RecruitingPhase 2NCT04383119

Trial in Patients With Metastatic or Locally Advanced Leiomyosarcoma

A Randomized Phase II Trial Comparing the Activity of trabectedIn vs Gemcitabine in Patients With Metastatic or Locally Advanced Leiomyosarcoma Pretreated With Conventional Chemotherapy


Sponsor

Italian Sarcoma Group

Enrollment

100 participants

Start Date

Oct 29, 2021

Study Type

INTERVENTIONAL

Conditions

Summary

Study is aimed at evaluating the activity of Trabectedin (arm A) in advanced leiomyosarcomas, having Gemcitabine (arm B) as the comparator. In addition to the randomized cohort, the study has also an observational prospective cohort which include patients who will refuse the randomization or for whom the investigator will not judge the randomization as an appropriate option. In order to allow the participation of sites only to the prospective-observational (non randomized) cohort, it was introduced the possibility to participate to the study and receive the ethical approval only to the Observational Prospective Cohort In parallel an optional translational study will be performed, in both cohorts, to identify factors predictive of the activity of Trabectedin or Gemcitabine in this specific histotype.


Eligibility

Min Age: 18 Years

Inclusion Criteria15

  • Patients with histologically documented diagnosis of leiomyosarcoma
  • Patients with diagnosis of unresectable or metastatic leiomyosarcoma
  • Patients who received at least on previous systemic treatment with anthracycline-based chemotherapy.
  • Patients suitable to receive gemcitabine or trabectedin therapy.
  • Measurable or evaluable disease with RECIST 1.1 criteria.
  • Evidence of progression according RECIST 1.1 during the 6 months before study entry.
  • Age ≥18 years
  • Eastern Cooperative Oncology Group (ECOG) Performance Status ≤ 2
  • All previous anticancer treatments must have completed ≥ 3 weeks prior to first dose of study drug.
  • The patient has resolution of adverse events, with the exception of alopecia, and of all clinically significant toxic effects of prior loco-regional therapy, surgery, radiotherapy or systemic anticancer therapy to ≤ Grade 1, by National Cancer Institute - Common Terminology Criteria for Adverse Events (NCI-CTCAE) Version 5.0
  • Adequate bone marrow, liver and renal function
  • Left Ventricular Ejection Fraction ≥ 50% and/or above lower institutional limit of normality.
  • Female patients of child-bearing potential must have negative pregnancy test within 7 days before initiation each cycle of chemotherapy.
  • No history of arterial and/or venous thromboembolic event within the previous 12 months.
  • The patient or legal representative must be able to read and understand the informed consent form and must have been willing to give written informed consent prior to any study specific procedure. The subject may also provide an optional consent for the biological/translational sub-study associated.

Exclusion Criteria18

  • Prior treatment with Trabectedin and/or Gemcitabine
  • Known hypersensitivity to any of the study drugs, study drug classes, or excipients in the formulation of the study drugs
  • History of other malignancies (except basal cell carcinoma or cervical carcinoma in situ, adequately treated), unless in remission from 5 years or more and judged of negligible potential of relapse.
  • Persistent toxicities with the exception of alopecia, caused by previous anticancer therapies
  • Metastatic brain or meningeal tumors
  • Active viral hepatitis
  • Immunocompromised patients, e.g., patients who are known to be serologically positive for human immunodeficiency virus
  • Patients with any severe and/or uncontrolled medical conditions
  • Medical history of hemorrhage or a bleeding event ≥ Grade 3 (NCI-CTCAE v 5.0) within 4 weeks prior to the initiation of study treatment
  • Active clinically serious infections
  • Immunocompromised patients, e.g., patients who are known to be serologically positive for human immunodeficiency virus
  • Previous treatment with radiation therapy within 14 days of first day of study drug dosing,
  • Major surgery within 4 weeks prior to study entry
  • Concomitant use of known strong CYP3A inhibitors or moderate CYP3A inhibitors
  • Concomitant use of known strong or moderate CYP3A inducers
  • Patients undergoing renal dialysis or with Creatinin Clearance \<30 ml/min or Creatinine \>1,5 mg/dL
  • Pregnant or breast feeding patients
  • Patients with severe and/or uncontrolled concurrent medical disease that in the opinion of the investigator could cause unacceptable safety risks or compromise compliance with the protocol

Interventions

DRUGTrabectedin

Trabectedin in monotherapy

DRUGGemcitabine

Gemcitabine, control arm

DRUGNo Intervention: Observational Cohort

Treatment according clinical practice


Locations(17)

Azienda Ospedaliera S. Orsola-Malpighi

Bologna, BO, Italy

Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori - IRST

Meldola, FC, Italy

Nuovo Ospedale di Prato

Prato, Firenze, Italy

Istituto Clinico Humanitas

Rozzano, MI, Italy

Centro di Riferimento Oncologico di Aviano

Aviano, PD, Italy

Policlinico Universitario Campus Biomedico

Roma, RM, Italy

IRCCS Fondazione Piemonte per l'Oncologia

Candiolo, Torino, Italy

A.O.U.San Luigi Gonzaga

Orbassano, Torino, Italy

Istituto Ortopedico Rizzoli - Unit of Chemotherapy of Muscoloskeletal Tumors

Bologna, Italy

H.San Martino di Genova

Genova, Italy

Fondazione IRCCS INT Milano

Milan, Italy

Istituto Europeo di Oncologia

Milan, Italy

IRCCS Istituto nazionale Tumori "Fondazione G.Pascale"

Napoli, Italy

Irccs Istituto Oncologico Veneto (Iov)

Padua, Italy

Ospedale Giaccone

Palermo, Italy

Istituto Regina Elena - IFO

Rome, Italy

ASL Città di Torino (Dipartimento di Oncologia)

Torino, Italy

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NCT04383119


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