An open-label, multi-center study to evaluate the efficacy of nilotinib in adult patients with gastrointestinal stromal tumors resistant to imatinib and sunitinib
- Conditions
- adult patients with unresectable or metastatic gastrointestinal stromal tumors showing progression of disease or intolerance to imatinib and/or sunitinibMedDRA version: 9.1Level: LLTClassification code 10051066Term: Gastrointestinal stromal tumour
- Registration Number
- EUCTR2008-000357-35-GB
- Lead Sponsor
- ovartis Pharma GmbH
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- ot Recruiting
- Sex
- All
- Target Recruitment
- Not specified
• Age = 18 years
• Histologically confirmed diagnosis of GIST that is unresectable and/or metastatic and therefore not amenable to surgery or combined modality with curative intent prior to or at Visit 1.
• Radiologically confirmed disease progression during imatinib therapy at a dose of at least 400 mg daily and/or radiologically confirmed disease progression during sunitinib therapy OR documented intolerance (defined above in population) to imatinib and/or sunitinib. (Patients with prior additional investigational treatment of GIST prior to study entry can be included).
• At least one measurable site of disease on CT/MRI as defined by RECIST criteria (see Protocol Post Text Supplement 3 for details). The scans should not be older than approximately 2-4 weeks. New scans are only required as baseline scans if they are older than approximately 2-4 weeks.
• WHO Performance Status of 0, 1 or 2.
• Patients should have the following laboratory values (= LLN (lower limit of normal) or corrected to within normal limits with supplements prior to the first dose of study medication):
- Potassium = LLN,
- Magnesium = LLN,
- Phosphorus = LLN,
Total calcium (corrected for serum albumin) = LLN.
• Patients must have normal organ, electrolyte, and marrow function as defined below:
- Absolute Neutrophil Count (ANC) = 1.5 x 109/L;
- Platelets = 100 x 109/L;
- ALT and AST = 2.5 x upper limit of normal (ULN) or = 5.0 x ULN if considered due to
tumour;
- Alkaline phosphatase = 2.5 x ULN unless considered due to tumour;
- Serum bilirubin = 1.5 x ULN; (if considered due to tumor = 2.5 x ULN)
- Serum lipase and amylase = 1.5 x ULN; (if considered due to tumour = 2.5 x ULN)
• Serum creatinine = 1.5 x ULN or 24-hour creatinine clearance = 50 ml/min (calculated creatinine clearance using Cockroft formula is acceptable).
• Ability to understand and willingness to sign a written informed consent.
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
• Prior treatment with nilotinib.
• Treatment with any cytotoxic and/or investigational cytotoxic drug = 4 weeks (6 weeks for nitrosurea or mitomycin C) prior to Visit 1.
• Prior or concomitant malignancies requiring active treatment other than GIST with the exception of previous or concomitant basal cell skin cancer, previous cervical carcinoma in situ.
• Impaired cardiac function at visit 1 any one of the following:
- LVEF < 45% or below the institutional LLN range (whichever is higher) as determined by echocardiogram or MUGA scans at Visit 1.
- Complete left bundle branch block.
- Use of a ventricular paced cardiac pacemaker.
- Congenital long QT syndrome or family history of long QT syndrome.
- History of or presence of significant ventricular or atrial tachyarrhythmias.
- Clinically significant resting bradycardia (< 50 beats per minute).
- QTc > 450 msec on screening ECG (using the QTcF formula). If QTc > 450 msec
and electrolytes are not within normal ranges, electrolytes should be corrected and
then the patient rescreened for QTc.
- Right bundle branch block plus left anterior hemiblock, bifascicular block.
- Myocardial infarction within 12 months prior to Visit 1.
- Other clinically significant heart disease (e.g., unstable angina, congestive heart
failure or uncontrolled hypertension).
• Patients with severe and/or uncontrolled concurrent medical disease that in the opinion of the investigator could cause unacceptable safety risks or compromise compliance with the protocol e.g. impairment of gastrointestinal (GI) function, or GI disease that may significantly alter the absorption of the study drugs, uncontrolled diabetes.
• Use of therapeutic coumarin derivatives (i.e. warfarin, acenoucumarol, phenprocoumon).
• Use of any medications that prolong the QT interval and CYP3A4 inhibitors if the
treatment cannot be either safely discontinued or switched to a different medication prior to starting study drug administration. Please see http://www.torsades.org/medicalpros/
drug-lists/printable-drug-list.cfm for a comprehensive list of agents that prolong the
QT interval as well as Post-Text Supplement 2.
• Patients who have undergone major surgery = 2 weeks prior to Visit 1 or who have not recovered from side effects of such surgery.
• Patients who have received wide field radiotherapy = 4 weeks or limited field radiation for palliation < 2 weeks prior to Visit 1 or who have not recovered from side effects of such therapy.
• A history of noncompliance to medical regimens or inability or unwillingness to return for scheduled visits.
• Female patients who are pregnant or breast feeding or patients of reproductive potential not employing an effective method of birth control. Because oral, implantable or injectable contraceptives may be affected by cytochrome P450 interactions, an appropriate method of birth control should be used throughout the trial in both sexes. Women of childbearing potential (WOCBP) must have a negative serum pregnancy test within 48 hours prior to the administration of study medication.Please see protocol for further information
• Patients unwilling or unable to comply with the protocol.
Study & Design
- Study Type
- Interventional clinical trial of medicinal product
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method
- Secondary Outcome Measures
Name Time Method