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Efficacy and Safety Study of GPX-150 to Treat Soft Tissue Sarcoma

Primary Purpose

Soft Tissue Sarcoma

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
GPX-150 for Injection
Sponsored by
Gem Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Soft Tissue Sarcoma focused on measuring soft tissue sarcoma

Eligibility Criteria

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

Inclusion Criteria:

  1. Age ≥18 years.
  2. Histological documentation of soft tissue sarcoma (biopsy may be historical and may have been obtained from primary tumor or a metastatic site).
  3. Advanced and/or metastatic malignant soft tissue sarcoma of intermediate or high histologic grade. Excluded are the following sarcoma subtypes:

    • Well-differentiated liposarcoma or atypical lipomatous tumor
    • Embryonal or alveolar rhabdomyosarcoma
    • Ewing sarcoma of soft tissue or bone
    • Gastrointestinal stromal tumor (GIST)
    • Dermatofibrosarcoma protuberans
    • Alveolar soft part sarcoma
    • Solitary fibrous tumor
    • Clear cell sarcoma
    • Kaposi sarcoma
    • Extraskeletal myxoid chondrosarcoma
    • PEComa (perivascular epithelial cell tumor)
    • Myoepithelioma / mixed tumor
  4. Measurable disease as per RECIST 1.1.
  5. Subject has received either:

    • No prior chemotherapy for current sarcoma, or
    • A single course of gemcitabine and/or docetaxel as adjuvant therapy that was completed at least 6 months prior to planned first dose
  6. ECOG Performance Status of 0 - 2.
  7. Adequate cardiac function:

    • LVEF above the institution's lower limit of normal
    • QTcF ≤ 450 msec for males or 470 msec for females.
  8. Willing and able to provide written informed consent.
  9. Male and female subjects must agree to use a highly reliable method of birth control for the duration of the study.
  10. Women of childbearing potential must have a serum pregnancy test performed within 28 days prior to the first day of study drug dosing.

Exclusion Criteria:

  1. Sarcomas arising from bone or cartilage, e.g. chondrosarcoma, osteosarcoma, chordoma.
  2. Subject is eligible for a potentially curative therapy.
  3. Prior primary chemotherapy.
  4. Prior radiotherapy to > 25% of bone marrow volume.
  5. Treatment within 28 days prior to Dose 1 with:

    • Palliative surgery or radiotherapy.
    • Approved anticancer therapy including chemotherapy or immunotherapy.
    • Contraindicated treatments noted in the product labelling for doxorubicin, including trastuzumab and inhibitors and inducers of CYP3A4, CYP2D6, or P-gp.
    • An investigational therapy.
    • Any major surgery (e.g. requiring general anesthesia).
  6. Inadequate bone marrow, liver, and renal function, as assessed by the following laboratory parameters:

    1. Absolute neutrophil count (ANC) < 1,500/mm3.
    2. Platelet count < 100,000/mm3.
    3. Total bilirubin > 1.5×ULN (upper limit of normal).
    4. ALT and AST > 2.5×ULN. For patients with documented liver metastases, ALT and AST > 5×ULN.
    5. Serum creatinine > 1.5 x ULN.
    6. International Normalized Ratio (INR) and activated partial thromboplastin time [PTT] ≥ 1.5×ULN, if not therapeutically anticoagulated.
    7. Serum albumin < 3.0 gm/dL.
  7. Congestive heart failure > Class II New York Heart Association Functional Classification, current pericarditis, myocardial infarction within 6 months, or symptomatic coronary artery disease.
  8. Unstable or clinically significant concurrent medical condition that would, in the opinion of the investigator, jeopardize the safety of a patient and/or their compliance with the protocol.
  9. Active infection requiring systemic antibacterial/antibiotic, antifungal, or antiviral therapy.
  10. Documented metastases to brain or meninges.
  11. Any malignancy other than soft tissue sarcoma within the last 5 years prior to screening, with the exception of cervical carcinoma in situ, basal cell carcinoma, or superficial bladder tumors that have been successfully and curatively treated with no evidence of recurrent or residual disease.
  12. Body surface area (BSA) ≥ 2.4 m2.
  13. Currently pregnant or nursing.
  14. Known allergy to any of the study drugs or their excipients.

Sites / Locations

  • Northwestern University
  • University of Iowa Holden Comprehensive Cancer Center
  • Washington University School of Medicine
  • Penn State Milton S Hershey Medical Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

GPX-150

Arm Description

GPX-150 for Injection, 265 mg/m2, every 21 days for 16 cycles or until death, disease progression, or unacceptable toxicity, or subject withdrawal.

Outcomes

Primary Outcome Measures

Number of Subjects Progression-free at 12 Months Per RECIST 1.1
The primary efficacy endpoint is the number of patients who were progression-free at 12 months, which is obtained by inversion of the Kaplan-Meier curve for progression-free survival (PFS) at 12 months. Of note, the statistical comparison to historical sarcoma data described in the protocol was not performed due to an enrollment of less than the planned sample size of 30 subjects. Progression is defined using RECIST 1.1, as at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study).

Secondary Outcome Measures

Number of Subjects Progression-free at Six Months Per RECIST 1.1
This secondary efficacy endpoint is the progression-free rate (PFR) at 6 months, obtained from the Kaplan-Meier curve for progression-free survival (PFS).
Number of Subjects Experiencing Adverse Events
Subjects who received at least one dose were included in safety analyses. Adverse events were tabulated by System Organ Class (SOC) and Preferred Term (PT) and coded using MedDRA Version 19.1. Safety and tolerability was determined by frequency, nature, and severity of adverse events and the profile of toxicities.

Full Information

First Posted
September 23, 2014
Last Updated
December 12, 2017
Sponsor
Gem Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT02267083
Brief Title
Efficacy and Safety Study of GPX-150 to Treat Soft Tissue Sarcoma
Official Title
Phase 2 Efficacy and Safety Study of Intravenous GPX-150, an Anthracycline Analog, in Patients With Soft Tissue Sarcoma
Study Type
Interventional

2. Study Status

Record Verification Date
December 2017
Overall Recruitment Status
Completed
Study Start Date
January 7, 2015 (undefined)
Primary Completion Date
November 11, 2015 (Actual)
Study Completion Date
August 18, 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Gem Pharmaceuticals

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This study will assess the safety and efficacy of GPX-150 administered intravenously every 3 weeks in the treatment of patients with soft tissue sarcoma.
Detailed Description
This is an open-label, single arm study of GPX-150 in patients with soft tissue sarcoma. Approximately 22 patients will be treated in this study. The population for this study is adult patients with histologically proven advanced and/or metastatic malignant soft tissue sarcoma of intermediate or high histologic grade. All patients who meet all entry criteria will receive GPX-150 at a starting dose of 265 mg/m2 every 21 days for 16 cycles or until death, disease progression, or unacceptable toxicity or subject withdrawal. Prior to initiation of treatment, subjects will undergo screening and baseline evaluations. During all study visits, subjects will be evaluated for safety. The dose of GPX-150 may be reduced when subjects meet specified dose reduction safety criteria. Subjects will be evaluated regularly for safety and tolerability. Tumor measurements will be calculated at baseline (within 28 days prior to treatment initiation), then at regular intervals while receiving treatment for up to 1 year. After discontinuing the treatment phase of the study, safety assessments and tumor measurements will be performed 3 weeks after the last dose of study drug.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Soft Tissue Sarcoma
Keywords
soft tissue sarcoma

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
GPX-150
Arm Type
Experimental
Arm Description
GPX-150 for Injection, 265 mg/m2, every 21 days for 16 cycles or until death, disease progression, or unacceptable toxicity, or subject withdrawal.
Intervention Type
Drug
Intervention Name(s)
GPX-150 for Injection
Other Intervention Name(s)
GPX-150, 5-imino-13-deoxy-doxorubicin HCl
Intervention Description
GPX-150 at a starting dose of 265 mg/m2 every 21 days for 16 cycles or until death, disease progression, or unacceptable toxicity. The dose of GPX-150 may be reduced by 25% if any dose reduction criteria are met. Two reductions are allowed per subject during the course of the study.
Primary Outcome Measure Information:
Title
Number of Subjects Progression-free at 12 Months Per RECIST 1.1
Description
The primary efficacy endpoint is the number of patients who were progression-free at 12 months, which is obtained by inversion of the Kaplan-Meier curve for progression-free survival (PFS) at 12 months. Of note, the statistical comparison to historical sarcoma data described in the protocol was not performed due to an enrollment of less than the planned sample size of 30 subjects. Progression is defined using RECIST 1.1, as at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study).
Time Frame
12 months from the beginning of study treatment
Secondary Outcome Measure Information:
Title
Number of Subjects Progression-free at Six Months Per RECIST 1.1
Description
This secondary efficacy endpoint is the progression-free rate (PFR) at 6 months, obtained from the Kaplan-Meier curve for progression-free survival (PFS).
Time Frame
6 months from the beginning of the study treatment
Title
Number of Subjects Experiencing Adverse Events
Description
Subjects who received at least one dose were included in safety analyses. Adverse events were tabulated by System Organ Class (SOC) and Preferred Term (PT) and coded using MedDRA Version 19.1. Safety and tolerability was determined by frequency, nature, and severity of adverse events and the profile of toxicities.
Time Frame
From the beginning of study treatment and up to 12 months
Other Pre-specified Outcome Measures:
Title
Number of Subjects With Tumor Response Per RECIST 1.1
Description
Tumor assessments using contrast enhanced computerized tomography (CT) scan of the Chest/Abdomen/Pelvis were performed to assess overall tumor burden. Response rate (RR), where response is defined as complete response (CR), partial response (PR), or stable disease (SD). Determination of CR or PR requires confirmation at the time of the next tumor assessment. An outcome of SD requires at least one assessment 6 weeks after the initiation of dosing. Progression is defined using RECIST 1.1, as at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study).
Time Frame
Assessed during screening, then every 6 weeks for the first 24 weeks on study, and then every 9 weeks for the next 24 weeks for up to 1 year. Subjects will be in the study for up to 1 year, or until disease progression or unacceptable toxicity.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ≥18 years. Histological documentation of soft tissue sarcoma (biopsy may be historical and may have been obtained from primary tumor or a metastatic site). Advanced and/or metastatic malignant soft tissue sarcoma of intermediate or high histologic grade. Excluded are the following sarcoma subtypes: Well-differentiated liposarcoma or atypical lipomatous tumor Embryonal or alveolar rhabdomyosarcoma Ewing sarcoma of soft tissue or bone Gastrointestinal stromal tumor (GIST) Dermatofibrosarcoma protuberans Alveolar soft part sarcoma Solitary fibrous tumor Clear cell sarcoma Kaposi sarcoma Extraskeletal myxoid chondrosarcoma PEComa (perivascular epithelial cell tumor) Myoepithelioma / mixed tumor Measurable disease as per RECIST 1.1. Subject has received either: No prior chemotherapy for current sarcoma, or A single course of gemcitabine and/or docetaxel as adjuvant therapy that was completed at least 6 months prior to planned first dose ECOG Performance Status of 0 - 2. Adequate cardiac function: LVEF above the institution's lower limit of normal QTcF ≤ 450 msec for males or 470 msec for females. Willing and able to provide written informed consent. Male and female subjects must agree to use a highly reliable method of birth control for the duration of the study. Women of childbearing potential must have a serum pregnancy test performed within 28 days prior to the first day of study drug dosing. Exclusion Criteria: Sarcomas arising from bone or cartilage, e.g. chondrosarcoma, osteosarcoma, chordoma. Subject is eligible for a potentially curative therapy. Prior primary chemotherapy. Prior radiotherapy to > 25% of bone marrow volume. Treatment within 28 days prior to Dose 1 with: Palliative surgery or radiotherapy. Approved anticancer therapy including chemotherapy or immunotherapy. Contraindicated treatments noted in the product labelling for doxorubicin, including trastuzumab and inhibitors and inducers of CYP3A4, CYP2D6, or P-gp. An investigational therapy. Any major surgery (e.g. requiring general anesthesia). Inadequate bone marrow, liver, and renal function, as assessed by the following laboratory parameters: Absolute neutrophil count (ANC) < 1,500/mm3. Platelet count < 100,000/mm3. Total bilirubin > 1.5×ULN (upper limit of normal). ALT and AST > 2.5×ULN. For patients with documented liver metastases, ALT and AST > 5×ULN. Serum creatinine > 1.5 x ULN. International Normalized Ratio (INR) and activated partial thromboplastin time [PTT] ≥ 1.5×ULN, if not therapeutically anticoagulated. Serum albumin < 3.0 gm/dL. Congestive heart failure > Class II New York Heart Association Functional Classification, current pericarditis, myocardial infarction within 6 months, or symptomatic coronary artery disease. Unstable or clinically significant concurrent medical condition that would, in the opinion of the investigator, jeopardize the safety of a patient and/or their compliance with the protocol. Active infection requiring systemic antibacterial/antibiotic, antifungal, or antiviral therapy. Documented metastases to brain or meninges. Any malignancy other than soft tissue sarcoma within the last 5 years prior to screening, with the exception of cervical carcinoma in situ, basal cell carcinoma, or superficial bladder tumors that have been successfully and curatively treated with no evidence of recurrent or residual disease. Body surface area (BSA) ≥ 2.4 m2. Currently pregnant or nursing. Known allergy to any of the study drugs or their excipients.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mohammed Milhem, MD
Organizational Affiliation
University of Iowa Holden Comprehensive Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Northwestern University
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
University of Iowa Holden Comprehensive Cancer Center
City
Iowa City
State/Province
Iowa
ZIP/Postal Code
52242
Country
United States
Facility Name
Washington University School of Medicine
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
Penn State Milton S Hershey Medical Center
City
Hershey
State/Province
Pennsylvania
ZIP/Postal Code
17033
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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Efficacy and Safety Study of GPX-150 to Treat Soft Tissue Sarcoma

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