- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01771458
A Randomized Phase II Trial Comparing Therapy Based on Tumor Molecular Profiling Versus Conventional Therapy in Patients With Refractory Cancer (SHIVA)
A Randomized Proof-of-concept Phase II Trial Comparing Therapy Based on Tumor Molecular Profiling Versus Conventional Therapy in Patients With Refractory Cancer.
SHIVA is a proof of concept randomized phase II trial which compares two treatment strategies for patients with refractory cancer.
From a tumor biopsy, a molecular profile of the disease is established (mutations, amplifications, hormone receptor status). If a molecular abnormality is identified for which an approved targeted agent is available, patients are randomized randomized between two arms:
- Targeted therapy based on the molecular profile
- Conventional therapy based on investigator's choice.
A cross-over is proposed at disease progression.
Study Overview
Status
Conditions
Intervention / Treatment
- Procedure: Tumor biopsy
- Drug: Standard Chemotherapy
- Drug: Targeted therapy based on molecular profiling : Imatinib
- Drug: Targeted therapy based on molecular profiling : Everolimus
- Drug: Targeted therapy based on molecular profiling : Vemurafenib
- Drug: Targeted therapy based on molecular profiling : Sorafenib
- Drug: Targeted therapy based on molecular profiling : Erlotinib
- Drug: Targeted therapy based on molecular profiling : Lapatinib + Trastuzumab
- Drug: Targeted therapy based on molecular profiling : Dasatinib
- Drug: Targeted therapy based on molecular profiling : Tamoxifen (or letrozole if contra-indication)
- Drug: Targeted therapy based on molecular profiling : Abiraterone
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
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Dijon, France, 21079
- Centre régional de lutte contre le cancer de Bourgogne Georges François Leclerc
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Lyon, France, 69373
- Centre Leon Berard
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Marseille, France, 13009
- Institut Paoli Calmettes
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Paris, France, 75248
- Insitut Curie
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Saint-cloud, France, 92210
- Institut Curie Hopital Rene Huguenin
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Saint-herblain, France, 44000
- Institut de Cancérologie de l'Ouest Centre René Gauducheau
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Toulouse, France, 31052
- Institut Claudius Regaud
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Vandoeuvre Les Nancy, France, 54500
- Centre Alexis Vautrin
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patient with recurrent/metastatic solid tumor who failed or are not candidate for treatments usually proposed in first intentions and for whom a prospective clinical trial has been indicated in a tumor board
- ECOG performance status of 0 or 1
- Biopsiable disease (tumor biopsy mandatory for tumor profiling). The biopsy can be performed when patients are being treated with standard therapy for their recurrent/metastatic cancer if it is not planned to treat them with molecularly targeted agents in the future.
- Measurable disease
- Adequate renal function defined by a serum creatinine <1.5xUNL (upper normal limit)
- Adequate liver function test defined by SGOT & SGPT <3xUNL (5xUNL in case of liver metastases), and bilirubin level <1.5xUNL
- Adequate bone marrow function defined by platelets >100,000/mm3, hemoglobin >10 g/dL, and neutrophils >1,000/mm3
- Patients must be affiliated to the French Social Security System
- Signed informed consent
- For female of child-bearing potential: a negative pregnancy test <72 hours before starting study treatment is required. If sexually active, female of childbearing potential must use "highly effective" methods of contraception for the study duration and for 3 months following the last treatment
- For male of reproductive potential: any sexually active male patient must use a condom while on study treatment and for 3 months following the last treatment
- Agreement to send the CD-ROMs of imaging for central review
Exclusion Criteria:
- Patients who have only bone and/or brain metastases
- Patients whose brain metastases have not been controlled for >3 months
- Patient participating in another clinical trial with an experimental drug
- Patients who are candidate to receive a molecularly targeted agent that is approved for their disease
- Anticoagulation with anti-vitamin K (Low Molecular Weight Heparin [LMWH] is allowed)
- Patients with other concurrent severe and/or uncontrolled medical disease which could compromise participation in the study, including uncontrolled diabetes, cardiac disease, uncontrolled hypertension, congestive cardiac failure, ventricular arrhythmias, active ischemic heart disease, myocardial infection within one year, chronic liver or renal disease, active gastrointestinal tract ulceration, severely impaired lung function
- Pregnant and/or breastfeeding women
- Individually deprived of liberty or placed under the authority of a tutor
- Patients with any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule
- Known HIV, HBV, or HCV infection
Eligibility criteria for the randomized part :
- Identification of tumor molecular abnormalities for which the Therapeutic Decision Committee (TDC) recommends a molecularly targeted therapy available in the context of the trial (even if the molecular profile is incomplete)
- Therapy recommended by the TDC is not approved for the patient's disease
- ECOG performance status of 0 or 1
- Adequate renal function defined by a serum creatinine <1.5xUNL
- Adequate liver function tests defined by SGOT & SGPT <3xUNL (5xUNL in case of liver metastases), and bilirubin level <1.5xUNL
- Adequate bone marrow function defined by platelets >100,000/mm3, hemoglobin >8 g/dL, and neutrophils >1,000/mm3
- Albumin, LDH and number of metastatic sites have been documented (in order to determine the RMH prognostic score)
- LVEF >50%
- QTc <480 ms on ECG
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Standard chemotherapy
Treatment choice is based on Investigator decision.
|
Other Names:
|
Experimental: Personalized treatment
Targeted therapy based on the patient molecular profil (if there is at least one abnormality that could be targeted) Elligible therapies in this trial are : Imatinib Everolimus Vemurafenib Sorafenib Erlotinib Lapatinib Trastuzumab Dasatinib Tamoxifen (or letrozole if contra-indication) Abiraterone |
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
---|---|
Patient's progression free survival (according RECIST 1.1) of targeted therapy based on molecular profiling versus conventional chemotherapy.
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Tumor evaluation according to RECIST 1.1 criteria (every 2 months)
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
---|---|
Overall response rate (ORR)
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Tumor evaluation according to RECIST 1.1 criteria (every 2 months)
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Overall Survival (OS)
|
|
Treatments side effects assessement according to the NCI CTCAE v4.03 scale.
|
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Treatment effect variations as defined by tumor growth according to the altered signaling pathway
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Evaluation of tumor growth before and during the study (according to RECIST 1.1)
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Patient's progression free survival (according RECIST 1.1) of targeted therapy based on molecular profiling versus conventional chemotherapy after cross-over.
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Tumor evaluation according to RECIST 1.1 criteria (every 2 months)
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Evaluation of the ability of ctDNA to early predict treament efficacy
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Comparing treatment efficacy to ctDNA level (before and during treatment course)
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Evaluation of the medico-economic impact of the experimental strategy
|
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Technical feasability of the SHIVA trial: number of screened patient compared to number of patients elligible to randomization.
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Number of screened patients. Number of patient with a molecular full profil in the timeframe (4 weeks between tumor biopsy and SHIVA's committees decision). Number of randomized patient. |
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Christophe Le Tourneau, MD, Institut Curie
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Primary Completion (Anticipated)
Study Completion (Anticipated)
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
- Neoplasms
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Antineoplastic Agents
- Immunosuppressive Agents
- Immunologic Factors
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Antineoplastic Agents, Hormonal
- Antineoplastic Agents, Immunological
- Protein Kinase Inhibitors
- Hormone Antagonists
- Bone Density Conservation Agents
- Aromatase Inhibitors
- Steroid Synthesis Inhibitors
- Estrogen Antagonists
- Selective Estrogen Receptor Modulators
- Estrogen Receptor Modulators
- Trastuzumab
- Sorafenib
- Letrozole
- Tamoxifen
- Everolimus
- Dasatinib
- Lapatinib
- Vemurafenib
Other Study ID Numbers
- IC 2012-04
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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