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Studio KPMNG sulla terapia guidata del profilo molecolare basata su alterazioni genomiche nei tumori solidi avanzati II (KOSMOSII)

29 settembre 2026 aggiornato da: Jee Hyun Kim, Seoul National University Bundang Hospital

Studio di gruppo di rete di medicina di precisione coreana sulla terapia guidata del profilo molecolare basata su alterazioni genomiche nei tumori solidi avanzati 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)

Panoramica dello studio

Stato

Attivo, non reclutante

Condizioni

Intervento / Trattamento

Descrizione dettagliata

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

Tipo di studio

Osservativo

Iscrizione (Effettivo)

1000

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Luoghi di studio

      • Bucheon-si, Corea del Sud
        • Soonchunhyang University Hospital Bucheon
      • Chungju, Corea del Sud
        • Chungbuk National University Hospital
      • Daegu, Corea del Sud
        • Keimyung University Dongsan Hospital
      • Daegu, Corea del Sud
        • Kyungpook National University Chilgok Hospital
      • Daegu, Corea del Sud
        • Yeungnam University Medical Center
      • Daejeon, Corea del Sud
        • Chungnam National University Hospital
      • Goyang, Corea del Sud
        • National Cancer Center
      • Hwasun, Corea del Sud
        • Chonnam National University Hwasun Hospital
      • Incheon, Corea del Sud
        • Gachon University Gil Medical Center
      • Incheon, Corea del Sud
        • The Catholic University of Korea, Incheon St. Mary's Hospital
      • Jeonju, Corea del Sud
        • Jeonbuk National University Hospital
      • Jinju, Corea del Sud
        • Gyeongsang National University Hospital
      • Pusan, Corea del Sud
        • Dong-A University Hospital
      • Seongnam, Corea del Sud
        • Cha University Bundang Medical Center
      • Seongnam, Corea del Sud
        • Seoul National University Bundang Hospital
      • Seoul, Corea del Sud
        • Asan Medical Center
      • Seoul, Corea del Sud
        • Korea University Anam Hospital
      • Seoul, Corea del Sud
        • Korea University Guro Hospital
      • Seoul, Corea del Sud
        • Samsung Medical Center
      • Seoul, Corea del Sud
        • Seoul National University Hospital
      • Seoul, Corea del Sud
        • The Catholic University of Korea, Yeouido St. Mary's Hospital
      • Seoul, Corea del Sud
        • Gangbuk Samsung Hospital
      • Seoul, Corea del Sud
        • Hanyang University Hospital
      • Seoul, Corea del Sud
        • Chung-ang University Hospital
      • Seoul, Corea del Sud
        • Ewha womans university Mokdong Hospital
      • Seoul, Corea del Sud
        • The Catholic University of Korea, Seoul ST. Mary's Hospital
      • Seoul, Corea del Sud
        • Yonsei Cancer Hospital
      • Suwon, Corea del Sud
        • Ajou University Hospital
      • Suwon, Corea del Sud
        • The Catholic University of Korea, ST. Vincent's Hospital
      • Ulsan, Corea del Sud
        • Ulsan University Hospital
      • Wŏnju, Corea del Sud
        • Wonju Severance Christian Hospital
      • Yangsan, Corea del Sud
        • Pusan National University Yangsan Hospital

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

19 anni e precedenti (Adulto, Adulto più anziano)

Accetta volontari sani

No

Sessi ammissibili allo studio

Tutto

Metodo di campionamento

Campione non probabilistico

Popolazione di studio

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

Descrizione

Inclusion Criteria:

  • 19 years of age or older

  • 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

  • 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.

    1. 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.
    2. 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.
  • Ability to understand and the willingness to sign a written informed consent document

  • Life expectancy of at least 12 weeks

  • 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

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Modelli osservazionali: COHORT
  • Prospettive temporali: PROSPECTIVE

Coorti e interventi

Gruppo / Coorte
Intervento / Trattamento
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

Altri nomi:
  • Alecensa

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)

Altri nomi:
  • Tecentriq

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

Altri nomi:
  • Tarceva

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

Altri nomi:
  • Herceptin + Perjeta

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

Altri nomi:
  • Kadcyla

BRAF_V600E/D/K/R mutations

Altri nomi:
  • Zelboraf

FH inactivating mutations or approved by the KOSMOS Molecular Tumor Board

Altri nomi:
  • Avastin+Tarceva

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

Altri nomi:
  • Rozlytrek

RET fusion or mutations; CCDC6 RET, RET V804L, RET V804M, RET M918T, KIF5B-RET, RET C634W or approved by the KOSMOS Molecular Tumor Board

Altri nomi:
  • Gavreto
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).

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.

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
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
Lasso di tempo: 12 months after treatment initiation (estimated average)

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)
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
Lasso di tempo: Assessed at 16 weeks of treatment

Percentage of patients achieving response defined as CR/PR/SD at 16 ± 2 weeks reported by site physician

Assessed at 16 weeks of treatment

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Objective response rate
Lasso di tempo: 12 months after treatment initiation (estimated average)

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)
Progression-free survival
Lasso di tempo: 12 months after treatment initiation (estimated average)

Progression-free survival in accordance with local clinical practice

12 months after treatment initiation (estimated average)
Treatment duration
Lasso di tempo: 12 months after treatment initiation (estimated average)

The period from the start of treatment to the end of treatment for any reason

12 months after treatment initiation (estimated average)
1-year overall survival rate
Lasso di tempo: 12 months after treatment initiation (estimated average)

Proportion of patients alive 1 year after study registration

12 months after treatment initiation (estimated average)
To evaluate safety of molecular profiling guided therapies
Lasso di tempo: 12 months after treatment initiation (estimated average)

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)

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Collaboratori

Investigatori

  • Direttore dello studio: JEEHYUN KIM, Seoul National University Bundang Hospital

Pubblicazioni e link utili

La persona responsabile dell'inserimento delle informazioni sullo studio fornisce volontariamente queste pubblicazioni. Questi possono riguardare qualsiasi cosa relativa allo studio.

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Effettivo)

28 settembre 2022

Completamento primario (Stimato)

31 marzo 2027

Completamento dello studio (Stimato)

31 marzo 2027

Date di iscrizione allo studio

Primo inviato

29 agosto 2022

Primo inviato che soddisfa i criteri di controllo qualità

30 agosto 2022

Primo Inserito (Effettivo)

2 settembre 2022

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

30 settembre 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

29 settembre 2026

Ultimo verificato

1 settembre 2026

Maggiori informazioni

Termini relativi a questo studio

Altri numeri di identificazione dello studio

  • KCSG AL 22-09

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

No

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .