NBTXR3 Crystalline Nanoparticles and Radiation Therapy in Treating Randomized Patients in Two Arms With Soft Tissue Sarcoma of the Extremity and Trunk Wall

Phase 2

Completed

• Conditions: Adult Soft Tissue Sarcoma
• Interventions: Device: Radiation therapy; Device: NBTXR3

• Registration Number: NCT02379845
• Lead Sponsor: Nanobiotix

Brief Summary

RATIONALE: Radiation therapy given before surgery of soft tissue sarcoma decreases the size of the tumor mass and the presence of malignant cells in its peripheral region. NBTXR3 and radiation therapy may kill more cancer cells and increase the tumor shrinkage rendering surgery more feasible or easier and achieve better local control of the tumor.

PURPOSE: This phase II/III is a prospective randomized, multi-center, open-label and active controlled two arms study in patients with locally advanced soft tissue sarcoma (STS) of the extremity and trunk wall. Patients will be randomized to receive either NBTXR3 as intratumor injection, activated by external beam radiation therapy or external beam radiation therapy alone, as preoperative treatment. Once the radiotherapy treatment is completed, tumor surgery will be performed in all patients.

Detailed Description

Patients who will be allocated in arm A, will receive a single intratumor injection of NBTXR3 and will receive external beam radiotherapy starting 24hrs after the injection up to completion of 5 weeks, 5 days a week of treatment (50Gy, 2Gy/fraction). Then, all patients will undergo surgical resection of the tumor 5 weeks later and will be followed for wound healing and toxicity assessment. A visit of end of treatment will take place approximately 3-4 weeks after surgery. Patients will be followed for evaluation of their disease status and adverse event until the end of study.

Study Timeline

• Study First Submitted: 2015-02-19
• Study First Submitted QC: 2015-03-01
• Study Start: 2015-03-03
• Study First Posted: 2015-03-05
• Primary Completion: 2018-05-22
• Study Completion: 2020-09-20
• Status Verified: 2021-04
• Last Update Submitted: 2021-04-05
• Last Update Posted: 2021-04-06

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 180

Inclusion Criteria

• Age: 18 years and older

• Locally Advanced Soft Tissue Sarcoma of the Extremity and Trunk Wall

• All grades

• Candidate to radiotherapy + surgery (ESMO guideline 2014) i.e. tumor must not have involvement of bone and / or vessel and or nerve :

  • Primary tumor or,
  • Relapsed tumor, localized out of previously irradiated area

• WHO performance score 0 to 2

• Adequate function of bone marrow

• Adequate renal function

• Adequate hepatic function

• Adequate pulmonary function

• All female patients of childbearing potential must have a negative serum/urinary pregnancy test

Exclusion Criteria

• Absence of written Informed Consent duly signed and dated
• Patients with the following histological type: embryonal or alveolar rhabdomyosarcoma, Ewing's sarcoma, osteosarcoma or chondrosarcoma, Kaposi's sarcoma, primitive neuroectodermal tumor, angiosarcoma, aggressive fibromatosis or dermatofibrosarcoma protuberans
• Soft Tissue Sarcoma of the Trunk Wall localized in the abdominal region i.e. the region defined cranially by the xiphoid process of the sternum and the costal margins, and caudally by the line joining the anterior superior iliac spines, both limited by the perpendicular lines crossing both nipples
• Patient with a calculated tumor baseline volume > 3000 mL
• Metastatic disease (CT-scan / MRI verification) with life expectancy shorter than 6 months
• Previous radiation therapy in relapse site of soft tissue sarcoma (no radiation re-challenge is permitted)
• Concurrent treatment with any other anticancer therapy, including chemotherapy, immunotherapy, targeted therapy, gene therapy, or patients planning to receive these treatments during the study
• Absence of histologically or cytologically proven cancer at the first diagnosis
• Previous neoadjuvant chemotherapy treatment given as an upfront of the current treatment line
• Hemolytic anemia
• Autoimmune disease
• Complete initial work up earlier than 4 weeks prior to patient registration
• Patients unable to comply with scheduled visits, treatment plans, laboratory tests, and other study procedures
• Patients participating in another clinical investigation at the time of signature of the informed consent

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Arm B	Radiation therapy	Radiotherapy alone
Arm A	NBTXR3	NBTXR3 + Radiotherapy
Arm A	Radiation therapy	NBTXR3 + Radiotherapy

Primary Outcome Measures

Name	Time	Method
Pathological Complete Response Rate (pCRR)	36 months	To compare antitumor activity in terms of Pathological complete response rate (pCRR) of intratumor injection of NBTXR3 activated by external beam radiation therapy (EBRT), versus EBRT alone

Secondary Outcome Measures

Name	Time	Method
Tumor volume changes (theoretical tumor volume estimated as: Length x Width x Depth	36 months
Incidence of early and late TEAE, post-TEAE, SAE and laboratory abnormalities (NCI CTCAE V4.0)	36 months
Objective Response Rate (ORR) by Imaging (MRI) according to RECIST 1.1	36 months
Limb amputation rate	36 months
Resection Margins (R0, R1, R2)	36 months
Hyalinization, fibrosis, necrosis and tumor infarction percentage	36 months

Trial Locations

Locations (42)

Chris O'Brien Lifehouse; 🇦🇺 Sydney, Australia

Capital Region Cancer Service, Canberra Hospital; 🇦🇺 Canberra, Australia

Jules Bordet Institute; 🇧🇪 Bruxelles, Belgium

Ghent University Hospital; 🇧🇪 Ghent, Belgium

Centre Rene Gauducheau; 🇫🇷 Nantes, Saint Herblain, France

Institut Bergonie; 🇫🇷 Bordeaux, France

Centre Regional de Lutte Contre Le Cancer Paul Lamarque; 🇫🇷 Montpellier, France

Centre Leon Berard; 🇫🇷 Lyon, France

Institut Paoli Calmettes; 🇫🇷 Marseille, France

Centre Antoine Lacassagne; 🇫🇷 Nice, France

Institut Curie; 🇫🇷 Paris, France

Institut Claudius Regaud - Oncopole; 🇫🇷 Toulouse, France

Institut Gustave Roussy; 🇫🇷 Villejuif, France

Klinikum Mannheim; 🇩🇪 Mannheim, Germany

Klinikum Nürnberg; 🇩🇪 Nürnberg, Germany

Medical Centre, Hungarian Defence Forces; 🇭🇺 Budapest, Hungary

University Pècs; 🇭🇺 Pecs, Hungary

Instituto Nazionale Tumori Regina Elena; 🇮🇹 Rome, Italy

Fondazione IRCCS Istituto Nazionale dei Tumori; 🇮🇹 Milan, Italy

Institute of Oncology Veneto IOV; 🇮🇹 Padova, Italy

St. Luke's Medical Center; 🇵🇭 Quezon City, Philippines

Amethyst-Cluj; 🇷🇴 Floresti, Romania

County Hospital, Targu Mures; 🇷🇴 Targu Mures, Romania

Iatros International; 🇿🇦 Bloemfontein, South Africa

The Oncology Centre; 🇿🇦 Durban, South Africa

Gvi Outeniqua Oncology Unit; 🇿🇦 George, South Africa

Wilgers Oncology Centre; 🇿🇦 Pretoria, South Africa

Hospital Universitari Vall D'Hebron; 🇪🇸 Barcelona, Spain

START MADRID, Hospital Fundacion Jimenez Diaz; 🇪🇸 Madrid, Spain

START MADRID, Hospital Universitario Madrid Norte Sanchinarro; 🇪🇸 Madrid, Spain

Hospital Clinico Universitario San Carlos; 🇪🇸 Madrid, Spain

University of Santo Thomas; 🇵🇭 Manila, Philippines

The Medical City; 🇵🇭 Pasig City, Philippines

Oslo University Hospital; 🇳🇴 Oslo, Norway

Municipal Emergency Hospital; 🇷🇴 Timisoara, Romania

National Institute of Oncology; 🇭🇺 Budapest, Hungary

Cancer Center Institute; 🇵🇱 Warsaw, Poland

Perpetual Succour Hospital Cebu; 🇵🇭 Cebu City, Philippines

Institutul Oncologic Bucuresti; 🇷🇴 Bucharest, Romania

Spitalului Universitar de Urgenta Militar Central; 🇷🇴 Bucharest, Romania

County Hospital 'Dr Gavril Curteanu'; 🇷🇴 Oradea, Romania

Princes of Wales Hospital; 🇭🇰 Shatin, Hong Kong