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Study of Continuous Dosing of Sunitinib in Non GIST Sarcomas With Concomitant Radiotherapy

Primary Purpose

Non GIST Sarcomas

Status
Completed
Phase
Phase 1
Locations
France
Study Type
Interventional
Intervention
sunitinib
Sponsored by
Centre Leon Berard
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Non GIST Sarcomas focused on measuring non GIST sarcomas, sunitinib, radiotherapy, dose escalation

Eligibility Criteria

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

Inclusion Criteria:

  1. Male or female patients > 18 years of age
  2. Histologically or cytologically (in case of recurrence) confirmed connective tissue neoplasm, including any of the following subtypes:

    • Liposarcomas
    • Fibrosarcoma, myxofibrosarcoma
    • Undifferentiated pleomorphic sarcoma
    • Leiomyosarcomas
    • Pleomorphic rhabdomyosarcomas only
    • Angiosarcomas
    • Uncertain differentiated tumors: synovial sarcomas, epithelioid sarcomas, alveolar sarcomas, clear cells sarcomas.

    or osteosarcoma diagnosis, chondrosarcoma or chordoma.

  3. Locally advanced or locally recurrent inoperable tumor without previous irradiation [inoperable status must be assessed by staff including a surgeon specialized in sarcoma].
  4. No prior treatment by sunitinib malate
  5. Life expectancy > 6 months
  6. ECOG performance status ≤ 2
  7. Blood tests, renal and liver functions in the normal range with, in the 7 days prior to study entry, blood or serum values as follows:

    • Absolute neutrophil count ≥ 1.,5 G/L
    • Platelet count ≥ 100 G/L
    • Bilirubin ≤ 1.5 mg/dL
    • PT and INR ≤ 1.5 times upper limit of normal [Patients under preventive anticoagulant therapy are allowed to participate]
    • AST and ALT ≤ 2.5 times upper limit of normal
    • Creatinine ≤ 150 umol/L
    • Calcium ≤ 12 mg/dL
    • Blood glucose < 150 mg/dL
  8. Fertile patients must use effective contraception prior to, during, and for 28 days after completion of study therapy
  9. Ability to swallow oral medications
  10. Mandatory affiliation with a health insurance company
  11. Signed written informed consent.

Exclusion Criteria:

  1. GIST, Ewing sarcoma or embryonic rhabdomyosarcomas
  2. Radiation field including lung, bowel, or central nervous system
  3. Pre-existing thyroid abnormality, defined as abnormal thyroid function tests despite medication
  4. NCI grade ≥ 3 hemorrhage within the past 4 weeks prior to study drug administration
  5. Significant cardiovascular disease (New York Heart Association (NYHA) > grade 2 congestive cardiac failure, myocardial infarction within 6 months prior to inclusion, unstable angina, severe cardiac arrhythmia, severe cerebrovascular accident within 6 months prior to inclusion, history of severe thromboembolism (pulmonary embolism or deep vein thrombosis DVT) within 6 months prior to inclusion (patients with recent history of DVT treated by anticoagulant (except therapeutic warfarin)during at least 6 weeks are eligibles), prolonged QTc interval (QTc > 480 msec with Bazett), bradycardia (heart rate < 45bpm), electrolytic troubles (hyponatremia<120mmol/l, kalemia≥6mmol/l) or uncontrolled hypertension while receiving appropriate medication (≥ 160 mm Hg systolic and/or ≥ 90 mm Hg diastolic).
  6. Less than 6 weeks between prior neoplastic treatment by tyrosine kinase inhibitor and inclusion and less than 4 weeks for other neoplastic treatments
  7. Major surgical procedure, open biopsy, or serious non healing wound within 28 days prior to first day of treatment
  8. Concurrent participation in another clinical trial
  9. Other disease or illness within the past 6 months prior to study drug administration, including the following:

    • Psychiatric illness or social situation that would preclude study compliance
    • Known human immunodeficiency virus (HIV)- or acquired immunodeficiency syndrome (AIDS)-related illness or other active infection
  10. Known brain metastases, spinal cord compression, or carcinomatous meningitis, or evidence of symptomatic brain or leptomeningeal disease
  11. peritoneal carcinosis
  12. number of metastatic sites > 2
  13. Restriction of freedom by judicial or administrative decision
  14. Pregnant or lactating women

Sites / Locations

  • Institut Bergonié
  • Centre Oscar Lambret
  • Centre Léon Bérard
  • CHU La Timone
  • Institut de Cancérologie de l'ouest
  • Institut Gustave Roussy

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

association sunitinib radiotherapy

Arm Description

Outcomes

Primary Outcome Measures

the number of DLT occurring at each dose level of sunitinib within 14 weeks after the start of treatment

Secondary Outcome Measures

the number of early toxicities (within 14 weeks after the beginning of treatment) and late toxicities (after 14 weeks and until 12 months after the start of treatment) using NCI-CTC v3.0 and RTOG-EORTC
response rate at 6 months using MRI (magnetic resonance imaging)
progression free survival measured from the date of inclusion to the date of first evidence of progression or date of death of any cause, or to the date of last follow up
evolution of neo-angiogenesis during treatment measured by DCE-US
correlation between clinical response and change of tumor perfusion measured by DCE-US
proportion of patients operable after treatment

Full Information

First Posted
March 1, 2011
Last Updated
January 3, 2022
Sponsor
Centre Leon Berard
Collaborators
Ministry of Health, France
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1. Study Identification

Unique Protocol Identification Number
NCT01308034
Brief Title
Study of Continuous Dosing of Sunitinib in Non GIST Sarcomas With Concomitant Radiotherapy
Official Title
Phase I Study of Continuous Dosing of Sunitinib in Non GIST Sarcomas With Concomitant Radiotherapy
Study Type
Interventional

2. Study Status

Record Verification Date
January 2022
Overall Recruitment Status
Completed
Study Start Date
March 2011 (undefined)
Primary Completion Date
May 2016 (Actual)
Study Completion Date
September 21, 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Centre Leon Berard
Collaborators
Ministry of Health, France

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to determine the safety of continuous dosing of sunitinib in association with radiotherapy in patients with non GIST (gastro intestinal stromal tumor) sarcomas who cannot be treated by surgery. The primary objective of the study is to determine the maximum tolerated dose (MTD) of continuous dosing of sunitinib in association with radiotherapy in patients with non GIST sarcomas who cannot be treated by surgery. This study is a multicentre, open-label phase I with dose escalation : 2 dose levels. 3-6 patients will be included at each dose level.3-18 patients will be included in the study.
Detailed Description
Study design : 2 dose levels Step 1 : 25 mg once daily Step 2 : 37.5 mg once daily 3-6 patients will be included at each of the sunitinib dose levels, depending on the number of DLTs (dose limiting toxicity) occurring in 14 weeks after start of treatment DLT is defined as : any grade 3 or 4 musculoskeletal or cutaneous toxicity within the field of radiation any other toxicity > or = 4 Secondary objectives are : to evaluate the safety with late toxicities to estimate the response rate at 6 months to estimate the progression free survival to evaluate the proportion of patients with an operable tumour after treatment Exploratory objectives are : to study evolution during treatment of neo-angiogenesis measured by dynamic contrast enhanced-ultrasonography (DCE-US) to study the correlation between clinical response and changes of tumor perfusion measured by DCE-US

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Non GIST Sarcomas
Keywords
non GIST sarcomas, sunitinib, radiotherapy, dose escalation

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
association sunitinib radiotherapy
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
sunitinib
Intervention Description
All patients will be treated with sunitinib (2 dose levels) once a day (in the morning) for 6 weeks in association with radiotherapy.Radiotherapy will be realised 1-4h after taking sunitinib. Dose level 1 : 25 mg once daily Dose level 2 : 37.5 mg once daily Authorization to include a patient in the upper step will be given only if the deadline of 14 weeks after the start of treatment of last patient included were strictly respected and depending of number of DLT occuring.
Primary Outcome Measure Information:
Title
the number of DLT occurring at each dose level of sunitinib within 14 weeks after the start of treatment
Time Frame
within 14 weeks after the start of treatment
Secondary Outcome Measure Information:
Title
the number of early toxicities (within 14 weeks after the beginning of treatment) and late toxicities (after 14 weeks and until 12 months after the start of treatment) using NCI-CTC v3.0 and RTOG-EORTC
Time Frame
within 12 months after the start of treatment
Title
response rate at 6 months using MRI (magnetic resonance imaging)
Time Frame
6 months after the start of treatment
Title
progression free survival measured from the date of inclusion to the date of first evidence of progression or date of death of any cause, or to the date of last follow up
Time Frame
within 12 months after the start of treatment
Title
evolution of neo-angiogenesis during treatment measured by DCE-US
Time Frame
within 6 weeks after the start of treatment
Title
correlation between clinical response and change of tumor perfusion measured by DCE-US
Time Frame
within 12 months after the start of treatment
Title
proportion of patients operable after treatment
Time Frame
at week 6 after the start of treatment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female patients > 18 years of age Histologically or cytologically (in case of recurrence) confirmed connective tissue neoplasm, including any of the following subtypes: Liposarcomas Fibrosarcoma, myxofibrosarcoma Undifferentiated pleomorphic sarcoma Leiomyosarcomas Pleomorphic rhabdomyosarcomas only Angiosarcomas Uncertain differentiated tumors: synovial sarcomas, epithelioid sarcomas, alveolar sarcomas, clear cells sarcomas. or osteosarcoma diagnosis, chondrosarcoma or chordoma. Locally advanced or locally recurrent inoperable tumor without previous irradiation [inoperable status must be assessed by staff including a surgeon specialized in sarcoma]. No prior treatment by sunitinib malate Life expectancy > 6 months ECOG performance status ≤ 2 Blood tests, renal and liver functions in the normal range with, in the 7 days prior to study entry, blood or serum values as follows: Absolute neutrophil count ≥ 1.,5 G/L Platelet count ≥ 100 G/L Bilirubin ≤ 1.5 mg/dL PT and INR ≤ 1.5 times upper limit of normal [Patients under preventive anticoagulant therapy are allowed to participate] AST and ALT ≤ 2.5 times upper limit of normal Creatinine ≤ 150 umol/L Calcium ≤ 12 mg/dL Blood glucose < 150 mg/dL Fertile patients must use effective contraception prior to, during, and for 28 days after completion of study therapy Ability to swallow oral medications Mandatory affiliation with a health insurance company Signed written informed consent. Exclusion Criteria: GIST, Ewing sarcoma or embryonic rhabdomyosarcomas Radiation field including lung, bowel, or central nervous system Pre-existing thyroid abnormality, defined as abnormal thyroid function tests despite medication NCI grade ≥ 3 hemorrhage within the past 4 weeks prior to study drug administration Significant cardiovascular disease (New York Heart Association (NYHA) > grade 2 congestive cardiac failure, myocardial infarction within 6 months prior to inclusion, unstable angina, severe cardiac arrhythmia, severe cerebrovascular accident within 6 months prior to inclusion, history of severe thromboembolism (pulmonary embolism or deep vein thrombosis DVT) within 6 months prior to inclusion (patients with recent history of DVT treated by anticoagulant (except therapeutic warfarin)during at least 6 weeks are eligibles), prolonged QTc interval (QTc > 480 msec with Bazett), bradycardia (heart rate < 45bpm), electrolytic troubles (hyponatremia<120mmol/l, kalemia≥6mmol/l) or uncontrolled hypertension while receiving appropriate medication (≥ 160 mm Hg systolic and/or ≥ 90 mm Hg diastolic). Less than 6 weeks between prior neoplastic treatment by tyrosine kinase inhibitor and inclusion and less than 4 weeks for other neoplastic treatments Major surgical procedure, open biopsy, or serious non healing wound within 28 days prior to first day of treatment Concurrent participation in another clinical trial Other disease or illness within the past 6 months prior to study drug administration, including the following: Psychiatric illness or social situation that would preclude study compliance Known human immunodeficiency virus (HIV)- or acquired immunodeficiency syndrome (AIDS)-related illness or other active infection Known brain metastases, spinal cord compression, or carcinomatous meningitis, or evidence of symptomatic brain or leptomeningeal disease peritoneal carcinosis number of metastatic sites > 2 Restriction of freedom by judicial or administrative decision Pregnant or lactating women
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jean Yves Blay, PR
Organizational Affiliation
Centre Léon Bérard, Lyon
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Marie Pierre Sunyach
Organizational Affiliation
Centre Léon Bérard, Lyon
Official's Role
Principal Investigator
Facility Information:
Facility Name
Institut Bergonié
City
Bordeaux
Country
France
Facility Name
Centre Oscar Lambret
City
Lille
Country
France
Facility Name
Centre Léon Bérard
City
Lyon
ZIP/Postal Code
69373
Country
France
Facility Name
CHU La Timone
City
Marseille
Country
France
Facility Name
Institut de Cancérologie de l'ouest
City
Saint Herblain
Country
France
Facility Name
Institut Gustave Roussy
City
Villejuif
Country
France

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8407399
Citation
Harrison LB, Franzese F, Gaynor JJ, Brennan MF. Long-term results of a prospective randomized trial of adjuvant brachytherapy in the management of completely resected soft tissue sarcomas of the extremity and superficial trunk. Int J Radiat Oncol Biol Phys. 1993 Sep 30;27(2):259-65. doi: 10.1016/0360-3016(93)90236-o.
Results Reference
result
PubMed Identifier
9440743
Citation
Yang JC, Chang AE, Baker AR, Sindelar WF, Danforth DN, Topalian SL, DeLaney T, Glatstein E, Steinberg SM, Merino MJ, Rosenberg SA. Randomized prospective study of the benefit of adjuvant radiation therapy in the treatment of soft tissue sarcomas of the extremity. J Clin Oncol. 1998 Jan;16(1):197-203. doi: 10.1200/JCO.1998.16.1.197.
Results Reference
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Study of Continuous Dosing of Sunitinib in Non GIST Sarcomas With Concomitant Radiotherapy

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