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Treatment of Patients With RAD001 With Progressive Sarcoma

Multicenter, Triple-arm, Single-stage, Phase II Trial to Determine the Preliminary Efficacy and Safety of RAD001 in Patients With Histological Evidence of Progressive or Metastatic Bone or Soft Tissue Sarcomas

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00767819
Enrollment
71
Registered
2008-10-07
Start date
2008-03-31
Completion date
2017-05-17
Last updated
2019-04-01

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

Conditions

Progressive Sarcoma

Keywords

progressive GIST, progressive sarcoma

Brief summary

The purpose of this multicenter, three-arm, exact binomial single-stage, phase II trial is to determine the preliminary efficacy and safety of RAD001 in patients with histological evidence of progressive or metastatic bone or soft tissue sarcoma.

Interventions

DRUGEverolimus

2.5 and 5 mg tablets taken orally and starting dose was 10 mg daily for all patients

Sponsors

Novartis Pharmaceuticals
Lead SponsorINDUSTRY

Study design

Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

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

Inclusion criteria

Histological evidence of progressive or metastatic bone or soft tissue sarcoma. The following tumor types are included: * malignant fibrous histiocytoma * liposarcoma * synovial sarcoma * malignant paraganglioma * fibrosarcoma * leiomyosarcoma * angiosarcoma including haemangiopericytoma * malignant peripheral nerve sheath tumor * STS, not otherwise specified * miscellaneous sarcoma including mixed mesodermal tumors of the uterus * osteosarcoma * Ewing's sarcoma * rhabdomyosarcoma * gastrointestinal stromal tumor (only after failure or intolerance of imatinib or sunitinib in 1st and 2nd line) * alveolar soft part sarcoma (ASPS) * Objective progression of disease may be documented by RECIST criteria. Any of the following would be sufficient according to RECIST: * a 20% increase in the sum of unidimensionally measured target lesions * a new lesion * unequivocal increase in non-measurable disease. * Patients must have disease not amenable to surgery, radiation, or combined modality therapy with curative intent. * ECOG performance status 0 - 2.

Exclusion criteria

Anticancer therapy within 3 weeks of enrollment including chemotherapy, hormonal therapy, immunotherapy, or radiotherapy. * The following tumor types will not be included: * gastrointestinal stromal tumor (except for patients after treatment with imatinib or sunitinib in 1st and 2nd line) * chondrosarcoma * malignant mesothelioma * neuroblastoma. * Prior therapy with RAD001 (everolimus) or other rapamycins (sirolimus, temsirolimus). * Neurotoxicity \> grade 2 CTC. * Radiation of the lung. Other protocol-defined inclusion/

Design outcomes

Primary

MeasureTime frameDescription
Best Overall Response Rates by Week 16 (ITT)Baseline up to 16 weeksThe best overall response is the best response recorded from treatment start until disease progression/recurrence (both measurement and confirmation criteria). Best lesion response was defined by (Resist Criteria V1 for target and non-target lesions): Complete Response (CR)=at least two determinations of CR 4 weeks apart before progression, Partial Response (PR)=at least two determinations of CR 4 weeks apart before progression (and not qualifying for a CR), Stable Disease (SD)=at least one SD assessment \>6 weeks after start of treatment and Progressive Disease (PD)=Progression or death due to underlying cancer ≤16 weeks after start of treatment. PD without radiologic evidence were classified as progression only, when clear evidence of clinical deterioration was available and patient discontinued due to disease progression. Unknown (UNK) = all other cases.

Secondary

MeasureTime frameDescription
Objective Tumor Response Rates (Complete Response and Partial Response) at Week 16 (ITT)Baseline up to approximately 16 weeksThe best overall response is the best response recorded from the start of the treatment until disease progression/recurrence (taking as reference for PD the smallest measurements recorded since the treatment started). In general, the patient's best response assignment will depend on the achievement of both measurement and confirmation criteria. Best lesion response was defined by (Resist Criteria V1 for target and non-target lesions).
Percentage of Participants With Duration of Response (CR, PR, SD) at 16 Weeks.Baseline up to 16 weeksDuration of response (CR, PR or SD) applied only to those patients whose best overall response was CR, PR or SD based on local radiologic assessments and was defined as the time from start of treatment to progression or death from underlying disease. Patients not experiencing progression or death at 16 weeks were censored with the date of their last tumor assessment. Duration of response was explored using the Kaplan-Meier method.
Percentage of Participants With Progression-free Survival (PFS) at 16 Weeks16 weeksProgression-free Survival (PFS) was defined as the time from the date of start of treatment to the date of event defined as the first documented progression or death from any cause. If a patient had not had an event, PFS was censored at the date of the last adequate tumor assessment at week 16
Time to Progression (TTP) (ITT)Baseline up to 16 weeksTime to progression (TTP) was defined as the time from the date of start of treatment to the date of event defined as the first documented progression or death from underlying disease. If a patient had not had an event, TTP was censored at the date of the last adequate tumor assessment, which was the date of Visit 6 (Week 16) for the core phase and the last available tumor assessment for the follow-up phase. TTP was explored by using the Kaplan-Meier method.
Percentage of Participants With Overall Survival (OS) at Week 16 (ITT)Baseline up to 16 weeksOverall survival (OS) was defined as the time from the date of start of treatment to death from any cause. If a patient was not known to have died (was alive), OS was censored at the date of the last contact, which was the date of Visit 6 (Week 16) for the core phase and the last available visit for the follow-up phase. OS was explored by using the Kaplan-Meier method. One death occurred in Arm 3 after Week 16.

Countries

Germany, Italy

Participant flow

Pre-assignment details

Seventy-four patients were screened and seventy-one enrolled.

Participants by arm

ArmCount
Arm 1
Progressive or metastatic bone or soft tissue sarcomas
37
Arm 2
Progressive gastrointestinal stromal tumors (GIST) after failure of prior imatinib and sunitinib 1st and 2nd line
24
Arm 3
Progressive or metastatic alveolar soft part sarcoma (ASPS)
10
Total71

Withdrawals & dropouts

PeriodReasonFG000FG001FG002
Overall StudyAbnormal lab values100
Overall StudyAdministrative problems010
Overall StudyAdverse Event200
Overall StudyDeath230
Overall StudyLost to Follow-up100
Overall StudyUnsatisfactory therapeutic effect18140
Overall StudyWithdrawal by Subject110

Baseline characteristics

CharacteristicArm 1Arm 2Arm 3Total
Age, Customized
< 65 years
31 Participants14 Participants9 Participants54 Participants
Age, Customized
>= 65 years
6 Participants10 Participants1 Participants17 Participants
Race/Ethnicity, Customized
Black
1 Participants0 Participants0 Participants1 Participants
Race/Ethnicity, Customized
Caucasian
36 Participants24 Participants10 Participants70 Participants
Sex: Female, Male
Female
14 Participants11 Participants6 Participants31 Participants
Sex: Female, Male
Male
23 Participants13 Participants4 Participants40 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
deaths
Total, all-cause mortality
8 / 374 / 241 / 10
other
Total, other adverse events
35 / 3721 / 2410 / 10
serious
Total, serious adverse events
15 / 3714 / 248 / 10

Outcome results

Primary

Best Overall Response Rates by Week 16 (ITT)

The best overall response is the best response recorded from treatment start until disease progression/recurrence (both measurement and confirmation criteria). Best lesion response was defined by (Resist Criteria V1 for target and non-target lesions): Complete Response (CR)=at least two determinations of CR 4 weeks apart before progression, Partial Response (PR)=at least two determinations of CR 4 weeks apart before progression (and not qualifying for a CR), Stable Disease (SD)=at least one SD assessment \>6 weeks after start of treatment and Progressive Disease (PD)=Progression or death due to underlying cancer ≤16 weeks after start of treatment. PD without radiologic evidence were classified as progression only, when clear evidence of clinical deterioration was available and patient discontinued due to disease progression. Unknown (UNK) = all other cases.

Time frame: Baseline up to 16 weeks

ArmMeasureGroupValue (NUMBER)
Arm 1Best Overall Response Rates by Week 16 (ITT)Progressive Disease51.4 percentage of participants
Arm 1Best Overall Response Rates by Week 16 (ITT)Stable Disease40.5 percentage of participants
Arm 1Best Overall Response Rates by Week 16 (ITT)Complete Response0 percentage of participants
Arm 1Best Overall Response Rates by Week 16 (ITT)Partial Response0 percentage of participants
Arm 1Best Overall Response Rates by Week 16 (ITT)Unknown8.1 percentage of participants
Arm 2Best Overall Response Rates by Week 16 (ITT)Stable Disease33.3 percentage of participants
Arm 2Best Overall Response Rates by Week 16 (ITT)Complete Response0 percentage of participants
Arm 2Best Overall Response Rates by Week 16 (ITT)Partial Response0 percentage of participants
Arm 2Best Overall Response Rates by Week 16 (ITT)Progressive Disease62.5 percentage of participants
Arm 2Best Overall Response Rates by Week 16 (ITT)Unknown4.2 percentage of participants
Arm 3Best Overall Response Rates by Week 16 (ITT)Unknown0 percentage of participants
Arm 3Best Overall Response Rates by Week 16 (ITT)Progressive Disease0 percentage of participants
Arm 3Best Overall Response Rates by Week 16 (ITT)Complete Response0 percentage of participants
Arm 3Best Overall Response Rates by Week 16 (ITT)Stable Disease100.0 percentage of participants
Arm 3Best Overall Response Rates by Week 16 (ITT)Partial Response0 percentage of participants
p-value: 0.180% CI: [29.5, 52.4]Clopper-Person confidence interval
Secondary

Objective Tumor Response Rates (Complete Response and Partial Response) at Week 16 (ITT)

The best overall response is the best response recorded from the start of the treatment until disease progression/recurrence (taking as reference for PD the smallest measurements recorded since the treatment started). In general, the patient's best response assignment will depend on the achievement of both measurement and confirmation criteria. Best lesion response was defined by (Resist Criteria V1 for target and non-target lesions).

Time frame: Baseline up to approximately 16 weeks

ArmMeasureGroupValue (NUMBER)
Arm 1Objective Tumor Response Rates (Complete Response and Partial Response) at Week 16 (ITT)Complete response0 percentage of participants
Arm 1Objective Tumor Response Rates (Complete Response and Partial Response) at Week 16 (ITT)Partial response0 percentage of participants
Arm 2Objective Tumor Response Rates (Complete Response and Partial Response) at Week 16 (ITT)Complete response0 percentage of participants
Arm 2Objective Tumor Response Rates (Complete Response and Partial Response) at Week 16 (ITT)Partial response0 percentage of participants
Arm 3Objective Tumor Response Rates (Complete Response and Partial Response) at Week 16 (ITT)Complete response0 percentage of participants
Arm 3Objective Tumor Response Rates (Complete Response and Partial Response) at Week 16 (ITT)Partial response0 percentage of participants
Secondary

Percentage of Participants With Duration of Response (CR, PR, SD) at 16 Weeks.

Duration of response (CR, PR or SD) applied only to those patients whose best overall response was CR, PR or SD based on local radiologic assessments and was defined as the time from start of treatment to progression or death from underlying disease. Patients not experiencing progression or death at 16 weeks were censored with the date of their last tumor assessment. Duration of response was explored using the Kaplan-Meier method.

Time frame: Baseline up to 16 weeks

ArmMeasureValue (NUMBER)
Arm 1Percentage of Participants With Duration of Response (CR, PR, SD) at 16 Weeks.60 percentage of participants
Arm 2Percentage of Participants With Duration of Response (CR, PR, SD) at 16 Weeks.62.5 percentage of participants
Arm 3Percentage of Participants With Duration of Response (CR, PR, SD) at 16 Weeks.100 percentage of participants
Secondary

Percentage of Participants With Overall Survival (OS) at Week 16 (ITT)

Overall survival (OS) was defined as the time from the date of start of treatment to death from any cause. If a patient was not known to have died (was alive), OS was censored at the date of the last contact, which was the date of Visit 6 (Week 16) for the core phase and the last available visit for the follow-up phase. OS was explored by using the Kaplan-Meier method. One death occurred in Arm 3 after Week 16.

Time frame: Baseline up to 16 weeks

ArmMeasureValue (NUMBER)
Arm 1Percentage of Participants With Overall Survival (OS) at Week 16 (ITT)68.8 percentage of participants
Arm 2Percentage of Participants With Overall Survival (OS) at Week 16 (ITT)56.9 percentage of participants
Arm 3Percentage of Participants With Overall Survival (OS) at Week 16 (ITT)100.0 percentage of participants
Secondary

Percentage of Participants With Progression-free Survival (PFS) at 16 Weeks

Progression-free Survival (PFS) was defined as the time from the date of start of treatment to the date of event defined as the first documented progression or death from any cause. If a patient had not had an event, PFS was censored at the date of the last adequate tumor assessment at week 16

Time frame: 16 weeks

ArmMeasureValue (NUMBER)
Arm 1Percentage of Participants With Progression-free Survival (PFS) at 16 Weeks35.1 percentage of participants
Arm 2Percentage of Participants With Progression-free Survival (PFS) at 16 Weeks30.5 percentage of participants
Arm 3Percentage of Participants With Progression-free Survival (PFS) at 16 Weeks100.0 percentage of participants
Secondary

Time to Progression (TTP) (ITT)

Time to progression (TTP) was defined as the time from the date of start of treatment to the date of event defined as the first documented progression or death from underlying disease. If a patient had not had an event, TTP was censored at the date of the last adequate tumor assessment, which was the date of Visit 6 (Week 16) for the core phase and the last available tumor assessment for the follow-up phase. TTP was explored by using the Kaplan-Meier method.

Time frame: Baseline up to 16 weeks

ArmMeasureValue (MEDIAN)
Arm 1Time to Progression (TTP) (ITT)57 days
Arm 2Time to Progression (TTP) (ITT)57 days
Arm 3Time to Progression (TTP) (ITT)499 days

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026