Regorafenib in GIST With Secondary C-KIT Exon 17 Mutation
Primary Purpose
Gastrointestinal Stromal Tumour (GIST)
Status
Completed
Phase
Phase 2
Locations
Taiwan
Study Type
Interventional
Intervention
regorafenib
Sponsored by
About this trial
This is an interventional treatment trial for Gastrointestinal Stromal Tumour (GIST)
Eligibility Criteria
Inclusion Criteria:
An eligible subject must fulfill all of the following inclusion criteria:
- Signed informed consent (IC) obtained before any study specific procedure. Patients must be able to understand and willing to sign the written IC.
- Pathologically confirmed gastrointestinal stromal tumours.
- All patients had received imatinib or sunitinib.
- Pathological confirmed c-kit exon 17 mutation.
- At least one measurable lesion in a non-irradiated area or allowed to be tracked whether there are circumstances recurrence by computed tomography (CT) or magnetic resonance imaging (MRI).
- Aged > 20 years old.
- Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1.
- Life expectancy greater than 12 weeks.
- Adequate bone marrow function: 1) Absolutely neutrophil count >= 1.5 x10^9/L or white blood cell count (WBC) >= 4x10^9/L; 2) Hemoglobin >= 9 g/dL; 3) Platelet count >= 100x10^9/L.
- Adequate liver function: 1) Total bilirubin <= 1.5x the upper limit of normal (ULN); 2) Alanine Aminotransferase (ALT) & Aspartate Aminotransferase (AST) <= 2.5x ULN if without liver metastasis or <= 5x ULN if with hepatic metastasis; 3) Alkaline phosphatase <= 2.5x ULN if without liver metastasis or <= 5x ULN if with hepatic metastasis or bone metastasis; 4) Bilirubin < 2x ULN.
- Adequate renal function: creatinine <1.5x ULN.
- Patients must be accessible for treatment and follow-up in the participating centers.
Exclusion Criteria:
Subject will not meet any of the following exclusion criteria:
- Major surgery within four weeks prior to entering the study.
- Patients with central nervous system (CNS) metastasis, including clinical suspicion.
- Patients who are under active or uncontrolled infections.
- Patients who with unstable angina (angina symptoms at rest, new-onset angina (begun within the last 3 months) or myocardial infarction history 6 months before entry.
- Cardiac arrhythmia requiring anti-arrhythmic therapy (beta blockers or digoxin are permitted).
- Congestive heart failure New York Heart Association (NYHA) class 2.
- Uncontrolled hypertension (systolic blood pressure [BP] > 150 mmHg or diastolic pressure > 90 mmHg despite optimal medical management.
- Arterial or venous thrombotic or embolic events such as cerebrovascular accident (including transient ischemic attacks), deep vein thrombosis or pulmonary embolism within 6 months before the start of study medication.
- Patients who are pregnant or with breast feeding.
- Other concomitant or previously malignancy within 5 years except for in situ cervix cancer or squamous cell carcinoma of the skin treated by surgery only.
- Mental status is not fit for clinical trial.
- Cannot take study medication orally.
- Fertile men and women unless using a reliable and appropriate contraceptive method.
- Patients with evidence or history of any bleeding diathesis, irrespective of severity.
- Any hemorrhage or bleeding event >= Common Terminology Criteria for Adverse Events (CTCAE) Grade 3 within 4 weeks prior to the start of study medication.
- Non-healing wound, ulcer, or bone fracture.
- Renal failure requiring hemo-or peritoneal dialysis.
Sites / Locations
- Chang Gung Memorial Hospital
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
regorafenib
Arm Description
regorafenib 160 mg daily, 3 weeks on/1 week off
Outcomes
Primary Outcome Measures
Overall clinical benefit rate
complete response (CR), partial response (PR), and stable disease (SD)
Secondary Outcome Measures
Progression free survival (PFS)
Overall survival (OS)
Full Information
NCT ID
NCT02606097
First Posted
November 12, 2015
Last Updated
March 19, 2019
Sponsor
Chang Gung Memorial Hospital
1. Study Identification
Unique Protocol Identification Number
NCT02606097
Brief Title
Regorafenib in GIST With Secondary C-KIT Exon 17 Mutation
Official Title
A Phase 2 Study of Regorafenib in Metastatic Gastrointestinal Stromal Tumours With C-KIT exon17 Mutation
Study Type
Interventional
2. Study Status
Record Verification Date
March 2019
Overall Recruitment Status
Completed
Study Start Date
April 2014 (Actual)
Primary Completion Date
May 2018 (Actual)
Study Completion Date
May 2018 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Chang Gung Memorial Hospital
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
The main purpose of this study is to examine whether regorafenib treatment can help people with gastrointestinal stromal tumours (GIST) and have gene mutation on c-kit exon 17. The safety of regorafenib treatment is also examined.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Gastrointestinal Stromal Tumour (GIST)
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
19 (Actual)
8. Arms, Groups, and Interventions
Arm Title
regorafenib
Arm Type
Experimental
Arm Description
regorafenib 160 mg daily, 3 weeks on/1 week off
Intervention Type
Drug
Intervention Name(s)
regorafenib
Other Intervention Name(s)
stivarga
Primary Outcome Measure Information:
Title
Overall clinical benefit rate
Description
complete response (CR), partial response (PR), and stable disease (SD)
Time Frame
till 2 weeks after last dose
Secondary Outcome Measure Information:
Title
Progression free survival (PFS)
Time Frame
till study end, estimated 3 years
Title
Overall survival (OS)
Time Frame
till study end, estimated 3 years
Other Pre-specified Outcome Measures:
Title
Adverse events (AEs)
Description
Incidence of AEs will be shown and severity will be graded using NCI-CTCAE version 4.0
Time Frame
till 2 weeks after last dose
Title
Changes in clinical hematology laboratory result by hemoglobin (Hb)
Description
(unit: g/dL)
Time Frame
till 2 weeks after last dose
Title
Changes in clinical hematology laboratory result by hematocrit (Hct)
Description
(unit: %)
Time Frame
till 2 weeks after last dose
Title
Changes in clinical hematology laboratory result by platelet count
Description
(unit: 10^9/L)
Time Frame
till 2 weeks after last dose
Title
Changes in clinical hematology laboratory result by red blood cell (RBC) count
Description
(unit: 10^9/L)
Time Frame
till 2 weeks after last dose
Title
Changes in clinical hematology laboratory result by white blood cell (WBC) count
Description
(unit: 10^9/L)
Time Frame
till 2 weeks after last dose
Title
Clinical hematology laboratory result by WBC differential
Description
(unit: %)
Time Frame
till 2 weeks after last dose
Title
Changes in clinical biochemistry laboratory result by potassium level
Description
(unit: mmol/L)
Time Frame
till 2 weeks after last dose
Title
Changes in clinical biochemistry laboratory result by calcium level
Description
(unit: mmol/L)
Time Frame
till 2 weeks after last dose
Title
Changes in clinical biochemistry laboratory result by glucose level
Description
(unit: mmol/L)
Time Frame
till 2 weeks after last dose
Title
Changes in clinical biochemistry laboratory result by lactate dehydrogenase (LDH) level
Description
(unit: U/L)
Time Frame
till 2 weeks after last dose
Title
Changes in clinical biochemistry laboratory result by blood urea nitrogen (BUN) level
Description
(unit: mmol/L)
Time Frame
till 2 weeks after last dose
Title
Changes in clinical biochemistry laboratory result by creatinine level
Description
(unit: mg/dL)
Time Frame
till 2 weeks after last dose
Title
Changes in clinical biochemistry laboratory result by total and direct bilirubin levels
Description
(unit: mg/dL)
Time Frame
till 2 weeks after last dose
Title
Changes in clinical biochemistry laboratory result by albumin levels
Description
(unit: g/L)
Time Frame
till 2 weeks after last dose
Title
Changes in clinical biochemistry laboratory result by alanine aminotransferase(ALT) levels
Description
(unit: U/L)
Time Frame
till 2 weeks after last dose
Title
Changes in clinical biochemistry laboratory result by aspartate aminotransferase (AST) levels
Description
(unit: U/L)
Time Frame
till 2 weeks after last dose
Title
Changes in clinical biochemistry laboratory result by alkaline phosphatase (ALP) level
Description
(unit: U/L)
Time Frame
till 2 weeks after last dose
Title
Changes in clinical biochemistry laboratory result by thyroid-stimulating hormone (TSH) level
Description
(unit: mIU/L)
Time Frame
till 2 weeks after last dose
Title
Changes in clinical biochemistry laboratory result by T3 level
Description
(unit: mIU/L)
Time Frame
till 2 weeks after last dose
Title
Changes in clinical biochemistry laboratory result by T4 level
Description
(unit: mIU/L)
Time Frame
till 2 weeks after last dose
Title
Changes in clinical urinalysis result by WBC count
Description
(unit: 10^9/L)
Time Frame
till 2 weeks after last dose
Title
Changes in clinical urinalysis result by RBC count
Description
(unit: 10^9/L)
Time Frame
till 2 weeks after last dose
Title
Changes in clinical urinalysis result by pH level
Time Frame
till 2 weeks after last dose
Title
Changes in clinical urinalysis result by protein level
Time Frame
till 2 weeks after last dose
Title
Changes in clinical urinalysis result by glucose level
Description
(unit: mmol/L)
Time Frame
till 2 weeks after last dose
Title
Changes in clinical coagulation results by prothrombin time (PT)
Description
(unit: sec)
Time Frame
till 2 weeks after last dose
Title
Changes in clinical coagulation results by activated partial thromboplastin time (APTT)
Description
(unit: sec)
Time Frame
till 2 weeks after last dose
Title
Changes in clinical coagulation results by international normalized ratio (INR)
Time Frame
till 2 weeks after last dose
Title
Physical examination
Time Frame
till 2 weeks after last dose
Title
Changes in vital signs by respiratory rate
Description
(unit: times/min)
Time Frame
till 2 weeks after last dose
Title
Changes in vital signs by pulse rate
Description
(unit: times/min)
Time Frame
till 2 weeks after last dose
Title
Changes in vital signs by systolic blood pressure
Description
(unit: mmHg)
Time Frame
till 2 weeks after last dose
Title
Changes in vital signs by diastolic blood pressure
Description
(unit: mmHg)
Time Frame
till 2 weeks after last dose
Title
Changes in vital signs by body temperature
Description
(unit: degree celsius)
Time Frame
till 2 weeks after last dose
10. Eligibility
Sex
All
Minimum Age & Unit of Time
20 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
An eligible subject must fulfill all of the following inclusion criteria:
Signed informed consent (IC) obtained before any study specific procedure. Patients must be able to understand and willing to sign the written IC.
Pathologically confirmed gastrointestinal stromal tumours.
All patients had received imatinib or sunitinib.
Pathological confirmed c-kit exon 17 mutation.
At least one measurable lesion in a non-irradiated area or allowed to be tracked whether there are circumstances recurrence by computed tomography (CT) or magnetic resonance imaging (MRI).
Aged > 20 years old.
Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1.
Life expectancy greater than 12 weeks.
Adequate bone marrow function: 1) Absolutely neutrophil count >= 1.5 x10^9/L or white blood cell count (WBC) >= 4x10^9/L; 2) Hemoglobin >= 9 g/dL; 3) Platelet count >= 100x10^9/L.
Adequate liver function: 1) Total bilirubin <= 1.5x the upper limit of normal (ULN); 2) Alanine Aminotransferase (ALT) & Aspartate Aminotransferase (AST) <= 2.5x ULN if without liver metastasis or <= 5x ULN if with hepatic metastasis; 3) Alkaline phosphatase <= 2.5x ULN if without liver metastasis or <= 5x ULN if with hepatic metastasis or bone metastasis; 4) Bilirubin < 2x ULN.
Adequate renal function: creatinine <1.5x ULN.
Patients must be accessible for treatment and follow-up in the participating centers.
Exclusion Criteria:
Subject will not meet any of the following exclusion criteria:
Major surgery within four weeks prior to entering the study.
Patients with central nervous system (CNS) metastasis, including clinical suspicion.
Patients who are under active or uncontrolled infections.
Patients who with unstable angina (angina symptoms at rest, new-onset angina (begun within the last 3 months) or myocardial infarction history 6 months before entry.
Cardiac arrhythmia requiring anti-arrhythmic therapy (beta blockers or digoxin are permitted).
Congestive heart failure New York Heart Association (NYHA) class 2.
Uncontrolled hypertension (systolic blood pressure [BP] > 150 mmHg or diastolic pressure > 90 mmHg despite optimal medical management.
Arterial or venous thrombotic or embolic events such as cerebrovascular accident (including transient ischemic attacks), deep vein thrombosis or pulmonary embolism within 6 months before the start of study medication.
Patients who are pregnant or with breast feeding.
Other concomitant or previously malignancy within 5 years except for in situ cervix cancer or squamous cell carcinoma of the skin treated by surgery only.
Mental status is not fit for clinical trial.
Cannot take study medication orally.
Fertile men and women unless using a reliable and appropriate contraceptive method.
Patients with evidence or history of any bleeding diathesis, irrespective of severity.
Any hemorrhage or bleeding event >= Common Terminology Criteria for Adverse Events (CTCAE) Grade 3 within 4 weeks prior to the start of study medication.
Non-healing wound, ulcer, or bone fracture.
Renal failure requiring hemo-or peritoneal dialysis.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Chun-Nan Yeh, MD
Organizational Affiliation
Professor and Chief, Department of Surgery
Official's Role
Principal Investigator
Facility Information:
Facility Name
Chang Gung Memorial Hospital
City
Taoyuan
ZIP/Postal Code
333
Country
Taiwan
12. IPD Sharing Statement
Citations:
PubMed Identifier
28487491
Citation
Yeh CN, Chen MH, Chen YY, Yang CY, Yen CC, Tzen CY, Chen LT, Chen JS. A phase II trial of regorafenib in patients with metastatic and/or a unresectable gastrointestinal stromal tumor harboring secondary mutations of exon 17. Oncotarget. 2017 Jul 4;8(27):44121-44130. doi: 10.18632/oncotarget.17310.
Results Reference
derived
Learn more about this trial
Regorafenib in GIST With Secondary C-KIT Exon 17 Mutation
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