- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01054911
Evaluation of Patients With Bulky GIST Using Sunitinib
Pilot Trial of Neoadjuvant Sunitinib in Patients With Bulky GIST
Study Overview
Detailed Description
Gastrointestinal stromal tumor (GIST) is a rare cancer affecting primarily the digestive tract and sometimes abdominal cavity in adults. The most common site is the stomach followed by the duodenum and small intestine.
Surgery is the mainstay of therapy for GIST patients whose primary tumor is felt to be resectable. Prior to the introduction of Gleevec, patients with inoperable GIST had essentially no therapeutic options. However, sunitinib trials offer options to patients who are Gleevec resistant or have intolerant GIST. Clinical benefit has been demonstrated with positive results in several sunitinib studies of varying phases.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Alabama
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Birmingham, Alabama, United States, 35294
- University of Alabama at Birmingham
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients more than 19 years old with pathologically proven GIST which is bulky or marginally resectable
- Patients must have at least one bidimensionally measurable disease site of 5 cm or greater not previously irradiated. Bone lesions do not qualify.
- Patients must have an ECOG performance of greater than or equal to 2, with projected survival of at least three months.
- Patients must have adequate laboratory parameters:
Hematologic: Hb >9.0; WBC >3200 and platelets >100,000/mm3; Hepatic: Bilirubin <2.0 and AST within 4 times upper limit of normal; Renal: Creatinine of less than or equal to 1.6 or eGFR greater than or equal to 50 mL/min
- Men and women who are of childbearing potential must practice strict birth control for the duration of the study.
- Women of childbearing potential must be non-lactating and non-pregnant with a negative pregnancy test within two weeks of trial registration.
- The patient, a witness, and attending physician will have signed an IRB-approved informed consent prior to Sunitinib administration.
Exclusion Criteria:
- Known brain metastases or significant pleural effusion or ascites.
- Uncontrolled hypertension, diabetes, or other medical condition.
- Major surgery within 21 days of registration.
- Patients wtih organ grafts with the exception of prior high dose chemotherapy with autologous bone marrow (or stem cell) transplantation.
- History of seizures, central nervous system disorders, dementia, or psychosis that might preclude adequate informed consent or protocol compliance.
- Prior therapy for GIST.
- A history of HIV or hepatitis virus infection.
- Any recent medical condition which, in the opinion of the investigator, makes the patient unsuitable for study participation.
- Patients with impaired kidney function.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Experimental: Sunitinib pill
Patients will receive six weeks of sunitinib and then subsequently continue for an additional 6 weeks if the evaluation at 6 weeks shows stable disease or objective response.
Restaging CT scans will be performed again after 12 weeks of therapy to determine response in preparation for surgical resection anticipated to occur around week 14-16.
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All patients will receive sunitinib 37.5 mg p.o. daily for up to 12 weeks to be taken orally.
Other Names:
Following sunitinib therapy, patients will be evaluated for surgery.
It is anticipated that the quality of response will allow for complete resection of residual tumor.
Surgical resection, if eligible, will occur around week 14-16.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
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Number of Participants With Adverse Events
Time Frame: 6 months
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6 months
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Measurable Disease Response Rate
Time Frame: FDG PET scan at baseline and Week 2, CT scan at baseline and Week 12
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Positron electron emission tomography (PET) using 18F-fluorodeoxyglucose (FDG) and computed tomography (CT) will be used.
None of the participants were analyzed
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FDG PET scan at baseline and Week 2, CT scan at baseline and Week 12
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Alteration in Diffusion and Vascularity Kinetics
Time Frame: MRI at baseline, Week 2 and Week 6
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The Response Evaluation Criteria in Solid Tumors (RECIST) criteria may be insensitive in assessing GIST so the Choi criteria will be used.
The Choi criteria accounts for morphologic tumor changes and biologic alterations.
Diffusion-weighted magnetic resonance imaging (MRI) and dynamic contrast magnetic resonance will be used to find the vascular permeability and apparent diffusion coefficient 9ACD) at baseline, Week 2 and Week 6. Weeks 2 and 6 values will be compared to the baseline values using paired t tests.
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MRI at baseline, Week 2 and Week 6
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Collaborators and Investigators
Collaborators
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
Other Study ID Numbers
- F090910001
- UAB 0855 (Other Identifier: Institutional study protocol number)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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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