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Safety and Efficacy of RAD001 (Everolimus) Monotherapy Plus Best Supportive Care in Patients With Advanced Gastric Cancer (AGC) (GRANITE-1)

8 oktober 2015 bijgewerkt door: Novartis Pharmaceuticals

A Randomized, Double-blind, Multi-center Phase III Study Comparing Everolimus (RAD001) Plus Best Supportive Care Versus Placebo Plus Best Supportive Care in Patients With Advanced Gastric Cancer After Progression on 1 or 2 Prior Systemic Chemotherapy

This study is designed to assess the safety and efficacy of RAD001 monotherapy in patients with advanced gastric cancer which has progressed after one or two lines of prior chemotherapy.

Studie Overzicht

Toestand

Voltooid

Conditie

Interventie / Behandeling

Studietype

Ingrijpend

Inschrijving (Werkelijk)

656

Fase

  • Fase 3

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studie Locaties

  • Argentinië
      • Buenos Aires, Argentinië, C1264AAA
        • Novartis Investigative Site
      • Cordoba, Argentinië, X5000IUG
        • Novartis Investigative Site
    • Viedma
      • Rio Negro, Viedma, Argentinië, 8500
        • Novartis Investigative Site
  • Australië
    • Australian Capital Territory
      • Canberra, Australian Capital Territory, Australië, 2605
        • Novartis Investigative Site
    • Queensland
      • Herston, Queensland, Australië, 4029
        • Novartis Investigative Site
    • South Australia
      • Kurralta Park, South Australia, Australië, 5037
        • Novartis Investigative Site
      • North Adelaide, South Australia, Australië, 5006
        • Novartis Investigative Site
    • Victoria
      • Box Hill, Victoria, Australië, 3128
        • Novartis Investigative Site
      • Clayton, Victoria, Australië, 3168
        • Novartis Investigative Site
      • Footscray, Victoria, Australië, 3011
        • Novartis Investigative Site
      • Heidelberg, Victoria, Australië, 3084
        • Novartis Investigative Site
      • Prahran, Victoria, Australië, 3181
        • Novartis Investigative Site
  • België
      • Charleroi, België, 6000
        • Novartis Investigative Site
      • Gent, België, 9000
        • Novartis Investigative Site
      • Leuven, België, 3000
        • Novartis Investigative Site
      • Liege, België, 4000
        • Novartis Investigative Site
  • Canada
    • British Columbia
      • North Vancouver, British Columbia, Canada, V7L 2L7
        • Novartis Investigative Site
      • Vancouver, British Columbia, Canada, V5Z 4E6
        • Novartis Investigative Site
    • Ontario
      • Toronto, Ontario, Canada, M4N 3M5
        • Novartis Investigative Site
      • Toronto, Ontario, Canada, M5B 1W8
        • Novartis Investigative Site
    • Quebec
      • Montreal, Quebec, Canada, H3G 1A4
        • Novartis Investigative Site
      • Sherbrooke, Quebec, Canada, J1H 5N4
        • Novartis Investigative Site
  • China
      • Beijing, China, 100039
        • Novartis Investigative Site
      • Beijing, China, 100036
        • Novartis Investigative Site
      • Guangzhou, China, 510060
        • Novartis Investigative Site
      • Shanghai, China, 200032
        • Novartis Investigative Site
      • Shanghai, China, 200003
        • Novartis Investigative Site
      • Shanghai, China, 200025
        • Novartis Investigative Site
    • Guangdong
      • Guangzhou, Guangdong, China, 510515
        • Novartis Investigative Site
    • Hebei
      • Shijiazhuang, Hebei, China, 050011
        • Novartis Investigative Site
    • Heilongjiang
      • Harbin, Heilongjiang, China, 150081
        • Novartis Investigative Site
    • Jiangsu
      • Nanjing, Jiangsu, China, 210002
        • Novartis Investigative Site
      • Suzhou, Jiangsu, China, 215006
        • Novartis Investigative Site
    • Liaoning
      • Shenyang, Liaoning, China
        • Novartis Investigative Site
    • Sichuan
      • Chengdu, Sichuan, China, 610041
        • Novartis Investigative Site
    • Zhejiang
      • Hangzhou, Zhejiang, China, 310016
        • Novartis Investigative Site
  • Duitsland
      • Berlin, Duitsland, 13353
        • Novartis Investigative Site
      • Bielefeld, Duitsland, 33604
        • Novartis Investigative Site
      • Frankfurt, Duitsland, 60488
        • Novartis Investigative Site
      • Mainz, Duitsland, 55131
        • Novartis Investigative Site
      • München, Duitsland, 81675
        • Novartis Investigative Site
      • Offenburg, Duitsland, 77652
        • Novartis Investigative Site
      • Trier, Duitsland, 54290
        • Novartis Investigative Site
    • Baden-Württemberg
      • Mannheim, Baden-Württemberg, Duitsland, 68305
        • Novartis Investigative Site
  • Frankrijk
      • Avignon Cedex, Frankrijk, 84082
        • Novartis Investigative Site
      • Clermont Ferrand cedex 1, Frankrijk, 63003
        • Novartis Investigative Site
      • Clichy, Frankrijk, 92110
        • Novartis Investigative Site
      • Dijon, Frankrijk, 21079
        • Novartis Investigative Site
      • Lyon Cedex 08, Frankrijk, 69373
        • Novartis Investigative Site
      • Marseille cedex 05, Frankrijk, 13385
        • Novartis Investigative Site
      • Montpellier Cedex 5, Frankrijk, 34298
        • Novartis Investigative Site
      • Nice Cedex 2, Frankrijk, 06189
        • Novartis Investigative Site
      • Paris, Frankrijk, 75015
        • Novartis Investigative Site
      • Pessac Cedex, Frankrijk, 33604
        • Novartis Investigative Site
      • Poitiers, Frankrijk, 86000
        • Novartis Investigative Site
      • Reims, Frankrijk, 51092
        • Novartis Investigative Site
      • Rennes Cedex, Frankrijk, 35062
        • Novartis Investigative Site
      • Toulouse Cedex 4, Frankrijk, 31054
        • Novartis Investigative Site
      • Villejuif Cedex, Frankrijk, 94805
        • Novartis Investigative Site
  • Hongkong
      • Hong Kong SAR, Hongkong
        • Novartis Investigative Site
  • Israël
      • Jerusalem, Israël, 9112001
        • Novartis Investigative Site
      • Petach Tikva, Israël, 49100
        • Novartis Investigative Site
      • Ramat Gan, Israël, 5266202
        • Novartis Investigative Site
      • Rehovot, Israël, 76100
        • Novartis Investigative Site
  • Italië
      • Frattamaggiore, Italië, 80020
        • Novartis Investigative Site
    • FI
      • Firenze, FI, Italië, 50134
        • Novartis Investigative Site
    • MI
      • Rozzano, MI, Italië, 20089
        • Novartis Investigative Site
    • MO
      • Modena, MO, Italië, 41100
        • Novartis Investigative Site
    • PN
      • Aviano, PN, Italië, 33081
        • Novartis Investigative Site
  • Japan
    • Aichi
      • Nagoya, Aichi, Japan, 464-8681
        • Novartis Investigative Site
    • Chiba
      • Kashiwa, Chiba, Japan, 277-8577
        • Novartis Investigative Site
    • Ehime
      • Matsuyama, Ehime, Japan, 791-0280
        • Novartis Investigative Site
    • Fukuoka
      • Fukuoka-city, Fukuoka, Japan, 812-8582
        • Novartis Investigative Site
    • Hokkaido
      • Sapporo-city, Hokkaido, Japan, 060-8648
        • Novartis Investigative Site
    • Kanagawa
      • Sagamihara, Kanagawa, Japan, 252-0380
        • Novartis Investigative Site
    • Miyagi
      • Sendai-city, Miyagi, Japan, 980-8574
        • Novartis Investigative Site
    • Osaka
      • OsakaSayama, Osaka, Japan, 589-8511
        • Novartis Investigative Site
      • Takatsuki-city, Osaka, Japan, 569-8686
        • Novartis Investigative Site
    • Saitama
      • Kitaadachi-gun, Saitama, Japan, 362-0806
        • Novartis Investigative Site
    • Tochigi
      • Utsunomiya, Tochigi, Japan, 320-0834
        • Novartis Investigative Site
    • Tokyo
      • Chuo-ku, Tokyo, Japan, 104-0045
        • Novartis Investigative Site
      • Koto, Tokyo, Japan, 135-8550
        • Novartis Investigative Site
      • Mitaka-city, Tokyo, Japan, 181-8611
        • Novartis Investigative Site
  • Korea, republiek van
      • Seoul, Korea, republiek van, 136-705
        • Novartis Investigative Site
      • Taegu, Korea, republiek van, 700 - 721
        • Novartis Investigative Site
    • Jeollabuk-do
      • Jeonju-si, Jeollabuk-do, Korea, republiek van, 561-712
        • Novartis Investigative Site
    • Korea
      • Seoul, Korea, Korea, republiek van, 05505
        • Novartis Investigative Site
      • Seoul, Korea, Korea, republiek van, 06351
        • Novartis Investigative Site
      • Seoul, Korea, Korea, republiek van, 110 744
        • Novartis Investigative Site
      • Seoul, Korea, Korea, republiek van, 03722
        • Novartis Investigative Site
  • Mexico
    • Distrito Federal
      • México, Distrito Federal, Mexico, 14080
        • Novartis Investigative Site
    • Guanajuato
      • León, Guanajuato, Mexico, 37000
        • Novartis Investigative Site
  • Nederland
      • Amsterdam, Nederland, 1105 AZ
        • Novartis Investigative Site
  • Nieuw-Zeeland
      • Auckland, Nieuw-Zeeland
        • Novartis Investigative Site
  • Peru
    • Lima
      • San Borja, Lima, Peru, 41
        • Novartis Investigative Site
      • San Isidro, Lima, Peru, 27
        • Novartis Investigative Site
  • Russische Federatie
      • Moscow, Russische Federatie, 115478
        • Novartis Investigative Site
      • St. Petersburg, Russische Federatie, 197758
        • Novartis Investigative Site
  • Spanje
    • Catalunya
      • Barcelona, Catalunya, Spanje, 08035
        • Novartis Investigative Site
  • Taiwan
      • Liouying Township, Taiwan
        • Novartis Investigative Site
      • Niaosong Township, Taiwan, 83301
        • Novartis Investigative Site
      • Taipei, Taiwan, 10048
        • Novartis Investigative Site
      • Taipei, Taiwan
        • Novartis Investigative Site
    • Taoyuan/ Taiwan ROC
      • Kuei-Shan Chiang, Taoyuan/ Taiwan ROC, Taiwan, 33305
        • Novartis Investigative Site
  • Thailand
      • Bangkok, Thailand, 10700
        • Novartis Investigative Site
      • Bangkok, Thailand, 10400
        • Novartis Investigative Site
      • Songkla, Thailand, 90110
        • Novartis Investigative Site
  • Verenigd Koninkrijk
      • East Yorkshire, Verenigd Koninkrijk, HU16 5JQ
        • Novartis Investigative Site
      • London, Verenigd Koninkrijk, SW3 6JJ
        • Novartis Investigative Site
      • London, Verenigd Koninkrijk, WC1E 6HX
        • Novartis Investigative Site
      • Manchester, Verenigd Koninkrijk, M20 4BX
        • Novartis Investigative Site
      • Wolverhampton, Verenigd Koninkrijk, WV10 0QP
        • Novartis Investigative Site
    • Middlesex
      • Northwood, Middlesex, Verenigd Koninkrijk, HA6 2RN
        • Novartis Investigative Site
    • Surrey
      • Sutton, Surrey, Verenigd Koninkrijk, SM2 5PT
        • Novartis Investigative Site
  • Verenigde Staten
    • Arkansas
      • Fayetteville, Arkansas, Verenigde Staten, 72703
        • Highlands Oncology Group DeptofHighlandsOncologyGrp(2)
    • California
      • Redlands, California, Verenigde Staten, 92374
        • Loma Linda Oncology Medical Group Loma Linda
    • Michigan
      • Detroit, Michigan, Verenigde Staten, 48202-2689
        • Henry Ford Hospital Dept. of Henry Ford Hospital
    • Minnesota
      • Minneapolis, Minnesota, Verenigde Staten, 55455
        • University of Minnesota Cancer Center
    • Texas
      • Dallas, Texas, Verenigde Staten, 75390-8527
        • University of Texas Southwestern Medical Center DeptofSimmons Cancer Center(4)
      • Fort Worth, Texas, Verenigde Staten, 76104
        • The Center for Cancer and Blood Disorders Dept. of The Ctr for C & BD(2)
      • Houston, Texas, Verenigde Staten, 77030-4009
        • University of Texas/MD Anderson Cancer Center Gastrointestinal Med. Oncology
    • Washington
      • Seattle, Washington, Verenigde Staten, 98109-1023
        • University of Washington Cancer Care Seattle Cancer Alliance

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

18 jaar en ouder (Volwassen, Oudere volwassene)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

Beschrijving

Inclusion Criteria:

  • Male or female patients > 18 years old
  • Histologically or cytologically confirmed and documented gastric adenocarcinoma
  • Documented progression after 1 or 2 prior chemotherapy treatments for advanced disease
  • ECOG Performance Status of < 2
  • Lab parameters within specifically defined intervals
  • Able to provide written informed consent

Exclusion Criteria:

  • Patients who have received > 2 prior systemic therapies for advanced disease
  • Administration of another anticancer therapy within 3 weeks prior to randomization
  • Chronic treatment with steroids or another immunosuppressive agent
  • Major surgery within 2 weeks prior to randomization
  • Patients with CNS metastases
  • Any other severe and/or uncontrolled medical condition

Other protocol-defined inclusion/exclusion criteria may apply

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Behandeling
  • Toewijzing: Gerandomiseerd
  • Interventioneel model: Parallelle opdracht
  • Masker: Verviervoudigen

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: Everolimus + BSC
All patients were randomized to receive everolimus + BSC. All patients orally took two 5 mg tablets of everolimus once daily. Therefore, all patients in the everolimus arm took a total daily dose of 10 mg. Best supportive care was in accordance with the local practice of an individual institution or center, and specifically excluded anti-cancer treatments.
Geneesmiddel: Everolimus
Everolimus was formulated as tablets of 5 mg strength. In both treatment arms, the study drug was given by continuous oral daily dosing of 10 mg (2 tablets x 5 mg) each morning.
Andere namen:
  • RAD001
Geneesmiddel: Best Supportive Care (BSC)
Best supportive care is defined as care in accordance with the local practice of an individual institution or center, specifically excluding anti-cancer treatments.
Placebo-vergelijker: Placebo + BSC
All patients were randomized to receive placebo + BSC. All patients orally took two 5 mg tablets of matching placebo once daily. Therefore, all patients in the placebo receive matching tablets of total daily dose of 10 mg. Best supportive care was in accordance with the local practice of an individual institution or center, and specifically excluded anti-cancer treatments.
Geneesmiddel: Best Supportive Care (BSC)
Best supportive care is defined as care in accordance with the local practice of an individual institution or center, specifically excluding anti-cancer treatments.
Geneesmiddel: Everolimus placebo
Placebo was formulated to be indistinguishable from the everolimus tablets, also formulated as tablets of 5 mg strength. In both treatment arms, the study drug was given by continuous oral daily dosing of 10 mg (2 tablets x 5 mg) each morning.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Overall Survival (OS)
Tijdsspanne: 2.5 years
The primary objective of this study was to compare OS between everolimus + best supportive care (BSC) and placebo + BSC. OS, was defined as the time from date of randomization to the date of death due to any cause. If at the analysis cut-off date a patient was not known to have died, survival was censored at the date of the last contact. OS was analyzed using the Kaplan Meier estimates method.
2.5 years

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Progression Free Survival (PFS)
Tijdsspanne: 2.5 years
Progression free survival was defined as the time from the date of randomization to the date of the first documented disease progression or death due to any cause, where progression was based on Investigator assessment of baseline and post-baseline scans according to RECIST. Progression free survival was censored if no PFS event was observed before the first to occur out of (i) the cut-off date, or (ii) the date when a further anticancer therapy was started. The censoring date was the date of the last adequate tumor assessment before either of these two events occurred. If a PFS event was observed after two or more missing or non-evaluable tumor assessments, then the date of progression was censored at the date of the last adequate tumor assessment; for a PFS event observed after a single missing or non-evaluable tumor assessment, the actual date of disease progression was used. Anslsis was done using Kaplan-Meier estimates method.
2.5 years
Patient Reported Outcome (PRO): Time to Definitive Deterioration of European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire 30 (EORTC QLQ-C30) Scores
Tijdsspanne: 2.5 years
The EORTC QLQ-C30 global health status/quality of life sub-scale (QL) was pre-specified as the primary domain of interest, followed by physical functioning (PF), social functioning (SF) and emotional functioning (EF).The EORTC QLQ-C30 questionnaire, along with a module specific for gastric cancer patients (EORTC QLQ-STO22), was used to evaluate PRO. The QLQ-C30 has five function scales (physical, role, cognitive, emotional and social), three symptom scales (fatigue, pain and nausea/vomiting) and a global health status/quality of life scale. In addition, there are questions that assess specific symptoms. The QLQ-STO22 consists of 22 questions that make up five multi-item scales (dysphagia, pain, reflux, eating and anxiety) and four single-item scales (dry mouth, tasting, body image and hair loss).
2.5 years
Time to Definitive Deterioration of Eastern Cooperative Oncology Group Performance Status (ECOG PS) Score
Tijdsspanne: 2.5 years
The ECOG PS scale was used to classify patients according to their functional impairment, with scores ranging from 0 (fully active) to 5 (dead). An analysis of the time to definitive deterioration of the ECOG PS by one category of the score from baseline was performed. Definitive deterioration was defined as a definitive increase by one category from baseline in ECOG PS, with no later improvements observed during the course of the study. A single measure reporting an increase in ECOG PS is sufficient to consider it as a definitive worsening only if it was the last one available for the patient. Kaplan-Meier method was used to estimate the distribution function of time to definitive worsening.
2.5 years
Overall Response Rate (ORR)
Tijdsspanne: 2.5 years
ORR was defined as the proportion of patients with measurable disease in whom best overall response (OR) was either complete response (CR) or partial response (PR) according to RECIST criteria.
2.5 years
Everolimus Steady State Concentraions at Predose (Cmin) and Cmax at Week 5
Tijdsspanne: Week 5
Cmin is the minimum (trough) steady-state drug concentration in the blood during multiple dosing and Cmax is the maximum (peak) blood drug concentration after dose administration. Cmax is estimated as the maximum of C1h and C2H. C1h is 1 hour post-dose blood concentration and C2h is 2 hour post-dose blood concentration. Only valid pre-dose (Cmin), C1h, and C2h everolimus samples were included in the analysis. Valid pre-dose samples were confirmed blood samples collected at steady-state, collected immediately prior to dosing on the same study day, and collected at approximately 24 ± 4 hours after the previous dose and with no vomiting within the first 4 hours following the last dose. Valid C1h and C2h samples were confirmed blood samples collected at steady-state and within ± 1 hour window and with no vomiting within the first 4 hours following the current and previous dose.
Week 5
Everolimus Steady State Concentraions at Predose (Cmin) and Cmax by Region Asia vs. Rest of the World (ROW) at Week 5
Tijdsspanne: Week 5
Cmin is the minimum (trough) steady-state drug concentration in the blood during multiple dosing and Cmax is the maximum (peak) blood drug concentration after dose administration. Cmax is estimated as the maximum of C1h and C2H. C1h is 1 hour post-dose blood concentration and C2h is 2 hour post-dose blood concentration. Only valid pre-dose (Cmin), C1h, and C2h everolimus samples were included in the analysis. Valid pre-dose samples were confirmed blood samples collected at steady-state, collected immediately prior to dosing on the same study day, and collected at approximately 24 ± 4 hours after the previous dose and with no vomiting within the first 4 hours following the last dose. Valid C1h and C2h samples were confirmed blood samples collected at steady-state and within ± 1 hour window and with no vomiting within the first 4 hours following the current and previous dose.
Week 5

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

Novartis Pharmaceuticals

Publicaties en nuttige links

De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.

Algemene publicaties

Nuttige links

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start

1 juli 2009

Primaire voltooiing (Werkelijk)

1 januari 2014

Studie voltooiing (Werkelijk)

1 januari 2014

Studieregistratiedata

Eerst ingediend

8 april 2009

Eerst ingediend dat voldeed aan de QC-criteria

9 april 2009

Eerst geplaatst (Schatting)

10 april 2009

Updates van studierecords

Laatste update geplaatst (Schatting)

3 november 2015

Laatste update ingediend die voldeed aan QC-criteria

8 oktober 2015

Laatst geverifieerd

1 oktober 2015

Meer informatie

Termen gerelateerd aan deze studie

Trefwoorden

Aanvullende relevante MeSH-voorwaarden

Andere studie-ID-nummers

  • CRAD001R2301
  • 2008-006544-20 (EudraCT-nummer)

Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .

Abonneren