Sorafenib in Treating Patients With Malignant Gastrointestinal Stromal Tumor That Progressed During or After Previous Treatment With Imatinib Mesylate and Sunitinib Malate

Gastrointestinal Stromal Tumor Clinical Trial

Official title:

A Phase 2 Study of BAY 43-9006 for Imatinib- and Sunitinib Resistant Gastrointestinal Stromal Tumor

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT00265798
• Other study ID #: NCI-2009-00116
• Secondary ID: NCI-2009-00116NC
• Status: Active, not recruiting
• Phase: Phase 2
• Start date: September 14, 2005
• Est. completion date: March 8, 2025

Study information

• Verified date: February 2024
• 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 sorafenib works in treating patients with malignant gastrointestinal stromal tumor that progressed during or after previous treatment with imatinib mesylate and sunitinib malate. Sorafenib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth and by blocking blood flow to the tumor.

Description:

PRIMARY OBJECTIVES:

I. To determine the objective response rate of patients with imatinib and sunitinib-resistant malignant gastrointestinal stromal tumor who are treated with BAY 43-9006.

SECONDARY OBJECTIVES:

I. To determine the toxicity experienced by patients with imatinib and sunitinib -resistant malignant gastrointestinal stromal tumor who are treated with BAY 43-9006.

II. To determine progression-free survival and overall survival in patients with imatinib and sunitinib -resistant malignant gastrointestinal stromal tumor who are treated with BAY 43-9006.

TERTIARY OBJECTIVES:

I. To examine if mutational status of KIT and PDGFA in patients with imatinib- and sunitinib resistant malignant gastrointestinal stromal tumor correlate with response to BAY 43-9006.

OUTLINE: This is a multicenter study. Patients are stratified according to response to prior treatment with imatinib mesylate and sunitinib malate (imatinib mesylate- and sunitinib malate-responsive disease vs primary imatinib mesylate- and sunitinib malate-refractory disease).

Patients receive oral sorafenib twice daily on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed periodically.

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 38
• Est. completion date: March 8, 2025
• Est. primary completion date: February 11, 2010
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Histologically confirmed gastrointestinal stromal tumor

• Not amenable to curative surgery

• Kit-expressing tumor

• Disease progression (i.e., new lesion or 20% increase in unidimensional tumor size) on or after treatment with imatinib mesylate and sunitinib malate

• Measurable disease, defined as = 1 unidimensionally measurable lesion > 20 mm by conventional techniques OR > 10 mm by spiral CT scan

• Only site of measurable disease must be outside of previously irradiated area

• No known brain metastases

• Performance status - ECOG 0-2

• More than 3 months

• Absolute neutrophil count > 1,500/mm^3

• Platelet count > 100,000/mm^3

• Bilirubin normal

• AST and ALT < 2.5 times upper limit of normal

• Creatinine = 1.5 mg/dL

• Creatinine clearance > 60 mL/min

• No symptomatic congestive heart failure

• No unstable angina pectoris

• No cardiac arrhythmia

• No uncontrolled hypertension

• Not pregnant or nursing

• Negative pregnancy test

• Fertile patients must use effective contraception

• No other malignancy within the past 5 years except nonmelanoma skin cancer or carcinoma in situ of the cervix

• No history of allergic reaction attributed to compounds of similar chemical or biological composition to sorafenib

• No ongoing or active infection

• No psychiatric illness or social situation that would preclude study compliance

• No other uncontrolled illness

• No evidence of bowel perforation or obstruction

• No prior angiogenesis inhibitors

• No immunotherapy after the last dose of imatinib mesylate or sunitinib malate

• No chemotherapy or chemoembolization therapy after the last dose of imatinib mesylate or sunitinib malate

• See Disease Characteristics

• At least 4 weeks since prior radiotherapy and recovered

• At least 14 days since prior imatinib mesylate or sunitinib malate

• No prior sorafenib

• No prior inhibitors of MAPK-signaling intermediates

• No other investigational agent after the last dose of imatinib mesylate or sunitinib malate

• Concurrent anticoagulation therapy with warfarin allowed provided the following criteria are met:

• On a therapeutic stable warfarin dose

• INR =3

• No active bleeding or pathologic condition that confers a high risk of bleeding

• No concurrent combination antiretroviral therapy for HIV-positive patients

• No concurrent administration of any of the following:

• Enzyme-inducing antiepileptic drugs (e.g., carbamazepine, phenytoin, or phenobarbital)

• Hypericum perforatum (St. John's wort)

• Rifampin

• No other concurrent anticancer agents or therapies

Related Conditions & MeSH terms

• Gastrointestinal Stromal Tumor
• Gastrointestinal Stromal Tumors

Intervention

Drug:
• Sorafenib Tosylate

Locations

Country	Name	City	State
United States	University of Chicago Comprehensive Cancer Center	Chicago	Illinois
United States	Decatur Memorial Hospital	Decatur	Illinois
United States	City of Hope Comprehensive Cancer Center	Duarte	California
United States	Memorial Sloan Kettering Cancer Center	New York	New York
United States	University of California Davis Comprehensive Cancer Center	Sacramento	California
United States	Central Illinois Hematology Oncology Center	Springfield	Illinois

Sponsors (1)

Lead Sponsor	Collaborator
National Cancer Institute (NCI)

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Objective Response Rate	Objective response (complete response (CR)+ partial response (PR)) will be evaluated using Response Evaluation Criteria in Solid Tumors (RECIST) criteria. CR is the disappearance of all target lesions. PR requires at least a 30% decrease in the sum of the longest diameter (LD) of target lesions, taking as reference the baseline sum LD.; Computed Tomography (CT) scans for disease reassessment will be obtained pre-therapy and every 8 weeks. In addition to a baseline scan, confirmatory scans will also be obtained 4 weeks following initial documentation of objective response.	Up to 5 years
Secondary	Progression-free Survival	Progression-free survival will be defined as time from the start of treatment until progression (documented according to Response Evaluation Criteria in Solid Tumors (RECIST) criteria and defined as at least a 20% increase in the sum of the longest diameter of target lesions) or death, whichever comes first.; CT scans for disease reassessment will be obtained pre-therapy and every 8 weeks.	Up to 5 years
Secondary	Overall Survival	Overall survival will be defined as time from the start of treatment until death from any cause.	Up to 5 years