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DETERMINE (Determining Extended Therapeutic Indications for Existing Drugs in Rare Molecularly Defined Indications Using a National Evaluation Platform Trial) - Master Screening Protocol

Registration Number
NCT05722886
Lead Sponsor
Cancer Research UK
Brief Summary

DETERMINE is an open-label phase II/III trial. It will look at targeted treatments in rare cancers or common cancers with rare genetic change (mutation). Participants must have a cancer with an identified mutation. This could be found during routine testing or as part of another research programme. The DETERMINE trial will recruit adults, teenagers and children. If a drug is found to benefit a new patient group, the study team will work with the NHS and the Cancer Drugs Funds to see if these drugs can be available for patients in the future. This clinicaltrials.gov record refers to the Overall Trial Protocol (Master Screening Record), additional records will be added to clinicaltrials.gov for each treatment arm.

Detailed Description

DETERMINE is an umbrella-basket platform trial to evaluate the efficacy of licensed targeted therapies in rare\* adult, paediatric and teenage/young adult (TYA) cancers with actionable genomic alterations, including common cancers with rare actionable alterations.

\*Rare is defined generally as incidence less than 6 cases in 100,000 patients (includes paediatric and teenagers/young adult cancers) or common cancers with rare alterations.

The number of treatment arms opened will depend on the number of licensed medicines identified for inclusion. Each trial cohort has a target sample size of 30 evaluable patients. Sub-cohorts may be defined and further expanded where promising activity is identified to a target of 30 evaluable patients each. The total number of patients recruited to the platform will depend on the number of treatment arms and sub-cohorts opened.

This clinicaltrials.gov record refers to the Overall Trial Protocol (Master Screening Record), please refer to the references section for links to the individual treatment arm records.

The main aims of the clinical trial arms are:

* To evaluate the anti-cancer activity of licensed targeted drugs outside their license indication.

* To assess the safety and adverse event (AE) profile of licensed, targeted anti-cancer drugs in the target population.

* To understand biological mechanisms for response and resistance to targeted therapies.

* This Master Screening Record will capture the number of patients with a cancer containing the appropriate genetic alteration that have been successfully allocated and consented to each arm. The trial results (according to the protocol defined outcome measures) will be reported per-arm for each treatment arm.

The ultimate aim is to translate positive clinical findings to NHS England to provide new treatment options for rare adult, paediatric and TYA cancers.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
825
Inclusion Criteria

Not provided

Read More
Exclusion Criteria

Not provided

Read More

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Treatment Arm 5: Vemurafenib in combination with cobimetinibVemurafenib in combination with cobimetinibThis vemurafenib and cobimetinib appendix is for BRAF V600 mutation-positive malignancies occurring in adults only.
Treatment Arm 4: Trastuzumab in combination with pertuzumabTrastuzumab in combination with pertuzumabThis trastuzumab and pertuzumab treatment arm is for adult, teenage/young adult (TYA) and paediatric participants with malignancies with HER2 amplification or activating mutations.
Treatment Arm 1: AlectinibAlectinibThis alectinib treatment arm is for adult, teenage/young adults (TYA) and paediatric participants with ALK-positive cancers.
Treatment Arm 2: AtezolizumabAtezolizumabThis atezolizumab treatment arm is for adult, teenage/young adults (TYA) and paediatric participants with high tumour mutational burden (TMB) or microsatellite instability high (MSI-high) or proven (previously diagnosed) constitutional mismatch repair deficiency (CMMRD) only.
Treatment Arm 3: EntrectinibEntrectinibThis entrectinib treatment arm is for adult, teenage/young adult (TYA) and paediatric participants with ROS1 gene fusion-positive malignancies only.
Primary Outcome Measures
NameTimeMethod
Number of patients who consent to each arm.Up to 5 years.

This is a master screening entry with sub-study entries to capture the results of each arm. As such a primary outcome measure for this entry is not relevant, however this entry will be used to report the number of patients with a cancer containing the appropriate genetic alteration that have been successfully allocated and consented to each arm.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (25)

Belfast City Hospital

🇬🇧

Belfast, United Kingdom

Bristol Royal Hospital for Children

🇬🇧

Bristol, United Kingdom

The Beatson Hospital

🇬🇧

Glasgow, United Kingdom

Velindre Cancer Centre

🇬🇧

Cardiff, United Kingdom

Birmingham Children's Hospital

🇬🇧

Birmingham, United Kingdom

Leicester Royal Infirmary

🇬🇧

Leicester, United Kingdom

University Hospital Birmingham

🇬🇧

Birmingham, United Kingdom

Bristol Haematology and Oncology Centre

🇬🇧

Bristol, United Kingdom

Addenbrooke's Hospital

🇬🇧

Cambridge, United Kingdom

Alder Hey Hospital

🇬🇧

Liverpool, United Kingdom

Great Ormond Street Hospital

🇬🇧

London, United Kingdom

John Radcliffe Hospital

🇬🇧

Oxford, United Kingdom

Southampton General Hospital

🇬🇧

Southampton, United Kingdom

Weston Park Hospital

🇬🇧

Sheffield, United Kingdom

Clatterbridge Cancer Centre

🇬🇧

Wirral, United Kingdom

Western General Hospital

🇬🇧

Edinburgh, United Kingdom

Royal Hospital for Children Glasgow

🇬🇧

Glasgow, United Kingdom

The Royal Marsden Hospital

🇬🇧

London Borough of Sutton, United Kingdom

University College London Hospital

🇬🇧

London, United Kingdom

The Christie Hospital

🇬🇧

Manchester, United Kingdom

Royal Manchester Children's Hospital

🇬🇧

Manchester, United Kingdom

Great North Children's Hospital

🇬🇧

Newcastle, United Kingdom

Freeman Hospital

🇬🇧

Newcastle, United Kingdom

Churchill Hospital

🇬🇧

Oxford, United Kingdom

Guy's Hospital

🇬🇧

London, United Kingdom

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