Interesse for postoperativ kemoterapi hos patienter med lokaliseret uterint leiomyosarkom, der mistænkes for at have en høj risiko for tilbagefald baseret på en biologisk test udført på tumoren (L-UteCIN)
Interessen for adjuverende kemoterapi hos patienter med CINSARC Højrisiko lokaliseret resekeret uterin leiomyosarkom - sarkom 15
Addition of postoperative chemotherapy to prevent or delay recurrence in patients newly diagnosed with localized uterine leiomyosarcoma and who have undergone complete tumor surgery.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
This is a biological driven study comprising:
- a multicenter, randomized and comparative phase II trial designed to demonstrate whether adding 4 cycles of post-operative chemotherapy improves relapse-free survival as compared with follow-up (standard management) in patients with resected FIGO stage I uterine leiomyosarcoma, considered at high-risk according to CINSARC NanoCind® signature.
- a prospective cohort for patients with resected FIGO stage I uterine leiomyosarcoma, considered at low-risk according to CINSARC NanoCind® signature.
HIGH-RISK (HR) CINSARC patients will be randomized post-operatively between the two arms of treatment, i.e. standard treatment (active post-surgical surveillance) or chemotherapy, with a 1:1 randomization on one factor: morcellation versus no morcellation of uterine tumor.
LOW-RISK (LR) CINSARC patients' data will be prospectively collected
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Fase 2
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Amel MEKALICHE, MS
- Telefonnummer: +33 761947045
- E-mail: a-mekaliche@unicancer.fr
Studiesteder
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Angers, Frankrig, 49100
- Ikke rekrutterer endnu
- Institut de Cancerologie de L'Ouest (Ico)
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Ledende efterforsker:
- Patrick SOULIÉ, MD
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Besançon, Frankrig, 25030
- Ikke rekrutterer endnu
- Hopital Jean Minjoz
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Ledende efterforsker:
- Loic CHAIGNEAU, MD
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Bordeaux, Frankrig, 33076
- Ikke rekrutterer endnu
- Institut Bergonie
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Ledende efterforsker:
- Maud TOULMONDE, MD
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Caen, Frankrig, 14176
- Ikke rekrutterer endnu
- Centre Francois Baclesse
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Ledende efterforsker:
- Zoé NEVIERE, MD
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Clermont-Ferrand, Frankrig, 63011
- Ikke rekrutterer endnu
- Centre Jean Perrin
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Ledende efterforsker:
- Pascale DUBRAY-LONGERAS, MD
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Dijon, Frankrig, 21079
- Ikke rekrutterer endnu
- Centre Georges Francois Leclerc
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Ledende efterforsker:
- Isabelle DESMOULINS, MD
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Limoges, Frankrig, 87042
- Ikke rekrutterer endnu
- Chu Limoges
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Ledende efterforsker:
- Tiffany DARBAS, MD
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Lyon, Frankrig, 69373
- Ikke rekrutterer endnu
- Centre Léon Berard
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Ledende efterforsker:
- Isabelle RAY-COCUARD, MD PhD
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Marseille, Frankrig, 13273
- Ikke rekrutterer endnu
- Institut Paoli Calmettes
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Ledende efterforsker:
- François BERTUCCI, MD PhD
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Marseille, Frankrig, 13385
- Rekruttering
- La Timone University Hospital
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Ledende efterforsker:
- Florence DUFFAUD, MD PhD
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Nice, Frankrig, 06189
- Ikke rekrutterer endnu
- Centre Antoine Lacassagne
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Ledende efterforsker:
- Agnès DUCOULOMBIER, MD
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Paris, Frankrig, 75014
- Ikke rekrutterer endnu
- Hôpital Cochin
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Ledende efterforsker:
- Sixtine DE PERCIN, MD
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Paris, Frankrig
- Ikke rekrutterer endnu
- Institut Curie
-
Ledende efterforsker:
- Clément BONET, MD
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Paris, Frankrig, 75010
- Ikke rekrutterer endnu
- Hopital Saint Louis
-
Ledende efterforsker:
- Tiphaine LAMBERT, MD
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Paris, Frankrig, 75020
- Ikke rekrutterer endnu
- Groupe Hospitalier Diaconesses Croix St Simon
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Ledende efterforsker:
- Frédéric SELLE, MD
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Paris, Frankrig, 75020
- Ikke rekrutterer endnu
- Hopital Tenon
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Ledende efterforsker:
- Laurent SEKNAZI, MD
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Poitiers, Frankrig, 86000
- Ikke rekrutterer endnu
- Chu de Poitiers
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Ledende efterforsker:
- Nicolas ISAMBERT, MD PHD
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Rennes, Frankrig, 35042
- Ikke rekrutterer endnu
- Centre Eugene Marquis
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Ledende efterforsker:
- Christophe PERRIN, MD
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Rouen, Frankrig, 76038
- Ikke rekrutterer endnu
- Centre Henri Becquerel
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Ledende efterforsker:
- Cécile GUILLEMET, MD
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Saint-Herblain, Frankrig, 44805
- Ikke rekrutterer endnu
- Institut de cancerologie de l'ouest site Rene Gauducheau
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Ledende efterforsker:
- Pierre KUBICEK, MD
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Strasbourg, Frankrig
- Ikke rekrutterer endnu
- Institut de Cancerologie Strasbourg Europe (Icans)
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Kontakt:
- Jean-Emmanuel KURTZ, MD
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Toulouse, Frankrig, 31052
- Ikke rekrutterer endnu
- Institut Claudius Regaud
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Ledende efterforsker:
- Thibaud VALENTIN, MD
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Tours, Frankrig, 37000
- Ikke rekrutterer endnu
- CHU Bretonneau
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Ledende efterforsker:
- Mathilde CANCEL, MD
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Vandœuvre-lès-Nancy, Frankrig, 54519
- Ikke rekrutterer endnu
- Centre Alexis Vautrin
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Ledende efterforsker:
- Maria RIOS, MD
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Villejuif, Frankrig, 94800
- Rekruttering
- Gustave Roussy
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Ledende efterforsker:
- Patricia PAUTIER, MD
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Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
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Patient must have a histologically confirmed diagnosis of uterine leiomyosarcoma obtained less than 8 weeks from the surgery
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Eastern cooperative oncology group (ECOG) performance status (PS) 0 or 1
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Patient was previously untreated with chemotherapy for a sarcoma, and did not receive anthracyclines and/or trabectedin for another cancer
-
Available Formalin Fixed Paraffin Embedded (FFPE) tumor blocks in sufficient quantity and quality to allow CINSARC NanoCind® qualification (low-risk or high-risk)
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Age ≥ 18 years and ≤ 75 years
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FIGO 2018 classification stage I (IA and IB), with complete resection (total hysterectomy and optional bilateral oophorectomy; possible ovarian preservation is feasible in selected cases)
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No measurable disease, as assessed by the investigator: normal post-operative thoracic, abdominal and pelvic CT-scan or normal MRI of abdomen and pelvis + normal chest CT performed within 4 weeks prior to inclusion or randomization in the study
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Signed informed consent form prior to any trial specific procedures consistent with international conference on harmonisation - good clinical practice (ICH-GCP) and local legislation
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Patient must be affiliated to a social security system or in possession of equivalent private health insurance (according to local regulations for participation in clinical trials).
Additional inclusion criteria for randomization
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Inclusion criteria checked at study entry are all still met at the time of randomization
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High-risk CINSARC signature
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Patient must have a diagnosis of uterine leiomyosarcoma confirmed by a local sarcoma expert pathologist from RRePS (Sarcoma Pathology Reference Network from NETSARC +) locally or by the study central RRePS expert pathologist.
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Adequate hematologic organ function:
- absolute neutrophil count ≥ 1.5 Giga/ L
- hemoglobin ≥ 9 g/dL
- platelets ≥ 100 Giga/L
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Adequate renal function: serum creatinine ≤ 1.5 mg/dL (≤ 132.6 µmol/L) or calculated creatinine clearance ≥60 mL/min (by the Cockcroft and Gault formula)
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Adequate liver function: total bilirubin ≤ upper limit of normal (ULN), transaminases ≤ 2.5 x ULN, alkaline phosphatases ≤ 1.5 x ULN
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Adequate cardiac function: cardiac ultrasound and/or isotopic ventriculography, shortening fraction (SF) > 30%, Left Ventricular Ejection Fraction (LVEF) (per ultrasound or scintigraphy) > 50%
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Creatine phosphokinase (CPK) ≤ 2,5 x ULN
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Albumin ≥ 25 g/L
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Signed informed consent form for the randomized phase, consistent with ICH-GCP and local legislation.
Exclusion Criteria:
-
Exclusion criteria:
- All other histology types of uterine sarcoma (adenosarcoma, endometrial sarcoma, undifferentiated uterine sarcoma)
- Prior or concurrent malignant disease diagnosed or treated in the last 5 years except for adequately treated in situ carcinoma of the cervix, basal or squamous skin cell carcinoma, or in situ transitional bladder cell carcinoma
- Planned pelvic post-operative radiation therapy
- Metastatic or measurable disease on CT-Scan
- Known hypersensitivity to doxorubicin or trabectedin or to any of the excipients
- Any contra-indication for the use of doxorubicin and/or trabectedin treatment
- Participation in another therapeutic trial within the 30 days prior to inclusion in the study
- Active viral hepatitis B or C or known human immunodeficiency virus (HIV) infection.
- Prior anticancer therapy, including radiotherapy, endocrine therapy, immunotherapy, chemotherapy (CT) or other investigational agents within the last 4 weeks (6 weeks for nitrosoureas and mitomycin C)
- Cardiovascular dysfunction:
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Congestive heart failure (New York Heart Association [NYHA]) ≥ 2)
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Myocardial infarction <6 months before study
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Poorly controlled cardiac arrhythmias
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Uncontrolled hypertension
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Unstable (angina symptoms at rest) or new-onset angina (begun within the last 3 months) 11. Ongoing infection > Grade 2 according to NCI-CTCAE v5.0 12. Breastfeeding woman 13. Patients unwilling or unable to comply with the medical procedures and follow-up required by the trial because of geographic, familial, social, or psychological reasons 14. Persons deprived of their liberty or under protective custody or guardianship.
Additional exclusion criteria for randomization 15. At least one of the exclusion criteria check at study entry is met at the time of randomization 16. Unknown risk for CINSARC signature 17. For patients who require a pathological review by the study central pathologist, failure to obtain a confirmed diagnosis at randomization 18. More than 13 weeks have elapsed since the surgery procedure. 19. Patient receiving phenytoin within 88 hours prior to randomisation and or live attenuated vaccines within 14 days prior to randomisation and or CYP3A4 inhibitors (e.g. oral ketoconazole, fluconazole, ritonavir, clarithromycin or aprepitant) and or strong CYP3A4 inducers (e.g. rifampicin, phenobarbital, St John's wort).
Criteria for continuing in the prospective cohort :
- Patient must have a diagnosis of uterine leiomyosarcoma confirmed by a sarcoma expert pathologist or by the study central pathologist
- Patients with a low-risk CINSARC signature
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Forebyggelse
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Ingen indgriben: Arm A
Standard of care : Active surveillance |
|
|
Eksperimentel: Arm B
Experimental treatment: 4 cycle of Doxorubicine + trabectedin |
60 mg/m² intravenous (IV) at Day 1 every 3 weeks (4 cycles) 1.1 mg/m² intravenous (IV) at Day 1 every 3 weeks (4 cycles)
Andre navne:
|
|
Ingen indgriben: Prospective Cohort
Standard of care : Active surveillance |
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Relapse-free survival
Tidsramme: From randomization or enrollment to disease recurrence or death, up to 5 years
|
The relapse-free survival is defined as the time from the date of randomization assignment (or the date of enrollment for patients in the prospective cohort) to the date of first disease recurrence/relapse (local/regional recurrence and/or distant metastasis) or death from any cause whichever comes first. |
From randomization or enrollment to disease recurrence or death, up to 5 years
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Overall survival
Tidsramme: From randomization or enrollment to death, up to 5 years
|
The overall survival is the length of time from randomization (or enrollment for patients in the prospective cohort) that patients enrolled in the study are still alive. |
From randomization or enrollment to death, up to 5 years
|
|
Metastases-free survival
Tidsramme: From randomization or enrollment to metastases onset or death, up to 5 years
|
The metastases-free survival is the length of time during and after the treatment for cancer that a patient is still alive and the cancer has not spread to other parts of the body. |
From randomization or enrollment to metastases onset or death, up to 5 years
|
|
Incidence of adverse events
Tidsramme: Throughout study completion, up to 5 years
|
The National Cancer Institute-Common Terminology Criteria for Adverse Events version 5 (NCI-CTCAE v5) is widely accepted in the community of oncology research as the leading rating scale for adverse events. This scale, divided into 5 grades (1 = "mild", 2 = "moderate", 3 = "severe", 4 = "life-threatening", and 5 = "death") determined by the investigator, will make it possible to assess the severity of the disorders. Safety and tolerability (NCI-CTCAE v5.0) will be assessed through the incidence of adverse events, treatment-related adverse events, serious adverse events (SAEs); and death. |
Throughout study completion, up to 5 years
|
|
Quality of life questionnaire - Core 30 (QLQ-C30)
Tidsramme: At baseline, end of treatment (up to week 12), 4 months, 6 months, 1 year and 2 years
|
Developed by the EORTC, this self-reported questionnaire assesses the health-related quality of life of cancer patients in clinical trials. The questionnaire includes five functional scales (physical, everyday activity, cognitive, emotional, and social), three symptom scales (fatigue, pain, nausea and vomiting), a health/quality of life overall scale, and a number of additional elements assessing common symptoms (including dyspnea, loss of appetite, insomnia, constipation, and diarrhea), as well as, the perceived financial impact of the disease. All of the scales and single-item measures range in score from 0 to 100. A high scale score represents a higher response level. |
At baseline, end of treatment (up to week 12), 4 months, 6 months, 1 year and 2 years
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Samarbejdspartnere
Samarbejdspartnere
Efterforskere
Efterforskere
- Ledende efterforsker: Florence DUFFAUD, MD, La TIMONE University Hospital
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
- Organiske kemikalier
- Heterocykliske forbindelser, 1-ring
- Heterocykliske forbindelser
- Heterocykliske forbindelser, 2-ring
- Heterocykliske forbindelser, smeltet ring
- Kulbrinter
- Kulbrinter, cyklisk
- Kulhydrater
- Polycykliske aromatiske kulbrinter
- Kulbrinter, aromatisk
- Polycykliske forbindelser
- Glycosider
- Anthracycliner
- Naphthacenes
- Aminoglycosider
- Daunorubicin
- Dioxoler
- Tetrahydroisoquinoliner
- Isoquinoliner
- Trabectedin
- Doxorubicin
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- UC-SAR-2212
- 2023-506350-21-00 (Ctis)
- 2023 (U.S. NIH-bevilling/kontrakt)
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
IPD-planbeskrivelse
Individual Participant Data will not be shared at an individual level. Those data will be part of the study database including all enrolled patients.
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
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