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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT02307500
Other study ID # ONC-2014-001
Secondary ID
Status Completed
Phase Phase 2
First received
Last updated
Start date December 2014
Est. completion date August 2020

Study information

Verified date September 2022
Source Istituto Clinico Humanitas
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

This is a single arm, single-stage, phase II trial to evaluate the activity of Regorafenib in patients with metastatic solid tumors (pancreatic cancer, ovarian cancer, melanoma, sarcoma, thymoma (type B2 - B3) and thymic carcinoma, who have progressed after standard therapy.


Description:

Each tumour will be assessed by itself. Regorafenib 40 mg tablets will be used in the study. Subjects will receive 160 mg regorafenib po every day (qd) for 3 weeks of every 4 week cycle (i.e., 3 weeks on, 1 week off). Subjects will continue on treatment until at least one of the following occurs (main criteria): - Progressive Disease (PD) by radiological assessments or clinical progression - Death - Unacceptable toxicity - Subject withdraws consent - Treating physician determines discontinuation of treatment is in the subject's best interest - Substantial non-compliance with the protocol


Recruitment information / eligibility

Status Completed
Enrollment 82
Est. completion date August 2020
Est. primary completion date December 2017
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: 1. Signed informed consent 2. Patients older then 18 years. 3. Locally advanced, recurrent or metastatic histologically confirmed malignancy refractory to available standard treatment, included Pancreatic cancer, Ovarian cancer, Melanoma, Sarcoma 4. At least one measurable lesion according to Response Evaluation Criteria In solid tumor 5. Eastern Cooperative Oncology Group Performance Status: 0-1 6. Life expectancy of at least 12 weeks 7. Adequate bone marrow, liver and renal function as assessed by the following laboratory : Hemoglobin > 9.0 g/dl Absolute neutrophil count > 1,500/mm3 Platelet count > 100,000/µl White blood cells >3.0 x 109/L Total bilirubin <1.5 times the upper limit of normal Alanine amino transferase and aspartate amino transferase <2.5 x upper limit of normal (<5 x upper limit of normal for patients with liver involvement) Serum creatinine <1.5 x upper limit of normal Alkaline phosphatase <2.5 x Upper Limit of Normal Prothrombin time / Partial prothrombin time <1.5 x Upper Limit of Normal Lipase = 1.5 x the Upper Limit of Normal 8. Able to swallow and retain oral medication. 9. Estimated creatinine clearance > 30ml/min as calculated using the Cockcroft-Gault equation 10. Resolution of any toxic effects of prior therapy to NCI Common Terminology Criteria for Adverse Event, Version 4.0, grade = 1 . 11. Women of childbearing potential and men must agree to use adequate contraception Exclusion Criteria: 1. Prior treatment with regorafenib. 2. Major surgical procedure, open biopsy, or significant traumatic injury within 28 days before start of study drug 3. Congestive heart failure >New York Heart Association class 2 4. Unstable angina), new-onset angina.Myocardial infarction less than 6 months before start of study drug 5. Myocardial infarction less than 6 months before start of study drug. 6. Cardiac arrhythmias requiring anti-arrhythmic therapy 7. Uncontrolled hypertension. 8. Pleural effusion or ascites that causes respiratory compromise 9. Ongoing infection > Grade 2 10. Known history of human immunodeficiency virus infection. 11. Active hepatitis B or C, or chronic hepatitis B or C requiring treatment with antiviral therapy. 12. Subjects with seizure disorder requiring medication. 13. History of organ allograft. Subjects with evidence or history of any bleeding diathesis, irrespective of severity. 14. Any hemorrhage or bleeding event > Common Toxicity Criteria for Adverse Effects Grade 3 15. Arterial or venous thrombotic or embolic events within the 6 months before start of study medication 16. Known history or symptomatic metastatic brain or meningeal tumors 17. Suggestive or consistent with central nervous system disease 18. Renal failure requiring hemo-or peritoneal dialysis. 19. Dehydration Common Toxicity Criteria for Adverse Effects v. 4.0 Grade >1. 20. Substance abuse, medical, psychological or social conditions that may interfere with the subject's participation in the study or evaluation of the study results. 21. Known hypersensitivity to any of the study drugs, study drug classes, or excipients in the formulation. 22. Any illness or medical conditions that are unstable or could jeopardize the safety of the subject and his/her compliance in the study. 23. Interstitial lung disease with ongoing signs and symptoms 24. Persistent proteinuria of CTCAE Grade 3 25. Any malabsorption condition. 26. Concomitant participation or participation within the last 30 days in another clinical trial 27. Systemic anticancer therapy including cytotoxic therapy, signal transduction inhibitors, immunotherapy, and hormonal therapy during this trial or within 4 weeks before starting to receive study medication.

Study Design


Intervention

Drug:
Regorafenib
oral therapy

Locations

Country Name City State
Italy Istituto Clinico Humanitas Rozzano Milan

Sponsors (1)

Lead Sponsor Collaborator
Istituto Clinico Humanitas

Country where clinical trial is conducted

Italy, 

References & Publications (27)

Acevedo VD, Ittmann M, Spencer DM. Paths of FGFR-driven tumorigenesis. Cell Cycle. 2009 Feb 15;8(4):580-8. Epub 2009 Feb 18. Review. — View Citation

Amit L, Ben-Aharon I, Vidal L, Leibovici L, Stemmer S. The impact of Bevacizumab (Avastin) on survival in metastatic solid tumors--a meta-analysis and systematic review. PLoS One. 2013;8(1):e51780. doi: 10.1371/journal.pone.0051780. Epub 2013 Jan 22. Review. — View Citation

Apperley JF, Gardembas M, Melo JV, Russell-Jones R, Bain BJ, Baxter EJ, Chase A, Chessells JM, Colombat M, Dearden CE, Dimitrijevic S, Mahon FX, Marin D, Nikolova Z, Olavarria E, Silberman S, Schultheis B, Cross NC, Goldman JM. Response to imatinib mesylate in patients with chronic myeloproliferative diseases with rearrangements of the platelet-derived growth factor receptor beta. N Engl J Med. 2002 Aug 15;347(7):481-7. — View Citation

Augustin HG, Koh GY, Thurston G, Alitalo K. Control of vascular morphogenesis and homeostasis through the angiopoietin-Tie system. Nat Rev Mol Cell Biol. 2009 Mar;10(3):165-77. doi: 10.1038/nrm2639. Review. — View Citation

Bach F, Uddin FJ, Burke D. Angiopoietins in malignancy. Eur J Surg Oncol. 2007 Feb;33(1):7-15. Epub 2006 Sep 7. Review. — View Citation

Bergers G, Song S, Meyer-Morse N, Bergsland E, Hanahan D. Benefits of targeting both pericytes and endothelial cells in the tumor vasculature with kinase inhibitors. J Clin Invest. 2003 May;111(9):1287-95. — View Citation

Carmeliet P, Jain RK. Angiogenesis in cancer and other diseases. Nature. 2000 Sep 14;407(6801):249-57. Review. — View Citation

Ferrara N. Vascular endothelial growth factor as a target for anticancer therapy. Oncologist. 2004;9 Suppl 1:2-10. Review. — View Citation

Ferrara N. VEGF and the quest for tumour angiogenesis factors. Nat Rev Cancer. 2002 Oct;2(10):795-803. Review. — View Citation

Fletcher JA, Rubin BP. KIT mutations in GIST. Curr Opin Genet Dev. 2007 Feb;17(1):3-7. Epub 2007 Jan 8. Review. — View Citation

Fong GH, Rossant J, Gertsenstein M, Breitman ML. Role of the Flt-1 receptor tyrosine kinase in regulating the assembly of vascular endothelium. Nature. 1995 Jul 6;376(6535):66-70. — View Citation

Goodman VL, Rock EP, Dagher R, Ramchandani RP, Abraham S, Gobburu JV, Booth BP, Verbois SL, Morse DE, Liang CY, Chidambaram N, Jiang JX, Tang S, Mahjoob K, Justice R, Pazdur R. Approval summary: sunitinib for the treatment of imatinib refractory or intolerant gastrointestinal stromal tumors and advanced renal cell carcinoma. Clin Cancer Res. 2007 Mar 1;13(5):1367-73. Review. — View Citation

Grothey A, Van Cutsem E, Sobrero A, Siena S, Falcone A, Ychou M, Humblet Y, Bouché O, Mineur L, Barone C, Adenis A, Tabernero J, Yoshino T, Lenz HJ, Goldberg RM, Sargent DJ, Cihon F, Cupit L, Wagner A, Laurent D; CORRECT Study Group. Regorafenib monotherapy for previously treated metastatic colorectal cancer (CORRECT): an international, multicentre, randomised, placebo-controlled, phase 3 trial. Lancet. 2013 Jan 26;381(9863):303-12. doi: 10.1016/S0140-6736(12)61900-X. Epub 2012 Nov 22. — View Citation

Heinrich MC, Blanke CD, Druker BJ, Corless CL. Inhibition of KIT tyrosine kinase activity: a novel molecular approach to the treatment of KIT-positive malignancies. J Clin Oncol. 2002 Mar 15;20(6):1692-703. Review. — View Citation

Herrera R, Sebolt-Leopold JS. Unraveling the complexities of the Raf/MAP kinase pathway for pharmacological intervention. Trends Mol Med. 2002;8(4 Suppl):S27-31. Review. Erratum in: Trends Mol Med 2002 May;8(5):243. — View Citation

Huang J, Bae JO, Tsai JP, Kadenhe-Chiweshe A, Papa J, Lee A, Zeng S, Kornfeld ZN, Ullner P, Zaghloul N, Ioffe E, Nandor S, Burova E, Holash J, Thurston G, Rudge J, Yancopoulos GD, Yamashiro DJ, Kandel JJ. Angiopoietin-1/Tie-2 activation contributes to vascular survival and tumor growth during VEGF blockade. Int J Oncol. 2009 Jan;34(1):79-87. — View Citation

Lanzi C, Cassinelli G, Nicolini V, Zunino F. Targeting RET for thyroid cancer therapy. Biochem Pharmacol. 2009 Feb 1;77(3):297-309. doi: 10.1016/j.bcp.2008.10.033. Epub 2008 Nov 6. — View Citation

Marshall CJ. MAP kinase kinase kinase, MAP kinase kinase and MAP kinase. Curr Opin Genet Dev. 1994 Feb;4(1):82-9. Review. — View Citation

Mross K, Frost A, Steinbild S, Hedbom S, Büchert M, Fasol U, Unger C, Krätzschmar J, Heinig R, Boix O, Christensen O. A phase I dose-escalation study of regorafenib (BAY 73-4506), an inhibitor of oncogenic, angiogenic, and stromal kinases, in patients with advanced solid tumors. Clin Cancer Res. 2012 May 1;18(9):2658-67. doi: 10.1158/1078-0432.CCR-11-1900. Epub 2012 Mar 15. — View Citation

Nikiforov YE. Thyroid carcinoma: molecular pathways and therapeutic targets. Mod Pathol. 2008 May;21 Suppl 2:S37-43. doi: 10.1038/modpathol.2008.10. Review. — View Citation

Saito M, Watanabe J, Fujisawa T, Kamata Y, Nishimura Y, Arai T, Miyamoto T, Obokata A, Kuramoto H. Angiopoietin-1, 2 and Tie2 expressions in endometrial adenocarcinoma--the Ang2 dominant balance up-regulates tumor angiogenesis in the presence of VEGF. Eur J Gynaecol Oncol. 2006;27(2):129-34. — View Citation

Sawyers CL. Finding the next Gleevec: FLT3 targeted kinase inhibitor therapy for acute myeloid leukemia. Cancer Cell. 2002 Jun;1(5):413-5. Review. — View Citation

Shalaby F, Rossant J, Yamaguchi TP, Gertsenstein M, Wu XF, Breitman ML, Schuh AC. Failure of blood-island formation and vasculogenesis in Flk-1-deficient mice. Nature. 1995 Jul 6;376(6535):62-6. — View Citation

Szarvas T, Jäger T, Tötsch M, vom Dorp F, Kempkensteffen C, Kovalszky I, Romics I, Ergün S, Rübben H. Angiogenic switch of angiopietins-Tie2 system and its prognostic value in bladder cancer. Clin Cancer Res. 2008 Dec 15;14(24):8253-62. doi: 10.1158/1078-0432.CCR-08-0677. — View Citation

Turner N, Grose R. Fibroblast growth factor signalling: from development to cancer. Nat Rev Cancer. 2010 Feb;10(2):116-29. doi: 10.1038/nrc2780. Review. — View Citation

Wilhelm SM, Dumas J, Adnane L, Lynch M, Carter CA, Schütz G, Thierauch KH, Zopf D. Regorafenib (BAY 73-4506): a new oral multikinase inhibitor of angiogenic, stromal and oncogenic receptor tyrosine kinases with potent preclinical antitumor activity. Int J Cancer. 2011 Jul 1;129(1):245-55. doi: 10.1002/ijc.25864. Epub 2011 Apr 22. — View Citation

Yancopoulos GD, Davis S, Gale NW, Rudge JS, Wiegand SJ, Holash J. Vascular-specific growth factors and blood vessel formation. Nature. 2000 Sep 14;407(6801):242-8. Review. — View Citation

* Note: There are 27 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Primary activity of regorafenib screening, in terms of 2-months progression free survival rate to evaluate activity of regorafenib, in terms of 2-months progression free survival rate 2 months
Secondary prognosis in terms of progression-free survival to explore the prognosis in terms of progression-free survival calculated from the first day of regorafenib treatment to the date of tumor progression or death, whichever occurs first. 36 months
Secondary overall survival (OS) to explore overall survival (OS) measured from the first day of regorafenib treatment until the date of death from any cause or the date of the last contact, at which the patients will be censored 36 months
Secondary safety profile of regorafenib according to NCI-CTC v.3 to assess the safety profile of regorafenib according to the National Cancer Institute Common Toxicity Criteria (NCI-CTC) version 3 3 months
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