MULTISARC : MOLECULAR PROFILING OF ADVANCED SOFT-TISSUE SARCOMAS. A phase III study
试验速览
- 阶段
- 3 期
- 状态
- 招募中
- 发起方
- 入组人数
- 960
- 试验地点
- 16
- 主要终点
- Feasibility next generation sequencing exome : NGS (exome) for the primary objective will be considered feasible if (i) NGS results are available and interpretable, and (ii) a report of exome sequencing including a clinical recommendation from a molecular tumor board is provided to investigators within 7 weeks (i.e. at most 49 calendar days) from reception of the samples (blood and tumor samples) by one of the MULTIPLI platforms.
研究概览
简要总结
In participants with advanced Soft-Tissue Sarcomas: to assess the feasibility of high throughput molecular analysis (next generation sequencing exome [NGS]).
Primary objective will be assessed in participants randomized in the arm “NGS”. Feasibility will be defined as the proportion of participants for whom results from NGS are (i) interpretable and (ii) for whom a validated report of exome sequencing including a clinical recommendation from the molecular tumor board is available within 7 weeks (i.e. at most 49 calendar days) after reception of blood and tumor samples by one of the molecular platform.
研究设计
- 分配方式
- Not Applicable
- 主要目的
- Sub-trails protocol
- 盲法
- None
入排标准
- 年龄范围
- 18 years 至 65+ years(65+ Years, 18-64 Years)
- 接受健康志愿者
- 否
入选标准
- •Age ≥ 18 years
- •Eligible to first-line systemic treatment
- •No prior or concurrent malignant disease diagnosed or treated in the last two years before inclusion. Note that patients with in situ carcinoma of the cervix, or adequately treated basal cell or squamous cell carcinoma of the skin, or adequately treated localized prostate cancer, or other localized cancer under maintenance therapy can be included as long as they don't limit assessment of efficacy of first-line systemic therapy.
- •Participant with a social security in compliance with the French law.
- •Voluntary signed and dated written informed consent prior to any study specific procedure (ICF1).
- •Histology: soft-tissue sarcoma confirmed by the RRePS Network, as recommended by the French NCI
- •Unresectable locally advanced and/or metastatic STS
- •No previous systemic treatment for advanced disease
- •Eastern Cooperative Oncology Group (ECOG) performance status ≤ 1
- •Adequate hematological and metabolic functions:
- •Hemoglobin > 9 g/dL,
- •Albumin > 30 g/L.
- •Measurable disease according to RECIST 1.
- •At least one site of disease must be uni-dimensionally > 10 mm.
- •Availability of suitable frozen archive tumor material from a metastatic lesion or advanced disease (not previously treated), or at least one lesion that can be biopsied for research purpose.
- •Archived FFPE block of specimen tumor sampling obtained anytime during disease development for research purpose.
排除标准
- •Radiological evidence of symptomatic or progressive brain metastases.
- •Previous enrolment in the present study.
- •Any contraindication to first-line systemic treatment.
- •Inability to swallow.
- •Major problem with intestinal absorption.
- •Previous allogeneic bone marrow transplant.
- •Evidence of severe or uncontrolled systemic disease (uncontrolled hypertension, active bleeding diatheses, or active Hepatitis B, C and HIV or active autoimmune disease).
- •Any condition which in the Investigator’s opinion makes it undesirable for the subject to participate in the trial or which would jeopardize compliance with the protocol.
- •ndividuals deprived of liberty or placed under guardianship.
- •Pregnant or breast feeding women.
- •Men or women refusing contraception.
结局指标
主要结局
Feasibility next generation sequencing exome : NGS (exome) for the primary objective will be considered feasible if (i) NGS results are available and interpretable, and (ii) a report of exome sequencing including a clinical recommendation from a molecular tumor board is provided to investigators within 7 weeks (i.e. at most 49 calendar days) from reception of the samples (blood and tumor samples) by one of the MULTIPLI platforms.
Feasibility next generation sequencing exome : NGS (exome) for the primary objective will be considered feasible if (i) NGS results are available and interpretable, and (ii) a report of exome sequencing including a clinical recommendation from a molecular tumor board is provided to investigators within 7 weeks (i.e. at most 49 calendar days) from reception of the samples (blood and tumor samples) by one of the MULTIPLI platforms.
次要结局
- Overall survival (OS): OS for the secondary objective is defined as the delay from the date of randomization to the date of death. OS for the assessment of efficacy of first-line treatment: OS will be defined as the delay from the date of onset of first-line treatment to the date of death. OS for the assessment of efficacy of targeted treatment: OS will be defined as the delay from the date of onset of targeted treatment to the date of death.
- Progression-free survival (PFS) for the secondary objective is defined as the delay from the date of randomization to the date of progression as per RECIST v1.1. or death, whichever occurs first. PFS for the assessment of efficacy of first-line treatment and the targeted treatment: PFS will be defined as the delay from the date of onset of first-line or targeted treatment to the date of progression as per RECIST v1.1. or death, whichever occurs first.
- Participants with targetable alteration(s) A participant will be considered as “presenting at least one targetable genomic alteration”, if the MTB consider that at least one genomic alteration identified can be matched with one of the drug available through the MULTISARC study.
- Best overall response for the assessment of efficacy of first-line treatment: Best response will be recorded from the date of onset of first-line treatment taking into account any requirement for confirmation as per RECIST 1.1 criteria. Best overall response under treatment for the assessment of efficacy of targeted treatment: Best response will be recorded from the date of onset of targeted treatment taking into account any requirement for confirmation as per RECIST 1.1 criteria.
- Objective response under treatment is defined as complete or partial response (CR, PR) as per RECIST v1.1 under first-line treatment. ). Following RECIST v1.1 recommendations, each participant will be assigned one of the following categories: complete response, partial response, stable disease, progression, invaluable for response. Moreover, claimed responses will have to be confirmed at least 4 weeks later to ensure responses identified are not the result of measurement errors.
- For the assessment of efficacy of first-line treatment and targeted treatment: Non-progression at 6 months is defined as complete or partial response (CR, PR) or stable disease (SD) at 6 months as per RECIST v1.1 under first-line or targeted treatment. Claimed responses will have to be confirmed at least 4 weeks later to ensure responses identified are not the result of measurement errors.
- Change in tumor size is defined as the difference (in percentage) in tumor size burden from the date of targeted treatment initiation (baseline) to the tumor assessment.
- Immunosequencing: Correlation of TCR-sequencing data with objective response (OR), progression-free survival (PFS) and Evaluate the association between immune profiles derived from ancillary analyses (VISIUM HD, multiplex IF, SomaScan proteomics) and treatment response, within an integrated immunosequencing framework. and overall survival (OS).
- Real cost of NGS: Micro-costing studies collect detailed data on resources utilized and the value of those resources. Cost of other resources: The French National Health Insurance reimburses the vast majority of other resources involved in the care of patients in this trial. These costs will be extracted from the French National Health Insurance data, and cost Per diem allowances: In case of sick leave.
- Utility data and Quality Adjusted Life Years Utility scores will be assessed through the EuroQol-5D-5L questionnaire. A Quality Adjusted Life Year is the survival (in years) weighted by a utility score.
- Incremental cost utility ratio: Our incremental cost-utility ratio is difference in cost between both strategies (NGS and no NGS) divided by the difference in QALYs.
研究者
Antoine ITALIANO, MD, PhD
Scientific
Institut National De La Sante Et De La Recherche Medicale
