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The Combination of Sintilimab and AI (Doxorubicin, ADM/Ifosfamide, IFO) for the First Line Treatment of Select Type of Metastatic/Unresectable Soft Tissue Sarcoma

Primary Purpose

Sarcoma, Soft Tissue

Status
Unknown status
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Sintilimab
Doxorubicin Hydrochloride
Ifosfamide
Sponsored by
Fudan University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Sarcoma, Soft Tissue focused on measuring PD-1, doxorubicin, ifosfamide, first line treatment

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Men and women aged 18-75 years;
  • Provide written informed consent;
  • Local advanced or metastatic unresectable sarcoma;
  • Histologically confirmed undifferentiated pleomorphic sarcoma, synovial sarcoma, de-differentiated liposarcoma and myxoid liposarcoma;
  • Performance status of 0 to 1 on the Eastern Cooperative Oncology Group (ECOG) performance scale;
  • Have measurable disease based on Response Evaluation Criteria in Solid Tumors (RECIST) 1.1;
  • Life span expectation over 3 months
  • Absolute neutrophil count (ANC) ≥1,500/mcL (within 7 days of treatment initiation) ;
  • Hemoglobin ≥9 g/dL (within 7 days of treatment initiation) ;
  • Platelets ≥ 90,000/mcL (within 7 days of treatment initiation) ;
  • Serum creatinine ≤ 1.5 X upper limit of normal (ULN) or creatinine clearance [CrCl]) ≥ 50 mL/min for subject with creatinine levels (within 7 days of treatment initiation) ;
  • Serum total bilirubin ≤ 1.5 X ULN (within 7 days of treatment initiation) ;
  • Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT]) and alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) ≤ 2.5 X ULN or =< 5 X ULN for subjects with liver metastases (within 7 days of treatment initiation);

Exclusion Criteria:

  • Prior systemic therapy for advanced and metastatic disease, except adjuvant treatment(not received anthracycline)replase over 6 months;
  • Received any testing anti-cancer drugs within four weeks of treatment initiation;
  • Prior immune related therapy including but not limited to PD-1, PD-L1, CD137, CTLA4, T cell stimulation, check point inhibitor etc;
  • Symptomatic, untreated, or uncontrolled brain metastases present
  • clinical meaningful active bleeding;
  • Other malignant cancer history rather than soft tissue sarcoma within five year prior to treatment initiation;
  • Have active infections requiring therapy;
  • Have active autoimmune disease or a documented history of autoimmune disease or syndrome that requires systemic steroids or immunosuppressive agents. Patients that require inhaled steroids or local steroid injections would not be excluded from the study. Patients with hypothyroidism not from autoimmune disease that is stable on hormone replacement will not be excluded from the study.
  • Pregnant or breast-feeding;
  • Any serious or unstable medical condition or mental illness;
  • Serious systemic diseases such as heart disease, history of (non-infectious) pneumonitis;
  • Active HBV (>10000 copy/ml) and HCV (RNA> 1000copy/ml) infection;
  • Positive human immunodeficiency virus (HIV)or any acquired immunodeficiency syndrome, organ implantation;

Sites / Locations

  • Fudan University, Cancer HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

treatment

Arm Description

The patients with metastatic and unresectable soft tissue sarcoma including undifferentiated pleomorphic sarcoma, synovial sarcoma, de-differentiated liposarcoma and myxoid liposarcoma will be enrolled and given sintilimab (PD-1) , doxorubicin and doxorubicin every three weeks for 6 cycles followed by sintilimab mono therapy till disease progression. The first enrolled six patients is safety run-in step for observing drug-limiting toxicity (DLTs). If the combinatory treatment is intolerable, the doses of chemo regimens will be reduced according to drug instruction.

Outcomes

Primary Outcome Measures

overall response rate, ORR
the best response rate

Secondary Outcome Measures

progression free survival, PFS
from first dose treatment to disease progression
adverse events, AE
treatment related adverse events, TRAEs
overall survival, OS
overall survival

Full Information

First Posted
April 17, 2020
Last Updated
July 13, 2020
Sponsor
Fudan University
Collaborators
Zhejiang Cancer Hospital, Tongji Hospital, Xijing Hospital, Shanghai Zhongshan Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT04356872
Brief Title
The Combination of Sintilimab and AI (Doxorubicin, ADM/Ifosfamide, IFO) for the First Line Treatment of Select Type of Metastatic/Unresectable Soft Tissue Sarcoma
Official Title
A Single Arm, Multi Centers, Phase II Study of Sintilimab, Doxorubicin and Ifosfamide at First-line Treatment of Soft Tissue Sarcoma Including Undifferentiated Pleomorphic Sarcoma, Synovial Sarcoma, Myxoid Liposarcoma and De-differentiated Liposarcoma
Study Type
Interventional

2. Study Status

Record Verification Date
July 2020
Overall Recruitment Status
Unknown status
Study Start Date
April 8, 2020 (Actual)
Primary Completion Date
March 30, 2022 (Anticipated)
Study Completion Date
March 30, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Fudan University
Collaborators
Zhejiang Cancer Hospital, Tongji Hospital, Xijing Hospital, Shanghai Zhongshan Hospital

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
This is a phase II trial to explore the feasibility of PD-1 immune check point inhibitor, sintilimab, in combination of stand of care chemotherapy in first-line treatment of selected soft tissue sarcoma.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Sarcoma, Soft Tissue
Keywords
PD-1, doxorubicin, ifosfamide, first line treatment

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
treatment
Arm Type
Experimental
Arm Description
The patients with metastatic and unresectable soft tissue sarcoma including undifferentiated pleomorphic sarcoma, synovial sarcoma, de-differentiated liposarcoma and myxoid liposarcoma will be enrolled and given sintilimab (PD-1) , doxorubicin and doxorubicin every three weeks for 6 cycles followed by sintilimab mono therapy till disease progression. The first enrolled six patients is safety run-in step for observing drug-limiting toxicity (DLTs). If the combinatory treatment is intolerable, the doses of chemo regimens will be reduced according to drug instruction.
Intervention Type
Drug
Intervention Name(s)
Sintilimab
Intervention Description
immune check point inhibitor, 200mg, iv, d1
Intervention Type
Drug
Intervention Name(s)
Doxorubicin Hydrochloride
Other Intervention Name(s)
ADM
Intervention Description
ADM, 60mg/m2, iv, d1
Intervention Type
Drug
Intervention Name(s)
Ifosfamide
Other Intervention Name(s)
IFO
Intervention Description
IFO, 1.8 g/m2/d, d1-5
Primary Outcome Measure Information:
Title
overall response rate, ORR
Description
the best response rate
Time Frame
up to two years
Secondary Outcome Measure Information:
Title
progression free survival, PFS
Description
from first dose treatment to disease progression
Time Frame
up to three years
Title
adverse events, AE
Description
treatment related adverse events, TRAEs
Time Frame
up to three years
Title
overall survival, OS
Description
overall survival
Time Frame
up to three years
Other Pre-specified Outcome Measures:
Title
PD-L1 expression
Description
PD-L1 expression will be detected by Immunohistologic chemistry, IHC or PCR method
Time Frame
up to two years
Title
tumor infiltrating lymphocytes measurement
Description
tumor infiltrating lymphocytes will be measured by flowcytometry using tissue and/or peripheral blood sample;
Time Frame
up to two years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Men and women aged 18-75 years; Provide written informed consent; Local advanced or metastatic unresectable sarcoma; Histologically confirmed undifferentiated pleomorphic sarcoma, synovial sarcoma, de-differentiated liposarcoma and myxoid liposarcoma; Performance status of 0 to 1 on the Eastern Cooperative Oncology Group (ECOG) performance scale; Have measurable disease based on Response Evaluation Criteria in Solid Tumors (RECIST) 1.1; Life span expectation over 3 months Absolute neutrophil count (ANC) ≥1,500/mcL (within 7 days of treatment initiation) ; Hemoglobin ≥9 g/dL (within 7 days of treatment initiation) ; Platelets ≥ 90,000/mcL (within 7 days of treatment initiation) ; Serum creatinine ≤ 1.5 X upper limit of normal (ULN) or creatinine clearance [CrCl]) ≥ 50 mL/min for subject with creatinine levels (within 7 days of treatment initiation) ; Serum total bilirubin ≤ 1.5 X ULN (within 7 days of treatment initiation) ; Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT]) and alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) ≤ 2.5 X ULN or =< 5 X ULN for subjects with liver metastases (within 7 days of treatment initiation); Exclusion Criteria: Prior systemic therapy for advanced and metastatic disease, except adjuvant treatment(not received anthracycline)replase over 6 months; Received any testing anti-cancer drugs within four weeks of treatment initiation; Prior immune related therapy including but not limited to PD-1, PD-L1, CD137, CTLA4, T cell stimulation, check point inhibitor etc; Symptomatic, untreated, or uncontrolled brain metastases present clinical meaningful active bleeding; Other malignant cancer history rather than soft tissue sarcoma within five year prior to treatment initiation; Have active infections requiring therapy; Have active autoimmune disease or a documented history of autoimmune disease or syndrome that requires systemic steroids or immunosuppressive agents. Patients that require inhaled steroids or local steroid injections would not be excluded from the study. Patients with hypothyroidism not from autoimmune disease that is stable on hormone replacement will not be excluded from the study. Pregnant or breast-feeding; Any serious or unstable medical condition or mental illness; Serious systemic diseases such as heart disease, history of (non-infectious) pneumonitis; Active HBV (>10000 copy/ml) and HCV (RNA> 1000copy/ml) infection; Positive human immunodeficiency virus (HIV)or any acquired immunodeficiency syndrome, organ implantation;
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Xin Liu, MD
Phone
0086-021-64175590
Email
jeanettexin@hotmail.com
Facility Information:
Facility Name
Fudan University, Cancer Hospital
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200000
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Xin Liu, MD
Phone
0086-18017317720
Email
jeanettexin@hotmail.com

12. IPD Sharing Statement

Plan to Share IPD
Undecided
IPD Sharing Plan Description
not yet decide, need to discuss with all collaborators

Learn more about this trial

The Combination of Sintilimab and AI (Doxorubicin, ADM/Ifosfamide, IFO) for the First Line Treatment of Select Type of Metastatic/Unresectable Soft Tissue Sarcoma

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