- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00330421
Sorafenib in Treating Patients With Soft Tissue Sarcomas (Extremity Sarcoma Closed to Entry as of 5/30/07)
A Phase II Clinical and Correlative Study of BAY 43-9006 (Sorafenib) IND 69,896 in Sarcoma
Study Overview
Status
Conditions
- Recurrent Osteosarcoma
- Metastatic Osteosarcoma
- Recurrent Adult Soft Tissue Sarcoma
- Stage III Adult Soft Tissue Sarcoma
- Stage IV Adult Soft Tissue Sarcoma
- Stage I Adult Soft Tissue Sarcoma
- Stage II Adult Soft Tissue Sarcoma
- Recurrent Ewing Sarcoma/Peripheral Primitive Neuroectodermal Tumor
- Metastatic Ewing Sarcoma/Peripheral Primitive Neuroectodermal Tumor
Detailed Description
PRIMARY OBJECTIVES:
I. To determine if the combined vascular endothelial growth factor receptor 2 (VEGF-R2)/platelet-derived growth factor receptor (PDGFR)-beta inhibitor BAY 43-9006/ sorafenib can decrease interstitial fluid pressure (IFP) in soft tissue sarcomas.
II. To investigate the effects of BAY 43-9006/sorafenib on tumor blood flow, circulating endothelial cells, vascular density and pericyte coverage.
III. To characterize the pharmacokinetics of BAY 43-9006/sorafenib in sarcoma patients.
SECONDARY OBJECTIVES:
I. To describe any preliminary evidence of anti-tumor activity. II. Assess whether there are any significant relationships between systemic drug exposure and drug-related toxicity or biological effect.
OUTLINE: This is a multicenter study. Patients are assigned to one of two groups (group 1 closed to accrual as of 5/30/07).
GROUP I (SARCOMAS OF THE EXTREMITY) (CLOSED TO ACCRUAL AS OF 5/30/07): Patients receive oral sorafenib twice daily on days 1-14. Patients undergo surgical resection of the tumor on approximately day 15. Once patients recover from surgery (and radiotherapy if indicated), patients who demonstrate a clinically and pathologically significant response (≥ 25% reduction in tumor size or ≥ 25% necrosis in the surgical specimen) may continue sorafenib as above for a maximum of 6 months in the absence of disease progression or unacceptable toxicity and at the discretion of the principal investigator. Biopsy tissue and blood samples are examined for biomarkers and interstitial fluid pressure (IFP) is measured at baseline and immediately before surgery.
GROUP II (METASTATIC OR INOPERABLE SARCOMAS): Patients receive oral sorafenib twice daily on days 1-28. Treatment repeats every 28 days for 2 courses. Patients with responding or stable disease may continue sorafenib in the absence of disease progression or unacceptable toxicity. Biopsy tissue and blood samples are examined for biomarkers and IFP is measured at baseline and on days 28 and 56.
In both groups, blood samples are drawn periodically for pharmacological studies.
After completion of study therapy, patients are followed monthly until all study-related toxicities are resolved and then at the discretion of the investigator.
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
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Massachusetts
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Boston, Massachusetts, United States, 02115
- Dana-Farber Cancer Institute
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
There are two groups of patients eligible for this study; treatment group 1 consists of patients with extremity sarcomas other than potentially curable osteosarcoma or Ewing's sarcoma who are candidates for potentially curative surgery; treatment group 2 consists of patients with metastatic or inoperable sarcoma, for which there is no known curative or survival prolonging palliative therapy, or failure of these therapies; patients must have at least one site of measurable disease by radiologic imaging techniques; patients must have at least one palpable tumor mass with no overlying viscera which is amenable to biopsy; the tumor mass should be approximately 2 cm or greater in diameter; patients with smaller palpable tumors are eligible if participation is approved by the treating surgeon after discussion with the study chairperson
- As of 5/30/07, no subjects will accrue to Treatment Group I
- Life expectancy >= 2 months
- Eastern Cooperative Oncology Group (ECOG) performance status =< 2
- Pretreatment laboratory data, obtained within 14 days of study entry, must meet the following criteria:
- Absolute Neutrophil Count (ANC) >= 1,500/mm^3
- Platelets >= 100,000/mm^3
- Serum glutamic oxaloacetic transaminase (SGOT) =< 2.5-times the upper limit of normal (ULN)
- Serum glutamic-pyruvic transaminase (SGPT)=< 2.5-times ULN
- Total Bilirubin =< ULN
- Serum creatinine =< 1.5-times ULN
- >= 3 weeks since major surgery unrelated to study disease (sarcoma)
- >= 3 weeks since chemotherapy or radiation therapy (6 weeks for nitrosourea or mitomycin C chemotherapy)
- No prior treatment with sorafenib (BAY 43-9006) or specific inhibitors of mitogen-activated protein kinase (MAPK) pathways are permitted; a previously irradiated tumor site cannot be used for clinical or correlative measurements, although irradiation to sites other than a measurable site is permitted; there are no limitations on the extent or type of prior therapy received by the patient other than the time intervals indicated in the above and demonstrating complete recovery from any adverse effects associated by satisfying all relevant eligibility criteria
- Patients who are on warfarin anticoagulation are allowed to participate as long as they are converted to a low molecular weight heparin (e.g. lovenox) from study entry until at least day 56
- Women of childbearing potential must not be pregnant or lactating; all women of childbearing potential (age < 50, last menstrual period [LMP] < 12 months ago) must have a negative serum or urine pregnancy test (minimum sensitivity 25 IU/L of beta-HCG) within 72 hr prior to receiving the study medication; BAY43-9006 has antiproliferative effects, which may be harmful to the developing fetus or nursing infant
- Fertile males and females must use adequate contraception
- Signed informed consent
Exclusion Criteria:
- Ewing's sarcoma or osteosarcoma that is potentially curable with surgery, chemotherapy, and/or radiation therapy
- Active brain metastases including evidence of cerebral edema by CT scan or MRI, or progression from prior imaging study, any requirements for steroids, or enzyme-inducing anti-convulsant agents, or clinical symptoms of/from brain metastases; patients with treated and/or stable brain metastasis who are asymptomatic can be enrolled, if otherwise eligible
- Any uncontrolled serious medical or psychiatric illness; particular note is given to uncontrolled hypertension (discretion left to investigators) and significant proteinuria > 1 gm/24 hr (does not require quantitation in absence of clinical indication)
- Patients receiving other investigational agents
- Human immunodeficiency virus (HIV) patients receiving combination anti-retroviral therapy are excluded because of potential pharmacokinetic interactions
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Group I (sarcomas of extremity, closed accrual as of 5/30/07)
Patients receive oral sorafenib twice daily on days 1-14.
Patients undergo surgical resection of the tumor on approximately day 15.
Once patients recover from surgery (and radiotherapy if indicated), patients who demonstrate a clinically and pathologically significant response (≥ 25% reduction in tumor size or ≥ 25% necrosis in the surgical specimen) may continue sorafenib as above for a maximum of 6 months in the absence of disease progression or unacceptable toxicity and at the discretion of the principal investigator.
Biopsy tissue and blood samples are examined for biomarkers and interstitial fluid pressure (IFP) is measured at baseline and immediately before surgery.
|
Correlative studies
Correlative studies
Other Names:
Undergo surgery
Correlative studies
Other Names:
Given PO
Other Names:
Correlative studies
Other Names:
|
Experimental: Group II (metastatic or inoperable sarcomas)
Patients receive oral sorafenib twice daily on days 1-28.
Treatment repeats every 28 days for 2 courses.
Patients with responding or stable disease may continue sorafenib in the absence of disease progression or unacceptable toxicity.
Biopsy tissue and blood samples are examined for biomarkers and IFP is measured at baseline and on days 28 and 56.
|
Correlative studies
Correlative studies
Other Names:
Correlative studies
Other Names:
Given PO
Other Names:
Correlative studies
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Fludeoxyglucose (FDG) Uptake (Maximal Standardized Uptake Value, or SUVmax)
Time Frame: Baseline to up to 1 month post-treatment
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Paired comparison made using a Wilcoxon signed rank test with one-sided type I error of 5%.
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Baseline to up to 1 month post-treatment
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Change in Interstitial Fluid Pressure (IFP)
Time Frame: Baseline to up to 1 month post-treatment
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Paired comparison made using a Wilcoxon signed rank test with one-sided type I error of 5%.
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Baseline to up to 1 month post-treatment
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Change in White Blood Cell Count (WBC)
Time Frame: Baseline to up to 1 month post-treatment
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Paired comparison made using a Wilcoxon signed rank test with one-sided type I error of 5%.
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Baseline to up to 1 month post-treatment
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Change in Pericyte Coverage of Endothelial Cells (Alpha-SMA)
Time Frame: Baseline to up to 1 month post-treatment
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Paired comparison made using a Wilcoxon signed rank test with one-sided type I error of 5%.
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Baseline to up to 1 month post-treatment
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Clinical Benefit as Measured by 50% Reduction in IFP
Time Frame: Baseline to surgery
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Baseline to surgery
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Clinical Benefit, Measured by Any Reduction in Tumor Dimensions on CT Scan as Measured by RECIST Criteria
Time Frame: Up to 1 month
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Up to 1 month
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Incidence of Adverse Events
Time Frame: Up to 1 month
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Up to 1 month
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Jeffrey Morgan, Dana-Farber Cancer Institute
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pathologic Processes
- Neoplasms, Connective and Soft Tissue
- Neoplasms by Histologic Type
- Neoplasms
- Neoplasms, Glandular and Epithelial
- Disease Attributes
- Neoplasms, Neuroepithelial
- Neoplasms, Germ Cell and Embryonal
- Neoplasms, Nerve Tissue
- Neoplasms, Bone Tissue
- Neoplasms, Connective Tissue
- Sarcoma
- Recurrence
- Sarcoma, Ewing
- Osteosarcoma
- Neuroectodermal Tumors
- Neuroectodermal Tumors, Primitive
- Neuroectodermal Tumors, Primitive, Peripheral
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Antineoplastic Agents
- Protein Kinase Inhibitors
- Sorafenib
Other Study ID Numbers
- NCI-2012-03122
- U01CA062490 (U.S. NIH Grant/Contract)
- 05-033
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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