of and radiotherapy and surgery(deep seated and/or > 5cm according to the RECIST 1.1 criteria and/or an anticipated close resection margin and/or grade II/III according to the WHO definition) Age ≥ 18 years WHO performance status of ≤ 1 Able and willing to undergo blood sampling for PK and PD analysis Able to swallow and retain oral medication Able and willing to undergo MRI scanning Able and willing to undergo tumor biopsies Adequate organ functions as described by the laboratory findings in the table 1. For thyroid function, the T4 and TSH values must be within normal values of the range of the participating centers Written informed consent prior to performance of study-specific procedures or assessments and must be willing to comply with treatment and follow up. Exclusion Criteria Prior malignancies; except another malignancy and disease-free for ≥ 5 years, or completely resected non-melanomatous skin carcinoma or successfully treated in situ carcinoma. Patients with recurrent sarcomas (even without prior radiotherapy) Ewing sarcoma and other PNET family tumors, rhabdomyosarcomas (both pediatric and adult), osteosarcomas Clinically significant gastrointestinal abnormalities which might interfere with oral dosing diagnosed Poorly controlled hypertension [defined as systolic blood pressure (SBP) of ≥140 mmHg or diastolic blood pressure (DBP) of ≥ 90mmHg] Unstable or serious concurrent condition (e.g., active infection requiring systemic therapy) Prolongation of corrected QT interval (QTc) > 480 msecs on ECG History of any of more of the following cardiovascular conditions within the past 6 months: Cardiac angioplasty or stenting Myocardial infarction Unstable angina Symptomatic peripheral vascular disease Coronary artery by-pass graft surgery Class II, III or IV congestive heart failure as defined by the New York Heart Association (NYHA) History of cerebrovascular accident, pulmonary embolism or untreated deep venous thrombosis (DVT) within the past 6 months Macroscopic hematuria Hemoptysis that is clinically relevant within 4 weeks of first dose of pazopanib Evidence of active bleeding or bleeding diathesis Prior major surgery or trauma within 28 days prior to first dose of study medication and/or presence of any non-healing wound, fracture, or ulcer Chemotherapy or radiation therapy within 2 weeks prior to the first dose of study medication Biological therapy or treatment with an investigational agent within 28 days or five half-lives, whichever is longer prior to the first dose of study medication Prohibited medications listed in the protocol for 14 days or five half-lives of a drug (whichever is longer) prior to visit 1 and for the duration of the study Known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs chemically related to pazopanib Any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule; those conditions should be discussed with the patient before registration in the trial Female patients who are pregnant, breast-feeding or male or female patients of reproductive potential who are not employing an effective method of birth control
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Rick Haas, MD, PhD
Organizational Affiliation
The Netherlands Cancer Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
Antoni van Leeuwenhoek
City
Amsterdam
ZIP/Postal Code
1066CX
Country
Netherlands
Facility Name
Leids Universitair Medisch Centrum
City
Leiden
ZIP/Postal Code
2333 ZA
Country
Netherlands
Facility Name
Royal Marsden Hospital
City
London
ZIP/Postal Code
SW3 6JJ
Country
United Kingdom

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Clinical Study of Concurrent Pazopanib and Radiotherapy for Non-metastatic Sarcoma Patients

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