Lurbinectedin Monotherapy in Patients With Progressive Malignant Pleural Mesothelioma.
Primary Purpose
Malignant Pleural Mesothelioma, Advanced
Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Lurbinectedin
Sponsored by
About this trial
This is an interventional treatment trial for Malignant Pleural Mesothelioma, Advanced focused on measuring Progressive Malignant Pleural Mesothelioma, Lurbinectedin, Mesothelioma, Phase II Trial
Eligibility Criteria
Inclusion Criteria:
- Written informed consent according to ICH/GCP regulations before registration and prior to any trial specific procedures
- Histologically confirmed malignant mesothelioma (all histologies are eligible)
- Progression on or after one line of platinum-based combination chemotherapy. Any previous treatment with surgery or radiotherapy is allowed
- ≤ 1 line of treatment with an immune checkpoint inhibitor
- Prior systemic treatment stopped at least 4 weeks before registration
- Measurable or evaluable disease according to the modified RECIST criteria for malignant pleural mesothelioma
- Age ≥ 18 years
- ECOG performance status ≤ 1
- Adequate bone marrow function: hemoglobin ≥ 90 g/L; absolute neutrophil count ≥ 2 x 109/L, platelet count ≥ 100 x 109/L
- Adequate hepatic function: total bilirubin ≤ 1.5 ULN (except for patients with Gilbert's disease ≤ 3.0 x ULN); aspartate aminotransferase and alanine aminotransferase ≤ 3.0 x ULN; albumin ≥ 30 g/L
- Adequate renal function: creatinine clearance ≥ 30 mL/min/1.73, calculated according to the corrected formula of Cockcroft-Gault
- Women with child-bearing potential are using effective contraception, are not pregnant or lactating and agree not to become pregnant during trial treatment and during 6 months thereafter. A negative pregnancy test before registration (within 7 days) into the trial is required for all women with child-bearing potential
- Men agree not to father a child during trial treatment and during 6 months after last treatment infusion.
Exclusion Criteria:
- Known brain or leptomeningeal metastases
- History of another hematologic or primary solid tumor (except for curatively treated basal or squamous cell carcinoma of the skin, properly treated in situ malignant melanoma, in situ carcinoma of the uterine cervix or pT1-2 prostate cancer with Gleason score ≤6) within five years prior to registration
- More than one previous line of chemotherapy. Re-challenge is not allowed
- Prior treatment with lurbinectedin or trabectedin
- Treatment with any other experimental drug within 4 weeks before registration
- Concomitant use of other anti-cancer drugs, anti-cancer surgical intervention or radiotherapy except for local pain control and/or other local symptoms (e.g. pleurodesis due to dyspnea)
- Grade > 1 from any AE derived from previous treatment; alopecia any grade, grade ≤ 2 peripheral neuropathy and clinically not significant elevation of GGT grade ≤ 2 (according to the NCI-CTCAE v4.03) are allowed
- Treatment with cortisone (prednisolone > 10 mg or equivalent) for immune-mediated side effects from previous immunotherapy (if applicable)
- Severe or uncontrolled cardiovascular disease (congestive heart failure NYHA III or IV), unstable angina pectoris, history of myocardial infarction within the last six months, serious arrhythmias requiring medication (with exception of atrial fibrillation or paroxysmal supraventricular tachycardia)
- Severe or uncontrolled endocrinopathy due to previous immune checkpoint inhibitor treatment (if applicable)
- Known history of human immunodeficiency virus or active chronic hepatitis C or hepatitis B virus infection or any uncontrolled active systemic infection requiring intravenous antimicrobial treatment
- Known hypersensitivity to the trial drug or to any component of the trial drug
- Any other serious underlying medical, psychiatric, psychological, familial or geographical condition, which in the judgment of the investigator may interfere with the planned staging, treatment and follow-up, affect patient compliance or place the patient at high risk from treatment-related complications.
Sites / Locations
- A.O. SS. Antonio e Biagio e Cesare Arrigo
- Istituto Clinico Humanitas
- Kantonsspital Baden
- IOSI Ospedale Regionale di Bellinzona e Valli
- Kantonsspital Graubuenden
- Kantonsspital St.Gallen
- Regionalspital Thun
- Kantonsspital Winterthur
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Lurbinectedin
Arm Description
Lurbinectedin 3.2 mg/m2 i.v. every 3 weeks (one cycle) until progression, unacceptable toxicity or patient's withdrawal.
Outcomes
Primary Outcome Measures
Progression free survival (PFS) at 12 weeks
PFS at 12 weeks is defined as absence of progression or death due to any cause during 12 weeks (±2 weeks) after registration.
Patients with no tumor assessment at 12 weeks (±2 weeks) will be considered:
Progressed at 12 weeks, if they have no following tumor assessment within the trial (patient died, refused, started a new treatment or was lost to follow-up) or if they progress at the following tumor assessment after 12 weeks (±2 weeks).
Progression-free at 12 weeks, if they do not progress at the following tumor assessment after 12 weeks (±2 weeks).
Secondary Outcome Measures
Progression-free survival (PFS)
PFS is defined as time from registration to one of the following events, whichever occurs first:
Relapse or progression according to the modified RECIST criteria for malignant pleural mesothelioma
Death due to any cause Patients not experiencing an event will be censored at the date of last evaluable tumor assessment before starting a subsequent treatment, if any.
Objective response (OR)
OR is defined as complete response (CR) or partial response (PR) achieved by the patient during trial treatment. Tumor response will be evaluated according to the modified RECIST criteria for malignant pleural mesothelioma.
Patients without any tumor assessment during trial treatment will be regarded as having a non-evaluable response (NE) and shall be considered as failures for this endpoint.
Disease control (DC) at 12 weeks
DC is defined as CR, PR or stable disease (SD) for at least 12 weeks achieved by the patient during trial treatment. Tumor response will be evaluated according to the modified RECIST criteria for malignant pleural mesothelioma.
Overall survival (OS)
OS is defined as time from registration until death due to any cause. Patients alive or lost to follow-up will be censored at the last date they were known to be alive.
Time to treatment failure (TTF)
TTF is defined as time from registration until treatment discontinuation due to any reason (unacceptable toxicity, patient refusal, progression, death or any other event that determines the termination of the trial treatment).
Patients not experiencing an event will be censored at the date of their last available assessment or visit.
Full Information
NCT ID
NCT03213301
First Posted
July 4, 2017
Last Updated
July 13, 2021
Sponsor
Swiss Group for Clinical Cancer Research
1. Study Identification
Unique Protocol Identification Number
NCT03213301
Brief Title
Lurbinectedin Monotherapy in Patients With Progressive Malignant Pleural Mesothelioma.
Official Title
Lurbinectedin Monotherapy in Patients With Progressive Malignant Pleural Mesothelioma. A Multicenter, Single-arm Phase II Trial
Study Type
Interventional
2. Study Status
Record Verification Date
July 2021
Overall Recruitment Status
Completed
Study Start Date
September 28, 2017 (Actual)
Primary Completion Date
June 11, 2021 (Actual)
Study Completion Date
June 11, 2021 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Swiss Group for Clinical Cancer Research
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
Aim of this study is to provide the "proof of concept" of efficacy and tolerability of lurbinectedin monotherapy in progressive malignant mesotheliomas.
Detailed Description
Malignant mesothelioma arises from the mesothelial cells of the pleural, peritoneal or pericardial lining and is often associated with asbestos exposition. There is no cure for most malignant mesotheliomas and the scope of all three major oncological therapeutic procedures (surgery, radiotherapy and chemotherapy) is to reduce/eliminate symptoms as well as to prolong progression free survival (PFS) and/or overall survival (OS). While progressive patients are still in good health able to undertake a second-line treatment, there is no standard treatment for progressive disease.
Lurbinectedin is a novel compound structurally related to trabectedin and with similar mode of action. Pre-clinical data showed a better safety profile than trabectedin. Lurbinectedin has been already tested in different Phase I-II trials showing promising activity in ovarian, pancreatic, breast, small and non-small cell lung cancer as well as in other tumor types, with objective responses averaging 30%, disease stabilization up to 75% and having manageable toxicity. Although lurbinectedin has not been widely tested in mesotheliomas, some mesothelioma patients have been already treated with lurbinectedin where again promising activity has been observed.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Malignant Pleural Mesothelioma, Advanced
Keywords
Progressive Malignant Pleural Mesothelioma, Lurbinectedin, Mesothelioma, Phase II Trial
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Model Description
Prospective 2-stage single-arm open-label multicenter phase II trial.
Masking
None (Open Label)
Allocation
N/A
Enrollment
42 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Lurbinectedin
Arm Type
Experimental
Arm Description
Lurbinectedin 3.2 mg/m2 i.v. every 3 weeks (one cycle) until progression, unacceptable toxicity or patient's withdrawal.
Intervention Type
Drug
Intervention Name(s)
Lurbinectedin
Other Intervention Name(s)
PM01183
Intervention Description
3.2 mg/m2 i.v. every 3 weeks
Primary Outcome Measure Information:
Title
Progression free survival (PFS) at 12 weeks
Description
PFS at 12 weeks is defined as absence of progression or death due to any cause during 12 weeks (±2 weeks) after registration.
Patients with no tumor assessment at 12 weeks (±2 weeks) will be considered:
Progressed at 12 weeks, if they have no following tumor assessment within the trial (patient died, refused, started a new treatment or was lost to follow-up) or if they progress at the following tumor assessment after 12 weeks (±2 weeks).
Progression-free at 12 weeks, if they do not progress at the following tumor assessment after 12 weeks (±2 weeks).
Time Frame
at 12 weeks
Secondary Outcome Measure Information:
Title
Progression-free survival (PFS)
Description
PFS is defined as time from registration to one of the following events, whichever occurs first:
Relapse or progression according to the modified RECIST criteria for malignant pleural mesothelioma
Death due to any cause Patients not experiencing an event will be censored at the date of last evaluable tumor assessment before starting a subsequent treatment, if any.
Time Frame
From date of registration until the date of first documented relapse or progression according to the modified RECIST criteria for malignant pleural mesothelioma or date of death from any cause, whichever came first, assessed up to 30 months.
Title
Objective response (OR)
Description
OR is defined as complete response (CR) or partial response (PR) achieved by the patient during trial treatment. Tumor response will be evaluated according to the modified RECIST criteria for malignant pleural mesothelioma.
Patients without any tumor assessment during trial treatment will be regarded as having a non-evaluable response (NE) and shall be considered as failures for this endpoint.
Time Frame
From date of registration until the date of treatment discontinuation for any cause, assessed up to 30 months.
Title
Disease control (DC) at 12 weeks
Description
DC is defined as CR, PR or stable disease (SD) for at least 12 weeks achieved by the patient during trial treatment. Tumor response will be evaluated according to the modified RECIST criteria for malignant pleural mesothelioma.
Time Frame
at 12 weeks: From date of registration until 14 weeks after.
Title
Overall survival (OS)
Description
OS is defined as time from registration until death due to any cause. Patients alive or lost to follow-up will be censored at the last date they were known to be alive.
Time Frame
From date of registration until the date of death from any cause, assessed up to 30 months.
Title
Time to treatment failure (TTF)
Description
TTF is defined as time from registration until treatment discontinuation due to any reason (unacceptable toxicity, patient refusal, progression, death or any other event that determines the termination of the trial treatment).
Patients not experiencing an event will be censored at the date of their last available assessment or visit.
Time Frame
From date of registration until the date of treatment discontinuation for any cause, assessed up to 30 months.
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Written informed consent according to ICH/GCP regulations before registration and prior to any trial specific procedures
Histologically confirmed malignant mesothelioma (all histologies are eligible)
Progression on or after one line of platinum-based combination chemotherapy. Any previous treatment with surgery or radiotherapy is allowed
≤ 1 line of treatment with an immune checkpoint inhibitor
Prior systemic treatment stopped at least 4 weeks before registration
Measurable or evaluable disease according to the modified RECIST criteria for malignant pleural mesothelioma
Age ≥ 18 years
ECOG performance status ≤ 1
Adequate bone marrow function: hemoglobin ≥ 90 g/L; absolute neutrophil count ≥ 2 x 109/L, platelet count ≥ 100 x 109/L
Adequate hepatic function: total bilirubin ≤ 1.5 ULN (except for patients with Gilbert's disease ≤ 3.0 x ULN); aspartate aminotransferase and alanine aminotransferase ≤ 3.0 x ULN; albumin ≥ 30 g/L
Adequate renal function: creatinine clearance ≥ 30 mL/min/1.73, calculated according to the corrected formula of Cockcroft-Gault
Women with child-bearing potential are using effective contraception, are not pregnant or lactating and agree not to become pregnant during trial treatment and during 6 months thereafter. A negative pregnancy test before registration (within 7 days) into the trial is required for all women with child-bearing potential
Men agree not to father a child during trial treatment and during 6 months after last treatment infusion.
Exclusion Criteria:
Known brain or leptomeningeal metastases
History of another hematologic or primary solid tumor (except for curatively treated basal or squamous cell carcinoma of the skin, properly treated in situ malignant melanoma, in situ carcinoma of the uterine cervix or pT1-2 prostate cancer with Gleason score ≤6) within five years prior to registration
More than one previous line of chemotherapy. Re-challenge is not allowed
Prior treatment with lurbinectedin or trabectedin
Treatment with any other experimental drug within 4 weeks before registration
Concomitant use of other anti-cancer drugs, anti-cancer surgical intervention or radiotherapy except for local pain control and/or other local symptoms (e.g. pleurodesis due to dyspnea)
Grade > 1 from any AE derived from previous treatment; alopecia any grade, grade ≤ 2 peripheral neuropathy and clinically not significant elevation of GGT grade ≤ 2 (according to the NCI-CTCAE v4.03) are allowed
Treatment with cortisone (prednisolone > 10 mg or equivalent) for immune-mediated side effects from previous immunotherapy (if applicable)
Severe or uncontrolled cardiovascular disease (congestive heart failure NYHA III or IV), unstable angina pectoris, history of myocardial infarction within the last six months, serious arrhythmias requiring medication (with exception of atrial fibrillation or paroxysmal supraventricular tachycardia)
Severe or uncontrolled endocrinopathy due to previous immune checkpoint inhibitor treatment (if applicable)
Known history of human immunodeficiency virus or active chronic hepatitis C or hepatitis B virus infection or any uncontrolled active systemic infection requiring intravenous antimicrobial treatment
Known hypersensitivity to the trial drug or to any component of the trial drug
Any other serious underlying medical, psychiatric, psychological, familial or geographical condition, which in the judgment of the investigator may interfere with the planned staging, treatment and follow-up, affect patient compliance or place the patient at high risk from treatment-related complications.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Yannis Metaxas, MD
Organizational Affiliation
Kantonsspital Graubünden, Chur
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Roger von Moos, Prof
Organizational Affiliation
Kantonsspital Graubünden, Chur
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Miklos Pless, MD
Organizational Affiliation
Kantonsspital Winterthur KSW
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Federica Grosso, MD
Organizational Affiliation
SS. Antonio e C. Arrigo Hospital Alessandria (Italy)
Official's Role
Study Chair
Facility Information:
Facility Name
A.O. SS. Antonio e Biagio e Cesare Arrigo
City
Alessandria
ZIP/Postal Code
15121
Country
Italy
Facility Name
Istituto Clinico Humanitas
City
Rozzano
ZIP/Postal Code
20089
Country
Italy
Facility Name
Kantonsspital Baden
City
Baden
ZIP/Postal Code
5404
Country
Switzerland
Facility Name
IOSI Ospedale Regionale di Bellinzona e Valli
City
Bellinzona
ZIP/Postal Code
6500
Country
Switzerland
Facility Name
Kantonsspital Graubuenden
City
Chur
ZIP/Postal Code
CH-7000
Country
Switzerland
Facility Name
Kantonsspital St.Gallen
City
St. Gallen
ZIP/Postal Code
8401
Country
Switzerland
Facility Name
Regionalspital Thun
City
Thun
ZIP/Postal Code
3600
Country
Switzerland
Facility Name
Kantonsspital Winterthur
City
Winterthur
ZIP/Postal Code
CH-8401
Country
Switzerland
12. IPD Sharing Statement
Plan to Share IPD
No
Citations:
PubMed Identifier
32085891
Citation
Metaxas Y, Fruh M, Eboulet EI, Grosso F, Pless M, Zucali PA, Ceresoli GL, Mark M, Schneider M, Maconi A, Perrino M, Biaggi-Rudolf C, Froesch P, Schmid S, Waibel C, Appenzeller C, Rauch D, von Moos R; Swiss Group for Clinical Cancer Research (SAKK). Lurbinectedin as second- or third-line palliative therapy in malignant pleural mesothelioma: an international, multi-centre, single-arm, phase II trial (SAKK 17/16). Ann Oncol. 2020 Apr;31(4):495-500. doi: 10.1016/j.annonc.2019.12.009. Epub 2020 Jan 16.
Results Reference
derived
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Lurbinectedin Monotherapy in Patients With Progressive Malignant Pleural Mesothelioma.
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