Metastatic Sarcoma
Conditions
Keywords
Metastatic Sarcoma, Unresectable Sarcoma, PM01183
Brief summary
This research study is investigating a drug called PM01183 alone and in combination with chemotherapy drugs called gemcitabine or doxorubicin as a possible treatment for metastatic or unresectable Sarcoma.
Detailed description
This research study is a Phase II clinical trial. Phase II clinical trials test the safety and effectiveness of an investigational intervention to learn whether the intervention works in treating a specific disease. Investigational means that the intervention is being studied. PM01183 is a new drug that is believed to bind DNA cause double strands of DNA to break. This drug has been studied in previous research studies, and these suggest that it may slow or stop the growth of cancers. The FDA (the U.S. Food and Drug Administration) has not approved PM01183 as a treatment for any disease. In this research study, the investigators are trying to assess the effects, good or bad, that PM01183, administered either alone or in combination with gemcitabine or doxorubicin has on metastatic or unresectable sarcoma.
Interventions
Sponsors
Dana-Farber Cancer Institute
PharmaMar
Massachusetts General Hospital
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Participants must have pathologically confirmed soft-tissue sarcoma, which is metastatic or unresectable, sarcoma with no curative multimodality options * Participants must have measurable disease by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1. * No more than two prior lines of chemotherapy for metastatic sarcoma are allowed; Neo-adjuvant/adjuvant chemotherapy with definitive therapy (radiation, surgery or radiation and surgery) will not be counted as one of these prior lines of therapy. * Age ≥ 18 and ≤ 75 years. * Eastern Cooperative Oncology Group performance status ≤1 (see Appendix A) * Life expectancy of greater than 3 months * Participants must have normal organ and marrow function as defined below: * Hemoglobin ≥ 9 g/dl * absolute neutrophil count ≥ 1,500/mcL * platelets ≥ 100,000/mcL * total bilirubin ≤ 1.5 X ULN * AST(SGOT)/ALT(SGPT) ≤3 X ULN (including patients with liver metastases) * creatinine ≤1.5 X ULN * CPK \< 2.5 X ULN * Albumin ≥ 3 g/dl * Women of childbearing potential must have a negative serum or urine pregnancy test within 7 days prior to receiving study agents. * For patients in stratum A, an echocardiogram or multiple gated acquisition scan (MUGA) demonstrating left ventricular ejection fraction \> 50% is required within 30 days prior to study drug administration. * Participants must be willing and able to comply with the study scheduled visits, laboratory tests, and other procedures outlined in the protocol. * Pre-menopausal women must have a negative pregnancy test before study entry. Both women and men must agree to use a medically acceptable method of contraception throughout the treatment period and for at least six weeks after treatment discontinuation. Acceptable methods of contraception include intrauterine device (IUD), oral contraceptive, subdermal implant, double barrier and/or complete abstinence (non-periodic). * Washout period prior to Day 1 Cycle 1: * ≥ 3 weeks since last chemotherapy or therapeutic radiation therapy (RT) * ≥ 4 weeks or 3 half-lives since prior antibody-based therapy, whichever is shorter * ≥ 2 weeks since any oral anti-neoplastic or oral investigational agent * Resolution of treatment-related toxicity to ≤ grade 1; alopecia and cutaneous toxicity are allowed ≤ grade 2. * ≥1 week since palliative RT * Ability to understand and the willingness to sign a written informed consent document.
Exclusion criteria
* Prior exposure to PM01183 * Patients who have received trabectedin (Yondelis, ET-743) or participated in the phase III clinical study of trabectedin NCT01343277 previously will not be eligible. * For stratum A, patients must not have received prior anthracycline-based therapy (prior treatment with non-anthracyclines is permitted). * For stratum B patients must have received prior anthracycline-based therapy (or have a contraindication to receiving this treatment) and must not have received prior gemcitabine * For stratum C, patients must have received prior anthracycline or gemcitabine-based therapy, or had a contraindication to either or both * Prior radiation treatment of \>45 Gy to the pelvis * Previously untreated Ewing Sarcoma and rhabdomyosarcoma * Non-soft tissue sarcomas, such as osteosarcoma and chondrosarcoma are excluded * Participants who are receiving any other investigational agents. * Active hepatopathy of any origin including active hepatitis B and hepatitis C * Participants with known uncontrolled brain metastases will be excluded from this clinical. * History of allergic reactions attributed to compounds of similar chemical or biologic composition to PM01183 or trabectedin (Yondelis, ET-743). * Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, chronic indwelling drains, history of interstitial pneumonitis or pulmonary fibrosis or psychiatric illness/social situations that would limit compliance with study requirements. * Actively breastfeeding women unless it is interrupted during treatment and at least 6 weeks after treatment discontinuation. * Known myopathy or persistent CPK elevations \>2.5 ULN in two different determinations performed one week apart. * Immunocompromised patients, including those with HIV.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Disease Control Rate | 24 Weeks | The number of participants that achieved either Stable Disease (SD) or a Partial Response (PR) as assessed by Response Evaluation Criteria in Solid Tumors (RECIST v1.1) at 24 weeks. * Partial Response (PR): At least a 30% decrease in the sum of the diameters of target lesions, taking as reference the baseline sum diameters. * Stable Disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Overall Response Rate | Every 6 weeks for the first 8 cycles (cycle is 21 days) and then every 9 weeks thereafter until disease progression | The overall response rate is the number of participants that achieved either Stable Disease (SD), a Partial Response (PR), or a Complete Response (CR) as assessed by Response Evaluation Criteria in Solid Tumors (RECIST v1.1). The overall response rate is the best response recorded from the start of treatment until disease progression/recurrence. * Complete Response (CR): Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \<10 mm. * Partial Response (PR): At least a 30% decrease in the sum of the diameters of target lesions, taking as reference the baseline sum diameters. * Stable Disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study. |
| Treatment Related Serious Adverse Events | From the start of treatment until 30 days after the end of treatment | Summary of the serious adverse events (SAE) experienced by participants that were deemed to be at least possibly related to PM01183 when administered alone or with Doxorubicin or Gemcitabine. Adverse events were assessed using Common Terminology Criteria for Adverse Events (CTCAE v4). |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| PM01183 and Doxorubicin Anthracycline-naïve patients will receive combination of PM01183 and Doxorubicin per cycle.
* PM01183 predetermined dose daily via IV per cycle
* Doxorubicin predetermined dose daily via IV per cycle
PM01183
Doxorubicin | 20 |
| PM01183 and Gemcitabine Prior anthracycline exposure and without prior gemcitabine exposure
* PM01183 predetermined dose given twice via IV per cycle
* Gemcitabine predetermined dose given twice via IV per cycle
PM01183
Gemcitabine | 10 |
| Single Agent PM01183 Patients who have received at least both prior anthracycline and prior gemcitabine
-PM01183 predetermined dose once via IV per cycle
PM01183 | 12 |
| Total | 42 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 |
|---|---|---|---|---|
| Overall Study | Withdrawal by Subject | 1 | 1 | 1 |
Baseline characteristics
| Characteristic | Total | Single Agent PM01183 | PM01183 and Gemcitabine | PM01183 and Doxorubicin |
|---|---|---|---|---|
| Age, Continuous | 51.9 years | 55.3 years | 44.2 years | 52.6 years |
| Ethnicity (NIH/OMB) Hispanic or Latino | 3 Participants | 0 Participants | 1 Participants | 2 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 37 Participants | 11 Participants | 8 Participants | 18 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 2 Participants | 1 Participants | 1 Participants | 0 Participants |
| Race/Ethnicity, Customized Asian | 1 Participants | 0 Participants | 0 Participants | 1 Participants |
| Race/Ethnicity, Customized Black or African-American | 3 Participants | 0 Participants | 1 Participants | 2 Participants |
| Race/Ethnicity, Customized More Than One Race | 3 Participants | 0 Participants | 1 Participants | 2 Participants |
| Race/Ethnicity, Customized Other | 2 Participants | 1 Participants | 1 Participants | 0 Participants |
| Race/Ethnicity, Customized White | 33 Participants | 11 Participants | 7 Participants | 15 Participants |
| Region of Enrollment United States | 42 participants | 12 participants | 10 participants | 20 participants |
| Sex: Female, Male Female | 26 Participants | 7 Participants | 6 Participants | 13 Participants |
| Sex: Female, Male Male | 16 Participants | 5 Participants | 4 Participants | 7 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 20 | 0 / 10 | 0 / 12 |
| other Total, other adverse events | 20 / 20 | 10 / 10 | 11 / 12 |
| serious Total, serious adverse events | 6 / 20 | 6 / 10 | 4 / 12 |
Outcome results
Primary
Disease Control Rate
The number of participants that achieved either Stable Disease (SD) or a Partial Response (PR) as assessed by Response Evaluation Criteria in Solid Tumors (RECIST v1.1) at 24 weeks. * Partial Response (PR): At least a 30% decrease in the sum of the diameters of target lesions, taking as reference the baseline sum diameters. * Stable Disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study.
Time frame: 24 Weeks
Population: Two participants (one from the PM01183 and Doxorubicin arm and one from the PM01183 alone arm) were not able to be evaluated for response.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| PM01183 and Doxorubicin | Disease Control Rate | 13 Participants |
| PM01183 and Gemcitabine | Disease Control Rate | 2 Participants |
| Single Agent PM01183 | Disease Control Rate | 3 Participants |
Secondary
Overall Response Rate
The overall response rate is the number of participants that achieved either Stable Disease (SD), a Partial Response (PR), or a Complete Response (CR) as assessed by Response Evaluation Criteria in Solid Tumors (RECIST v1.1). The overall response rate is the best response recorded from the start of treatment until disease progression/recurrence. * Complete Response (CR): Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \<10 mm. * Partial Response (PR): At least a 30% decrease in the sum of the diameters of target lesions, taking as reference the baseline sum diameters. * Stable Disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study.
Time frame: Every 6 weeks for the first 8 cycles (cycle is 21 days) and then every 9 weeks thereafter until disease progression
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| PM01183 and Doxorubicin | Overall Response Rate | Partial Response | 7 Participants |
| PM01183 and Doxorubicin | Overall Response Rate | Unknown | 1 Participants |
| PM01183 and Doxorubicin | Overall Response Rate | Complete Response | 0 Participants |
| PM01183 and Doxorubicin | Overall Response Rate | Stable Disease | 6 Participants |
| PM01183 and Gemcitabine | Overall Response Rate | Unknown | 0 Participants |
| PM01183 and Gemcitabine | Overall Response Rate | Stable Disease | 1 Participants |
| PM01183 and Gemcitabine | Overall Response Rate | Partial Response | 1 Participants |
| PM01183 and Gemcitabine | Overall Response Rate | Complete Response | 0 Participants |
| Single Agent PM01183 | Overall Response Rate | Unknown | 1 Participants |
| Single Agent PM01183 | Overall Response Rate | Complete Response | 0 Participants |
| Single Agent PM01183 | Overall Response Rate | Partial Response | 0 Participants |
| Single Agent PM01183 | Overall Response Rate | Stable Disease | 3 Participants |
Secondary
Treatment Related Serious Adverse Events
Summary of the serious adverse events (SAE) experienced by participants that were deemed to be at least possibly related to PM01183 when administered alone or with Doxorubicin or Gemcitabine. Adverse events were assessed using Common Terminology Criteria for Adverse Events (CTCAE v4).
Time frame: From the start of treatment until 30 days after the end of treatment
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| PM01183 and Doxorubicin | Treatment Related Serious Adverse Events | Diarrhea | 1 participants |
| PM01183 and Doxorubicin | Treatment Related Serious Adverse Events | Febrile neutropenia | 1 participants |
| PM01183 and Doxorubicin | Treatment Related Serious Adverse Events | Lymphocyte count decreased | 2 participants |
| PM01183 and Doxorubicin | Treatment Related Serious Adverse Events | Nausea | 1 participants |
| PM01183 and Doxorubicin | Treatment Related Serious Adverse Events | Neutrophil count decreased | 4 participants |
| PM01183 and Doxorubicin | Treatment Related Serious Adverse Events | Platelet count decreased | 1 participants |
| PM01183 and Doxorubicin | Treatment Related Serious Adverse Events | Port Infection | 0 participants |
| PM01183 and Doxorubicin | Treatment Related Serious Adverse Events | Vomiting | 1 participants |
| PM01183 and Doxorubicin | Treatment Related Serious Adverse Events | White blood cell decreased | 3 participants |
| PM01183 and Doxorubicin | Treatment Related Serious Adverse Events | Any Treatment Related SAE | 4 participants |
| PM01183 and Gemcitabine | Treatment Related Serious Adverse Events | White blood cell decreased | 1 participants |
| PM01183 and Gemcitabine | Treatment Related Serious Adverse Events | Diarrhea | 0 participants |
| PM01183 and Gemcitabine | Treatment Related Serious Adverse Events | Platelet count decreased | 1 participants |
| PM01183 and Gemcitabine | Treatment Related Serious Adverse Events | Neutrophil count decreased | 4 participants |
| PM01183 and Gemcitabine | Treatment Related Serious Adverse Events | Febrile neutropenia | 1 participants |
| PM01183 and Gemcitabine | Treatment Related Serious Adverse Events | Any Treatment Related SAE | 5 participants |
| PM01183 and Gemcitabine | Treatment Related Serious Adverse Events | Vomiting | 0 participants |
| PM01183 and Gemcitabine | Treatment Related Serious Adverse Events | Lymphocyte count decreased | 1 participants |
| PM01183 and Gemcitabine | Treatment Related Serious Adverse Events | Port Infection | 1 participants |
| PM01183 and Gemcitabine | Treatment Related Serious Adverse Events | Nausea | 0 participants |
| Single Agent PM01183 | Treatment Related Serious Adverse Events | Vomiting | 1 participants |
| Single Agent PM01183 | Treatment Related Serious Adverse Events | Nausea | 1 participants |
| Single Agent PM01183 | Treatment Related Serious Adverse Events | Neutrophil count decreased | 1 participants |
| Single Agent PM01183 | Treatment Related Serious Adverse Events | Platelet count decreased | 0 participants |
| Single Agent PM01183 | Treatment Related Serious Adverse Events | White blood cell decreased | 0 participants |
| Single Agent PM01183 | Treatment Related Serious Adverse Events | Port Infection | 0 participants |
| Single Agent PM01183 | Treatment Related Serious Adverse Events | Diarrhea | 1 participants |
| Single Agent PM01183 | Treatment Related Serious Adverse Events | Any Treatment Related SAE | 2 participants |
| Single Agent PM01183 | Treatment Related Serious Adverse Events | Febrile neutropenia | 0 participants |
| Single Agent PM01183 | Treatment Related Serious Adverse Events | Lymphocyte count decreased | 0 participants |