Phase II study of sorafenib in malignant mesothelioma previously treated with platinum-based chemotherapy - SMS

Phase 1

• Conditions: Malignant Mesothelioma; MedDRA version: 13.1Level: PTClassification code 10027407Term: Mesothelioma malignantSystem Organ Class: 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)

• Registration Number: EUCTR2007-005091-13-GB
• Lead Sponsor: Guy's & St Thomas' NHS Foundation Trust

Brief Summary

Not available

Detailed Description

Not available

Study Timeline

• Study Start: 2007-12-13
• Last Update Posted: 4 December 2018

Recruitment & Eligibility

• Status: ot Recruiting
• Sex: All
• Target Recruitment: 55

Inclusion Criteria

1) Malignant pleural or peritoneal mesothelioma previously treated with first line platinum-based chemotherapy (prior pemetrexed not required);

2) Not suitable for radical resection. Prior radical or cytoreductive surgery allowed;

3) Age >18 years;

4) ECOG performance status 0-2;

5) Measurable disease. Lesions must be measured by CT scan or MRI according to modified RECIST (Appendix B);

6) Life expectancy of at least 12 weeks;

7) Adequate bone marrow, liver and renal function as assessed by the following laboratory requirements to be conducted within 7 days prior to start of first dose:
a) haemoglobin = 9.0 g/dL
b) neutrophil count = 1.5 x109/L
c) platelet count = 100 x109/L
d) total bilirubin = 1.5 x upper limit of normal
e) ALT and AST = 2.5 x upper limit of normal (= 5 x upper limit of normal for patients with liver involvement)
f) alkaline phosphatase = 4 x upper limit of normal
g) PT-INR (international normalized ratio of PT) / PTT =1.5 x upper limit of normal;

8) Ability to understand and the willingness to sign a written informed consent. A signed informed consent must be obtained prior to performing any study specific procedures.

Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range

Exclusion Criteria

Excluded medical conditions:
1) History of cardiac disease: congestive heart failure > NYHA (New York Heart Association) class 2; active coronary artery disease (myocardial infarction more than 6 months prior to study entry is allowed); cardiac arrhythmias requiring anti-arrhythmic therapy (beta blockers or digoxin are permitted); or uncontrolled hypertension (defined as systolic blood pressure >150mmHg or diastolic pressure >90mmHg despite optimal medical management);

2) Impaired immunity or chronic infection including history of HIV (human immunodeficiency virus) infection or chronic hepatitis B or C;

3) Active clinically serious infections (> grade 2 NCI-CTCAE version 3.0);

4) Seizure disorder requiring medication (such as steroids or anti-epileptics);

5) Known brain metastasis. Patients with neurological symptoms should undergo a CT scan/MRI of the brain to exclude brain metastasis;

6) History of organ allograft;

7) Evidence or history of bleeding diathesis or coagulopathy;

8) Renal dialysis;

9) Cancer other than mesothelioma within 5 years prior to start of study treatment EXCEPT cervical carcinoma in situ, treated basal cell carcinoma, or superficial bladder tumours [Ta (noninvasive tumour), Tis (carcinoma in situ) & T1 (tumour invading lamina propria)];

10) Thrombotic or embolic events such as cerebrovascular accident including transient ischemic attacks within the past 6 months;

11) Pulmonary haemorrhage/bleeding event > CTCAE Grade 2 within 4 weeks of first dose of study drug;

12) Any other haemorrhage/bleeding event > CTCAE Grade 2 within 4 weeks of first dose of study drug;

13) Serious, non-healing wound, ulcer, or bone fracture;

14) Pregnant or breast-feeding patients. Women of childbearing potential must have a negative pregnancy test performed within 7 days of the start of treatment. Both men and women enrolled in this trial must use adequate birth control measures during the course of the trial. The definition of effective contraception will be based on the judgment of the principal investigator or a designated associate;

15) Substance abuse, medical, psychological or social conditions that may interfere with the patient’s participation in the study or evaluation of the study results;

16) Known or suspected allergy to the investigational agent or any agent given in association with this trial;

17) Any condition that is unstable or could jeopardise the safety of the patient and their compliance in the study;

18) Patients unable to swallow oral medications;

19) Any malabsorption condition.

Study & Design

• Study Type: Interventional clinical trial of medicinal product
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Main Objective: To determine the progression-free survival in patients with malignant mesothelioma receiving oral sorafenib 400mg BD daily.;Secondary Objective: i) To determine the response rate as assessed with CT scanning;<br>ii) To determine overall survival;<br>iii) To investigate the use of PET scanning as a predictor of outcome;<br>iv) To investigate any relationship between outcome and changes on treatment or levels at baseline of serum biomarkers of angiogenesis, and of serum mesothelin.<br>;Primary end point(s): The primary endpoint is the proportion of patients surviving progression-free at 24 weeks. <br>Secondary endpoints are: <br>i)partial response rate assessed using CT scan;<br>ii)disease control rate (partial response plus stable disease);<br>iii)median overall survival; <br>iv)change in FDG-PET avidity at 8 weeks compared with baseline;<br>v)baseline levels and changes in serum biomarkers of angiogenesis, including VEGF, and in mesothelin.<br>