KPMNG Studie molekulárního profilování řízené terapie založené na genomových změnách u pokročilých pevných nádorů II (KOSMOSII)
Korejská skupinová studie pro precizní medicínu zaměřená na terapii řízenou molekulárním profilováním na základě genomických změn u pokročilých pevných nádorů II
A national, prospective, multi-center, open-label, multi-cohort study comprised of a framework to screen patients for actionable targets and evaluation of molecular profiling guided therapy recommended by MTB based on genomic alterations using targeted and/or immunotherapies outside of the approved indications via local clinical practice (Tier 1 & 2) and clinical trials (Tier 3)
Přehled studie
Postavení
Postavení
Podmínky
Podmínky
Intervence / Léčba
Intervence / Léčba
Detailní popis
A. The KOSMOS-II study will recruit locally advanced or metastatic solid tumor patients who had disease progression on standard first line anti-cancer treatment and/or has no standard treatment option, in order to prove MTB value to guide treatment within local clinical practice.
B. After site physicians confirm that NGS results of patients are available, they preliminarily decide initial treatment before MTB submission and collect informed consent form, and then patients can register to the KOSMOS-II study. Site physicians upload patients' clinical, pathologic, and genomic data for MTB submission. If site physician cannot determine initial treatment before MTB, site physician can record 'initial treatment cannot be determined' and can register the patient for MTB.
C. MTB records its treatment recommendations within available drugs list based on uploaded data, then site physicians make a final treatment decision, after informing patient about MTB decision and assessment of patients' final health status and preference.
D. Patients who have insufficient genomic information from their NGS results (e.g., lack of variant calling format file or uninterpretable reports) or who are candidates of immunotherapy will submit their tissue and/or blood, for central NGS testing and exploratory biomarker analysis.
E. Recommended treatment option There are three different options including (1) Tier 1: Therapeutic use of investigational products (KOSMOS-II drugs), (2) Tier 2: alternative treatment options, and (3) Tier 3: clinical trials
Typ studie
Typ studie
Zápis (Aktuální)
Zápis
Kontakty a umístění
Studijní místa
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Bucheon-si, Jižní Korea
- Soonchunhyang University Hospital Bucheon
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Chungju, Jižní Korea
- Chungbuk National University Hospital
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Daegu, Jižní Korea
- Keimyung University Dongsan Hospital
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Daegu, Jižní Korea
- Kyungpook National University Chilgok Hospital
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Daegu, Jižní Korea
- Yeungnam University Medical Center
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Daejeon, Jižní Korea
- Chungnam National University Hospital
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Goyang, Jižní Korea
- National Cancer Center
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Hwasun, Jižní Korea
- Chonnam National University Hwasun Hospital
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Incheon, Jižní Korea
- Gachon University Gil Medical Center
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Incheon, Jižní Korea
- The Catholic University of Korea, Incheon St. Mary's Hospital
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Jeonju, Jižní Korea
- Jeonbuk National University Hospital
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Jinju, Jižní Korea
- Gyeongsang National University Hospital
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Pusan, Jižní Korea
- Dong-A University Hospital
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Seongnam, Jižní Korea
- Cha University Bundang Medical Center
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Seongnam, Jižní Korea
- Seoul National University Bundang Hospital
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Seoul, Jižní Korea
- Asan Medical Center
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Seoul, Jižní Korea
- Korea University Anam Hospital
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Seoul, Jižní Korea
- Korea University Guro Hospital
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Seoul, Jižní Korea
- Samsung Medical Center
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Seoul, Jižní Korea
- Seoul National University Hospital
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Seoul, Jižní Korea
- The Catholic University of Korea, Yeouido St. Mary's Hospital
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Seoul, Jižní Korea
- Gangbuk Samsung Hospital
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Seoul, Jižní Korea
- Hanyang University Hospital
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Seoul, Jižní Korea
- Chung-ang University Hospital
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Seoul, Jižní Korea
- Ewha womans university Mokdong Hospital
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Seoul, Jižní Korea
- The Catholic University of Korea, Seoul ST. Mary's Hospital
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Seoul, Jižní Korea
- Yonsei Cancer Hospital
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Suwon, Jižní Korea
- Ajou University Hospital
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Suwon, Jižní Korea
- The Catholic University of Korea, ST. Vincent's Hospital
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Ulsan, Jižní Korea
- Ulsan University Hospital
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Wŏnju, Jižní Korea
- Wonju Severance Christian Hospital
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Yangsan, Jižní Korea
- Pusan National University Yangsan Hospital
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Kritéria účasti
Kritéria způsobilosti
Kritéria způsobilosti
Věk způsobilý ke studiu
Přijímá zdravé dobrovolníky
Pohlaví způsobilá ke studiu
Metoda odběru vzorků
Studijní populace
Histologically proven locally advanced or metastatic solid tumor patients with disease progression on standard first line anti-cancer treatment and/or has no standard treatment option
Popis
Inclusion Criteria:
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19 years of age or older
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Histologically proven locally advanced or metastatic solid tumors*** who showed disease progression on standard first line anti-cancer treatment and/or has no standard treatment option
*** very rare diseases without standard treatment option which form solid mass, such as Erdheim Chester disease can be enrolled after KOSMOS MTB approval
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A genomic test results must be available in a MFDS-accredited for laboratories offering service, or in part of clinical trial/study or other commercial labs approved and certified by regulatory bodies compatible with MFDS, such as CLIA. A genomic test can be conducted with tumor tissue as well as plasma circulating tumor DNA.
- Results from genomic profiling tests performed after diagnosis with metastatic/advanced disease to registration are acceptable. NGS results performed within three years prior to registration are preferred. Those patients with NGS results from primary tumor or more than 3 years prior to enrollment can be registered and whether NGS data is acceptable will be subject to MTB decision.
- NGS panels should be i. Tested in a lab that is accredited by one or more quality assurance program (e.g., Korean Institute of Genomic Testing Evaluation, The Korean Society of Pathologists, Korean Society for Laboratory Medicine, Korea Laboratory Accreditation Scheme, etc.) ii. Patients who have insufficient genomic information from their NGS results (e.g., lack of variant calling format file or uninterpretable reports) or who are candidates of immunotherapy will submit their tissue and/or blood, for central NGS testing and exploratory biomarker analysis.
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Ability to understand and the willingness to sign a written informed consent document
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Life expectancy of at least 12 weeks
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Adequate recovery from most recent systemic or local treatment for cancer.
Exclusion Criteria:
- Patients receiving any anti-cancer treatment (local treatment, chemotherapy, immunotherapy, targeted therapy) within 2 weeks prior to the start of study treatment
- Any clinical condition, according to the opinion of site physicians, which makes molecular profiling guided therapy not at the best interest of the participating patient.
- Patients who have ongoing toxicities of ≥ CTCAE 2, other than peripheral neuropathy, related to previous anti-cancer treatment. Patients with ongoing peripheral neuropathy of ≥ CTCAE 3 will be excluded. Laboratory abnormalities ≥ CTCAE 2 considered as not clinically significant by the study physician will be allowed.
- Pregnant or breastfeeding, or intending to become pregnant during the study
Studijní plán
Jak je studie koncipována?
Detaily designu
- Observační modely: COHORT
- Časové perspektivy: PROSPECTIVE
Počet skupin / kohort
Kohorty a intervence
Skupina / kohortaSkupina / kohorta |
Intervence / LéčbaIntervence / Léčba |
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Tier 1. Therapeutic use of investigational products (KOSMOS-II drugs)
If there are no drugs available under current regulation or patients are not feasible to any clinical trials, and If tumors have actionable genetic alterations and approved drug in any indications but tumor type is not indicative, the MTB may recommend one of KOSMOS-II drugs, therapeutic use of investigational products. |
ALK fusion or mutations, Mutations or amplification in any of the following: RET
Ostatní jména:
MSI high status by any method Or Any mutation in any of these genes: MLH1 or MSH2 or MSH6 or PMS2 or EPCAM Or Any of the following mutations in POLE: R150X, P286R, P286H, S297F, Y298fs, F367S, V411, L424V, P436R, S459F, R665W, L698fs, R762W, R1519C, R1826W, D316H, D316G, R409W, L474P Or Any of the following mutations in POLD1: P112fs, A930fs, S478N Or Any mutation in the following: POLE not listed above, POLD1 not listed above, POLD2, POLD3, POLD4, POLQ or PRKDC Or Any loss of function mutations in BRCA1, BRCA2, ATM, MSH3, PMS1, MLH3, EXO1, RFC1, RFC2, RFC3, RFC4, RFC5, PCNA, RPA1, PRA2, PRA3, PRA4, or SSBP1 High tumor mutational burden decided by KOSMOS-II MTB (TMB ≥20/Mb in local NGS or if 10-20/Mb, confirmed by central NGS te sting)
Ostatní jména:
EGFR Exon 19 deletions in the region E746_E759; Any of the following EGFR mutations: E709A, E709G, E709K, E884K, G719A, G719C, G719S, L858R, L861Q, L833V, S768I
Ostatní jména:
ERBB2 amplification, or over-expression; or presence of any of the following ERBB2 mutations: G309A, G309E, S310F, S310Y, R678Q, I655V, D769H, D769Y, L755S, p.L75 5_T759del, I767M, V777L, E321G, R896C; P780ins; delL755-T759 ERBB2 amplification or approved by the KOSMOS Molecular Tumor Board
Ostatní jména:
ERBB2 amplification, or over-expression; or presence of any of the following ERBB2 mutations: G309A, G309E, S310F, S310Y, R678Q, I655V, D769H, D769Y,L755S, p.L75 5_T759del, I767M, V777L, E321G, R896C; P780ins; delL755-T759 ERBB2 oncogenic mutations; G152V, X215_splice, D277Y, G292C, N302K, V308M, G309A, S310F, S310Y, S244C, L651V, V659E, G660D, R678Q, V697L, G727A, T733I, L755A, L755P, L755S, D769H, D769Y, A775_G776insSVMA, A775_G776insYVMA (i.e.,Y772_A775dup,M774_A775insAYVME 770delinsEAYVM), G776_V777 > AVCV, G776_V777 > AVGCV, G776_V777 > VCV, G776_V777insVC, G776C, G776delinsLCT, G776L, G776dleinsVC, G776L777_G778insC, V777L, V777M, G778_Y779insGSP, P780_Y781insGSP (i.e.,G778_P780dup), L786V, N813D, R840W, V842I, T862A, R896G, E1021Q or approved by the KOSMOS Molecular Tumor Board
Ostatní jména:
BRAF_V600E/D/K/R mutations
Ostatní jména:
FH inactivating mutations or approved by the KOSMOS Molecular Tumor Board
Ostatní jména:
ROS1 gene fusion using either a fluo rescence in situ hybridization (FISH) or next-generation sequencing (NGS) or approved by the KOSMOS Molecular Tumor Board
Ostatní jména:
RET fusion or mutations; CCDC6 RET, RET V804L, RET V804M, RET M918T, KIF5B-RET, RET C634W or approved by the KOSMOS Molecular Tumor Board
Ostatní jména:
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Tier 2: Alternative treatments
If there are no KOSMOS-II drugs (Tier 1) or clinical trials (Tier 3) appropriate for patients, the MTB may recommend alternative treatment options (e.g., conventional therapy, radiotherapy, or supportive care). |
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Tier 3: Clinical trial
If patient is eligible for clinical trials matched for actionable genomic alterations found in NGS testing, the MTB will recommend enrollment to clinical trials. |
Co je měření studie?
Primární výstupní opatření
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
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To evaluate the feasibility of molecular profiling guided therapies (MGT) based on genomic alterations in patients with advanced solid tumors in terms of the proportion of receipt of the treatment
Časové okno: 12 months after treatment initiation (estimated average)
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Percentage of patients who receive molecular profiling guided therapy as recommended by MTB, either in therapeutic use of investigational products (KOSMOS-II drugs), alternative treatment, or clinical trial. |
12 months after treatment initiation (estimated average)
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To evaluate the effectiveness of molecular profiling guided therapies in terms of clinical benefit rate (CR/PR/SD beyond 16 +/- 2 weeks) in Tier 1* population
Časové okno: Assessed at 16 weeks of treatment
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Percentage of patients achieving response defined as CR/PR/SD at 16 ± 2 weeks reported by site physician |
Assessed at 16 weeks of treatment
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Sekundární výstupní opatření
Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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Objective response rate
Časové okno: 12 months after treatment initiation (estimated average)
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The proportion of patients who obtained CR/PR as the best response according to the RECIST 1.1 criteria |
12 months after treatment initiation (estimated average)
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Progression-free survival
Časové okno: 12 months after treatment initiation (estimated average)
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Progression-free survival in accordance with local clinical practice |
12 months after treatment initiation (estimated average)
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Treatment duration
Časové okno: 12 months after treatment initiation (estimated average)
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The period from the start of treatment to the end of treatment for any reason |
12 months after treatment initiation (estimated average)
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1-year overall survival rate
Časové okno: 12 months after treatment initiation (estimated average)
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Proportion of patients alive 1 year after study registration |
12 months after treatment initiation (estimated average)
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To evaluate safety of molecular profiling guided therapies
Časové okno: 12 months after treatment initiation (estimated average)
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The incidence of serious adverse events will be calculated among the adverse events in patients with Tier 1 and Tier 3. ( based on NCI-CTCAE v5.0 ) |
12 months after treatment initiation (estimated average)
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Spolupracovníci a vyšetřovatelé
Sponzor
Sponzor
Spolupracovníci
Spolupracovníci
Vyšetřovatelé
Vyšetřovatelé
- Ředitel studie: JEEHYUN KIM, Seoul National University Bundang Hospital
Publikace a užitečné odkazy
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia (Aktuální)
Začátek studia
Primární dokončení (Odhadovaný)
Primární dokončení
Dokončení studie (Odhadovaný)
Dokončení studie
Termíny zápisu do studia
První předloženo
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Aktuální)
První zveřejněno
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Poslední zveřejněná aktualizace
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Naposledy ověřeno
Více informací
Termíny související s touto studií
Další relevantní podmínky MeSH
- Patologické procesy
- Novotvary
- Neoplastické procesy
- Patologické stavy, příznaky a symptomy
- Metastáza novotvaru
- Aminokyseliny, peptidy a proteiny
- Proteiny
- Sloučeniny síry
- Organické chemikálie
- Heterocyklické sloučeniny
- Heterocyklické sloučeniny, 2-prsten
- Heterocyklické sloučeniny, fúzované kroužek
- Polycyklické sloučeniny
- Amidy
- Indoly
- Protilátky, monoklonální, humanizované
- Protilátky, monoklonální
- Protilátky
- Imunoglobuliny
- Imunoproteiny
- Krevní proteiny
- Sérové globuliny
- Globuliny
- Makrolidy
- Laktony
- Laktams, makrocyklické
- Makrocyklické sloučeniny
- Sulfonamidy
- Sulfony
- Quinazoliny
- Maytansine
- Trastuzumab
- Erlotinib hydrochlorid
- Bevacizumab
- Ado-trastuzumab emtansin
- Vemurafenib
- pertuzumab
- Atezolizumab
- Entrectinib
- Alektinib
- pralsetinib
Další identifikační čísla studie
Další identifikační čísla studie
- KCSG AL 22-09
Informace o lécích a zařízeních, studijní dokumenty
Studuje lékový produkt regulovaný americkým FDA
Studuje produkt zařízení regulovaný americkým úřadem FDA
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