Efficacy Study on Trabectedin in Retroperitoneal Leiomyosarcoma and Well Differentiated/Dedifferentiated Liposarcoma

NCT ID: NCT02247544

Last Updated: 2021-11-01

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE2
• Total Enrollment: 105 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2014-03-31
• Study Completion Date: 2019-03-12

Brief Summary

This is an Italian, multicentre, single arm, phase II study, with an intra-patient comparison end point. This study aims at confirming the activity of the drug trabectedin as second/further line treatment in retroperitoneal leiomyosarcoma and well differentiated/dedifferentiated liposarcoma expressed in terms of slowing down tumour growth.

Another objective is to investigate this peculiar benefit of trabectedin in typical retroperitoneal sarcomas may be exploited to help multidisciplinary clinical decision-making in the management of retroperitoneal sarcomas

Detailed Description

Retroperitoneal soft-tissue sarcomas (R-STSs) are rare neoplasms, accounting for 10% to 15% of Soft Tissue Sarcomas (STSs), which represent 1-3% of all cancers. They may show different histological types, but the predominant ones in the retroperitoneal region are: leiomyosarcoma, liposarcoma. The most commonly encountered in the retroperitoneum is the well differentiated/dedifferentiated liposarcoma.

First-line chemotherapy usually consists of doxorubicin and/or ifosfamide. These two drugs are the most active agents in adult STSs, with a dose-response relationship and response rates between 20% and 50%. However, the sarcoma community is currently doubtful as to the activity of ifosfamide in the subgroup of leiomyosarcomas.

Trabectedin has been found to be mainly active in leiomyosarcoma and liposarcoma and is approved by European Medicines Agency (EMA) as second-line chemotherapy for STSs. Although the response rate observed in pre-registration studies did not exceed 10%, trabectedin provided disease control, with progression arrest rates exceeding 50% and Progression Free Survival (PFS) rates exceeding 20% at 6 months.

Since so far no phase II studies tested the activity of trabectedin in retroperitoneal sarcomas, this is the specific aim of this study.

Target population: Patients with previously treated, histologically confirmed, retroperitoneal leiomyosarcoma and well differentiated/dedifferentiated liposarcoma. Patients may be either unamenable to surgery or amenable but in whom the addition of medical treatment is considered clinically advisable.

Translational studies will be performed, with the aim of characterising the tumour biological features associated with different response patterns to trabectedin. These assessments will be done in 15-20 patients who will undergo surgery after trabectedin, comparing tumour tissue specimens collected before and after treatment.

Conditions

Liposarcoma; Leiomyosarcoma

Keywords

STS, leiomyosarcoma, liposarcoma, trabectedin

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Trabectedin

Trabectedin will be administered intravenously at a dose of 1.5 mg/m2 or 1.3 mg/m2 (at investigator's discretion, with a top-dose of 2.6 total mg per cycle) as a 24-hour infusion once every 3 weeks (cycle day 1).

Since trabectedin has no cumulative toxicities, treatment can be continued until progressive disease, major toxicity, patient's intolerance or unwillingness to continue treatment or medical decision by the responsible physician. In the subgroup of patients amenable to surgery, treatment will be reasonably continued until the best dimensional response.

Group Type: EXPERIMENTAL

Trabectedin

Intervention Type: DRUG

Trabectedin administered at a dose of 1.5 mg/m2 - 1.3 mg/m2 (at investigator's discretion, with a top-dose of 2.6 total mg per cycle) as a 24-hour continuous infusion via a central venous access until progressive disease, major toxicity, patient's intolerance, unwillingness to continue treatment, or medical decision by the responsible physician

Interventions

Trabectedin

Trabectedin administered at a dose of 1.5 mg/m2 - 1.3 mg/m2 (at investigator's discretion, with a top-dose of 2.6 total mg per cycle) as a 24-hour continuous infusion via a central venous access until progressive disease, major toxicity, patient's intolerance, unwillingness to continue treatment, or medical decision by the responsible physician

Intervention Type: DRUG

Other Intervention Names

Yondelis

Eligibility Criteria

Inclusion Criteria

• Persistent or locally relapsed and/or metastatic disease (in case of local disease, surgery may be technically feasible or not, but the clinical judgment must be that medical therapy is indicated)
• Pathology specimens available for centralized review
• Age ≥ 18 years
• European Eastern Cooperative Oncology Group Personal Status (ECOG PS) ≤ 2
• One or more previous systemic treatments employing anthracyclines and ifosfamide (unless one or both are clinically contraindicated)
• Measurable disease, as defined by Response Evaluation Criteria In Solid Tumors (RECIST)
• A minimum of 3 weeks since any previous medical therapy
• Recovery from toxic effects of prior therapies to National Cancer Institute Common Toxicity Criteria (NCI CTC) Grade 1 or lower
• Adequate haematological, renal and liver functions
• Ability and willingness to provide informed consent

Exclusion Criteria

• Pregnant or breast-feeding women
• Prior exposure to trabectedin
• Peripheral neuropathy, Grade 2 or higher
• History of other malignancies (except for basal cell carcinoma or cervical carcinoma in situ, adequately treated), unless in remission for 5 years or more and judged of negligible potential of relapse
• Known central nervous system (CNS) metastases
• Active viral hepatitis or chronic liver disease
• Unstable cardiac condition, including congestive heart failure or angina pectoris, myocardial infarction within one year before enrolment, uncontrolled arterial hypertension or arrhythmias
• Active major infection
• Other serious concomitant illnesses

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Istituto Di Ricerche Farmacologiche Mario Negri

OTHER

Sponsor Role: collaborator

Italian Sarcoma Group

NETWORK

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Paolo G. Casali, MD

Role: PRINCIPAL_INVESTIGATOR

IRCCS Fondazione Istituto Nazionale per la cura dei tumori di Milano

Locations

Istituto Tumori Giovanni Paolo II

Bari, BA, Italy

Azienda Ospedaliera Giovanni Paolo XXIII

Bergamo, BG, Italy

Azienda Ospedaliera S. Orsola-Malpighi

Bologna, BO, Italy

A.O. Spedali Civili

Brescia, BS, Italy

Ospedale Oncologico A. Businco

Cagliari, CA, Italy

Azienda Ospedaliera S Croce e Carle

Cuneo, CN, Italy

Azienda Ospedaliera Sant'Anna

Como, CO, Italy

IRST IRCCS Meldola

Meldola, FC, Italy

Fondazione IRCCS Istituto Nazionale dei Tumori

Milan, MI, Italy

Istituto Europeo di Oncologia

Milan, MI, Italy

Istituto Clinico Humanitas

Rozzano, MI, Italy

Azienda Ospedaliera Universitaria Paolo Giaccone

Palermo, PA, Italy

Centro di Riferimento Oncologico di Aviano

Aviano, PD, Italy

Istituto Oncologico Veneto

Padua, PD, Italy

Azienda Ospedaliera Universitaria Santa Chiara

Pisa, PI, Italy

Ospedale Misericordia e Dolce

Prato, PO, Italy

Policlinico Universitario Campus Biomedico

Roma, RM, Italy

Istituto per la Ricerca e la Cura del Cancro di Candiolo

Candiolo, TO, Italy

Ospedale Gradenigo

Torino, TO, Italy

Azienda Ospedaliera Santa Maria

Terni, TR, Italy

Istituto Nazionale Tumori - IRCCS - Fondazione Pascale

Napoli, , Italy

Countries

Italy

Other Identifiers

2012-005428-14

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

ISG-STS-TRAB-2012

Identifier Type: -

Identifier Source: org_study_id