Brentuximab Vedotin (SGN-35) as Salvage Treatment for CD30-positive Germ Cell Tumors

Germ Cell Cancer Clinical Trial

Official title:

Brentuximab Vedotin (SGN-35) as Salvage Therapy for Males With Advanced and Platinum-resistant Germ-cell Tumors. An Open Label, Single Group, Phase 2 Trial.

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01851200
• Other study ID #: FM-12-GCT01
• Secondary ID: 2012-004508-36
• Status: Completed
• Phase: Phase 2
• First received: April 20, 2013
• Last updated: February 6, 2018
• Start date: May 2013
• Est. completion date: September 2017

Study information

• Verified date: April 2016
• Source: Fondazione Michelangelo
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of the study is to assess the activity of Brentuximab vedotin in refractory germ cell tumors.

Description:

Complete responses with third-line or later salvage chemotherapy (CT) for germ cell tumors (GCT) range 0% to 10% and are usually short-lived and nearly all patients (pts) progressing after multiple courses or high-dose CT will ultimately die from progressive disease.

Cluster of Differentiation antigen-30 (CD30) is expressed by untreated embryonal carcinoma (ECA) thus lending support to a rationale for a targeted approach. The investigators retrospectively re-assessed ECA to strongly retain CD30 staining in most cases (>70%), even after multiple courses or high-dose CT. Moreover, a negative prognostic value of CD30 expression by residuals after CT, particularly in the salvage setting, was set. Brentuximab vedotin is an antibody-drug conjugate consisting of the chimeric anti-CD30 antibody chemically conjugated to an antitubulin synthetic analog (MMAE).

Proof of activity will provide rationale for developing first-line chemo-immunotherapy or maintenance immunotherapy for selected high-risk pts. The primary objective of the study will be the activity of Brentuximab vedotin in refractory GCT. Secondary objectives will include safety and survival.

24 pts with biopsy-proven CD30 positive GCT will receive intravenous Brentuximab vedotin at the dose of 1.8 mg/Kg every 3 weeks until disease progression or onset of unacceptable toxicity. Further eligibility requirements will include failure of 2 or 3 platinum-based CT (prior high-dose CT is allowed). All pts will undergo measurement of serum tumor markers, a computed tomography and a positron emission tomography (PET) scan every weeks. An optimal Simon's 2-stage design will be applied. The primary endpoint is the objective response-rate (ORR). An ORR of 5% is not promising, while a 25% rate will be promising. In stage 1, 9 evaluable patients will be accrued. The type I and II error are both set at 10%.

Additional post-treatment tissue will be available for pts undergoing surgery in the treatment time-course. Tissue array blocks will be constructed from samples of all pts. Assessment will include mutational analysis of most-frequently mutated genes. Two serum aliquots will be collected at baseline and during/end of treatment to assess circulating CD30.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 9
• Est. completion date: September 2017
• Est. primary completion date: August 2017
• Accepts healthy volunteers: No
• Gender: Male
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Age of at least 18 years.

• Confirmation of germ cell tumor histology based on pathologic review at the study site.

• Presence of a CD30 positive embryonal carcinoma component.

• Unequivocal progression of measurable disease.

• A minimum of 2 and a maximum of 3 platinum-based chemotherapy lines for metastatic disease EXCEPT for primary mediastinal germ cell tumors where failure of first-line chemotherapy only is accepted.

• Prior high dose chemotherapy with hematopoietic stem cell rescue is allowed.

Exclusion Criteria:

• Failure to meet any of the above inclusion criteria.

• Patients with late-relapse (defined as relapse occurring after at least 2 years from the date of completion of the last chemotherapy regimen) whose disease is completely surgically resectable (and for whom initial surgical extirpation is recommended) are ineligible. Patients with unresectable late disease relapse are eligible.

Related Conditions & MeSH terms

• Germ Cell Cancer
• Neoplasms, Germ Cell and Embryonal

Intervention

Drug:
• Brentuximab Vedotin
Intravenous Brentuximab Vedotin at the dose of 1.8 mg/Kg every 3 weeks until disease progression or onset of unacceptable toxicity

Locations

Country	Name	City	State
Italy	Fondazione IRCCS Istituto Nazionale dei Tumori	Milano	Mi

Sponsors (3)

Lead Sponsor	Collaborator
Fondazione Michelangelo	Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Millennium Pharmaceuticals, Inc.

Country where clinical trial is conducted

Italy, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Metabolic response to Brentuximab Vedotin measured by means of a Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG-PET/CT) scan.		Six weeks after the first administration of the study drug.
Primary	The number of objective responses (partial and complete responses) according to the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 integrated with response of serum tumor markers.		Six weeks after the first administration of the study drug.
Secondary	Progression-Free Survival		3 months after the initiation of study treatment
Secondary	Overall Survival		Six months after the initiation of study treatment
Secondary	Incidence of adverse events related to the study drug		Six weeks after the initiation of the study drug and every 6 weeks thereafter up to 16 weeks.

External Links

•   Web site of the study Sponsor