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Pemetrexed for the Treatment of Chordoma

Primary Purpose

Chordoma

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Pemetrexed
Sponsored by
Saint John's Cancer Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Chordoma

Eligibility Criteria

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

Inclusion Criteria:

  1. Participant has the ability to understand and the willingness to provide a signed and dated informed consent form.
  2. Participant has the willingness to comply with all study procedures and availability for the duration of the study.
  3. Participant has a diagnosis of chordoma.
  4. Participant is male or female, 18 years of age or older.
  5. Participant has a Karnofsky Performance Status of 50% or greater.
  6. Participant has adequate organ function:

    1. ANC at least 1.5 x 10^9/L or higher
    2. Platelets at least 100 x 10^9/L or higher
    3. Hemoglobin at least 8 g/dL or higher.
    4. Total bilirubin 1.5 x upper limit of normal (ULN) or lower.
    5. ALT and AST 3 x ULN or lower.
    6. Serum creatinine 1.5 x ULN or lower.
  7. Participant has the ability to interrupt non-steroidal anti-inflammatory drugs (NSAIDS) 2 days before (5 days for long-acting NSAIDs), the day of, and 2 days following administration of Pemetrexed.
  8. Participant has the ability to take folic acid, Vitamin B12, and dexamethasone according to protocol.
  9. Participant has recovered from any previous therapy-related toxicity to CTCAE Grade 1 or to their clinical baseline at study entry.

Exclusion Criteria:

  1. Participant is less than 28 days from any investigational agent.
  2. Participant has third space fluid which cannot be controlled by drainage.
  3. Participant has a severe or uncontrolled medical disorder that would, in the investigator's opinion, impair ability to receive study intervention, including, but not limited to:

    1. Uncontrolled diabetes;
    2. Renal disease that requires dialysis;
    3. Pulmonary disorder requiring supplemental oxygen to keep saturation >95% and the situation is not expected to resolve within 2 weeks;
    4. Severe dyspnea at rest or requiring oxygen therapy;
    5. Interstitial lung disease;
    6. History of major surgical resection involving the stomach or small bowel;
    7. Preexisting Crohn's disease;
    8. Ulcerative colitis;
    9. Uncontrolled vasculitis and/or disease with known vasculitis;
    10. Preexisting chronic condition resulting in baseline Grade 2 or higher diarrhea;
    11. Psychiatric illness/social situations that would limit compliance with study requirements.
  4. Participant has an active bacterial infection requiring intravenous [IV] antibiotics at time of initiating study treatment, fungal infection, or detectable viral infection (such as known human immunodeficiency virus positivity or with known active hepatitis B or C).
  5. Participant has a personal history or presence of any of the following cardiovascular conditions:

    1. Syncope of cardiovascular etiology;
    2. Ventricular arrhythmia of pathological origin (including, but not limited to, ventricular tachycardia and ventricular fibrillation);
    3. Myocardial infraction within 6 months of investigational product administration;
    4. Unstable angina;
    5. Sudden cardiac arrest;
    6. Congestive heart failure (NYHA classification ≥ 3).
  6. Participant is a female of childbearing potential who is pregnant or nursing.

Sites / Locations

  • John Wayne Cancer Institute

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Pemetrexed

Arm Description

Pemetrexed

Outcomes

Primary Outcome Measures

Progression free survival
duration of time from start of treatment until objective tumor progression or withdrawal
Radiographic response assessed by RECIST v1.1
rate of radiographic imaging alterations following treatment

Secondary Outcome Measures

Toxicity assessed by CTCAE v 4.03 criteria
proportion of patients experiencing adverse events

Full Information

First Posted
May 14, 2019
Last Updated
March 3, 2023
Sponsor
Saint John's Cancer Institute
Collaborators
Eli Lilly and Company, Chordoma Foundation
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1. Study Identification

Unique Protocol Identification Number
NCT03955042
Brief Title
Pemetrexed for the Treatment of Chordoma
Official Title
Pilot Study of Pemetrexed for the Treatment of Chordoma
Study Type
Interventional

2. Study Status

Record Verification Date
March 2023
Overall Recruitment Status
Completed
Study Start Date
September 6, 2019 (Actual)
Primary Completion Date
July 27, 2022 (Actual)
Study Completion Date
January 18, 2023 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Saint John's Cancer Institute
Collaborators
Eli Lilly and Company, Chordoma Foundation

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to test the safety and tolerability of pemetrexed administered to people with chordoma. Other purposes of this study are to: find out side effects (good and bad) of pemetrexed; learn more about how pemetrexed might affect the growth of cancer cells; evaluate tumor characteristics by collecting tumor tissue samples if available; look at biomarkers (biochemical features that can be used to measure the progress of disease or the effects of a drug) in blood and cerebrospinal fluid if available.
Detailed Description
This is a prospective, open-label, single-arm pilot feasibility study of pemetrexed for the treatment of adult patients with chordoma. All patients providing informed consent will be screened for eligibility. Eligible patients will receive pemetrexed by intravenous infusion on Day 1 of each 21-day treatment cycle, pre-medications (folic acid, vitamin B12, and dexamethasone), and ibuprofen if needed. Patients will continue dosing of pemetrexed until disease progression, unacceptable toxicity, withdrawal of consent, or treating physician determines it is in their best interest to stop. All patients will have regular evaluations for assessment of safety parameters and anti-tumor activity as detailed in the study flow chart.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chordoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
15 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Pemetrexed
Arm Type
Experimental
Arm Description
Pemetrexed
Intervention Type
Drug
Intervention Name(s)
Pemetrexed
Other Intervention Name(s)
Alimta
Intervention Description
Pemetrexed 900 mg/m^2 on Day 1 of each 21-day cycle. Supportive medications of ibuprofen, folic acid, vitamin B12, and dexamethasone.
Primary Outcome Measure Information:
Title
Progression free survival
Description
duration of time from start of treatment until objective tumor progression or withdrawal
Time Frame
one year
Title
Radiographic response assessed by RECIST v1.1
Description
rate of radiographic imaging alterations following treatment
Time Frame
one year
Secondary Outcome Measure Information:
Title
Toxicity assessed by CTCAE v 4.03 criteria
Description
proportion of patients experiencing adverse events
Time Frame
one year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Participant has the ability to understand and the willingness to provide a signed and dated informed consent form. Participant has the willingness to comply with all study procedures and availability for the duration of the study. Participant has a diagnosis of chordoma. Participant is male or female, 18 years of age or older. Participant has a Karnofsky Performance Status of 50% or greater. Participant has adequate organ function: ANC at least 1.5 x 10^9/L or higher Platelets at least 100 x 10^9/L or higher Hemoglobin at least 8 g/dL or higher. Total bilirubin 1.5 x upper limit of normal (ULN) or lower. ALT and AST 3 x ULN or lower. Serum creatinine 1.5 x ULN or lower. Participant has the ability to interrupt non-steroidal anti-inflammatory drugs (NSAIDS) 2 days before (5 days for long-acting NSAIDs), the day of, and 2 days following administration of Pemetrexed. Participant has the ability to take folic acid, Vitamin B12, and dexamethasone according to protocol. Participant has recovered from any previous therapy-related toxicity to CTCAE Grade 1 or to their clinical baseline at study entry. Exclusion Criteria: Participant is less than 28 days from any investigational agent. Participant has third space fluid which cannot be controlled by drainage. Participant has a severe or uncontrolled medical disorder that would, in the investigator's opinion, impair ability to receive study intervention, including, but not limited to: Uncontrolled diabetes; Renal disease that requires dialysis; Pulmonary disorder requiring supplemental oxygen to keep saturation >95% and the situation is not expected to resolve within 2 weeks; Severe dyspnea at rest or requiring oxygen therapy; Interstitial lung disease; History of major surgical resection involving the stomach or small bowel; Preexisting Crohn's disease; Ulcerative colitis; Uncontrolled vasculitis and/or disease with known vasculitis; Preexisting chronic condition resulting in baseline Grade 2 or higher diarrhea; Psychiatric illness/social situations that would limit compliance with study requirements. Participant has an active bacterial infection requiring intravenous [IV] antibiotics at time of initiating study treatment, fungal infection, or detectable viral infection (such as known human immunodeficiency virus positivity or with known active hepatitis B or C). Participant has a personal history or presence of any of the following cardiovascular conditions: Syncope of cardiovascular etiology; Ventricular arrhythmia of pathological origin (including, but not limited to, ventricular tachycardia and ventricular fibrillation); Myocardial infraction within 6 months of investigational product administration; Unstable angina; Sudden cardiac arrest; Congestive heart failure (NYHA classification ≥ 3). Participant is a female of childbearing potential who is pregnant or nursing.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Santosh Kesari, MD, PhD
Organizational Affiliation
Saint John's Cancer Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
John Wayne Cancer Institute
City
Santa Monica
State/Province
California
ZIP/Postal Code
90404
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Pemetrexed for the Treatment of Chordoma

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