Anlotinib and Irinotecan for Ewing Sarcoma

Ewing's Tumor Metastatic Clinical Trial

Official title:

Anlotinib and Irinotecan for Advanced Ewing Sarcoma After Failure of Standard Multimodal Therapy

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT03416517
• Other study ID #: PKUPH-EWS-02
• Status: Recruiting
• Phase: Phase 1/Phase 2
• Start date: January 22, 2018
• Est. completion date: December 2020

Study information

• Verified date: February 2019
• Source: Peking University People's Hospital
• Contact: Wei Guo, M.D, Ph.D
• Phone: 86 010 88326152
• Email: bonetumor[@]163.com
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The investigators explored the activity of anlotinib combined with irinotecan in patients with relapsed and metastatic Ewing Sarcoma.

Description:

After standard multimodal therapy, the prognosis of relapsed and metastatic Ewing Sarcoma is dismal and unchanged over the last decades.Thus, the investigators explored the activity of anlotinib combined with irinotecan in patients with relapsed and metastatic Ewing Sarcoma after the failure of first-line chemotherapy with doxorubicin, vincristine, cyclophosphamide, ifosphamide and etoposide.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 47
• Est. completion date: December 2020
• Est. primary completion date: February 2020
• Accepts healthy volunteers: No
• Gender: All
• Age group: 5 Years to 65 Years

Eligibility

Inclusion Criteria:

• Histologically confirmed Ewing sarcoma.

• Evidence of Ewing sarcoma translocation by fluorescence in situ hybridization (FISH) or real-time polymerase chain reaction (RT-PCT).

• Recurrent or refractory tumors with no known curative treatment options according to the judgment of the investigator.

• Prior treatment consisted of standard Ewing Sarcoma chemotherapy agents including doxorubicin, vincristine, cyclophosphamide, ifosfamide and etoposide; metastatic relapsed and unresectable progressive disease (PD);

• Life expectancy of = 3 months.

• Eastern Cooperative Oncology Group performance status 0-1

• Measurable disease on CT or MRI by RECIST 1.1.

• Adequate organ function.

• Time elapsed from previous therapy must be = 3 weeks for systemic therapy, = 2 weeks for radiation therapy or major surgery.

• Patients who have undergone autologous hematopoietic stem cell transplantation are eligible once they have recovered from all toxicities from therapy.

• Patients who have received allogeneic hematopoietic stem cell transplantation will be eligible 6 months after the procedure provided there is no evidence of active graft-versus-host disease and immunosuppressive treatment has been discontinued for at least 30 days.

• Patients with central nervous system disease are eligible for enrollment if they have received prior radiotherapy or surgery to sites of central nervous system metastatic disease, have been off glucocorticoids for at least 4 weeks, have no overt evidence of neurological deficit and are = 6 weeks from completion of brain irradiation.

• Females of childbearing potential as well as males and their partners must agree to use an effective form of contraception during the study and for 6 months following the last dose of study medication.

Exclusion Criteria:

• Clinically significant unrelated illness which would, in the judgment of the treating physician, compromise the patient's ability to tolerate the investigational agent or be likely to interfere with the study procedures or results.

• Prior treatment consisted of anlotinib, any other antiangiogenic TKIs, or irinotecan.

• Patients with baseline corrected QT interval(QTc) > 480 msec.

• Known hypersensitivity reaction to anlotinib or any of its components, and irinotecan or any of its components.

• Concomitant use of any other investigational or anticancer agent(s).

• Pregnant patients or patients who are breast feeding. Subjects capable of pregnancy (post menarche and not post-menopausal, defined as over 12 months since final menstrual period) must have a negative pregnancy test within 7 days prior to first dose.

• Inability to swallow capsules or water.

• Other clinically significant malignant disease diagnosed within the previous 5 years, excluding intra-epithelial cervical neoplasia or non-melanoma skin cancer.

• Known persistent (> 4 weeks) = Grade 2 neutropenia, = Grade 2 thrombocytopenia or > Grade 3 anemia from prior cancer therapy.

• Other kinds of malignant tumors at the same time.

Related Conditions & MeSH terms

• Ewing's Tumor Metastatic
• Sarcoma
• Sarcoma, Ewing

Intervention

Drug:
• Anlotinib
Anlotinib 12 or 8 mg/d po D1-14 q3w
• Irinotecan
Irinotecan 20 or 15mg/m^2/d IV over 60 minutes on days 1-5 and 8-12, q3w

Locations

Country	Name	City	State
China	Peking University First Hospital	Beijing
China	Peking University People's Hospital	Beijing
China	Peking University Shougang Hospital	Beijing
China	Peking University Third Hospital	Beijing
China	People's Liberation Army General Hospital	Beijing

Sponsors (1)

Lead Sponsor	Collaborator
Peking University People's Hospital

Country where clinical trial is conducted

China, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Maximum tolerated dose (MTD) (phase 1b)	evaluate the maximum tolerated dose (MTD) of combination therapy with irinotecan and anlotinib	12 months
Primary	Object response rate(ORR) at 12 weeks (phase 2)	complete response (CR) + partial response (PR) at 12 weeks	12 months
Secondary	Progression-free survival(PFS)	Calculated from the date of treatment start until the time of disease progression or death, whichever comes first.	2 years
Secondary	Overall survival(OS)	Calculated from the date of treatment start until last follow-up or death, whichever comes first.	2 years
Secondary	Adverse Effect	Adverse effect measured by CTCAE v.4 (Common Terminology Criteria for Adverse Events)	2 years
Secondary	Quality of Life (QoL)	Quality of Life measured by EORTC QLQ(quality of life questionnair) C-30 for adults or PedsQL3.0 for children.	2 years
Secondary	Pain management	Pain management measured by Visual Analog Score for pain.	2 years