Multicenter, Open-Label, Single Arm Phase II Clinical Trial of Dasatinib in the Treatment of Systemic Mastocytosis
Overview
- Phase
- Phase 2
- Intervention
- Dasatinib
- Conditions
- Systemic Mastocytosis
- Sponsor
- Federico II University
- Enrollment
- 30
- Locations
- 12
- Primary Endpoint
- To assess the clinical response rate in terms of both B/C findings and mediator-related symptoms in subjects with SM who have been treated with dasatinib.
- Last Updated
- 16 years ago
Overview
Brief Summary
This is a multicenter, open-label, single arm phase II non-randomized study of dasatinib in which subjects with systemic mastocytosis (SM) will be treated with a continuous regimen of dasatinib.
Upon completion of a treatment induction period, subjects will be treated with dasatinib at a dose of 100 mg per os (OS) once daily (QD).
Detailed Description
Dasatinib may have clinical efficacy and is safe in subjects with SM. This Multicenter, open-label, single arm Phase II study will investigate the clinical response rate in terms of both B/C findings and mediator-related symptoms. 30 adult patients will be treated with a continuous regimen of dasatinib at a starting dose of 20 mg administered orally (PO) once daily (QD), that can be escalated up to 100 mg QD at the end of Week 3. Upon completion of a treatment induction period, subjects will be treated with dasatinib at a daily dose of 100 mg PO QD. Patients will remain on dasatinib treatment for 12 months unless disease progression, unacceptable toxicity or other reasons determine treatment discontinuation. Subjects may continue receiving protocol therapy as long as they are deriving a clinical benefit. Additionally, all subjects will be followed until disease progression, death, or 12 months beyond discontinuation from study treatment. The total duration of the study is estimated to 36 months.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Signed Written Informed Consent
- •Subjects with confirmed diagnosis of SM according to the WHO criteria and the following must be met:
- •All SM clinical variations, smoldering SM should have ≥ 2 B-findings and severe mediator related symptoms.
- •KIT mutation status on BM cells must be available at baseline or ≤ 6 months prior to study entry.
- •Subjects may have not prior treatment with chemotherapeutic regimen including imatinib or have either failed a prior chemotherapeutic regimen including imatinib or other agent.
- •At least two weeks must have elapsed from the last dose of chemotherapy, hormonal therapy, immunotherapy, biological therapy or investigational product and radiation therapy, and subjects must have recovered to baseline or Grade ≤ 1 (NCI CTCAE, version 3.0) from the toxicities resulting from any of those recent therapies prior to the first dose of dasatinib.
- •ECOG performance status of 0, 1 or
- •Subject must be willing and able to comply with scheduled visits, treatment schedule, laboratory tests, and requirements of the study.
- •Adequate liver and renal functions defined as:
- •Total bilirubin ≤ 2 x upper limit of normal (ULN) or ≤ 4 ULN if the sole cause of liver elevation is due to SM
Exclusion Criteria
- •WOCBP who are unwilling or unable to use an acceptable method to avoid pregnancy for the entire study period and for up to at least 4 weeks after the last dose of investigational product.
- •Women who are pregnant or breastfeeding
- •Indolent SM (presence of B-findings without severe mediator-related symptoms)
- •Pericarditis, clinically significant pleural effusion or ascites within 12 months prior to study entry not attributable to SM.
- •Pulmonary infiltrates within 4 weeks prior to study entry or abnormal chest X-ray at baseline not attributable to SM.
- •Any surgical procedure, excluding central venous catheter placement or other minor procedures (e.g. skin biopsy) within 14 days prior to initiation of dasatinib therapy.
- •Presence of active bacterial, fungal or viral infections at study entry.
- •Clinically significant cardiac disease (NYHA Class III or IV) including preexisting arrhythmia, (such as ventricular tachycardia, ventricular fibrillation, or "Torsade de Pointes"), myocardial infarction, uncontrolled angina within 6 months, congestive heart failure, or cardiomyopathy.
- •Abnormal QTcF interval prolonged ( ≥ 450 msec) after electrolytes have been corrected on baseline ECG.
- •Malabsorption syndrome not attributable to SM or uncontrolled (e.g. not corrected by antimediator therapy) gastrointestinal toxicities (nausea, diarrhea, vomiting) NCI CTCAE Grade =
Arms & Interventions
Dasatinib
Patient will be treat at a starting dose of 20mg once daily, that can be escalated up to 100mg once daily.
Intervention: Dasatinib
Outcomes
Primary Outcomes
To assess the clinical response rate in terms of both B/C findings and mediator-related symptoms in subjects with SM who have been treated with dasatinib.
Time Frame: December 2011
Secondary Outcomes
- To assess of the Time to Response (TTR), Duration of Response (DOR) and Progression-Free survival (PFS).(December 2012)
- To evaluate the changes in specific biological markers and molecular mutations.(June 2012)
- To evaluate the safety and toxicity of dasatinib in this population.(December 2011)