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A Study To Assess The Safety And Efficacy Of SU11248 In Patients With Gastrointestinal Stromal Tumor(GIST)

A Phase III, Randomized, Double-Blind, Placebo-Controlled Study Of SU011248 In The Treatment Of Patients With Imatinib Mesylate (Gleevec Tm, Glivec)-Resistant Or Intolerant Malignant Gastrointestinal Stromal Tumor

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00075218
Enrollment
361
Registered
2004-01-08
Start date
2003-12-31
Completion date
2008-05-31
Last updated
2009-09-28

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Gastrointestinal Stromal Tumor

Brief summary

A study to assess the safety and efficacy of SU11248 in patients with gastrointestinal stromal tumor (GIST) whose disease has failed imatinib therapy or who were intolerant to imatinib treatment.

Interventions

DRUGPlacebo

50 mg taken orally once a day. 6 week treatment cycle (Schedule 4/2) 4 weeks on study drug/2 weeks off study drug.

50 mg taken orally once a day. 6 week treatment cycle (Schedule 4/2) 4 weeks on study drug/2 weeks off study drug.

Sponsors

Pfizer
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

Key Inclusion Criteria: * Histologically-proven diagnosis of malignant GIST not amenable to surgery, radiation or combined modality treatment with curative intent * Failed Gleevec treatment or intolerant to Gleevec therapy Key

Exclusion criteria

* Treatment with any chemotherapy, chemoembolization therapy, immunotherapy, or investigational agent since the last dose of Gleevec

Design outcomes

Primary

MeasureTime frameDescription
Time to Tumor Progression (TTP) as Assessed by Imaging Studies at End of Double-blind Treatment PhaseDay 28 of each 6-week cycle : duration of double-blind treatment phaseTime from randomization to first documentation of objective tumor progression based on the assessment of an independent, third-party imaging laboratory using RECIST (Response Evaluation Criteria in Solid Tumors).
Time to Tumor Progression (TTP) as Assessed in the Double-blind Treatment Phase at End of StudyDay 28 of each 6-week cycle : duration of double-blind treatment phase after Last Subject Last Visit (LSLV)Time from randomization to first documentation of objective tumor progression based on the assessment of an independent, third-party imaging laboratory using RECIST (Response Evaluation Criteria in Solid Tumors).

Secondary

MeasureTime frameDescription
Overall Survival Status of Subjectsclinic visit or telephone contact every 2 months for up to 3 years from the last dose of study drugNumber of subjects alive at end of study.
Overall Survival Based on the Rank Preserving Structural Failure Time Methodclinic visit or telephone contact every 2 months for up to 3 years from the last dose of study drugtime from date of randomization to date of death due to any cause (rank preserving structural failure time method).
Best Overall Tumor Response During Double-blind Treatment PhaseDay 28 of each cycle : duration of double-blind treatment phaseTumor response according to Response Evaluation Criteria in Solid Tumors (RECIST).
Confirmed Objective Response (CR or PR) in SubjectsDay 28 of each cycle : duration of double-blind treatment phaseOverall confirmed objective response = confirmed Complete Response (CR) OR confirmed Partial Response (PR) according to RECIST. Confirmed responses were those that persisted on repeat imaging study ≥ 4 weeks after initial documentation of response.
Time to Tumor Response (TTR)Day 28 of each cycle : duration of double-blind treatment phaseTime from date of randomization to first documentation of objective tumor response that was subsequently confirmed. TTR was only calculated for the subgroup of subjects with a confirmed objective tumor response.
Overall Survivalclinic visit or telephone contact every 2 months for up to 3 years from the last dose of study drugTime from date of randomization to date of death due to any cause.
Time to Pain Progression Using McGill Pain Questionnaire-present Pain Intensity (MPQ-PPI)Day 1 & 28 of each cycle : duration of double-blind treatment phase25th Quartile: Time to Progression. Progression: a) No change (NC) in MPQ-PPI score (0=no pain to 5=excruciating pain) with increase total analgesic use \>= 50% over baseline OR b) Increase score \>= 1 point with either NC in total analgesic use or increase total analgesic use \>= 50% over baseline. (50th Quartile not achieved.)
Subjects With Pain Relief Response Using McGill Pain Questionnaire-present Pain Intensity (MPQ-PPI)Day 1 & 28 of each cycle : duration of double-blind treatment phaseMPQ-PPI: 0=no pain to 5= excruciating pain. Pain Relief Response= 1) Decrease by \>= 1 points in MPQ-PPI score with either Decrease or No Change in total analgesic use \>= 50% over baseline OR 2) No change in MPQ-PPI score with Decrease total analgesic use \>= 50% over baseline.
Change From Baseline Score in EuroQoL Visual Analog Scale (EQ-VAS)Day 1 & 28 of each cycle : duration of double-blind treatment phaseChange: median score at observation minus median score at baseline. EQ-VAS score on the self-rated thermometer, indicating the patient's own assessment of their health status from 0 (worst) to 100 (best) imaginable health state.
Change From Baseline in EQ-5D Health State Profile IndexDay 1 & 28 of each cycle : duration of double-blind treatment phaseChange: median index score at observation minus median index score at baseline. EQ-5D is a generic instrument that describes health status in 5 dimensions (mobility, self-care, pain/discomfort, anxiety/depression, usual activities) with a weighted health Index based on general population values where where 0.0 = death and 1.0 = perfect health.
Duration of Performance Status MaintenanceDay 28 of each cycle : duration of double-blind treatment phaseTime from randomization until the last time the performance status was no worse than at baseline or to death due to cancer in the absence of previous documentation of performance status worsening.
Progression Free Survival (PFS)Day 28 of each cycle : duration of double-blind treatment phaseTime from randomization to first documentation of objective tumor progression or to death due to any cause (on treatment or within 28 days of last dose).

Countries

Australia, Belgium, Canada, France, Italy, Netherlands, Singapore, Spain, Switzerland, United Kingdom, United States

Participant flow

Recruitment details

Enrollment began (medical clinic) in December 2003. Study was unblinded on 27 January 2005 (end of Double-blind treatment). Subjects experiencing disease progression could crossover to Open-label treatment. Open-label data collection ended May 2008.

Pre-assignment details

361 subjects randomized to double-blind treatment in 2:1 ratio (sunitinib vs. Placebo). 255 subjects continued on or crossed over to Open-label treatment.

Participants by arm

ArmCount
Sunitinib Double-Blind Treatment
Starting dose: 50 mg orally once daily as a single agent for 4 consecutive weeks followed by a 2-week off-treatment period to form a complete cycle of 6 weeks. (Schedule 4/2). Subjects received best supportive care in addition to the study treatment.
243
Placebo Double-Blind Treatment
Starting daily dose of 1 capsule, size- and color-matched to the sunitinib 50-mg capsule for 4 consecutive weeks followed by a 2-week off-treatment period to form a complete cycle of 6 weeks (Schedule 4/2). Subjects received best supportive care in addition to the study treatment. Subjects were provided the opportunity to receive open-label sunitinib at the time of confirmed disease progression or study unblinding.
118
Total361

Withdrawals & dropouts

PeriodReasonFG000FG001FG002
Double-Blind TreatmentAdverse Event2340
Double-Blind TreatmentDecision of Sponsor010
Double-Blind TreatmentLack of Efficacy5860
Double-Blind TreatmentLost to Follow-up100
Double-Blind TreatmentNo study medication taken200
Double-Blind TreatmentWithdrawal by Subject740
Open-Label TreatmentAdverse Event0051
Open-Label TreatmentDecision of Sponsor008
Open-Label Treatmentenrolled in a separate continuation009
Open-Label TreatmentLack of Efficacy00174
Open-Label TreatmentProtocol Violation001
Open-Label TreatmentWithdrawal by Subject0012

Baseline characteristics

CharacteristicSunitinib Double-Blind TreatmentPlacebo Double-Blind TreatmentTotal
Age, Categorical
<=18 years
0 Participants0 Participants0.0 Participants
Age, Categorical
>=65 years
73 Participants37 Participants110.0 Participants
Age, Categorical
Between 18 and 65 years
170 Participants81 Participants251.0 Participants
Sex: Female, Male
Female
91 Participants71 Participants162.0 Participants
Sex: Female, Male
Male
152 Participants47 Participants199.0 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
deaths
Total, all-cause mortality
— / —— / —— / —
other
Total, other adverse events
223 / —110 / —254 / —
serious
Total, serious adverse events
83 / —27 / —122 / —

Outcome results

Primary

Time to Tumor Progression (TTP) as Assessed by Imaging Studies at End of Double-blind Treatment Phase

Time from randomization to first documentation of objective tumor progression based on the assessment of an independent, third-party imaging laboratory using RECIST (Response Evaluation Criteria in Solid Tumors).

Time frame: Day 28 of each 6-week cycle : duration of double-blind treatment phase

Population: From the Intent to Treat (ITT) population, 82 subjects on sunitinib treatment were observed to have disease progression during blinded phase and were included in TTP analysis. 67 subjects on placebo were observed to have disease progression during blinded phase.

ArmMeasureValue (MEDIAN)
Sunitinib Double-Blind TreatmentTime to Tumor Progression (TTP) as Assessed by Imaging Studies at End of Double-blind Treatment Phase27.3 weeks
Placebo Double-Blind TreatmentTime to Tumor Progression (TTP) as Assessed by Imaging Studies at End of Double-blind Treatment Phase6.4 weeks
Comparison: The study was designed to test the null hypothesis that the median TTP from placebo treatment is 4 months versus the alternative hypothesis that the median TTP from sunitinib treatment is at least 6 months with an overall 2-sided significance level of 0.05 and power of 90%.p-value: <0.00195% CI: [0.233, 0.466]Log Rank
Primary

Time to Tumor Progression (TTP) as Assessed in the Double-blind Treatment Phase at End of Study

Time from randomization to first documentation of objective tumor progression based on the assessment of an independent, third-party imaging laboratory using RECIST (Response Evaluation Criteria in Solid Tumors).

Time frame: Day 28 of each 6-week cycle : duration of double-blind treatment phase after Last Subject Last Visit (LSLV)

Population: From the Intent to Treat (ITT) population, 91 subjects on sunitinib treatment were observed to have disease progression during blinded phase and were included in TTP analysis. 73 subjects on placebo were observed to have disease progression during blinded phase.

ArmMeasureValue (MEDIAN)
Sunitinib Double-Blind TreatmentTime to Tumor Progression (TTP) as Assessed in the Double-blind Treatment Phase at End of Study26.6 weeks
Placebo Double-Blind TreatmentTime to Tumor Progression (TTP) as Assessed in the Double-blind Treatment Phase at End of Study6.4 weeks
p-value: <0.00195% CI: [0.244, 0.472]Log Rank
Comparison: Stratified log-rank testp-value: <0.00195% CI: [0.232, 0.46]Log Rank
Secondary

Best Overall Tumor Response During Double-blind Treatment Phase

Tumor response according to Response Evaluation Criteria in Solid Tumors (RECIST).

Time frame: Day 28 of each cycle : duration of double-blind treatment phase

Population: ITT population

ArmMeasureGroupValue (NUMBER)
Sunitinib Double-Blind TreatmentBest Overall Tumor Response During Double-blind Treatment PhaseComplete Response (CR)0 participants
Sunitinib Double-Blind TreatmentBest Overall Tumor Response During Double-blind Treatment PhasePartial Response (PR)16 participants
Sunitinib Double-Blind TreatmentBest Overall Tumor Response During Double-blind Treatment PhaseStable Disease128 participants
Sunitinib Double-Blind TreatmentBest Overall Tumor Response During Double-blind Treatment PhaseProgressive Disease45 participants
Sunitinib Double-Blind TreatmentBest Overall Tumor Response During Double-blind Treatment PhaseUnable to Evaluate1 participants
Sunitinib Double-Blind TreatmentBest Overall Tumor Response During Double-blind Treatment PhaseMissing53 participants
Placebo Double-Blind TreatmentBest Overall Tumor Response During Double-blind Treatment PhaseUnable to Evaluate0 participants
Placebo Double-Blind TreatmentBest Overall Tumor Response During Double-blind Treatment PhaseComplete Response (CR)0 participants
Placebo Double-Blind TreatmentBest Overall Tumor Response During Double-blind Treatment PhaseProgressive Disease44 participants
Placebo Double-Blind TreatmentBest Overall Tumor Response During Double-blind Treatment PhasePartial Response (PR)0 participants
Placebo Double-Blind TreatmentBest Overall Tumor Response During Double-blind Treatment PhaseMissing24 participants
Placebo Double-Blind TreatmentBest Overall Tumor Response During Double-blind Treatment PhaseStable Disease50 participants
Secondary

Change From Baseline in EQ-5D Health State Profile Index

Change: median index score at observation minus median index score at baseline. EQ-5D is a generic instrument that describes health status in 5 dimensions (mobility, self-care, pain/discomfort, anxiety/depression, usual activities) with a weighted health Index based on general population values where where 0.0 = death and 1.0 = perfect health.

Time frame: Day 1 & 28 of each cycle : duration of double-blind treatment phase

Population: ITT Population. Number subjects with evaluable data: (n=sunitinib, placebo)

ArmMeasureGroupValue (MEDIAN)
Sunitinib Double-Blind TreatmentChange From Baseline in EQ-5D Health State Profile IndexCycle 1 Day 28 (n=185, 87)0.000 score on scale
Sunitinib Double-Blind TreatmentChange From Baseline in EQ-5D Health State Profile IndexCycle 2 Day 1 (n=149, 53)0.000 score on scale
Sunitinib Double-Blind TreatmentChange From Baseline in EQ-5D Health State Profile IndexCycle 2 Day 28 (n=129, 41)-0.017 score on scale
Sunitinib Double-Blind TreatmentChange From Baseline in EQ-5D Health State Profile IndexCycle 3 Day 1 (n=104, 17)0.000 score on scale
Sunitinib Double-Blind TreatmentChange From Baseline in EQ-5D Health State Profile IndexCycle 3 Day 28 (n=91, 13)-0.036 score on scale
Sunitinib Double-Blind TreatmentChange From Baseline in EQ-5D Health State Profile IndexCycle 4 Day 1 (n=74, 10)0.000 score on scale
Placebo Double-Blind TreatmentChange From Baseline in EQ-5D Health State Profile IndexCycle 3 Day 28 (n=91, 13)0.000 score on scale
Placebo Double-Blind TreatmentChange From Baseline in EQ-5D Health State Profile IndexCycle 1 Day 28 (n=185, 87)0.000 score on scale
Placebo Double-Blind TreatmentChange From Baseline in EQ-5D Health State Profile IndexCycle 3 Day 1 (n=104, 17)0.000 score on scale
Placebo Double-Blind TreatmentChange From Baseline in EQ-5D Health State Profile IndexCycle 2 Day 1 (n=149, 53)0.000 score on scale
Placebo Double-Blind TreatmentChange From Baseline in EQ-5D Health State Profile IndexCycle 4 Day 1 (n=74, 10)0.059 score on scale
Placebo Double-Blind TreatmentChange From Baseline in EQ-5D Health State Profile IndexCycle 2 Day 28 (n=129, 41)0.000 score on scale
Secondary

Change From Baseline Score in EuroQoL Visual Analog Scale (EQ-VAS)

Change: median score at observation minus median score at baseline. EQ-VAS score on the self-rated thermometer, indicating the patient's own assessment of their health status from 0 (worst) to 100 (best) imaginable health state.

Time frame: Day 1 & 28 of each cycle : duration of double-blind treatment phase

Population: ITT population. Number subjects with evaluable data: (n=sunitinib, placebo)

ArmMeasureGroupValue (MEDIAN)
Sunitinib Double-Blind TreatmentChange From Baseline Score in EuroQoL Visual Analog Scale (EQ-VAS)Cycle 1 Day 28 (n=187, 89)-3.0 score on scale
Sunitinib Double-Blind TreatmentChange From Baseline Score in EuroQoL Visual Analog Scale (EQ-VAS)Cycle 2 Day 1 (n=148, 53)0.0 score on scale
Sunitinib Double-Blind TreatmentChange From Baseline Score in EuroQoL Visual Analog Scale (EQ-VAS)Cycle 2 Day 28 (n=132, 41)-4.5 score on scale
Sunitinib Double-Blind TreatmentChange From Baseline Score in EuroQoL Visual Analog Scale (EQ-VAS)Cycle 3 Day 1 (n=102,16)0.0 score on scale
Sunitinib Double-Blind TreatmentChange From Baseline Score in EuroQoL Visual Analog Scale (EQ-VAS)Cycle 3 Day 28 (n=91,13)-5.0 score on scale
Sunitinib Double-Blind TreatmentChange From Baseline Score in EuroQoL Visual Analog Scale (EQ-VAS)Cycle 4 Day 1 (n=73,10)0.0 score on scale
Placebo Double-Blind TreatmentChange From Baseline Score in EuroQoL Visual Analog Scale (EQ-VAS)Cycle 3 Day 28 (n=91,13)-1.0 score on scale
Placebo Double-Blind TreatmentChange From Baseline Score in EuroQoL Visual Analog Scale (EQ-VAS)Cycle 1 Day 28 (n=187, 89)0.0 score on scale
Placebo Double-Blind TreatmentChange From Baseline Score in EuroQoL Visual Analog Scale (EQ-VAS)Cycle 3 Day 1 (n=102,16)0.0 score on scale
Placebo Double-Blind TreatmentChange From Baseline Score in EuroQoL Visual Analog Scale (EQ-VAS)Cycle 2 Day 1 (n=148, 53)0.0 score on scale
Placebo Double-Blind TreatmentChange From Baseline Score in EuroQoL Visual Analog Scale (EQ-VAS)Cycle 4 Day 1 (n=73,10)5.0 score on scale
Placebo Double-Blind TreatmentChange From Baseline Score in EuroQoL Visual Analog Scale (EQ-VAS)Cycle 2 Day 28 (n=132, 41)0.0 score on scale
Secondary

Confirmed Objective Response (CR or PR) in Subjects

Overall confirmed objective response = confirmed Complete Response (CR) OR confirmed Partial Response (PR) according to RECIST. Confirmed responses were those that persisted on repeat imaging study ≥ 4 weeks after initial documentation of response.

Time frame: Day 28 of each cycle : duration of double-blind treatment phase

Population: ITT population.

ArmMeasureValue (NUMBER)
Sunitinib Double-Blind TreatmentConfirmed Objective Response (CR or PR) in Subjects16 participants
Placebo Double-Blind TreatmentConfirmed Objective Response (CR or PR) in Subjects0 participants
95% CI: [3.8, 10.5]
p-value: 0.00495% CI: [3.47, 9.7]Pearson chi-square test
Secondary

Duration of Performance Status Maintenance

Time from randomization until the last time the performance status was no worse than at baseline or to death due to cancer in the absence of previous documentation of performance status worsening.

Time frame: Day 28 of each cycle : duration of double-blind treatment phase

Population: ITT Population. Number of subjects at median observed to have status worsening or died before status worsening.

ArmMeasureValue (MEDIAN)
Sunitinib Double-Blind TreatmentDuration of Performance Status Maintenance18.9 weeks
Secondary

Overall Survival

Time from date of randomization to date of death due to any cause.

Time frame: clinic visit or telephone contact every 2 months for up to 3 years from the last dose of study drug

Population: ITT population; Number subjects Dead = 176, 90 (sunitinib, placebo respectively). Subjects who were not known to be dead at the time the database was closed for analysis were censored on the date they were last known to be alive.

ArmMeasureValue (MEDIAN)
Sunitinib Double-Blind TreatmentOverall Survival72.7 weeks
Placebo Double-Blind TreatmentOverall Survival64.9 weeks
p-value: 0.30695% CI: [0.679, 1.129]Log Rank
Secondary

Overall Survival Based on the Rank Preserving Structural Failure Time Method

time from date of randomization to date of death due to any cause (rank preserving structural failure time method).

Time frame: clinic visit or telephone contact every 2 months for up to 3 years from the last dose of study drug

Population: ITT population

ArmMeasureValue (MEDIAN)
Sunitinib Double-Blind TreatmentOverall Survival Based on the Rank Preserving Structural Failure Time Method72.7 weeks
Placebo Double-Blind TreatmentOverall Survival Based on the Rank Preserving Structural Failure Time Method39.0 weeks
p-value: 0.30695% CI: [0.262, 1.134]Rank Preserving Structural Failure Time
Secondary

Overall Survival Status of Subjects

Number of subjects alive at end of study.

Time frame: clinic visit or telephone contact every 2 months for up to 3 years from the last dose of study drug

Population: ITT population.

ArmMeasureGroupValue (NUMBER)
Sunitinib Double-Blind TreatmentOverall Survival Status of SubjectsDead176 participants
Sunitinib Double-Blind TreatmentOverall Survival Status of SubjectsAlive67 participants
Placebo Double-Blind TreatmentOverall Survival Status of SubjectsAlive28 participants
Placebo Double-Blind TreatmentOverall Survival Status of SubjectsDead90 participants
Secondary

Progression Free Survival (PFS)

Time from randomization to first documentation of objective tumor progression or to death due to any cause (on treatment or within 28 days of last dose).

Time frame: Day 28 of each cycle : duration of double-blind treatment phase

Population: ITT population

ArmMeasureValue (MEDIAN)
Sunitinib Double-Blind TreatmentProgression Free Survival (PFS)22.9 weeks
Placebo Double-Blind TreatmentProgression Free Survival (PFS)6.0 weeks
p-value: <0.00195% CI: [0.253, 0.475]Log Rank
Secondary

Subjects With Pain Relief Response Using McGill Pain Questionnaire-present Pain Intensity (MPQ-PPI)

MPQ-PPI: 0=no pain to 5= excruciating pain. Pain Relief Response= 1) Decrease by \>= 1 points in MPQ-PPI score with either Decrease or No Change in total analgesic use \>= 50% over baseline OR 2) No change in MPQ-PPI score with Decrease total analgesic use \>= 50% over baseline.

Time frame: Day 1 & 28 of each cycle : duration of double-blind treatment phase

Population: Pain-Relief-Response population.

ArmMeasureValue (NUMBER)
Sunitinib Double-Blind TreatmentSubjects With Pain Relief Response Using McGill Pain Questionnaire-present Pain Intensity (MPQ-PPI)46 participants
Placebo Double-Blind TreatmentSubjects With Pain Relief Response Using McGill Pain Questionnaire-present Pain Intensity (MPQ-PPI)10 participants
p-value: 0.004695% CI: [6.7, 28]Pearson chi-square
Secondary

Time to Pain Progression Using McGill Pain Questionnaire-present Pain Intensity (MPQ-PPI)

25th Quartile: Time to Progression. Progression: a) No change (NC) in MPQ-PPI score (0=no pain to 5=excruciating pain) with increase total analgesic use \>= 50% over baseline OR b) Increase score \>= 1 point with either NC in total analgesic use or increase total analgesic use \>= 50% over baseline. (50th Quartile not achieved.)

Time frame: Day 1 & 28 of each cycle : duration of double-blind treatment phase

Population: Pain-Relief-Response population. Subjects at 25th Quartile with pain progress during blinded phase.

ArmMeasureValue (MEDIAN)
Sunitinib Double-Blind TreatmentTime to Pain Progression Using McGill Pain Questionnaire-present Pain Intensity (MPQ-PPI)12.1 weeks (25th Quartile)
p-value: 0.932295% CI: [0.508, 1.86]Log Rank
Secondary

Time to Tumor Response (TTR)

Time from date of randomization to first documentation of objective tumor response that was subsequently confirmed. TTR was only calculated for the subgroup of subjects with a confirmed objective tumor response.

Time frame: Day 28 of each cycle : duration of double-blind treatment phase

Population: ITT population. Number of subjects analyzed = number of subjects with tumor response.

ArmMeasureValue (MEDIAN)
Sunitinib Double-Blind TreatmentTime to Tumor Response (TTR)13.4 weeks

Source: ClinicalTrials.gov · Data processed: Apr 8, 2026