A multicenter, open label, two cohort, single arm, phase II study to evaluate the efficacy and safety of the anti-TROP-2 antibody-drug conjugate sacituzumab govitecan in patients with advanced differentiated and anaplastic thyroid neoplasms.
Overview
- Phase
- Phase 2
- Status
- Recruiting
- Sponsor
- Grupo Espanol De Tumores Neuroendocrinos
- Enrollment
- 42
- Locations
- 11
- Primary Endpoint
- The primary endpoint will be objective response rate (ORR), defined as the percentage/proportion of patients with confirmed complete response (CR) or partial response (PR) as their overall best response throughout the study period. Objective responses will be assessed locally by the investigator according to RECIST, version 1.1 (Appendix 3), and indicating the change in size of tumors as compared with baseline, at the first dose of study treatment.
Overview
Brief Summary
The main hypothesis is that treatment with sacituzumab govitecan, a anti-Trophoblast cell surface antigen 2 (TROP-2), could be an effective treatment option for patients with either differentiated and anaplastic thyroid neoplasms because TROP-2 is highly expressed at the membrane of DTC and ATC. The primary aim of this study is to seek for activity of a novel drug and mechanism of action in order to provide an additional line of treatment for thyroid neoplasms. Concisely, the study will assess the efficacy and safety of the anti-TROP-2 antibody-drug conjugate sacituzumab govitecan for differentiated and anaplastic thyroid neoplasms using objective response rate (ORR) as primary endpoint surrogate of efficacy.
Eligibility Criteria
- Ages
- 18 years to 65+ years (18-64 Years, 65+ Years)
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •Institutional Review Board (IRB)/Independent Ethics Committee (IEC) approved written informed consent.
- •Female patients must agree not to breastfeed or donate ovules starting at screening and throughout the study period, and for at least 6 months after the final study drug administration.
- •Male patients must not donate sperm starting at screening and throughout the study period, and for at least 6 months after the final study drug administration.
- •Male patients with a partner with childbearing potential, or who is pregnant or breastfeeding must agree to abstinence or use a condom plus 1 form of highly effective birth control throughout the study period and for at least 6 months after the final study drug administration.
- •Patient agrees not to participate in another interventional study while on treatment in the present study.
- •Patient is ≥ 18 years of age.
- •Patient has histologically confirmed metastatic or locally advanced unresectable radioactive-iodine refractory differentiated thyroid cancer (cohort A) or anaplastic thyroid carcinoma (cohort B).
- •Prior therapy in each cohort: a. Cohort A: Patients must have experienced progression on at least one previous treatment line with approved systemic therapies (Sorafenib, Lenvatinib or Cabozantinib) and a maximum of 3 prior systemic therapies. b. Cohort B: Patients should be included in first-line setting or after failure of any systemic therapy (up to 1 prior treatment lines).
- •Patient has radiographically documented and measurable metastatic or locally advanced disease at baseline.
- •An archival tumor tissue sample should be available for submission to the central laboratory for translational studies. If an archival tumor tissue sample is not available, a new biopsy tissue sample should be provided. No central pathological review will be needed to include the patient in the trial.
Exclusion Criteria
- •Patient has central nervous system (CNS) metastases.
- •Patient has radiotherapy or major surgery within 4 weeks prior to the first dose of study drug.
- •Patients has received a live vaccine within 30 days, or antibiotics within one week prior to the first dose of study drug.
- •Patient has had chemotherapy, biologics, investigational agents, and/or antitumor treatment with immunotherapy that is not completed 2 weeks prior to the first dose of study drug. Note: Patients participating in observational studies are eligible.
- •Patient has previously received topoisomerase 1 inhibitors.
- •Patient has known hypersensitivity to sacituzumab govitecan or to any excipient contained in the drug formulation.
- •Patient has other underlying medical conditions that, in the opinion of the investigator, would impair the ability of the patient to receive or tolerate the planned treatment and follow-up.
- •Patient has ongoing clinically significant toxicity (Grade 2 or higher with the exception of neuropathy and alopecia) associated with prior treatment (including systemic therapy, radiotherapy or surgery). Note: if patients received major surgery, they must have recovered adequately from the toxicity and/or complications from the intervention prior to starting therapy.
- •Patient has a history of another malignancy within 3 years before the first dose of study drug, or any evidence of residual disease from a previously diagnosed malignancy. Note: Patients with non melanoma skin cancer, curatively treated localized prostate cancer, or carcinoma in situ of any type (if complete resection was performed) are allowed.
- •Patient has known active Hepatitis B or active hepatitis C: a. Patients who test positive for hepatitis B surface antigen (HBsAg). Patients who test positive for hepatitis B core antibody (anti-HBc) will require HBV DNA by quantitative polymerase chain reaction (PCR) for confirmation of active disease. b. Patients who test positive for HCV antibody. Patients who test positive for HCV antibody will require HCV RNA by quantitative PCR for confirmation of active disease. Patients with a known history of HCV or a positive HCV antibody test will not require a HCV antibody at screening and will only require HCV RNA by quantitative PCR for confirmation of active disease. c. Patients who test positive for HIV antibody.
Outcomes
Primary Outcomes
The primary endpoint will be objective response rate (ORR), defined as the percentage/proportion of patients with confirmed complete response (CR) or partial response (PR) as their overall best response throughout the study period. Objective responses will be assessed locally by the investigator according to RECIST, version 1.1 (Appendix 3), and indicating the change in size of tumors as compared with baseline, at the first dose of study treatment.
The primary endpoint will be objective response rate (ORR), defined as the percentage/proportion of patients with confirmed complete response (CR) or partial response (PR) as their overall best response throughout the study period. Objective responses will be assessed locally by the investigator according to RECIST, version 1.1 (Appendix 3), and indicating the change in size of tumors as compared with baseline, at the first dose of study treatment.
Secondary Outcomes
- Efficacy secondary endpoints will be analyzed per cohort: ● Disease control rate (DCR). ● Duration of the response (DoR). ● Progression free survival (PFS). ● Overall survival (OS). ● Efficacy variables will be reported for subgroups to find potential correlation between patient characteristics (i.e. age, gender, ECOG, AJCC stage, differentiation, or previous treatments) and the clinical outcomes to sacituzumab govitecan.
- Secondary safety endpoints: ● Frequency and severity of adverse events and Treatment-related adverse events (TRAEs) assessed by NCI CTCAE v5.0. ● Frequency of AEs leading to treatment discontinuation. ● Health-related quality of life (HRQoL), assessed through the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) version 3.
- Secondary exploratory endpoints: ● Correlation of TROP-2 expression levels with efficacy endpoints (i.e. ORR, PFS, OS). ● Correlation of tumor genetic alterations with efficacy endpoints (i.e. ORR, PFS, OS).
Investigators
GETNE
Scientific
Grupo Espanol De Tumores Neuroendocrinos