Nintedanib as Switch Maintenance Treatment of Pleural Malignant Mesothelioma

Malignant Pleural Mesothelioma Clinical Trial

— NEMO  

Official title:

Nintedanib as Maintenance Treatment of Pleural Malignant Mesothelioma (NEMO): a Randomized Double Blinded Phase II Study of the EORTC Lung Cancer Group

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT02863055
• Other study ID #: EORTC-08112
• Status: Active, not recruiting
• Phase: Phase 2
• Start date: February 4, 2018
• Est. completion date: March 31, 2024

Study information

• Verified date: April 2024
• Source: European Organisation for Research and Treatment of Cancer - EORTC
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This is a multicenter, randomized, 1:1, double blinded phase II trial. Patients with unresectable malignant pleural mesothelioma (MPM) will be randomized between arm A: nintedanib and arm B:placebo

Description:

This is a multicenter, prospective, double blinded, randomized, two-arm phase II trial aiming to evaluate nintedanib treatment as switch maintenance in patients with unresectable MPM. After signing of the informed consent and upon confirmation of all eligibility criteria, patients will be randomized 1:1 to: - Arm A: twice daily nintedanib at a dose of 200 mg until progression or unacceptable toxicities. - Arm B: matched placebo. Response evaluation will be performed through CT scans every 8 weeks.

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 37
• Est. completion date: March 31, 2024
• Est. primary completion date: March 26, 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 90 Years

Eligibility

Inclusion Criteria:

• Histological diagnosis of unresectable Malignant Pleural Mesothelioma (MPM);
• Response or Stable disease according to modified RECIST criteria [48] after first line platinum-pemetrexed chemotherapy for 4-6 cycles;
• Last platinum chemotherapy dose administered within 60 days (i.e. randomization must occur within 60 days from the last dose of the last cycle of platinum-pemetrexed chemotherapy);
• Age >18 years;
• ECOG performance status (PS) 0-2;
• Life expectancy of at least 12 weeks in the opinion of the investigator;
• Adequate bone marrow, liver and renal function as assessed by the following laboratory requirements to be conducted within 7 days prior to start of first dose

Exclusion Criteria:

• prior systemic anticancer therapy including cytotoxic therapy or immune-checkpoint inhibitor, for MPM, other than first line platinum-based doublet chemotherapy;
• previous extra-pleural pneumonectomy (other forms of previous surgery eg pleurectomy are acceptable);
• previous Vascular Endothelial Growth Factor (VEGF) inhibitors (eg bevacizumab, sorafenib, etc);
• treatment with other investigational drugs or treatment in another clinical interventional trial within the past 4 weeks before start of therapy or concomitantly with the trial;
• patients that, in the opinion of the investigator, have reduced performance status by 2 ECOG levels (e.g. PS 0 to 2 or PS 1 to 3) from beginning to completion of 1st line chemotherapy;
• radiotherapy (with the exception of palliative radiotherapy) during study or within 4 weeks of start of study drug;
• known brain metastasis or lepto-meningeal disease. Patients with suspicious neurological symptoms should undergo a CT scan/MRI of the brain to exclude brain metastasisNo active brain metastases (e.g. stable for < 4 weeks;, no adequate previous treatment with radiotherapy;, symptomatic, requiring treatment with anti-convulsants; dexamethasone therapy will be allowed if administered as stable dose for at least one month before randomization); patients with suspicious neurological symptoms should undergo a CT scan/MRI of the brain to assess brain metastasis;
• leptomeningeal metastases;
• significant weight loss (> 10 %) within the past 6 weeks prior to treatment in the present trial;
• pre-existing clinically significant ascites and/or clinically significant pleural effusion;
• active or history of bleeding complications that would prevent anti-angiogenic therapy
• centrally located tumors with radiographic evidence (CT or MRI) of local invasion of major blood vessels; typical mediastinal pleural involvement with mesothelioma remains eligible;
• clinically active cancer other than mesothelioma within 5 years prior to start of study treatment;
• radiographic evidence of cavitatory or necrotic tumors;
• unstoppable use of therapeutic anticoagulation (except low dose heparin and/or heparin flush as needed for maintenance of an indwelling intravenous device) or antiplatelet therapy (except for chronic low-dose therapy with acetylsalicylic acid =325mg per day);
• clinically significant cardiovascular diseases (i.e. hypertension not controlled by medical therapy, unstable angina, history of myocardial infarction within the past 6 months, congestive New York Heart Association (NYHA) II, serious cardiac arrhythmia, clinically significant pericardial effusion)

Related Conditions & MeSH terms

• Malignant Pleural Mesothelioma
• Mesothelioma
• Mesothelioma, Malignant

Intervention

Drug:
• Nintedanib
Nintedanib 200 mg administered twice daily
• Placebo
Matching placebo administered twice daily

Locations

Country	Name	City	State
Belgium	UZ Antwerpen	Antwerpen
Belgium	UZ Gent	Gent
Italy	Ospedale San Paolo	Milan
United Kingdom	Royal Marsden Hospital	Chelsea
United Kingdom	Royal Marsden Hospital - Kingston	Kingston
United Kingdom	Sheffield Teaching Hospitals NHS Foundation Trust - Weston Park Hospital	Sheffield
United Kingdom	NHS South Tyneside-South Tyneside District Hospital	South Shields
United Kingdom	Royal Marsden Hospital	Sutton
United Kingdom	Manchester University NHS Foundation Trust - UHSM-Wythenshawe Hospital	Wythenshawe	Manchester

Sponsors (1)

Lead Sponsor	Collaborator
European Organisation for Research and Treatment of Cancer - EORTC

Countries where clinical trial is conducted

Belgium,  Italy,  United Kingdom, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Progression-free survival	From randomization until progression or death	6 months
Secondary	Overall survival	From randomization until progression or death	12 months
Secondary	Overall Response Rate	Response according to modified RECIST	6 months