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A Trial of TH-302 in Combination With Doxorubicin Versus Doxorubicin Alone to Treat Patients With Locally Advanced Unresectable or Metastatic Soft Tissue Sarcoma

Phase 3
Completed
Conditions
Soft Tissue Sarcoma
Interventions
Registration Number
NCT01440088
Lead Sponsor
Threshold Pharmaceuticals
Brief Summary

The purpose of this study is to determine whether TH-302 in combination with Doxorubicin is safe and effective in the treatment of Locally Advanced Unresectable or Metastatic Soft Tissue Sarcoma.

Detailed Description

TH-302 is designed to target the hypoxic regions of tumors which are generally located distant from tumor vessels. Doxorubicin has poor tissue penetration and targets the regions of tumors that are located in proximity to the tumor vessels. The presence of hypoxia in solid tumors is associated with a more malignant phenotype and resistance to chemotherapy. The hypoxia-activated prodrug, TH-302, is designed to selectively target the hypoxic microenvironment. Soft tissue sarcomas have evidence supporting the presence of hypoxia based on pO2 histography, F-MISO and gene expression profiling. There is an absence of therapeutic options for subjects with soft tissue sarcoma. Combining doxorubicin with TH-302 may enable the targeting of both the normoxic and hypoxic regions of soft tissue sarcoma.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
640
Inclusion Criteria
  • Male or female ≥ 15 years of age

  • Ability to understand the purposes and risks of the study and has signed or, if appropriate, the subject's parent or legal guardian has signed a written informed consent form approved by the investigator's IRB/Ethics Committee

  • Pathologically confirmed diagnosis of soft tissue sarcoma of the following histopathologic types:

    • Synovial sarcoma
    • High grade fibrosarcoma
    • Undifferentiated sarcoma; sarcoma not otherwise specified (NOS)
    • Liposarcoma
    • Leiomyosarcoma (excluding GIST)
    • Angiosarcoma (excluding Kaposi's sarcoma)
    • Malignant peripheral nerve sheath tumor
    • Pleomorphic Rhabdomyosarcoma
    • Myxofibrosarcoma
    • Epithelioid sarcoma
    • Undifferentiated pleomorphic sarcoma/malignant fibrous histiocytoma (MFH) (including pleomorphic, giant cell, myxoid and inflammatory forms)
  • Locally advanced unresectable or metastatic disease with no standard curative therapy available and for whom treatment with single agent doxorubicin is considered appropriate.

  • Recovered from reversible toxicities of prior therapy

  • Measurable disease by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1

  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1

  • Life expectancy of at least 3 months

  • Acceptable liver, renal, hematological and cardiac function

  • All women of childbearing potential must have a negative serum pregnancy test and all subjects must agree to use effective means of contraception

Exclusion Criteria
  • Prior systemic therapy for advanced or metastatic disease (neoadjuvant therapy followed by surgical resection and adjuvant therapy permitted). Palliative radiotherapy to non-target lesions is allowed if completed at least two weeks prior to study entry
  • Low grade tumors according to standard grading systems
  • Prior therapy with ifosfamide or cyclophosphamide or other nitrogen mustards
  • Prior therapy with an anthracycline or anthracenedione
  • Prior mediastinal/cardiac radiotherapy
  • Current use of drugs with known cardiotoxicity or known interactions with doxorubicin
  • Anti-cancer treatment with radiation therapy, neoadjuvant or adjuvant chemotherapy, targeted therapies, immunotherapy, hormones or other antitumor therapies within 4 weeks prior to study entry (6 weeks for nitrosoureas or mitomycin C). Palliative radiotherapy to non-target lesions is allowed, is completed at least two weeks prior to study entry.
  • Significant cardiac dysfunction precluding treatment with doxorubicin
  • Seizure disorders requiring anticonvulsant therapy unless seizure-free for the last year
  • Known brain metastases (unless previously treated and well controlled for a period of ≥ 3 months)
  • Previously treated malignancies, except for adequately treated non-melanoma skin cancer, in situ cancer, or other cancer from which the subject has been disease-free for at least 5 years
  • Severe chronic obstructive or other pulmonary disease with hypoxemia or in the opinion of the investigator any physiological state likely to cause normal tissue hypoxia
  • Major surgery, other than diagnostic surgery, within 4 weeks prior to Day 1, without complete recovery
  • Active, uncontrolled bacterial, viral, or fungal infections, requiring systemic therapy
  • Prior therapy with a hypoxic cytotoxin
  • Subjects who participated in an investigational drug or device study within 28 days prior to study entry
  • Known infection with HIV, hepatitis B, or hepatitis C
  • Subjects who have exhibited allergic reactions to a structural compound similar to TH-302,doxorubicin or their excipients
  • Females who are pregnant or breast-feeding
  • Concomitant disease or condition that could interfere with the conduct of the study, or that would, in the opinion of the investigator, pose an unacceptable risk to the subject in this study
  • Unwillingness or inability to comply with the study protocol for any reason

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
TH-302 in Combination with DoxorubicinTH-302 in Combination with Doxorubicin-
DoxorubicinDoxorubicin-
Primary Outcome Measures
NameTimeMethod
Efficacy of TH-302 in combination with doxorubicin2 years

Efficacy will be determined by overall survival in subjects with locally advanced unresectable or metastatic soft tissue sarcoma previously untreated with chemotherapy compared with doxorubicin alone

Secondary Outcome Measures
NameTimeMethod
Safety of TH-302 in combination with doxorubicin in subjects with locally advanced unresectable or metastatic soft tissue sarcoma compared with doxorubicin alone2 years

To investigate the pharmacokinetics of TH-302, Br-IPM, doxorubicin, and doxorubicinol in plasma

Trial Locations

Locations (92)

Oncology Specialists

🇺🇸

Park Ridge, Illinois, United States

Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Hospital

🇺🇸

Baltimore, Maryland, United States

Mayo Arizona

🇺🇸

Scottsdale, Arizona, United States

USC-Norris Comprehensive Cancer Center

🇺🇸

Los Angeles, California, United States

Sarcoma Oncology Center

🇺🇸

Santa Monica, California, United States

Columbia University Medical Center

🇺🇸

NY, New York, United States

University of Pittsburg Medical Center

🇺🇸

Pittsburg, Pennsylvania, United States

Duke University Medical Center

🇺🇸

Durham, North Carolina, United States

Wake Forest University Baptist Medical Center

🇺🇸

Winston Salem, North Carolina, United States

The Arthur G. James Cancer Hospital and Richard J Solove Research Institue, The Ohio State University Comprehensive Cancer Center

🇺🇸

Columbus, Ohio, United States

Georgetown University Hospital

🇺🇸

Washington, District of Columbia, United States

Cancer Care Manitoba

🇨🇦

Winnipeg, Canada

Pennsylvania Oncology Hematology Associates

🇺🇸

Philadelphia, Pennsylvania, United States

Dana Farber Cancer Institute Center for Sarcoma and Bone Oncology

🇺🇸

Boston, Massachusetts, United States

Carolinas Hematology-oncology Associates-Blumenthal Cancer Center

🇺🇸

Charlotte, North Carolina, United States

Juravinski Cancer Centre at Hamilton Health Sciences - Department of Medicine

🇨🇦

Hamilton, Ontario, Canada

Hospital de la Santa Creu i Sant Pau

🇪🇸

Barcelona, Spain

Krankenhaus Nordwest GmbH

🇩🇪

Frankfurt, Germany

South Florida Center for Gynecologic Oncology

🇺🇸

Boca Raton, Florida, United States

Winship Cancer Institute of Emory University, Midtown Campus

🇺🇸

Atlanta, Georgia, United States

Washington University School of Medicine

🇺🇸

St. Louis, Missouri, United States

Mayo Clinic-Florida-Cancer Clinical Studies Unit

🇺🇸

Jacksonville, Florida, United States

BCCA- Vancouver Cancer Centre - Division of Medical Oncology

🇨🇦

Vancouver, Canada

HELIOS Klinikum Berlin-Buch

🇩🇪

Berlin, Germany

Stanford Comprehensive Cancer Center

🇺🇸

Stanford, California, United States

Roswell Park Cancer Institute

🇺🇸

Buffalo, New York, United States

Virginia Commonwealth Universtiy-Massey Cancer Center

🇺🇸

Richmond, Virginia, United States

University Klinikum Graz

🇦🇹

Graz, Austria

Northwestern University

🇺🇸

Chicago, Illinois, United States

Département d'Oncologie Moléculaire, Institut Paoli-Calmettes (IPC) and U119 Inserm

🇫🇷

Marseille, France

Cleveland Clinic Foundation

🇺🇸

Cleveland, Ohio, United States

Centre Antoine Lacassagne

🇫🇷

Nice, France

University of Iowa Health Care - University of Iowa Hospital

🇺🇸

Iowa City, Iowa, United States

Mayo Rochester

🇺🇸

Rochester, Minnesota, United States

Ottawa Health Research Institue

🇨🇦

Ottawa, Canada

Fox Chase Cancer Center

🇺🇸

Philadelphia, Pennsylvania, United States

Departement d'Oncologie Medicale

🇫🇷

Dijon, France

University of Washington Cancer Center

🇺🇸

Seattle, Washington, United States

CHU Strasbourg

🇫🇷

Strasbourg, France

Centre Leon Berard

🇫🇷

Lyon, France

Cross Cancer Institute

🇨🇦

Edmonton, Canada

Wilhelm's University, Universitatsklinikum Muenster, Medizinische Klinik und Poliklinik A, Albert-Schweitzer-Campus 1

🇩🇪

Munster, Germany

Universitätsklinikum Essen

🇩🇪

Essen, Germany

Sharette Institute of Oncology, Hadassah-Hebrew University Medical Center, Hadassah Medical Org-Ein Karem

🇮🇱

Kiryat Hadassah, Jerusalem, Israel

ROTSN RAMS them. Н.Н.Блохина NN Blokhin

🇷🇺

Moscow, Russian Federation

Div. of Surgical Oncology & Thoracic Surgery, Mannheim University Medical Center

🇩🇪

Mannheim, Germany

Centrum Onkologii Instytut im M. Sklodowskiej-Curie

🇵🇱

Krakow, Poland

Hospital Universitario Ramón y Cajal.

🇪🇸

Madrid, Spain

GUZ "Regional Oncology Dispensay", Kazan

🇷🇺

Kazan, Russian Federation

H.U. Canarias, Hospital Universitario de Canarias. Servicio de Oncología Médica

🇪🇸

Tenerife, Canarias, Spain

Indiana University Simon Cancer Center

🇺🇸

Indianapolis, Indiana, United States

Allgemeines Krankenhaus Wien

🇦🇹

Wien, Austria

Magyar Honvedseg Honvedkorhaz, Onkologiai Osztaly

🇭🇺

Budapest, Hungary

Centrum Onkologii-Instytut im. M. Sklodowskiej-Curie

🇵🇱

Warszawa, Poland

Fondazione del Piemonte per l'Oncologia, Instituto per la Ricerca e la Cura del cancro (I.R.C.C.), Dipartimento Oncologico, Direzione Operativa Oncologia Medica a Direzione Universitaria

🇮🇹

Candiolo, Torino, Italy

Centro di Riferimento Oncologico (CRO)

🇮🇹

Aviano, Italy

Azienda Ospedaliera Garibaldi

🇮🇹

Catania, Italy

Azienda Ospedaliero Universitaria-Policlinico Paolo Giacco

🇮🇹

Palermo, Italy

ASL TO/2 di TORINO_Presidio Sanitario Gradenigo, S.C. di Oncologia

🇮🇹

Torino, Italy

University Hospital Herlev at Copenhagen

🇩🇰

Herlev, Copenhagen, Denmark

Washington Cancer Institute

🇺🇸

Washington, District of Columbia, United States

Rush University Medical Center

🇺🇸

Chicago, Illinois, United States

H.Lee Moffitt Cancer Center and Research Institute

🇺🇸

Tampa, Florida, United States

MD Anderson Cancer Center Orlando

🇺🇸

Orlando, Florida, United States

Kootenai Health - Kootenai Cancer Center

🇺🇸

Coeur d'Alene, Idaho, United States

Montefiore

🇺🇸

Bronx, New York, United States

University Hospitals Seidman Cancer Center

🇺🇸

Cleveland, Ohio, United States

Medical College of Wisconsin

🇺🇸

Milwaukee, Wisconsin, United States

Universitaire Ziekenhuizen (UZ) Leuven - Gasthuisberg

🇧🇪

Leuven, Belgium

Tom Baker Cancer Centre

🇨🇦

Calgary, Canada

Institut Bergonie

🇫🇷

Bordeaux, France

ICO Rene Gauducheau

🇫🇷

Saint Herblain Cedex, Nantes, France

Institut Claudius Regaud

🇫🇷

Toulouse Cedex, France

Jasz-Nagykun-Szolnok Megyei Hetenyi Geza Korhaz-Rendelointezet, Megyei Onkologiai Kozpont

🇭🇺

Szolnok, Hungary

Hospital Sant Joan de Deu, Department de Oncologia

🇪🇸

Barcelona, Spain

Universidad Complutense Madrid Facultad de Medicina - Hospital Universitario 12 de Octubre, Servicio de Oncologia Medica Hospital Universitario 12 de Octubre

🇪🇸

Madrid, Spain

Institut Catala d'Oncologia

🇪🇸

Barcelona, Spain

Medizinische Hochschule Hannover (MHH) - Klinik fuer Haemonstaseologie, Onkologie und Stammzelltransplantation

🇩🇪

Hannover, Germany

Helios Klinikum Bad Saarow, Department of Hematology, Oncology, and Palliative Care, Sarcoma Center Berlin-Brandenburg

🇩🇪

Berlin, Germany

Arizona Cancer Center

🇺🇸

Tucson, Arizona, United States

Memorial Sloan-Kettering Cancer Center

🇺🇸

New York, New York, United States

University of Michigan Cancer Center

🇺🇸

Ann Arbor, Michigan, United States

Oregon Health and Science University

🇺🇸

Portland, Oregon, United States

MUSC - Hollings Cancer Center

🇺🇸

Charleston, South Carolina, United States

University of California, Los Angeles

🇺🇸

Los Angeles, California, United States

Univ. Klinik fur Innere Medizin I Internistische Onkologie Medizinische Universitat Innsbruck

🇦🇹

Innsbruck, Austria

McGill University Health Centre

🇨🇦

Montreal, Quebec, Canada

IRCCS Centro di Riferimento Oncologico-Struttura Operativa

🇮🇹

Aviano, Pordenone, Italy

Wojewodzkie Centrum Onkologii

🇵🇱

Gdansk, Poland

University of Vermont

🇺🇸

Burlington, Vermont, United States

Vanderbilt-Ingram Cancer Center

🇺🇸

Nashville, Tennessee, United States

FGU Moscow Research Institute of Oncology named after P.A. Hertzen of Rosmedtechnology

🇷🇺

Moscow, Russian Federation

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