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Study on TSR-042 in Advanced Clear Cell Sarcoma (ACCeSs)

Primary Purpose

Sarcoma, Clear Cell

Status
Recruiting
Phase
Phase 2
Locations
Italy
Study Type
Interventional
Intervention
TSR-042
Sponsored by
Italian Sarcoma Group
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Sarcoma, Clear Cell focused on measuring advanced clear cell sarcoma, anti-PDL1

Eligibility Criteria

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

Inclusion Criteria:

  1. Written informed consent
  2. Histological centrally confirmed diagnosis of clear cell sarcoma
  3. Availability of archived tumor tissue block, or 15 slides.
  4. Locally advanced disease
  5. Measurable disease based on RECIST 1.1
  6. Patient can be naive or previously treated with 1 or 2 systemic regimens given for recurrent and/or metastatic disease
  7. Eastern Cooperative Oncology Group (ECOG) Performance Status ≤ 2
  8. Adequate bone marrow function
  9. Adequate organ function
  10. Cardiac ejection fraction ≥50%
  11. At least 18 years of age on day of signing informed consent.
  12. Non-pregnant female patients
  13. Non-ot breastfeed during the study for 90 days after the last dose of study treatment.
  14. Male participant agrees to use an adequate method of contraception
  15. No history of arterial and/or venous thromboembolic event within the previous 12 months.
  16. Participant receiving corticosteroids may continue as long as their dose is stable for least 4 weeks prior to initiating protocol therapy.
  17. Patients who are willing and able to comply with scheduled visits, treatment plan, laboratory tests, and other study procedures.

Exclusion Criteria:

  1. Participant must not be simultaneously enrolled in any interventional clinical trial
  2. Previous treatment with any non-investigational agents within 14 days of first day of study drug dosing.
  3. Must not have received investigational therapy ≤ 4 weeks, or within a time interval less than at least 5 half-lives of the investigational agent, whichever is shorter, prior initiating protocol therapy
  4. Other primary malignancy with <5 years clinically assessed disease-free interval, except basal cell skin cancer, cervical carcinoma in situ, or other neoplasms judged to entail a low risk of relapse
  5. Previous treatment with radiation therapy within 14 days of first day of study drug dosing, or patients who have not recovered from adverse events due to agents administered more than 4 weeks earlier
  6. Has known active central nervous system (CNS) metastases, leptomeningeal metastases, and/or carcinomatous meningitis. Subjects with previously treated brain metastases may participate provided they are stable, have no evidence of new or enlarging brain metastases, and are not using steroids for at least 7 days prior to trial treatment. This exception does not include carcinomatous meningitis which is excluded regardless of clinical stability
  7. Has active, non-infectious pneumonitis
  8. Has an active infection requiring systemic therapy
  9. Has received prior therapy with an anti-PD-1, anti-PD-L1, or anti-PD-L2 agents
  10. Has received a live vaccine within 30 days of planned start of study therapy
  11. Major surgery within 3 weeks prior to study entry
  12. Any one of the following currently or in the previous 6 months:

Myocardial infarction, congenital long QT syndrome, Torsades de Pointes, arrhythmias right bundle branch block and left anterior hemiblock unstable angina coronary/peripheral artery bypass graft, symptomatic congestive heart failure New York Heart Association Class III or IV, cerebrovascular accident, or transient ischemic attack symptomatic pulmonary embolism. Ongoing cardiac dysrhythmias of Grade >=3, atrial fibrillation of any grade,or QTcF interval >470 msec 14. Severe and/or uncontrolled medical disease 15. Patient experienced ≥ Grade 3 immune-related AE with prior immunotherapy 16. Participant has a diagnosis of immunodeficiency or has receiving systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to initiating protocol therapy 17. Any known active hepatitis B or hepatitis C 18. Any known history of human immunodeficiency virus 19. Subjects who have current active hepatic or biliary disease (with exception of patients with Gilbert's syndrome, asymptomatic gallstones, liver metastases or stable chronic liver disease per investigator assessment) 20. Expected non-compliance to medical regimens 21. Known history of interstitial lung disease 22. Active autoimmune disease that has required systemic treatment in the past 2 years 23. Known severe hypersensitivity reactions to monoclonal antibodies, any history of anaphylaxis, or uncontrolled asthma

Sites / Locations

  • A.O.U.San Luigi Gonzaga di Orbassano
  • Fondazione IRCSS Istituto Nazionale dei TumoriRecruiting
  • Irccs Istituto Oncologico Veneto (Iov)
  • Azienda Ospedaliera Universitaria Policlinico "Paolo Giaccone"
  • Fondazione Policlinico Universitario Campus Bio-Medico

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

TSR-042 arm

Arm Description

TSR-042 at a dose of 500 mg in IV infusion (given over t30-minutes) every 21 days for the first 4 doses, followed by 1.000 mg on day 1 of every 42 day.

Outcomes

Primary Outcome Measures

Overall Response Rate
Response rate according Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1

Secondary Outcome Measures

Immune-related RECIST (ir-RECIST) response rate
Response rate according ir-RECIST criteria
Choi criteria response rate
Response rate according Choi criteria
Progression Free Survival (PFS)
Survival without disease progression
Overall Survival
Proportion of patients who are still alive at 36 and 60 months after have started the treatment
Clinical Benefit Rate
Proportion of patients who experienced Complete Response, Progression Response or Stable Disease for over 6 months
Adverse events related to the treatment
Safety in term of grading of adverse event is evaluate from the firs treatment dose throughout the study according to CTCAE 5.0
Growth Modulation Index (GMI)
Correlation between response and prior disease medical treatment: ratio of time to progression with the nth line of therapy to the those with the n-1th line.
Quality of Life according the 30 questions European Organization for Research and Treatment of Cancer Quality of Life Questionnaire
Evaluation of the quality of life collected with European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30
Quality of Life according the questionnaire Euro Quality Of Life 5 Domains (EQ-5D)
Evaluation of the quality of life collected with Euro Quality Of Life 5 Domains (EQ-5D)
Safety according the Patient Reported Outcome according Common Terminology Criteria for Adverse Events (PRO-CTCAE)
Evaluation of the quality of safety reported by the patient with the PRO-CTCAE

Full Information

First Posted
February 13, 2020
Last Updated
September 12, 2023
Sponsor
Italian Sarcoma Group
Collaborators
GlaxoSmithKline
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1. Study Identification

Unique Protocol Identification Number
NCT04274023
Brief Title
Study on TSR-042 in Advanced Clear Cell Sarcoma
Acronym
ACCeSs
Official Title
Phase II Study on TSR-042 in Advanced Clear Cell Sarcoma
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
February 19, 2021 (Actual)
Primary Completion Date
May 1, 2024 (Anticipated)
Study Completion Date
May 1, 2024 (Anticipated)

3. Sponsor/Collaborators

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

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
Phase II,single arm study designed to explore the activity of TSR-042, an immunotherapy agent, in patients with a diagnosis of advanced or metastatic clear cell sarcoma (CCS).
Detailed Description
Phase II, single arm, not randomized, European multicentric study designed to explore the activity of TSR-042, a human monoclonal anti-PD-1 inhibitor, in a population of patients with a diagnosis of advanced/metastatic clear cell sarcoma (CCS).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Sarcoma, Clear Cell
Keywords
advanced clear cell sarcoma, anti-PDL1

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Model Description
Single arm
Masking
None (Open Label)
Allocation
N/A
Enrollment
16 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
TSR-042 arm
Arm Type
Experimental
Arm Description
TSR-042 at a dose of 500 mg in IV infusion (given over t30-minutes) every 21 days for the first 4 doses, followed by 1.000 mg on day 1 of every 42 day.
Intervention Type
Drug
Intervention Name(s)
TSR-042
Intervention Description
TSR-042 is an IgG4 humanized monoclonal antibody that binds with high affinity to PD-1, resulting in inhibition of binding to PD-L1 and PD-L2.
Primary Outcome Measure Information:
Title
Overall Response Rate
Description
Response rate according Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1
Time Frame
At week 12
Secondary Outcome Measure Information:
Title
Immune-related RECIST (ir-RECIST) response rate
Description
Response rate according ir-RECIST criteria
Time Frame
At weeks 6, 12, 24, 36, 48, 60, 72, 84, 96
Title
Choi criteria response rate
Description
Response rate according Choi criteria
Time Frame
At weeks 6, 12, 24, 36, 48, 60, 72, 84, 96
Title
Progression Free Survival (PFS)
Description
Survival without disease progression
Time Frame
At 3 and 5 years
Title
Overall Survival
Description
Proportion of patients who are still alive at 36 and 60 months after have started the treatment
Time Frame
At 3 and 5 years
Title
Clinical Benefit Rate
Description
Proportion of patients who experienced Complete Response, Progression Response or Stable Disease for over 6 months
Time Frame
Month 6
Title
Adverse events related to the treatment
Description
Safety in term of grading of adverse event is evaluate from the firs treatment dose throughout the study according to CTCAE 5.0
Time Frame
Week 3, week 6, week 9, week 12, week 18, week 24, week 36, week 48, week 60, week 72
Title
Growth Modulation Index (GMI)
Description
Correlation between response and prior disease medical treatment: ratio of time to progression with the nth line of therapy to the those with the n-1th line.
Time Frame
At weeks 6, 12, 24, 36, 48, 60, 72, 84, 96
Title
Quality of Life according the 30 questions European Organization for Research and Treatment of Cancer Quality of Life Questionnaire
Description
Evaluation of the quality of life collected with European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30
Time Frame
Day1 Cycle 2, Day 1 Cycle 3, Every 3 cycles (Day1Cyle6, Day1Cycle 9, …) and through study completion, an average of 1 year
Title
Quality of Life according the questionnaire Euro Quality Of Life 5 Domains (EQ-5D)
Description
Evaluation of the quality of life collected with Euro Quality Of Life 5 Domains (EQ-5D)
Time Frame
Day1 Cycle 2, Day 1 Cycle 3, Every 3 cycles (Day1Cyle6, Day1Cycle 9, …) and through study completion, an average of 1 year
Title
Safety according the Patient Reported Outcome according Common Terminology Criteria for Adverse Events (PRO-CTCAE)
Description
Evaluation of the quality of safety reported by the patient with the PRO-CTCAE
Time Frame
Day1 Cycle 2, Day 1 Cycle 3, Every 3 cycles (Day1Cyle6, Day1Cycle 9, …) and through study completion, an average of 1 year
Other Pre-specified Outcome Measures:
Title
Expression level of PD1 and PDL1 at pre-treatment evaluated on cancer cells and in tumor infiltrating myeloid cells
Description
Analysis of immune contexture in pretreatment tumor tissue.
Time Frame
Day1 (pre-treatment)
Title
Frequency in the expression of myeloid-derived suppressor cells in peripheral blood mononuclear cell
Description
Immunological monitoring of peripheral blood immune subsets, to evaluate the systemic immunological status of patients,
Time Frame
Day1, day15, day45 of treatment and through study completion, an average of 1 year
Title
Frequency in the expression of anti-tumor immune cells in PBMC collected at baseline and during TSR-042.
Description
Immunological monitoring of peripheral blood immune subsets, to evaluate the systemic immunological status of patients,
Time Frame
Day1, day15, day45 of treatment and through study completion, an average of 1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Written informed consent Histological centrally confirmed diagnosis of clear cell sarcoma Availability of archived tumor tissue block, or 15 slides. Locally advanced disease Measurable disease based on RECIST 1.1 Patient can be naive or previously treated with 1 or 2 systemic regimens given for recurrent and/or metastatic disease Eastern Cooperative Oncology Group (ECOG) Performance Status ≤ 2 Adequate bone marrow function Adequate organ function Cardiac ejection fraction ≥50% At least 18 years of age on day of signing informed consent. Non-pregnant female patients Non-ot breastfeed during the study for 90 days after the last dose of study treatment. Male participant agrees to use an adequate method of contraception No history of arterial and/or venous thromboembolic event within the previous 12 months. Participant receiving corticosteroids may continue as long as their dose is stable for least 4 weeks prior to initiating protocol therapy. Patients who are willing and able to comply with scheduled visits, treatment plan, laboratory tests, and other study procedures. Exclusion Criteria: Participant must not be simultaneously enrolled in any interventional clinical trial Previous treatment with any non-investigational agents within 14 days of first day of study drug dosing. Must not have received investigational therapy ≤ 4 weeks, or within a time interval less than at least 5 half-lives of the investigational agent, whichever is shorter, prior initiating protocol therapy Other primary malignancy with <5 years clinically assessed disease-free interval, except basal cell skin cancer, cervical carcinoma in situ, or other neoplasms judged to entail a low risk of relapse Previous treatment with radiation therapy within 14 days of first day of study drug dosing, or patients who have not recovered from adverse events due to agents administered more than 4 weeks earlier Has known active central nervous system (CNS) metastases, leptomeningeal metastases, and/or carcinomatous meningitis. Subjects with previously treated brain metastases may participate provided they are stable, have no evidence of new or enlarging brain metastases, and are not using steroids for at least 7 days prior to trial treatment. This exception does not include carcinomatous meningitis which is excluded regardless of clinical stability Has active, non-infectious pneumonitis Has an active infection requiring systemic therapy Has received prior therapy with an anti-PD-1, anti-PD-L1, or anti-PD-L2 agents Has received a live vaccine within 30 days of planned start of study therapy Major surgery within 3 weeks prior to study entry Any one of the following currently or in the previous 6 months: Myocardial infarction, congenital long QT syndrome, Torsades de Pointes, arrhythmias right bundle branch block and left anterior hemiblock unstable angina coronary/peripheral artery bypass graft, symptomatic congestive heart failure New York Heart Association Class III or IV, cerebrovascular accident, or transient ischemic attack symptomatic pulmonary embolism. Ongoing cardiac dysrhythmias of Grade >=3, atrial fibrillation of any grade,or QTcF interval >470 msec 14. Severe and/or uncontrolled medical disease 15. Patient experienced ≥ Grade 3 immune-related AE with prior immunotherapy 16. Participant has a diagnosis of immunodeficiency or has receiving systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to initiating protocol therapy 17. Any known active hepatitis B or hepatitis C 18. Any known history of human immunodeficiency virus 19. Subjects who have current active hepatic or biliary disease (with exception of patients with Gilbert's syndrome, asymptomatic gallstones, liver metastases or stable chronic liver disease per investigator assessment) 20. Expected non-compliance to medical regimens 21. Known history of interstitial lung disease 22. Active autoimmune disease that has required systemic treatment in the past 2 years 23. Known severe hypersensitivity reactions to monoclonal antibodies, any history of anaphylaxis, or uncontrolled asthma
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Silvia Stacchiotti, MD
Phone
39022390
Ext
2804
Email
silvia.stacchiotti@istitutotumori.mi.it
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Silvia Stacchiotti, MD
Organizational Affiliation
Fondazione IRCCS Istituto Nazionale dei Tumori di Milano
Official's Role
Principal Investigator
Facility Information:
Facility Name
A.O.U.San Luigi Gonzaga di Orbassano
City
Orbassano
State/Province
Torino
ZIP/Postal Code
10043
Country
Italy
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Lorenzo D'Ambrosio, MD
Email
lorenzo.dambrosio@unito.it
Facility Name
Fondazione IRCSS Istituto Nazionale dei Tumori
City
Milan
ZIP/Postal Code
20133
Country
Italy
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Silvia Stacchiotti, MD
Phone
+39022390
Email
silvia.stacchiotti@istitutotumori.mi.it
First Name & Middle Initial & Last Name & Degree
Silvia Stacchiotti, MD
Facility Name
Irccs Istituto Oncologico Veneto (Iov)
City
Padova
ZIP/Postal Code
35128
Country
Italy
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Antonella Brunello
Email
antonella.brunello@iov.veneto.it
Facility Name
Azienda Ospedaliera Universitaria Policlinico "Paolo Giaccone"
City
Palermo
ZIP/Postal Code
90127
Country
Italy
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Giuseppe Badalamenti, Prof
Email
giuseppe.badalamenti@unipa.it
Facility Name
Fondazione Policlinico Universitario Campus Bio-Medico
City
Roma
ZIP/Postal Code
00128
Country
Italy
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Bruno Vincenzi, Prof.
Email
b.vincenzi@policlinicocampus.it

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
11211309
Citation
Granter SR, Weilbaecher KN, Quigley C, Fletcher CD, Fisher DE. Clear cell sarcoma shows immunoreactivity for microphthalmia transcription factor: further evidence for melanocytic differentiation. Mod Pathol. 2001 Jan;14(1):6-9. doi: 10.1038/modpathol.3880249.
Results Reference
background
PubMed Identifier
11826187
Citation
Antonescu CR, Tschernyavsky SJ, Woodruff JM, Jungbluth AA, Brennan MF, Ladanyi M. Molecular diagnosis of clear cell sarcoma: detection of EWS-ATF1 and MITF-M transcripts and histopathological and ultrastructural analysis of 12 cases. J Mol Diagn. 2002 Feb;4(1):44-52. doi: 10.1016/S1525-1578(10)60679-4.
Results Reference
background
PubMed Identifier
20093352
Citation
Stacchiotti S, Grosso F, Negri T, Palassini E, Morosi C, Pilotti S, Gronchi A, Casali PG. Tumor response to sunitinib malate observed in clear-cell sarcoma. Ann Oncol. 2010 May;21(5):1130-1. doi: 10.1093/annonc/mdp611. Epub 2010 Jan 21. No abstract available.
Results Reference
background
PubMed Identifier
25880253
Citation
Tazzari M, Palassini E, Vergani B, Villa A, Rini F, Negri T, Colombo C, Crippa F, Morosi C, Casali PG, Pilotti S, Stacchiotti S, Rivoltini L, Castelli C. Melan-A/MART-1 immunity in a EWS-ATF1 translocated clear cell sarcoma patient treated with sunitinib: a case report. BMC Cancer. 2015 Feb 14;15:58. doi: 10.1186/s12885-015-1044-0.
Results Reference
background

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Study on TSR-042 in Advanced Clear Cell Sarcoma

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