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A randomized, open-label, multi-center phase III study to evaluate the efficacy and safety of nilotinib versus imatinib in adult patients with unresectable or metastatic gastrointestinal stromal tumors (GIST). - N/A

Conditions
adult patients with histologically confirmed unresectable or metastatic GIST, either who have not received any prior anti-neoplastic therapy or, who experienced recurrence of GIST > 6 months after stopping adjuvant treatment with imatinib.
MedDRA version: 14.1Level: LLTClassification code 10062427Term: Gastrointestinal stromal tumorSystem Organ Class: 100000004864
Registration Number
EUCTR2008-004758-34-DE
Lead Sponsor
ovartis Pharma Services AG
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
ot Recruiting
Sex
All
Target Recruitment
736
Inclusion Criteria

•Age =18 years
•At least one measurable site of disease on CT/MRI scan as defined by
RECIST criteria (refer to Post-text supplement 2) based on investigator's
assessment
•Histologically confirmed diagnosis of GIST which is unresectable
and/or metastatic and either:
•have not received any prior anti-neoplastic therapy other than adjuvant
imatinib. Note: newly diagnosed patients may have received up to 14
days of treatment with imatinib for disease management while awaiting
entry to the study
or
•had no clinical or radiological evidence of disease during the adjuvant
treatment with imatinib, have recurrent GIST = 6 months after stopping
adjuvant treatment with imatinib, and who have subsequently not
received any other therapies,
For patients with recurrent GIST after stopping adjuvant imatinib two CT
scans will be required prior to study entry: one demonstrating absence
of disease following completion of adjuvant imatinib and another
demonstrating recurrence of disease = 6 months after discontinuation of
adjuvant imatinib.
•WHO Performance Status of 0, 1 or 2
•Patients must have normal organ, electrolyte, and marrow function as
defined below:
•Absolute Neutrophil Count (ANC) = 1.5 x 109/L
•Hemoglobin = 9.0 g/dL
•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 liver metastases
•Alkaline phosphatase = 2.5 x ULN or = 5.0 x ULN if considered due to
liver metastases
•Serum bilirubin = 1.5 x ULN
•Serum lipase and amylase = 1.5 x ULN
•Serum potassium within the normal limits or corrected to within normal
limits with supplements
•Total calcium (corrected for serum albumin) within the normal limits or
corrected to within normal limits with supplements
•Serum magnesium within the normal limits or corrected to within
normal limits with supplements
•Serum phosphorous within the normal limits or corrected to within
normal limits with supplements
•Serum creatinine = 1.5 x ULN
•A written informed consent must be obtained
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

•Any prior anti-neoplastic therapy (e.g. TKIs, chemotherapy, investigational therapy) with the exception of patients who have received adjuvant imatinib or patients with newly diagnosed
metastatic/unresectable GIST whose disease requires therapy while
awaiting entry to the study, up to 14 days of treatment with imatinib (a
washout period of a minimum of 4 days will be required prior to the first
dose of study medication).
•History of active malignancy (other than GIST) within 10 years prior to
study entry with the exception of previous or concomitant basal cell skin
cancer, previous cervical carcinoma in situ
•Impaired cardiac function, including any one of the following:
•LVEF < 45% or below the institutional lower limit of the normal range
(whichever is higher) as determined by echocardiogram or MUGA scan.
•Inability to determine the QT interval on ECG.
•Complete left bundle branch block.
•Use of a ventricular-paced pacemaker.
•Congenital long QT syndrome or a known family history of long QT
syndrome.
•History of or presence of clinically significant ventricular or atrial
tachyarrhythmias.
•Clinically significant resting bradycardia (< 50 beats per minute).
•QTc > 450 msec (using the QTcF formula) as determined by central
reading. If QTcF > 450 msec and electrolytes are not within normal
ranges, electrolytes should be corrected and then the patient rescreened
for QTc.
•History or signs of prior myocardial infarction (during the last 12
months).
•History of unstable angina (during the last 12 months).
•Other clinically significant heart disease (e.g. congestive heart failure
or uncontrolled hypertension).
•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. uncontrolled diabetes,
active or uncontrolled infection.
•History of significant congenital or acquired bleeding disorder
unrelated to cancer.
•Known symptomatic brain metastases.
•Major surgery within 4 weeks prior to randomization or who have not
recovered from prior surgery.
•History of non-compliance to medical regimens or inability to grant
consent.
•Patients who are currently receiving treatment with any medications
that have the potential to prolong the QT interval and the treatment
cannot be either safely discontinued or switched to a different
medication prior to starting study drug administration. Please see
torsades.org/medical-pros/drug-lists/printable-drug-list.cfm or
http://www.arizonacert.org/medical-pros/drug-lists/drug-lists for a list
of agents that prolong the QT interval. This list may not be
comprehensive.
•Patients actively receiving therapy with strong CYP3A4 inhibitors and
the treatment cannot be either discontinued or switched to a different
medication prior to starting study drug. See Post-text supplement 4 for a
list of these medications. This list may not be comprehensive.
•Patients actively receiving therapy with strong CYP3A4 inducers and
the treatment cannot be either discontinued or switched to a different
medication prior to starting study drug. See Post-text supplement 4 for a
list of these medications.. This list may not be comprehensive.
•Patients actively receiving therapy with herbal medicines that are
CYP3A4 inhibitors and/or inducers, and the treatment cannot be either
discontinued or switched to a different medication prior to starting study
drug. These herba

Study & Design

Study Type
Interventional clinical trial of medicinal product
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Secondary Outcome Measures
NameTimeMethod
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