Thalidomide in Treating Patients With Recurrent or Persistent Carcinosarcoma of the Uterus

Uterine Carcinosarcoma Clinical Trial

Official title:

A Phase II Evaluation of Thalidomide (NSC #66847) in the Treatment of Recurrent or Persistent Carcinosarcoma of the Uterus

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00025506
• Other study ID #: NCI-2012-02421
• Secondary ID: NCI-2012-02421CD
• Status: Completed
• Phase: Phase 2
• Start date: September 2001
• Est. completion date: January 2013

Study information

• Verified date: July 2019
• Source: National Cancer Institute (NCI)
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This phase II trial is studying how well thalidomide works in treating patients with carcinosarcoma of the uterus that has come back or that does not go to remission (decrease or disappear but may still be in the body) despite treatment. Thalidomide may stop the growth of cancer by stopping blood flow to the tumor.

Description:

OBJECTIVES: Primary I. Determine the antitumor cytostatic activity of thalidomide, as measured by the probability of progression-free survival (PFS) for at least 6 months, in patients with recurrent or persistent uterine carcinosarcoma.

II. Determine the nature and degree of toxicity of this drug in these patients.

Secondary I. Determine the partial and complete response rates in patients treated with this drug.

II. Determine the duration of PFS and overall survival of patients treated with this drug.

III. Determine the effect of this drug on initial performance status and histological grade in these patients.

IV. Correlate serum and plasma biomarkers, including vascular endothelial growth factor and basic fibroblast growth factor, with clinical outcome (i.e., PFS) in patients treated with this drug.

OUTLINE: This is a multicenter study.

Patients receive oral thalidomide once daily on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

Patients are followed every 3 months for 2 years, every 6 months for 3 years, and then annually thereafter.

PROJECTED ACCRUAL: A total of 19-51 patients will be accrued for this study within 3 years.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 55
• Est. completion date: January 2013
• Est. primary completion date: January 2013
• Accepts healthy volunteers: No
• Gender: Female
• Age group: N/A and older

Eligibility

Inclusion Criteria:

• Histologically confirmed uterine sarcoma

• Carcinosarcoma (malignant mixed müllerian tumor)

• Homologous or heterologous type

• Recurrent or persistent with documented disease progression after prior local therapy

• At least 1 unidimensionally measurable target lesion

• At least 20 mm by conventional techniques, including palpation, plain x-ray, CT scan, or MRI

• At least 10 mm by spiral CT scan

• Tumors within a previously irradiated field are considered non-target lesions

• Must have received 1 prior initial chemotherapy regimen (including high-dose ,consolidation, or extended therapy after surgical or nonsurgical assessment) for carcinosarcoma

• No documented brain metastases since diagnosis of cancer

• Patients with stable CNS deficits are allowed provided that there is no evidence of brain metastases on CT scan or MRI

• Ineligible for a higher priority Gynecologic Oncology Group (GOG) protocol (if one exists), including any active phase III GOG protocol for the same patient population

• Performance status - GOG 0-2 if received 1 prior therapy regimen

• Performance status - GOG 0-1 if received 2 prior therapy regimens

• Absolute neutrophil count at least 1,500/mm^3

• Platelet count at least 100,000/mm^3

• Bilirubin no greater than 1.5 times upper limit of normal (ULN)

• SGOT no greater than 2.5 times ULN

• Alkaline phosphatase no greater than 2.5 times ULN

• Creatinine no greater than 1.5 times ULN

• Creatinine clearance greater than 60 mL/min

• Not pregnant

• Negative pregnancy test

• Fertile patients must use at least 1 highly active method of contraception and 1 additional effective method of contraception for at least 4 weeks before, during, and for at least 4 weeks after study participation

• No seizure disorders since diagnosis of cancer

• Patients with a history of seizure disorders are allowed provided that the seizures have been stable (i.e., no seizure within the past 12 months) while on an appropriately monitored treatment regimen

• No active infection requiring antibiotics

• No greater than grade 1 sensory or motor neuropathy

• No other invasive malignancy within the past 5 years except nonmelanoma skin cancer

• At least 3 weeks since prior immunologic agents for uterine sarcoma

• No prior thalidomide

• See Disease Characteristics

• At least 3 weeks since prior chemotherapy for uterine sarcoma and recovered

• No more than 1 prior cytotoxic chemotherapy regimen for recurrent or persistent uterine sarcoma

• No prior non-cytotoxic chemotherapy for recurrent or persistent uterine sarcoma

• No concurrent bisphosphonates (e.g., zoledronate)

• At least 1 week since prior hormonal therapy for uterine sarcoma

• Concurrent hormone replacement therapy allowed

• See Disease Characteristics

• At least 3 weeks since prior radiotherapy for uterine sarcoma and recovered

• No prior radiotherapy to more than 25% of marrow-bearing areas

• See Disease Characteristics

• Recovered from prior surgery

• At least 3 weeks since any other prior therapy for uterine sarcoma

• No prior anticancer therapy that would preclude study

Related Conditions & MeSH terms

• Carcinosarcoma
• Mixed Tumor, Mullerian
• Recurrent Uterine Corpus Sarcoma
• Uterine Carcinosarcoma
• Uterine Neoplasms

Intervention

Other:
• Laboratory Biomarker Analysis
Correlative studies

Drug:
• Thalidomide
Given orally

Locations

Country	Name	City	State
United States	Gynecologic Oncology Group	Philadelphia	Pennsylvania

Sponsors (2)

Lead Sponsor	Collaborator
National Cancer Institute (NCI)	Gynecologic Oncology Group

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Serum and Plasma Concentrations of VEGF and bFGF With PFS		Up to 5 years
Other	Serum and Plasma Concentrations of Vascular Endothelial Growth Factor (VEGF) and bFGF		Up to 5 years
Primary	Progression-free Survival (PFS) > 6 Months	Progression is defined according to RECIST v1.0 as at least a 20% increase in the sum of LD target lesions taking as reference the smallest sum LD recorded since study entry, the appearance of one or more new lesions, death due to disease without prior objective documentation of progression, global deterioration in health status attributable to the disease requiring a change in therapy without objective evidence of progression, or unequivocal progression of existing non-target lesions.	Every other cycle for 6 months
Primary	Frequency and Severity of Adverse Effects as Assessed by Common Toxicity Criteria (CTC) v2.0		Each cycle during treatment and 30 days after the last treatment (average 4 months)
Secondary	Progression Free Survival	Progression is defined according to RECIST v1.0 as at least a 20% increase in the sum of LD target lesions taking as reference the smallest sum LD recorded since study entry, the appearance of one or more new lesions, death due to disease without prior objective documentation of progression, global deterioration in health status attributable to the disease requiring a change in therapy without objective evidence of progression, or unequivocal progression of existing non-target lesions.	Every other cycle until progression or death, up to 5 years.
Secondary	Tumor Response	RECIST 1.0 defines complete response as the disappearance of all target lesions and non-target lesions and no evidence of new lesions documented by two disease assessments at least 4 weeks apart. Partial response is defined as at least a 30% decrease in the sum of longest dimensions (LD) of all target measurable lesions taking as reference the baseline sum of LD. There can be no unequivocal progression of non-target lesions and no new lesions. Documentation by two disease assessments at least 4 weeks apart is required. In the case where the ONLY target lesion is a solitary pelvic mass measured by physical exam, which is not radiographically measurable, a 50% decrease in the LD is required. These patients will have their response classified according to the definitions stated above. Complete and partial responses are included in the objective tumor response rate.	For those patients whose disease can be evaluated by physical examination, response was assessed prior to each 28-day cycle. CT scan or MRI if used to follow lesion for measurable disease every other cycle. (average = 4 months)
Secondary	Overall Survival	The observed length of life from entry into the study to death or the date of last contact.	From study entry to death or last contact, up to 5 years.
Secondary	Initial Performance Status	Performance status 0 = Fully active, able to carry on all pre-disease performance without restriction.; Performance status 1 = Restricted in physically strenuous activity but ambulatory and able to carry out work of light or sedentary nature, e.g., light housework, office work.; Performance status 2 = Ambulatory and capable of all selfcare but unable to carry out any work activities. Up and about more than 50% of waking hours.	baseline
Secondary	Initial Histologic Grade	G3 - Predominantly solid or entirely undifferentiated carcinoma. Not graded - tumor grade not reported.	Baseline