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Phase 3 Study to Treat Patients With Soft Tissue Sarcomas

Phase 3
Completed
Conditions
Metastatic, Locally Advanced or Unresectable Soft Tissue Sarcoma
Interventions
Drug: Investigator's Choice Treatment (Darcabazine, Pazopanib, Gemcitabine + Docetaxel, Doxorubicin, Ifosfamide)
Registration Number
NCT02049905
Lead Sponsor
ImmunityBio, Inc.
Brief Summary

The purpose of this study is to determine the efficacy and safety of aldoxorubicin in subjects with metastatic, locally advanced, or unresectable soft tissue sarcomas.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
433
Inclusion Criteria
  1. Has provided written informed consent prior to any study related activities.
  2. Age ≥15 years (US only), and 18-80 (rest of world (ROW)), male or female.
  3. Histological confirmation of intermediate or high grade soft-tissue sarcoma. Tissue must be sent to a central pathology lab for review but will not preclude entry onto the study. Final assignment of tumor grade and histology will be based on the designation provided by the central pathology review.
  4. An adequate tumor specimen obtained by either excisional biopsy, incisional biopsy or core needle biopsy must be sent to the central pathology lab for evaluation. The material must measure at least 0.8 × 0.1 cm in size or contain at least 50 tumor cells.
  5. Locally advanced, unresectable, and/or metastatic soft-tissue sarcoma of intermediate or high grade with evidence of disease progression by either computed tomography (CT) or magnetic resonance imaging (MRI) scan, or clinical judgment on or after the last cancer therapy within 6 months prior to randomization.
  6. Relapsed or refractory (lack of response) to ≥1 course of systemic therapy regimen(s), excluding adjuvant or neoadjuvant chemotherapy, and is incurable by either surgery or radiation.
  7. Capable of providing informed consent and complying with trial procedures.
  8. ECOG PS 0-2.
  9. Life expectancy >12 weeks.
  10. Measurable tumor lesions according to RECIST 1.1 criteria.[50]
  11. Women must not be able to become pregnant (e.g., post-menopausal for at least 1 year, surgically sterile, or practicing adequate birth control methods) for the duration of the study. (Adequate contraception includes: oral contraception, implanted contraception, intrauterine device implanted for at least 3 months, or barrier method in conjunction with spermicide.)
  12. Males and their female partner(s) of child-bearing potential must use 2 forms of effective contraception (see Inclusion 11 plus condom or vasectomy for males) from the last menstrual period of the female partner during the study treatment and agree to continue use for 6 months after the final dose of study treatment.
  13. Women of child bearing potential must have a negative serum or urine pregnancy test at the Screening Visit and be non-lactating.
  14. Accessibility to the site that optimizes the subject's ability to keep all study-related appointments.
Exclusion Criteria
  1. Prior exposure to >375 mg/m2 of doxorubicin or liposomal doxorubicin.
  2. Palliative surgery and/or radiation treatment within 30 days prior to date of randomization.
  3. Exposure to any investigational agent within 30 days of date of randomization.
  4. Exposure to any systemic chemotherapy within 30 days of date of randomization.
  5. An inadequate tumor specimen as defined by the central pathologist.
  6. Current evidence/diagnosis of alveolar soft part sarcoma, extraskeletal myxoid chondrosarcoma, rhabdomyosarcoma, osteosarcoma, gastrointestinal stromal tumor (GIST), dermatofibrosarcoma (unless transformed to fibrosarcoma), Ewing's sarcoma, Kaposi's sarcoma, mixed mesodermal tumor, clear cell sarcomas.
  7. Evidence of central nervous system (CNS) metastasis who have not received prior definitive therapy for their lesions.
  8. History of other malignancies except cured basal cell carcinoma, cutaneous squamous cell carcinoma, melanoma in situ, superficial bladder cancer or carcinoma in situ of the cervix unless documented free of cancer for ≥5 years.
  9. Laboratory values: Screening serum creatinine >1.5 x upper limit of normal (ULN), alanine aminotransferase (ALT) >3×ULN or >5×ULN if liver metastases are present, total bilirubin >2×ULN, absolute neutrophil count (ANC) <1,500/mm3, platelet concentration <100,000/mm3, hemoglobin <9g/dL.
  10. Clinically evident congestive heart failure (CHF) > class II of the New York Heart Association (NYHA) guidelines.
  11. Current, serious, clinically significant cardiac arrhythmias, defined as the existence of an absolute arrhythmia or ventricular arrhythmias classified as Lown III, IV or V.
  12. Baseline QTc >470 msec and/or previous history of QT prolongation while taking other medications.
  13. Concomitant use of medications associated with a high incidence of QT prolongation is not allowed.
  14. History or signs of active coronary artery disease with or without angina pectoris within the last 6 months.
  15. Serious myocardial dysfunction defined by ECHO as absolute left ventricular ejection fraction (LVEF) below the institution's lower limit of predicted normal.
  16. Known history of HIV infection.
  17. Active, clinically significant serious infection requiring treatment with antibiotics, anti-virals or anti-fungals. The Medical Monitor should be contacted for any uncertainties.
  18. Major surgery within 30 days prior to date of randomization.
  19. Current or past substance abuse or any condition that might interfere with the subject's participation in the study or in the evaluation of the study results.
  20. Any condition that is unstable and could jeopardize the subject's participation in the study.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
AldoxorubicinAldoxorubicinAldoxorubicin is administered at 350 mg/m2 (260 mg/m2 doxorubicin equivalent) intravenously on Day 1 every 21-day cycles until tumor progression or unacceptable toxicity occurs.
Investigator's Choice of TreatmentInvestigator's Choice Treatment (Darcabazine, Pazopanib, Gemcitabine + Docetaxel, Doxorubicin, Ifosfamide)These treatments include: 1. Dacarbazine administered at 1000 mg/m2 by intravenous infusion (IVI), over 90±15 minutes on Day 1 every 21 days until tumor progression or unacceptable toxicity occurs; 2. Pazopanib, 800 mg orally each day until tumor progression or unacceptable toxicity occurs; 3. Gemcitabine, 900 mg/m2 by IVI over 90 minutes on Days 1 and 8, plus docetaxel, 100 mg/m2 by IVI over 1 hour on Day 8 of a 28 day cycle until tumor progression or unacceptable toxicity occurs; 4. Doxorubicin, 75 mg/m2 by IVI over 5 to 30 minutes every 21 days for a maximum cumulative dose of 550 mg/m2 or unacceptable toxicity occurs; or 5. Ifosfamide 2.0 g/m2 administered over 2 to 4 hours on Days 1-4 of a 21 day cycle + mesna per standard site administration regimen until tumor progression or unacceptable toxicity occurs.
Primary Outcome Measures
NameTimeMethod
Progression-Free Survival (PFS)24 months

PFS is defined as the time from the date of randomization to first documentation of objective tumor progression, according to RECIST 1.1 Criteria, or to death due to any cause in the absence of previous documentation of objective tumor progression. For subjects without documentation of objective tumor progression, who started other anti-tumor treatment, or lost to follow up/withdrew consent prior to confirmed progression, PFS is censored at the date of the last tumor assessment.

PFS is defined as the interval from the date of randomization to the earliest date of documented evidence of recurrent or progressive disease, or the date of death due to any cause, whichever occurs first.

PD is defined as: 20% increase in the sum of the longest diameter of target lesions from the smallest sum of the longest diameter recorded since the treatment started; the sum must also demonstrate an absolute increase of at least 5 mm. The appearance of 1 new lesion is also considered PD.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (73)

Complejo Hospitalario de Navarra

🇪🇸

Pamplona, Navarra, Spain

The James Cancer Hospital and Solove Research Institute

🇺🇸

Columbus, Ohio, United States

Fletcher Allen Health Care

🇺🇸

Burlington, Vermont, United States

U of Pittsburgh Cancer Institute

🇺🇸

Pittsburgh, Pennsylvania, United States

University Hospitals Case Medical Center

🇺🇸

Cleveland, Ohio, United States

Cleveland Clinic

🇺🇸

Cleveland, Ohio, United States

Leiden Universitair Medisch Centrum

🇳🇱

Leiden, Zuid-Holland, Netherlands

Vanderbilt University

🇺🇸

Nashville, Tennessee, United States

University of Alabama at Birmingham

🇺🇸

Birmingham, Alabama, United States

Arizona Oncology Associates, PC

🇺🇸

Phoenix, Arizona, United States

Mayo Clinic

🇺🇸

Rochester, Minnesota, United States

Center for Health and Healing

🇺🇸

Portland, Oregon, United States

Nebraska Methodist Hospital

🇺🇸

Omaha, Nebraska, United States

Medical College of Wisconsin

🇺🇸

Milwaukee, Wisconsin, United States

Samuel Oschin Cancer Center

🇺🇸

Los Angeles, California, United States

Georgia Cancer Specialists

🇺🇸

Atlanta, Georgia, United States

Kansas City Cancer Center

🇺🇸

Overland Park, Kansas, United States

Northwestern Medical Faculty Foundation

🇺🇸

Chicago, Illinois, United States

Hospital Universitario La Paz

🇪🇸

Madrid, Spain

Massachusetts General Hospital

🇺🇸

Boston, Massachusetts, United States

Oncology Specialists, SC

🇺🇸

Niles, Illinois, United States

Institut Bergonie

🇫🇷

Bordeaux Cedex, Aquitaine, France

Roswell Park Cancer Institute

🇺🇸

Buffalo, New York, United States

Centre Georges Francois Leclerc

🇫🇷

Dijon, Bourgogne, France

Westmead Hospital

🇦🇺

Westmead, New South Wales, Australia

City of Hope Medical Group

🇺🇸

Duarte, California, United States

Cross Cancer Institute

🇨🇦

Edmonton, Alberta, Canada

City Oncology Hospital #2

🇷🇺

Moscow, Russian Federation

IRCCS Instituto Ortopedico Rizzoli

🇮🇹

Bologna, Italy

Sharet Institute of Oncology Hadassah Ein Karem Medical Center

🇮🇱

Jerusalem, Israel

Herlev Hospital

🇩🇰

Herlev, Denmark

University of Minnesota

🇺🇸

Minneapolis, Minnesota, United States

Edward Cancer Center

🇺🇸

Naperville, Illinois, United States

Centre Hospitalier Regional et Universitaire - Hospital Bretonneau

🇫🇷

Tours, Centre-Val-de-Loire, France

Dana Farber Cancer Institute

🇺🇸

Boston, Massachusetts, United States

University of Michigan

🇺🇸

Ann Arbor, Michigan, United States

Hospital Puerta de Hierro Majadahonda

🇪🇸

Majadahonda, Madrid, Spain

Hopital Rene Huguenin - Institut Curie

🇫🇷

Saint-Cloud, Ile-de-France, France

Institut Gustave Roussy

🇫🇷

Villejuif, Ile-de-France, France

Levine Cancer Institute

🇺🇸

Charlotte, North Carolina, United States

Hospital Universitario Miguel Servet

🇪🇸

Zaragoza, Spain

Washington University

🇺🇸

Saint Louis, Missouri, United States

Royal North Shore Hospital

🇦🇺

Saint Leonards, New South Wales, Australia

Rocky Mountain Cancer Centers

🇺🇸

Denver, Colorado, United States

U of CO Health Sciences Center

🇺🇸

Aurora, Colorado, United States

Moffitt Cancer Center

🇺🇸

Tampa, Florida, United States

Sarcoma Oncology Center

🇺🇸

Santa Monica, California, United States

Juravinski Cancer Center

🇨🇦

Hamilton, Ontario, Canada

Wake Forest University Baptist Medical Center

🇺🇸

Winston-Salem, North Carolina, United States

Jefferson Medical College

🇺🇸

Philadelphia, Pennsylvania, United States

The University of Arizona

🇺🇸

Tucson, Arizona, United States

Stanford University Medical Center

🇺🇸

Stanford, California, United States

UCLA Medical Center

🇺🇸

Los Angeles, California, United States

Centre Leon Berard

🇫🇷

Lyon, Rhone-Alpes, France

McGill University

🇨🇦

Montreal, Quebec, Canada

Fondazione del Piemonte per l'Oncologia

🇮🇹

Candiolo, Torino, Italy

Azienda Ospedaliero-Universitaria di Bologna-Policlinico S Orsola-Malpighi

🇮🇹

Bologna, Italy

Instytut im.Marii Sklodowskiej-Curie

🇵🇱

Warszawa, Poland

Istituto Europeo di Oncologia Milano

🇮🇹

Milano, Italy

Istituto Oncologico Veneto

🇮🇹

Padova, Italy

State Institution "Blokhin Cancer Research Centre RAMS"

🇷🇺

Moscow, Russian Federation

Hospital Universitario Son Espases

🇪🇸

Palma de Mallorca, Baleares, Spain

Republican Clinical Oncologic Dispensary of Ministry of Health Republic Tatarstan

🇷🇺

Tatarstan, Russian Federation

Consorcio Hospitalario Provincial de Castellon

🇪🇸

Castellón de la Plana, Castellon, Spain

Inst Catala D'Oncologia

🇪🇸

Barcelona, Spain

Hospital Santa Creu i Sant Pau

🇪🇸

Barcelona, Spain

Centro Integral Oncologico Clara Campal, Hospital de Madrid Norte-San Chinarro

🇪🇸

Madrid, Spain

Hospital San Carlos Madrid

🇪🇸

Madrid, Spain

Rambam Medical Center

🇮🇱

Haifa, Israel

Chaim Sheba Medical Center

🇮🇱

Ramat Gan, Israel

Instituto Clinico Oncologica del Sur (ICOS)

🇨🇱

Temuco, Araucanía, Chile

Tel Aviv Sourasky Medical Center

🇮🇱

Tel Aviv, Israel

Magyar Honvedseg Egeszsegugyi Kozpont

🇭🇺

Budapest, Hungary

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