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Regorafenib in Patients With Metastatic Solid Tumors Who Have Progressed After Standard Therapy (RESOUND)

Primary Purpose

Pancreas Cancer, Ovarian Cancer, Melanoma

Status
Completed
Phase
Phase 2
Locations
Italy
Study Type
Interventional
Intervention
Regorafenib
Sponsored by
Istituto Clinico Humanitas
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pancreas Cancer

Eligibility Criteria

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

Inclusion Criteria:

  1. Signed informed consent
  2. Patients older then 18 years.
  3. Locally advanced, recurrent or metastatic histologically confirmed malignancy refractory to available standard treatment, included Pancreatic cancer, Ovarian cancer, Melanoma, Sarcoma
  4. At least one measurable lesion according to Response Evaluation Criteria In solid tumor
  5. Eastern Cooperative Oncology Group Performance Status: 0-1
  6. Life expectancy of at least 12 weeks
  7. Adequate bone marrow, liver and renal function as assessed by the following laboratory : Hemoglobin > 9.0 g/dl Absolute neutrophil count > 1,500/mm3 Platelet count > 100,000/μl White blood cells >3.0 x 109/L Total bilirubin <1.5 times the upper limit of normal Alanine amino transferase and aspartate amino transferase <2.5 x upper limit of normal (<5 x upper limit of normal for patients with liver involvement) Serum creatinine <1.5 x upper limit of normal Alkaline phosphatase <2.5 x Upper Limit of Normal Prothrombin time / Partial prothrombin time <1.5 x Upper Limit of Normal Lipase ≤ 1.5 x the Upper Limit of Normal
  8. Able to swallow and retain oral medication.
  9. Estimated creatinine clearance > 30ml/min as calculated using the Cockcroft-Gault equation
  10. Resolution of any toxic effects of prior therapy to NCI Common Terminology Criteria for Adverse Event, Version 4.0, grade ≤ 1 .
  11. Women of childbearing potential and men must agree to use adequate contraception

Exclusion Criteria:

  1. Prior treatment with regorafenib.
  2. Major surgical procedure, open biopsy, or significant traumatic injury within 28 days before start of study drug
  3. Congestive heart failure >New York Heart Association class 2
  4. Unstable angina), new-onset angina.Myocardial infarction less than 6 months before start of study drug
  5. Myocardial infarction less than 6 months before start of study drug.
  6. Cardiac arrhythmias requiring anti-arrhythmic therapy
  7. Uncontrolled hypertension.
  8. Pleural effusion or ascites that causes respiratory compromise
  9. Ongoing infection > Grade 2
  10. Known history of human immunodeficiency virus infection.
  11. Active hepatitis B or C, or chronic hepatitis B or C requiring treatment with antiviral therapy.
  12. Subjects with seizure disorder requiring medication.
  13. History of organ allograft. Subjects with evidence or history of any bleeding diathesis, irrespective of severity.
  14. Any hemorrhage or bleeding event > Common Toxicity Criteria for Adverse Effects Grade 3
  15. Arterial or venous thrombotic or embolic events within the 6 months before start of study medication
  16. Known history or symptomatic metastatic brain or meningeal tumors
  17. Suggestive or consistent with central nervous system disease
  18. Renal failure requiring hemo-or peritoneal dialysis.
  19. Dehydration Common Toxicity Criteria for Adverse Effects v. 4.0 Grade >1.
  20. Substance abuse, medical, psychological or social conditions that may interfere with the subject's participation in the study or evaluation of the study results.
  21. Known hypersensitivity to any of the study drugs, study drug classes, or excipients in the formulation.
  22. Any illness or medical conditions that are unstable or could jeopardize the safety of the subject and his/her compliance in the study.
  23. Interstitial lung disease with ongoing signs and symptoms
  24. Persistent proteinuria of CTCAE Grade 3
  25. Any malabsorption condition.
  26. Concomitant participation or participation within the last 30 days in another clinical trial
  27. Systemic anticancer therapy including cytotoxic therapy, signal transduction inhibitors, immunotherapy, and hormonal therapy during this trial or within 4 weeks before starting to receive study medication.

Sites / Locations

  • Istituto Clinico Humanitas

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Regorafenib

Arm Description

Regorafenib 160 mg (40 mg tablets), po, every day for 3 weeks of every 4 week cycle

Outcomes

Primary Outcome Measures

activity of regorafenib screening, in terms of 2-months progression free survival rate
to evaluate activity of regorafenib, in terms of 2-months progression free survival rate

Secondary Outcome Measures

prognosis in terms of progression-free survival
to explore the prognosis in terms of progression-free survival calculated from the first day of regorafenib treatment to the date of tumor progression or death, whichever occurs first.
overall survival (OS)
to explore overall survival (OS) measured from the first day of regorafenib treatment until the date of death from any cause or the date of the last contact, at which the patients will be censored
safety profile of regorafenib according to NCI-CTC v.3
to assess the safety profile of regorafenib according to the National Cancer Institute Common Toxicity Criteria (NCI-CTC) version 3

Full Information

First Posted
November 25, 2014
Last Updated
September 9, 2022
Sponsor
Istituto Clinico Humanitas
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1. Study Identification

Unique Protocol Identification Number
NCT02307500
Brief Title
Regorafenib in Patients With Metastatic Solid Tumors Who Have Progressed After Standard Therapy
Acronym
RESOUND
Official Title
An Open-label Phase II Study of Regorafenib in Patients With Metastatic Solid Tumors Who Have Progressed After Standard Therapy - RESOUND
Study Type
Interventional

2. Study Status

Record Verification Date
September 2022
Overall Recruitment Status
Completed
Study Start Date
December 2014 (undefined)
Primary Completion Date
December 2017 (Actual)
Study Completion Date
August 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Istituto Clinico Humanitas

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a single arm, single-stage, phase II trial to evaluate the activity of Regorafenib in patients with metastatic solid tumors (pancreatic cancer, ovarian cancer, melanoma, sarcoma, thymoma (type B2 - B3) and thymic carcinoma, who have progressed after standard therapy.
Detailed Description
Each tumour will be assessed by itself. Regorafenib 40 mg tablets will be used in the study. Subjects will receive 160 mg regorafenib po every day (qd) for 3 weeks of every 4 week cycle (i.e., 3 weeks on, 1 week off). Subjects will continue on treatment until at least one of the following occurs (main criteria): Progressive Disease (PD) by radiological assessments or clinical progression Death Unacceptable toxicity Subject withdraws consent Treating physician determines discontinuation of treatment is in the subject's best interest Substantial non-compliance with the protocol

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pancreas Cancer, Ovarian Cancer, Melanoma, Sarcoma, Thymoma Type B3, Thymoma Type B2, Thymic Carcinoma

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Regorafenib
Arm Type
Experimental
Arm Description
Regorafenib 160 mg (40 mg tablets), po, every day for 3 weeks of every 4 week cycle
Intervention Type
Drug
Intervention Name(s)
Regorafenib
Other Intervention Name(s)
Stivarga
Intervention Description
oral therapy
Primary Outcome Measure Information:
Title
activity of regorafenib screening, in terms of 2-months progression free survival rate
Description
to evaluate activity of regorafenib, in terms of 2-months progression free survival rate
Time Frame
2 months
Secondary Outcome Measure Information:
Title
prognosis in terms of progression-free survival
Description
to explore the prognosis in terms of progression-free survival calculated from the first day of regorafenib treatment to the date of tumor progression or death, whichever occurs first.
Time Frame
36 months
Title
overall survival (OS)
Description
to explore overall survival (OS) measured from the first day of regorafenib treatment until the date of death from any cause or the date of the last contact, at which the patients will be censored
Time Frame
36 months
Title
safety profile of regorafenib according to NCI-CTC v.3
Description
to assess the safety profile of regorafenib according to the National Cancer Institute Common Toxicity Criteria (NCI-CTC) version 3
Time Frame
3 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Signed informed consent Patients older then 18 years. Locally advanced, recurrent or metastatic histologically confirmed malignancy refractory to available standard treatment, included Pancreatic cancer, Ovarian cancer, Melanoma, Sarcoma At least one measurable lesion according to Response Evaluation Criteria In solid tumor Eastern Cooperative Oncology Group Performance Status: 0-1 Life expectancy of at least 12 weeks Adequate bone marrow, liver and renal function as assessed by the following laboratory : Hemoglobin > 9.0 g/dl Absolute neutrophil count > 1,500/mm3 Platelet count > 100,000/μl White blood cells >3.0 x 109/L Total bilirubin <1.5 times the upper limit of normal Alanine amino transferase and aspartate amino transferase <2.5 x upper limit of normal (<5 x upper limit of normal for patients with liver involvement) Serum creatinine <1.5 x upper limit of normal Alkaline phosphatase <2.5 x Upper Limit of Normal Prothrombin time / Partial prothrombin time <1.5 x Upper Limit of Normal Lipase ≤ 1.5 x the Upper Limit of Normal Able to swallow and retain oral medication. Estimated creatinine clearance > 30ml/min as calculated using the Cockcroft-Gault equation Resolution of any toxic effects of prior therapy to NCI Common Terminology Criteria for Adverse Event, Version 4.0, grade ≤ 1 . Women of childbearing potential and men must agree to use adequate contraception Exclusion Criteria: Prior treatment with regorafenib. Major surgical procedure, open biopsy, or significant traumatic injury within 28 days before start of study drug Congestive heart failure >New York Heart Association class 2 Unstable angina), new-onset angina.Myocardial infarction less than 6 months before start of study drug Myocardial infarction less than 6 months before start of study drug. Cardiac arrhythmias requiring anti-arrhythmic therapy Uncontrolled hypertension. Pleural effusion or ascites that causes respiratory compromise Ongoing infection > Grade 2 Known history of human immunodeficiency virus infection. Active hepatitis B or C, or chronic hepatitis B or C requiring treatment with antiviral therapy. Subjects with seizure disorder requiring medication. History of organ allograft. Subjects with evidence or history of any bleeding diathesis, irrespective of severity. Any hemorrhage or bleeding event > Common Toxicity Criteria for Adverse Effects Grade 3 Arterial or venous thrombotic or embolic events within the 6 months before start of study medication Known history or symptomatic metastatic brain or meningeal tumors Suggestive or consistent with central nervous system disease Renal failure requiring hemo-or peritoneal dialysis. Dehydration Common Toxicity Criteria for Adverse Effects v. 4.0 Grade >1. Substance abuse, medical, psychological or social conditions that may interfere with the subject's participation in the study or evaluation of the study results. Known hypersensitivity to any of the study drugs, study drug classes, or excipients in the formulation. Any illness or medical conditions that are unstable or could jeopardize the safety of the subject and his/her compliance in the study. Interstitial lung disease with ongoing signs and symptoms Persistent proteinuria of CTCAE Grade 3 Any malabsorption condition. Concomitant participation or participation within the last 30 days in another clinical trial Systemic anticancer therapy including cytotoxic therapy, signal transduction inhibitors, immunotherapy, and hormonal therapy during this trial or within 4 weeks before starting to receive study medication.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Armando Santoro, MD
Organizational Affiliation
Istituto Clinico Humanitas
Official's Role
Principal Investigator
Facility Information:
Facility Name
Istituto Clinico Humanitas
City
Rozzano
State/Province
Milan
ZIP/Postal Code
20089
Country
Italy

12. IPD Sharing Statement

Citations:
PubMed Identifier
21170960
Citation
Wilhelm SM, Dumas J, Adnane L, Lynch M, Carter CA, Schutz G, Thierauch KH, Zopf D. Regorafenib (BAY 73-4506): a new oral multikinase inhibitor of angiogenic, stromal and oncogenic receptor tyrosine kinases with potent preclinical antitumor activity. Int J Cancer. 2011 Jul 1;129(1):245-55. doi: 10.1002/ijc.25864. Epub 2011 Apr 22.
Results Reference
background
PubMed Identifier
11001068
Citation
Carmeliet P, Jain RK. Angiogenesis in cancer and other diseases. Nature. 2000 Sep 14;407(6801):249-57. doi: 10.1038/35025220.
Results Reference
background
PubMed Identifier
15178810
Citation
Ferrara N. Vascular endothelial growth factor as a target for anticancer therapy. Oncologist. 2004;9 Suppl 1:2-10. doi: 10.1634/theoncologist.9-suppl_1-2.
Results Reference
background
PubMed Identifier
7596436
Citation
Fong GH, Rossant J, Gertsenstein M, Breitman ML. Role of the Flt-1 receptor tyrosine kinase in regulating the assembly of vascular endothelium. Nature. 1995 Jul 6;376(6535):66-70. doi: 10.1038/376066a0.
Results Reference
background
PubMed Identifier
7596435
Citation
Shalaby F, Rossant J, Yamaguchi TP, Gertsenstein M, Wu XF, Breitman ML, Schuh AC. Failure of blood-island formation and vasculogenesis in Flk-1-deficient mice. Nature. 1995 Jul 6;376(6535):62-6. doi: 10.1038/376062a0.
Results Reference
background
PubMed Identifier
17332278
Citation
Goodman VL, Rock EP, Dagher R, Ramchandani RP, Abraham S, Gobburu JV, Booth BP, Verbois SL, Morse DE, Liang CY, Chidambaram N, Jiang JX, Tang S, Mahjoob K, Justice R, Pazdur R. Approval summary: sunitinib for the treatment of imatinib refractory or intolerant gastrointestinal stromal tumors and advanced renal cell carcinoma. Clin Cancer Res. 2007 Mar 1;13(5):1367-73. doi: 10.1158/1078-0432.CCR-06-2328.
Results Reference
background
PubMed Identifier
23349675
Citation
Amit L, Ben-Aharon I, Vidal L, Leibovici L, Stemmer S. The impact of Bevacizumab (Avastin) on survival in metastatic solid tumors--a meta-analysis and systematic review. PLoS One. 2013;8(1):e51780. doi: 10.1371/journal.pone.0051780. Epub 2013 Jan 22.
Results Reference
background
PubMed Identifier
11001067
Citation
Yancopoulos GD, Davis S, Gale NW, Rudge JS, Wiegand SJ, Holash J. Vascular-specific growth factors and blood vessel formation. Nature. 2000 Sep 14;407(6801):242-8. doi: 10.1038/35025215.
Results Reference
background
PubMed Identifier
19182515
Citation
Acevedo VD, Ittmann M, Spencer DM. Paths of FGFR-driven tumorigenesis. Cell Cycle. 2009 Feb 15;8(4):580-8. doi: 10.4161/cc.8.4.7657. Epub 2009 Feb 18.
Results Reference
background
PubMed Identifier
12727920
Citation
Bergers G, Song S, Meyer-Morse N, Bergsland E, Hanahan D. Benefits of targeting both pericytes and endothelial cells in the tumor vasculature with kinase inhibitors. J Clin Invest. 2003 May;111(9):1287-95. doi: 10.1172/JCI17929.
Results Reference
background
PubMed Identifier
19234476
Citation
Augustin HG, Koh GY, Thurston G, Alitalo K. Control of vascular morphogenesis and homeostasis through the angiopoietin-Tie system. Nat Rev Mol Cell Biol. 2009 Mar;10(3):165-77. doi: 10.1038/nrm2639.
Results Reference
background
PubMed Identifier
19082480
Citation
Huang J, Bae JO, Tsai JP, Kadenhe-Chiweshe A, Papa J, Lee A, Zeng S, Kornfeld ZN, Ullner P, Zaghloul N, Ioffe E, Nandor S, Burova E, Holash J, Thurston G, Rudge J, Yancopoulos GD, Yamashiro DJ, Kandel JJ. Angiopoietin-1/Tie-2 activation contributes to vascular survival and tumor growth during VEGF blockade. Int J Oncol. 2009 Jan;34(1):79-87.
Results Reference
background
PubMed Identifier
16962282
Citation
Bach F, Uddin FJ, Burke D. Angiopoietins in malignancy. Eur J Surg Oncol. 2007 Feb;33(1):7-15. doi: 10.1016/j.ejso.2006.07.015. Epub 2006 Sep 7.
Results Reference
background
PubMed Identifier
16620053
Citation
Saito M, Watanabe J, Fujisawa T, Kamata Y, Nishimura Y, Arai T, Miyamoto T, Obokata A, Kuramoto H. Angiopoietin-1, 2 and Tie2 expressions in endometrial adenocarcinoma--the Ang2 dominant balance up-regulates tumor angiogenesis in the presence of VEGF. Eur J Gynaecol Oncol. 2006;27(2):129-34.
Results Reference
background
PubMed Identifier
19088043
Citation
Szarvas T, Jager T, Totsch M, vom Dorp F, Kempkensteffen C, Kovalszky I, Romics I, Ergun S, Rubben H. Angiogenic switch of angiopietins-Tie2 system and its prognostic value in bladder cancer. Clin Cancer Res. 2008 Dec 15;14(24):8253-62. doi: 10.1158/1078-0432.CCR-08-0677.
Results Reference
background
PubMed Identifier
20094046
Citation
Turner N, Grose R. Fibroblast growth factor signalling: from development to cancer. Nat Rev Cancer. 2010 Feb;10(2):116-29. doi: 10.1038/nrc2780.
Results Reference
background
PubMed Identifier
17208434
Citation
Fletcher JA, Rubin BP. KIT mutations in GIST. Curr Opin Genet Dev. 2007 Feb;17(1):3-7. doi: 10.1016/j.gde.2006.12.010. Epub 2007 Jan 8.
Results Reference
background
PubMed Identifier
19028457
Citation
Lanzi C, Cassinelli G, Nicolini V, Zunino F. Targeting RET for thyroid cancer therapy. Biochem Pharmacol. 2009 Feb 1;77(3):297-309. doi: 10.1016/j.bcp.2008.10.033. Epub 2008 Nov 6.
Results Reference
background
PubMed Identifier
8193545
Citation
Marshall CJ. MAP kinase kinase kinase, MAP kinase kinase and MAP kinase. Curr Opin Genet Dev. 1994 Feb;4(1):82-9. doi: 10.1016/0959-437x(94)90095-7.
Results Reference
background
PubMed Identifier
11927284
Citation
Herrera R, Sebolt-Leopold JS. Unraveling the complexities of the Raf/MAP kinase pathway for pharmacological intervention. Trends Mol Med. 2002;8(4 Suppl):S27-31. doi: 10.1016/s1471-4914(02)02307-9. Erratum In: Trends Mol Med 2002 May;8(5):243.
Results Reference
background
PubMed Identifier
12360282
Citation
Ferrara N. VEGF and the quest for tumour angiogenesis factors. Nat Rev Cancer. 2002 Oct;2(10):795-803. doi: 10.1038/nrc909.
Results Reference
background
PubMed Identifier
12124170
Citation
Sawyers CL. Finding the next Gleevec: FLT3 targeted kinase inhibitor therapy for acute myeloid leukemia. Cancer Cell. 2002 Jun;1(5):413-5. doi: 10.1016/s1535-6108(02)00080-6.
Results Reference
background
PubMed Identifier
11896121
Citation
Heinrich MC, Blanke CD, Druker BJ, Corless CL. Inhibition of KIT tyrosine kinase activity: a novel molecular approach to the treatment of KIT-positive malignancies. J Clin Oncol. 2002 Mar 15;20(6):1692-703. doi: 10.1200/JCO.2002.20.6.1692.
Results Reference
background
PubMed Identifier
18437172
Citation
Nikiforov YE. Thyroid carcinoma: molecular pathways and therapeutic targets. Mod Pathol. 2008 May;21 Suppl 2(Suppl 2):S37-43. doi: 10.1038/modpathol.2008.10.
Results Reference
background
PubMed Identifier
12181402
Citation
Apperley JF, Gardembas M, Melo JV, Russell-Jones R, Bain BJ, Baxter EJ, Chase A, Chessells JM, Colombat M, Dearden CE, Dimitrijevic S, Mahon FX, Marin D, Nikolova Z, Olavarria E, Silberman S, Schultheis B, Cross NC, Goldman JM. Response to imatinib mesylate in patients with chronic myeloproliferative diseases with rearrangements of the platelet-derived growth factor receptor beta. N Engl J Med. 2002 Aug 15;347(7):481-7. doi: 10.1056/NEJMoa020150.
Results Reference
background
PubMed Identifier
22421192
Citation
Mross K, Frost A, Steinbild S, Hedbom S, Buchert M, Fasol U, Unger C, Kratzschmar J, Heinig R, Boix O, Christensen O. A phase I dose-escalation study of regorafenib (BAY 73-4506), an inhibitor of oncogenic, angiogenic, and stromal kinases, in patients with advanced solid tumors. Clin Cancer Res. 2012 May 1;18(9):2658-67. doi: 10.1158/1078-0432.CCR-11-1900. Epub 2012 Mar 15.
Results Reference
background
PubMed Identifier
23177514
Citation
Grothey A, Van Cutsem E, Sobrero A, Siena S, Falcone A, Ychou M, Humblet Y, Bouche O, Mineur L, Barone C, Adenis A, Tabernero J, Yoshino T, Lenz HJ, Goldberg RM, Sargent DJ, Cihon F, Cupit L, Wagner A, Laurent D; CORRECT Study Group. Regorafenib monotherapy for previously treated metastatic colorectal cancer (CORRECT): an international, multicentre, randomised, placebo-controlled, phase 3 trial. Lancet. 2013 Jan 26;381(9863):303-12. doi: 10.1016/S0140-6736(12)61900-X. Epub 2012 Nov 22.
Results Reference
background
PubMed Identifier
32590747
Citation
Marrari A, Bertuzzi A, Bozzarelli S, Gennaro N, Giordano L, Quagliuolo V, De Sanctis R, Sala S, Balzarini L, Santoro A. Activity of regorafenib in advanced pretreated soft tissue sarcoma: Results of a single-center phase II study. Medicine (Baltimore). 2020 Jun 26;99(26):e20719. doi: 10.1097/MD.0000000000020719.
Results Reference
derived
PubMed Identifier
31746632
Citation
Bozzarelli S, Rimassa L, Giordano L, Sala S, Tronconi MC, Pressiani T, Smiroldo V, Prete MG, Spaggiari P, Personeni N, Santoro A. Regorafenib in patients with refractory metastatic pancreatic cancer: a Phase II study (RESOUND). Future Oncol. 2019 Dec;15(35):4009-4017. doi: 10.2217/fon-2019-0480. Epub 2019 Nov 20.
Results Reference
derived

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Regorafenib in Patients With Metastatic Solid Tumors Who Have Progressed After Standard Therapy

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