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Study on Leiomyosarcoma, Liposarcomas and Synovial Sarcoma With Trabectedin (TRADITIONS)

Primary Purpose

Leiomyosarcoma, Liposarcoma, Synovial Sarcoma

Status
Withdrawn
Phase
Phase 3
Locations
Italy
Study Type
Interventional
Intervention
Trabectedin discontinuation
Trabectedin continuation
Sponsored by
Italian Sarcoma Group
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Leiomyosarcoma focused on measuring trabectedin, soft tissue sarcoma

Eligibility Criteria

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

Inclusion Criteria:

  1. The patient or legal representative must be able to read and understand the informed consent form and must have been willing to give written informed consent and any locally required authorization before any study-specific procedures, including screening evaluations, sampling, and analyses
  2. Diagnosis of well differentiated/dedifferentiated liposarcoma, mixoid round cell liposarcoma, leiomyosarcoma or synovial sarcoma
  3. Persistent or locally relapsed and/or metastatic disease
  4. Pathology specimens available for centralized review (central review is not mandatory prior to start the treatment, but within a month from screening, tumor sample must be sent to central pathology reviewer for a retrospective diagnosis confirmation).
  5. Age ≥ 18 years
  6. Adequate bone marrow function
  7. Adequate organ function,
  8. Eastern Cooperative Oncology Group Performance Status ≤ 2
  9. One or more previous systemic treatments with anthracyclines with or without ifosfamide (unless one or both are clinically contraindicated)
  10. Measurable disease. Patient who received radiotherapy within 3 weeks form the treatment start, can be included as long there is a measurable lesion outside of the irradiation field
  11. A minimum of 3 weeks since any previous chemotherapy treatment
  12. Recovery from toxic effects of prior therapies to (Grade 1 or lower)
  13. Female patients of child-bearing potential must have negative pregnancy test within 7 days before initiation each cycle of chemotherapy. Post-menopausal women must be amenorrhoeic for at least 12 months to be considered of non-childbearing potential. Male and female patients of reproductive potential must agree to employ an effective method of birth control throughout the study.

Exclusion Criteria:

  1. Pregnant or breast-feeding women
  2. Prior exposure to Trabectedin
  3. Peripheral neuropathy, Grade 2 or higher
  4. History of other malignancies (except basal cell carcinoma or cervical carcinoma in situ, adequately treated), unless in remission from 5 years or more and judged of negligible potential of relapse
  5. Known central nervous system metastases
  6. Active viral hepatitis or chronic liver disease
  7. Unstable cardiac condition, including congestive heart failure or angina pectoris, myocardial infarction within six months before enrollment, uncontrolled arterial hypertension or arrhythmia
  8. Active major infection
  9. Previous treatment with any other investigational or not investigational agents within 14 days of first day of study drug dosing
  10. Known history of human immunodeficiency virus infection
  11. Known hypersensitivity to any of the study drugs, study drug classes, or excipients in the formulation of the study drugs
  12. Other serious concomitant illnesses or any condition that may interfere with the subject's participation in the study or evaluation of the study results

Sites / Locations

  • A.O. SS Antonio e Biagio e Cesare Arrigo
  • Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori - IRST
  • Istituto Europeo di Oncologia
  • Istituto Clinico Humanitas
  • Centro di Riferimento Oncologico di Aviano
  • Policlinico Universitario Campus Biomedico
  • Fondazione del Piemonte per l'Oncologia IRCC Candiolo
  • Ospedale Gradenigo
  • Istituto Ortopedico Rizzoli - Unit of Chemotherapy of Muscoloskeletal Tumors
  • Azienda ospedaliero Universitaria Careggi di Firenze
  • Fondazione IRCCS INT Milano
  • Policlinico Federico II
  • Irccs Istituto Oncologico Veneto (Iov)
  • Ospedale Giaccone
  • Istituti Fisioterapici Ospitalieri di Roma

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Experimental

Arm Label

Trabectedin continuation

Trabectedin discontinuation

Arm Description

All the patients who will complete 6 cycles of trabectedin without disease progression, will continue trabectedin until progressive disease, unacceptable toxicity, patient or investigator decision

All the patients who will complete 6 cycles of trabectedin without disease progression , will discontinue trabectedin. The treatment will be resumed again at progression for other 6 cycles and this scheme of treatment will be proposed until progression under trabectedin.

Outcomes

Primary Outcome Measures

Time secondary resistance to Trabectedin
Time secondary resistance to Trabectedin is the time from the first trabectedin dose to progression not amenable to treatment with Trabectedin, or death, whichever occurs first

Secondary Outcome Measures

Overall Survival
Overall Survival is the time from the first trabectedin dose to death for any cause
Incidence of adverse event
Adverse events are evaluate from the first trabectedin dose throughout the study according to CTCAE 5.0
Progression free survival
Time from the first trabectedin dose to time of onset of progression disease

Full Information

First Posted
December 10, 2018
Last Updated
May 9, 2019
Sponsor
Italian Sarcoma Group
Collaborators
PharmaMar
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1. Study Identification

Unique Protocol Identification Number
NCT03773510
Brief Title
Study on Leiomyosarcoma, Liposarcomas and Synovial Sarcoma With Trabectedin
Acronym
TRADITIONS
Official Title
Time to Secondary Resistance to Trabectedin After Interruption Versus Continuation in Responding Patients With Liposarcoma, Leiomyosarcoma and Synovial Sarcoma
Study Type
Interventional

2. Study Status

Record Verification Date
May 2019
Overall Recruitment Status
Withdrawn
Why Stopped
Not approved by the coordinating Ethical Committee
Study Start Date
February 28, 2019 (Anticipated)
Primary Completion Date
October 1, 2025 (Anticipated)
Study Completion Date
October 1, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Italian Sarcoma Group
Collaborators
PharmaMar

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
Two arm, randomized, open-label study, to determine the best time to secondary resistance between responding patients who discontinue treatment and resumed Trabectedin at the time of progression versus patients who continued treatment until progression. T
Detailed Description
This is an Italian, multicenter, randomized, open-label , two arm, study, to determine the best time to secondary resistance between responding patients who discontinue treatment and resumed Trabectedin at the time of progression versus patients who continued treatment until progression. The aim is to evaluate the best clinical practice for responding patients as Trabectedin has an acceptable safety profile with no evidence of cumulative toxicity. After signing informed consent and being assessed for eligibility criteria , eligible patients will start the trabectedin treatment. All the patients who will complete 6 cycles of treatment without disease progression will be be randomized to continue Trabectedin versus "treatment interruption" followed by re-challenge at progression. Patients randomized to discontinue treatment will be candidate to other 6 cycles of treatment and if they do not progress, to another interruption. The treatment will be resumed again at progression for other 6 cycles and this scheme of treatment will be proposed until progression under Trabectedin. The study will be conducted in Italy in approximately 12 centers, in order to recruit 330 evaluable patients over a 4 year period. The follow-up will last approximately 3 years.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Leiomyosarcoma, Liposarcoma, Synovial Sarcoma
Keywords
trabectedin, soft tissue sarcoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Model Description
Randomized, open-label , two arm study All the patients who will complete 6 cycles of treatment without disease progression will be be randomized to continue Trabectedin versus "treatment interruption" followed by re-challenge at progression. Patients randomized to discontinue treatment will be candidate to other 6 cycles of treatment and if they do not progress, to another interruption. The treatment will be resumed again at progression for other 6 cycles and this scheme of treatment will be proposed until progression under Trabectedin.
Masking
None (Open Label)
Allocation
Randomized
Enrollment
0 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Trabectedin continuation
Arm Type
Active Comparator
Arm Description
All the patients who will complete 6 cycles of trabectedin without disease progression, will continue trabectedin until progressive disease, unacceptable toxicity, patient or investigator decision
Arm Title
Trabectedin discontinuation
Arm Type
Experimental
Arm Description
All the patients who will complete 6 cycles of trabectedin without disease progression , will discontinue trabectedin. The treatment will be resumed again at progression for other 6 cycles and this scheme of treatment will be proposed until progression under trabectedin.
Intervention Type
Drug
Intervention Name(s)
Trabectedin discontinuation
Other Intervention Name(s)
Treatment discontinuation
Intervention Description
Patients who did not progressed after 6 cycles of trabectedin will stop the treatment and resume drug in case of progression for other 6 cycles. The treatment will be resumed again at progression for other 6 cycles and this scheme of treatment will be proposed until progression under trabectedin.
Intervention Type
Drug
Intervention Name(s)
Trabectedin continuation
Other Intervention Name(s)
Treatment continuation
Intervention Description
Patients who did not progressed after 6 cycles of trabectedin will continue the treatment until Progressive Disease or unacceptable toxicity
Primary Outcome Measure Information:
Title
Time secondary resistance to Trabectedin
Description
Time secondary resistance to Trabectedin is the time from the first trabectedin dose to progression not amenable to treatment with Trabectedin, or death, whichever occurs first
Time Frame
Week 18
Secondary Outcome Measure Information:
Title
Overall Survival
Description
Overall Survival is the time from the first trabectedin dose to death for any cause
Time Frame
month 6,month 12, month 18, month 24, months 30, month 36, month 42, month 48, month 54, month 60
Title
Incidence of adverse event
Description
Adverse events are evaluate from the first trabectedin dose throughout the study according to CTCAE 5.0
Time Frame
Week 9, week 18, week 27, week 36, week 45, week 54, week 63, week 72, week 81
Title
Progression free survival
Description
Time from the first trabectedin dose to time of onset of progression disease
Time Frame
Week 9, week 18, week 27, week 36, week 45, week 54, week 63, week 72, week 81

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: The patient or legal representative must be able to read and understand the informed consent form and must have been willing to give written informed consent and any locally required authorization before any study-specific procedures, including screening evaluations, sampling, and analyses Diagnosis of well differentiated/dedifferentiated liposarcoma, mixoid round cell liposarcoma, leiomyosarcoma or synovial sarcoma Persistent or locally relapsed and/or metastatic disease Pathology specimens available for centralized review (central review is not mandatory prior to start the treatment, but within a month from screening, tumor sample must be sent to central pathology reviewer for a retrospective diagnosis confirmation). Age ≥ 18 years Adequate bone marrow function Adequate organ function, Eastern Cooperative Oncology Group Performance Status ≤ 2 One or more previous systemic treatments with anthracyclines with or without ifosfamide (unless one or both are clinically contraindicated) Measurable disease. Patient who received radiotherapy within 3 weeks form the treatment start, can be included as long there is a measurable lesion outside of the irradiation field A minimum of 3 weeks since any previous chemotherapy treatment Recovery from toxic effects of prior therapies to (Grade 1 or lower) Female patients of child-bearing potential must have negative pregnancy test within 7 days before initiation each cycle of chemotherapy. Post-menopausal women must be amenorrhoeic for at least 12 months to be considered of non-childbearing potential. Male and female patients of reproductive potential must agree to employ an effective method of birth control throughout the study. Exclusion Criteria: Pregnant or breast-feeding women Prior exposure to Trabectedin Peripheral neuropathy, Grade 2 or higher History of other malignancies (except basal cell carcinoma or cervical carcinoma in situ, adequately treated), unless in remission from 5 years or more and judged of negligible potential of relapse Known central nervous system metastases Active viral hepatitis or chronic liver disease Unstable cardiac condition, including congestive heart failure or angina pectoris, myocardial infarction within six months before enrollment, uncontrolled arterial hypertension or arrhythmia Active major infection Previous treatment with any other investigational or not investigational agents within 14 days of first day of study drug dosing Known history of human immunodeficiency virus infection Known hypersensitivity to any of the study drugs, study drug classes, or excipients in the formulation of the study drugs Other serious concomitant illnesses or any condition that may interfere with the subject's participation in the study or evaluation of the study results
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Roberta Sanfilippo, MD
Organizational Affiliation
Fondazione IRCCS INT di Milano
Official's Role
Principal Investigator
Facility Information:
Facility Name
A.O. SS Antonio e Biagio e Cesare Arrigo
City
Alessandria
State/Province
AL
ZIP/Postal Code
15100
Country
Italy
Facility Name
Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori - IRST
City
Meldola
State/Province
FC
Country
Italy
Facility Name
Istituto Europeo di Oncologia
City
Milano
State/Province
MI
ZIP/Postal Code
20141
Country
Italy
Facility Name
Istituto Clinico Humanitas
City
Rozzano
State/Province
MI
ZIP/Postal Code
20089
Country
Italy
Facility Name
Centro di Riferimento Oncologico di Aviano
City
Aviano
State/Province
PD
ZIP/Postal Code
33081
Country
Italy
Facility Name
Policlinico Universitario Campus Biomedico
City
Roma
State/Province
RM
ZIP/Postal Code
00128
Country
Italy
Facility Name
Fondazione del Piemonte per l'Oncologia IRCC Candiolo
City
Candiolo
State/Province
Torino
ZIP/Postal Code
10060
Country
Italy
Facility Name
Ospedale Gradenigo
City
Torino
State/Province
TO
ZIP/Postal Code
10153
Country
Italy
Facility Name
Istituto Ortopedico Rizzoli - Unit of Chemotherapy of Muscoloskeletal Tumors
City
Bologna
ZIP/Postal Code
40136
Country
Italy
Facility Name
Azienda ospedaliero Universitaria Careggi di Firenze
City
Firenze
Country
Italy
Facility Name
Fondazione IRCCS INT Milano
City
Milano
ZIP/Postal Code
20133
Country
Italy
Facility Name
Policlinico Federico II
City
Napoli
Country
Italy
Facility Name
Irccs Istituto Oncologico Veneto (Iov)
City
Padova
Country
Italy
Facility Name
Ospedale Giaccone
City
Palermo
Country
Italy
Facility Name
Istituti Fisioterapici Ospitalieri di Roma
City
Roma
Country
Italy

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
20647340
Citation
D'Incalci M, Galmarini CM. A review of trabectedin (ET-743): a unique mechanism of action. Mol Cancer Ther. 2010 Aug;9(8):2157-63. doi: 10.1158/1535-7163.MCT-10-0263. Epub 2010 Jul 20.
Results Reference
background
PubMed Identifier
26371143
Citation
Demetri GD, von Mehren M, Jones RL, Hensley ML, Schuetze SM, Staddon A, Milhem M, Elias A, Ganjoo K, Tawbi H, Van Tine BA, Spira A, Dean A, Khokhar NZ, Park YC, Knoblauch RE, Parekh TV, Maki RG, Patel SR. Efficacy and Safety of Trabectedin or Dacarbazine for Metastatic Liposarcoma or Leiomyosarcoma After Failure of Conventional Chemotherapy: Results of a Phase III Randomized Multicenter Clinical Trial. J Clin Oncol. 2016 Mar 10;34(8):786-93. doi: 10.1200/JCO.2015.62.4734. Epub 2015 Sep 14.
Results Reference
background
PubMed Identifier
25763543
Citation
Sanfilippo R, Dileo P, Blay JY, Constantinidou A, Le Cesne A, Benson C, Vizzini L, Contu M, Baldi GG, Dei Tos AP, Casali PG. Trabectedin in advanced synovial sarcomas: a multicenter retrospective study from four European institutions and the Italian Rare Cancer Network. Anticancer Drugs. 2015 Jul;26(6):678-81. doi: 10.1097/CAD.0000000000000228.
Results Reference
background
PubMed Identifier
16737808
Citation
Grosso F, Dileo P, Sanfilippo R, Stacchiotti S, Bertulli R, Piovesan C, Jimeno J, D'Incalci M, Gescher A, Casali PG. Steroid premedication markedly reduces liver and bone marrow toxicity of trabectedin in advanced sarcoma. Eur J Cancer. 2006 Jul;42(10):1484-90. doi: 10.1016/j.ejca.2006.02.010. Epub 2006 Jun 5.
Results Reference
background
PubMed Identifier
25680558
Citation
Le Cesne A, Blay JY, Domont J, Tresch-Bruneel E, Chevreau C, Bertucci F, Delcambre C, Saada-Bouzid E, Piperno-Neumann S, Bay JO, Mir O, Ray-Coquard I, Ryckewaert T, Valentin T, Isambert N, Italiano A, Clisant S, Penel N. Interruption versus continuation of trabectedin in patients with soft-tissue sarcoma (T-DIS): a randomised phase 2 trial. Lancet Oncol. 2015 Mar;16(3):312-9. doi: 10.1016/S1470-2045(15)70031-8. Epub 2015 Feb 11.
Results Reference
background

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Study on Leiomyosarcoma, Liposarcomas and Synovial Sarcoma With Trabectedin

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