Study of Nilotinib Efficacy in Pigmented Villo-Nodular Synovitis/ Tenosynovial Giant Cell Tumour (PVNS/TGCT)
Primary Purpose
Pigmented Villonodular Synovitis
Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Tasigna
Sponsored by
About this trial
This is an interventional treatment trial for Pigmented Villonodular Synovitis focused on measuring Pigmented villonodular synovitis, tenosynovial giant cell tumour, nilotinib
Eligibility Criteria
Inclusion Criteria:
- Age > 18 years
- Histologically confirmed diagnosis of inoperable progressive or relapsing PVNS/TGCT OR resectable tumour requesting mutilating surgery
- Demonstrated progressive disease in the last 12 months
- At least one measurable site of disease on MRI/CT scan according to RECIST criteria (RECIST version 1.1) based on investigator's assessment
- WHO Performance status of 0, 1 or 2
- Adequate organ, electrolyte and marrow function, defined as the following: serum bilirubin > or =1.5 x ULN, ALT and AST < or = 2.5 x ULN, serum creatinine < or = 1.5 x ULN or creatinine clearance > or = 50 mL/min, absolute neutrophil count (ANC) > or = 1.5x109/L, platelets > or = 100x109/L, serum lipase < or =1.5 x ULN, magnesium ≥ lower limit of normal (LLN) and potassium ≥ LLN
- Prior adequate physical examination including weight, height, ECOG PS and vital signs (systolic and diastolic blood pressure, heart rate after at least 5 minutes in supine position)
- Signed written informed consent form
- Covered by a medical insurance (in countries where applicable)
Exclusion Criteria:
- Pregnant or lactating female or female of child-bearing potential not employing adequate contraception during the study and for up to three months following termination of the study
- Known hypersensitivity to nilotinib or to any of the excipients, galactose intolerance, lactase deficiency or glucose-galactose malabsorption prior to enrollment
- Acute or chronic uncontrolled liver disease, or severe renal disease
- Impaired cardiac function, including:
- LVEF<50% or below the institutional lower limit of the normal range (whichever is higher) as determined by echocardiogram or MUGA scan
- History or signs of prior myocardial infarction
- History of unstable angina
- Congenital long QT prolongation
- Personal history of unexplained syncope
- QTc interval ≥ 450 msec on screening ECG
- Other clinically significant heart disease (e.g. bradycardia, congestive heart failure or uncontrolled hypertension)
- Patient with family history of long QT syndrome, of unexplained syncope or of unexplained sudden death
- Patients with severe and/or uncontrolled concurrent medical disease that in the opinion of the investigator could cause unacceptable safety risks or compromise compliance with the protocol e.g. uncontrolled diabetes, active or uncontrolled infection, history of pancreatitis
- History of non-compliance to medical regimens
- Concomitant treatment with medicinal products that induce CYP3A4 (e.g. dexamethasone, phenytoin, carbamazepine, rifampicin, phenobarbital or St. John's Wort), or that inhibit the CYP3A4 activity (e.g. ketoconazole, itraconazole, voriconazole, erythromycin, clarithromycin, telithromycin)
- Concomitant treatment with warfarin
- Concomitant treatment with anti-arrhythmic drug (e. g. amiodarone, sotalol, disopyramide, quinidine, procainamide) or medication that prolongs the QT interval (e.g. chloroquine, chlorpromazine, domperidone, droperidol, halofantrine, haloperidol, methadone, pentamidine, pimozide, thioridazine)
- Prior treatment with imatinib except if no progression was demonstrated
Sites / Locations
- Institut Bergonié
- Centre Oscar Lambret
- Centre Léon Bérard
- Hôpital La Timone
- Institut Paoli Calmettes
- Institut Curie
- Institut Claudius Regaud
- Institut Gustave Roussy
- Istituto Nazionale dei Tumori
- Regina Elena National Cancer Institute
- Leiden University Medical Center
- Radboud University Nijmegen Medical Centre
- Sklodowska-Curie Memorial Cancer Center and Institute of Oncology
- University College Hospital UCL Hospitals NHS Foundation Trust
- Oxford Cancer Centre
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Nilotinib
Arm Description
Outcomes
Primary Outcome Measures
the non progression rate after 12 weeks (3 months) of treatment, based on the response evaluated by CT scan or MRI according to RECIST criteria (RECIST version 1.1) and validated by a central review committee.
Secondary Outcome Measures
Non progression rate after 24 weeks (6 months) of treatment, based on the response evaluated by CT scan or MRI according to RECIST criteria (RECIST version 1.1).
Objective tumour response according to RECIST version 1.1 (CR and PR) after 12 weeks of treatment
Duration of response
Best overall response
Progression-free survival
Time to progression
Time to treatment failure
Non progression rate after 12 weeks of treatment, based on the response evaluated locally by the investigator in charge using CT scan or MRI and according to RECIST criteria (RECIST version 1.1)
Proportion of patients with an operable tumour after nilotinib exposure according to investigator evaluation
Concomitant treatment use during the study
Correlation between trough level of nilotinib at 6 weeks and 12 weeks and objective tumour response
Safety evaluation will be based on overall safety profile characterized by type, frequency and severity (as graded using NCI-CTCAE V3.0) of adverse events.
Full Information
NCT ID
NCT01261429
First Posted
December 15, 2010
Last Updated
April 15, 2013
Sponsor
Centre Leon Berard
Collaborators
Ministry of Health, France
1. Study Identification
Unique Protocol Identification Number
NCT01261429
Brief Title
Study of Nilotinib Efficacy in Pigmented Villo-Nodular Synovitis/ Tenosynovial Giant Cell Tumour (PVNS/TGCT)
Official Title
Phase II Study of Nilotinib Efficacy in Pigmented Villo-Nodular Synovitis/ Tenosynovial Giant Cell Tumour (PVNS/TGCT)
Study Type
Interventional
2. Study Status
Record Verification Date
April 2013
Overall Recruitment Status
Completed
Study Start Date
December 2010 (undefined)
Primary Completion Date
April 2013 (Actual)
Study Completion Date
April 2013 (Actual)
3. Sponsor/Collaborators
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 explore the efficacy of nilotinib as a treatment of patients with progressive or relapsing pigmented villo-nodular synovitis / tenosynovial giant cell tumour (PVNS/TGCT) who cannot be treated by surgery.
The primary objective of the study will be to determine the efficacy of 12 weeks (3 months) of nilotinib treatment as measured by the non progression rate (Complete response + Partial Response + Stable disease according to Response Evaluation Criteria In Solid Tumours - RECIST version 1.1) in patients with progressive or relapsing PVNS/TGCT who cannot be treated by surgery.
this study is an international, multicentre, non-randomized, open-label phase II clinical trial with a Bayesian design.
A maximum sample size of 50 patients will be included in the study
Detailed Description
A key secondary objective of the study will be to determine the efficacy of 24 weeks (6 months) of nilotinib treatment as measured by the non progression rate (Complete response + Partial Response + Stable disease according to Response Evaluation Criteria In Solid Tumours - RECIST version 1.1) in patients with progressive or relapsing PVNS/TGCT who cannot be treated by surgery.
This key secondary objective was defined for the purpose of a further analysis (not described in this protocol) which will pool the data of the PVNS study with those of a similar concomitant study conducted in the US and Australia.
The other secondary objectives will be:
To evaluate the efficacy of nilotinib according to:
The objective tumour response rate (Complete response + Partial Response according to RECIST version 1.1) after 12 weeks of treatment
The duration of treatment response
The best overall response obtained during the study
The progression-free survival (PFS)
The time to progression (TTP)
The time to treatment failure (TTF)
The proportion of patients with an operable tumour after nilotinib exposure according to investigator evaluation
The description of concomitant treatments use
The correlation between trough levels of nilotinib and objective tumour response To assess the safety of nilotinib for PVNS/TGCT patients
An exploratory objective of the study will be to study the relationship between the objective tumour response and the following tumour characteristics (tissues collected in a prior surgery, or by biopsy, upon specific acceptance by the patient; if no tissue is available in the prior surgery, a biopsy will be done at visit 2):
Presence of COL6A3/CSF1 fusion gene Presence of M-CSF, CSF1R, KIT, PDGFRA and B on immunohistochemistry Presence of phosphorylated c-fms on tumour samples Activation of the PI3K/Akt/mTor pathway, presence of activating mutations of ras, and other potential molecular alterations
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pigmented Villonodular Synovitis
Keywords
Pigmented villonodular synovitis, tenosynovial giant cell tumour, nilotinib
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
50 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Nilotinib
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Tasigna
Intervention Description
The study drug is nilotinib (Tasigna®). All patients will be administered with nilotinib 400 mg twice a day for one year. The patient will begin the treatment the day of inclusion.
The prescribed dose should be swallowed whole with a glass of water. Doses of 400 mg should be administered twice daily approximately 12 hours apart. Patients should not eat within two hours before and one hour after taking nilotinib and need to avoid foods such as grapefruit juice which may inhibit CYP3A4 enzymes.
Primary Outcome Measure Information:
Title
the non progression rate after 12 weeks (3 months) of treatment, based on the response evaluated by CT scan or MRI according to RECIST criteria (RECIST version 1.1) and validated by a central review committee.
Time Frame
after 12 weeks (3 months) of treatment
Secondary Outcome Measure Information:
Title
Non progression rate after 24 weeks (6 months) of treatment, based on the response evaluated by CT scan or MRI according to RECIST criteria (RECIST version 1.1).
Time Frame
after 24 weeks (6 months) of treatment
Title
Objective tumour response according to RECIST version 1.1 (CR and PR) after 12 weeks of treatment
Time Frame
after 12 weeks of treatment
Title
Duration of response
Time Frame
during the study
Title
Best overall response
Time Frame
during the study
Title
Progression-free survival
Time Frame
during the study
Title
Time to progression
Time Frame
during the study
Title
Time to treatment failure
Time Frame
during the study
Title
Non progression rate after 12 weeks of treatment, based on the response evaluated locally by the investigator in charge using CT scan or MRI and according to RECIST criteria (RECIST version 1.1)
Time Frame
after 12 weeks of treatment
Title
Proportion of patients with an operable tumour after nilotinib exposure according to investigator evaluation
Time Frame
at the end of the study (last visit)
Title
Concomitant treatment use during the study
Time Frame
during the study
Title
Correlation between trough level of nilotinib at 6 weeks and 12 weeks and objective tumour response
Time Frame
at the end of the study
Title
Safety evaluation will be based on overall safety profile characterized by type, frequency and severity (as graded using NCI-CTCAE V3.0) of adverse events.
Time Frame
at the end of the study
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Age > 18 years
Histologically confirmed diagnosis of inoperable progressive or relapsing PVNS/TGCT OR resectable tumour requesting mutilating surgery
Demonstrated progressive disease in the last 12 months
At least one measurable site of disease on MRI/CT scan according to RECIST criteria (RECIST version 1.1) based on investigator's assessment
WHO Performance status of 0, 1 or 2
Adequate organ, electrolyte and marrow function, defined as the following: serum bilirubin > or =1.5 x ULN, ALT and AST < or = 2.5 x ULN, serum creatinine < or = 1.5 x ULN or creatinine clearance > or = 50 mL/min, absolute neutrophil count (ANC) > or = 1.5x109/L, platelets > or = 100x109/L, serum lipase < or =1.5 x ULN, magnesium ≥ lower limit of normal (LLN) and potassium ≥ LLN
Prior adequate physical examination including weight, height, ECOG PS and vital signs (systolic and diastolic blood pressure, heart rate after at least 5 minutes in supine position)
Signed written informed consent form
Covered by a medical insurance (in countries where applicable)
Exclusion Criteria:
Pregnant or lactating female or female of child-bearing potential not employing adequate contraception during the study and for up to three months following termination of the study
Known hypersensitivity to nilotinib or to any of the excipients, galactose intolerance, lactase deficiency or glucose-galactose malabsorption prior to enrollment
Acute or chronic uncontrolled liver disease, or severe renal disease
Impaired cardiac function, including:
LVEF<50% or below the institutional lower limit of the normal range (whichever is higher) as determined by echocardiogram or MUGA scan
History or signs of prior myocardial infarction
History of unstable angina
Congenital long QT prolongation
Personal history of unexplained syncope
QTc interval ≥ 450 msec on screening ECG
Other clinically significant heart disease (e.g. bradycardia, congestive heart failure or uncontrolled hypertension)
Patient with family history of long QT syndrome, of unexplained syncope or of unexplained sudden death
Patients with severe and/or uncontrolled concurrent medical disease that in the opinion of the investigator could cause unacceptable safety risks or compromise compliance with the protocol e.g. uncontrolled diabetes, active or uncontrolled infection, history of pancreatitis
History of non-compliance to medical regimens
Concomitant treatment with medicinal products that induce CYP3A4 (e.g. dexamethasone, phenytoin, carbamazepine, rifampicin, phenobarbital or St. John's Wort), or that inhibit the CYP3A4 activity (e.g. ketoconazole, itraconazole, voriconazole, erythromycin, clarithromycin, telithromycin)
Concomitant treatment with warfarin
Concomitant treatment with anti-arrhythmic drug (e. g. amiodarone, sotalol, disopyramide, quinidine, procainamide) or medication that prolongs the QT interval (e.g. chloroquine, chlorpromazine, domperidone, droperidol, halofantrine, haloperidol, methadone, pentamidine, pimozide, thioridazine)
Prior treatment with imatinib except if no progression was demonstrated
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
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
Country
France
Facility Name
Hôpital La Timone
City
Marseille
Country
France
Facility Name
Institut Paoli Calmettes
City
Marseille
Country
France
Facility Name
Institut Curie
City
Paris
Country
France
Facility Name
Institut Claudius Regaud
City
Toulouse
Country
France
Facility Name
Institut Gustave Roussy
City
Villejuif
Country
France
Facility Name
Istituto Nazionale dei Tumori
City
Milano
Country
Italy
Facility Name
Regina Elena National Cancer Institute
City
Roma
Country
Italy
Facility Name
Leiden University Medical Center
City
Leiden
Country
Netherlands
Facility Name
Radboud University Nijmegen Medical Centre
City
Nijmegen
Country
Netherlands
Facility Name
Sklodowska-Curie Memorial Cancer Center and Institute of Oncology
City
Warsaw
Country
Poland
Facility Name
University College Hospital UCL Hospitals NHS Foundation Trust
City
London
Country
United Kingdom
Facility Name
Oxford Cancer Centre
City
Oxford
Country
United Kingdom
12. IPD Sharing Statement
Citations:
PubMed Identifier
17148989
Citation
Mendenhall WM, Mendenhall CM, Reith JD, Scarborough MT, Gibbs CP, Mendenhall NP. Pigmented villonodular synovitis. Am J Clin Oncol. 2006 Dec;29(6):548-50. doi: 10.1097/01.coc.0000239142.48188.f6.
Results Reference
background
PubMed Identifier
10671695
Citation
Martin RC 2nd, Osborne DL, Edwards MJ, Wrightson W, McMasters KM. Giant cell tumor of tendon sheath, tenosynovial giant cell tumor, and pigmented villonodular synovitis: defining the presentation, surgical therapy and recurrence. Oncol Rep. 2000 Mar-Apr;7(2):413-9.
Results Reference
background
PubMed Identifier
16407111
Citation
West RB, Rubin BP, Miller MA, Subramanian S, Kaygusuz G, Montgomery K, Zhu S, Marinelli RJ, De Luca A, Downs-Kelly E, Goldblum JR, Corless CL, Brown PO, Gilks CB, Nielsen TO, Huntsman D, van de Rijn M. A landscape effect in tenosynovial giant-cell tumor from activation of CSF1 expression by a translocation in a minority of tumor cells. Proc Natl Acad Sci U S A. 2006 Jan 17;103(3):690-5. doi: 10.1073/pnas.0507321103. Epub 2006 Jan 6.
Results Reference
background
PubMed Identifier
17527089
Citation
Cupp JS, Miller MA, Montgomery KD, Nielsen TO, O'Connell JX, Huntsman D, van de Rijn M, Gilks CB, West RB. Translocation and expression of CSF1 in pigmented villonodular synovitis, tenosynovial giant cell tumor, rheumatoid arthritis and other reactive synovitides. Am J Surg Pathol. 2007 Jun;31(6):970-6. doi: 10.1097/PAS.0b013e31802b86f8.
Results Reference
background
PubMed Identifier
15637141
Citation
Dewar AL, Cambareri AC, Zannettino AC, Miller BL, Doherty KV, Hughes TP, Lyons AB. Macrophage colony-stimulating factor receptor c-fms is a novel target of imatinib. Blood. 2005 Apr 15;105(8):3127-32. doi: 10.1182/blood-2004-10-3967. Epub 2005 Jan 6.
Results Reference
background
PubMed Identifier
18296418
Citation
Blay JY, El Sayadi H, Thiesse P, Garret J, Ray-Coquard I. Complete response to imatinib in relapsing pigmented villonodular synovitis/tenosynovial giant cell tumor (PVNS/TGCT). Ann Oncol. 2008 Apr;19(4):821-2. doi: 10.1093/annonc/mdn033. Epub 2008 Feb 21. No abstract available.
Results Reference
background
PubMed Identifier
17851554
Citation
Brownlow N, Russell AE, Saravanapavan H, Wiesmann M, Murray JM, Manley PW, Dibb NJ. Comparison of nilotinib and imatinib inhibition of FMS receptor signaling, macrophage production and osteoclastogenesis. Leukemia. 2008 Mar;22(3):649-52. doi: 10.1038/sj.leu.2404944. Epub 2007 Sep 13. No abstract available.
Results Reference
background
Citation
P. A. Cassier, S. Stacchiotti, H. Gelderblom, D. M. Thomas, W. Van Der Graaf, B. M. Seddon, D. Julien, A. J. Wagner, J. Blay. Imatinib mesylate for the treatment of locally advanced and/or metastatic pigmented villonodular synovitis/tenosynovial giant cell tumor (PVNS/TGCT). J Clin Oncol. 2010 (suppl; abstr 10012); 28:15s. Meeting: 2010 ASCO Annual Meeting Abstract No: 10012
Results Reference
background
Citation
V. Ravi, W. Wang, D. M. Araujo, J. A. Ludwig, R. J. Luke, V. O. Lewis, J. C. Trent, R. S. Benjamin, S. Patel. Imatinib in the treatment of tenosynovial giant-cell tumor and pigmented villonodular synovitis. J Clin Oncol. 2010 (suppl; abstr 10011); 28:15s. Meeting: 2010 ASCO Annual Meeting Abstract No: 10011
Results Reference
background
PubMed Identifier
35932628
Citation
Spierenburg G, Grimison P, Chevreau C, Stacchiotti S, Piperno-Neumann S, Le Cesne A, Ferraresi V, Italiano A, Duffaud F, Penel N, Metzger S, Chabaud S, van der Heijden L, Perol D, van de Sande MAJ, Blay JY, Gelderblom H. Long-term follow-up of nilotinib in patients with advanced tenosynovial giant cell tumours: Long-term follow-up of nilotinib in TGCT. Eur J Cancer. 2022 Sep;173:219-228. doi: 10.1016/j.ejca.2022.06.028. Epub 2022 Aug 3.
Results Reference
derived
PubMed Identifier
29571946
Citation
Gelderblom H, Cropet C, Chevreau C, Boyle R, Tattersall M, Stacchiotti S, Italiano A, Piperno-Neumann S, Le Cesne A, Ferraresi V, Penel N, Duffaud F, Cassier P, Toulmonde M, Casali P, Taieb S, Guillemaut S, Metzger S, Perol D, Blay JY. Nilotinib in locally advanced pigmented villonodular synovitis: a multicentre, open-label, single-arm, phase 2 trial. Lancet Oncol. 2018 May;19(5):639-648. doi: 10.1016/S1470-2045(18)30143-8. Epub 2018 Mar 20.
Results Reference
derived
Learn more about this trial
Study of Nilotinib Efficacy in Pigmented Villo-Nodular Synovitis/ Tenosynovial Giant Cell Tumour (PVNS/TGCT)
We'll reach out to this number within 24 hrs