Clinical Trials /

Phase 1b/2 Study of Vorinostat in Combination With Gemcitabine and Docetaxel in Advanced Sarcoma

NCT01879085

Description:

This is a Phase Ib/II experimental, open-label, dose escalation, active treatment study designed to determine the safety, tolerability, and recommended dose of the combination. During the Phase 2 portion of the study, we will assess progression-free survival (PFS), overall survival (OS),overall response rate (ORR), correlative endpoints, DNA methylation measured by microarray, and expression level of the genes as measured by microarray

Related Conditions:
  • Soft Tissue Sarcoma
Recruiting Status:

Active, not recruiting

Phase:

Phase 1/Phase 2

Trial Eligibility

Document

Title

  • Brief Title: Phase 1b/2 Study of Vorinostat in Combination With Gemcitabine and Docetaxel in Advanced Sarcoma
  • Official Title: Phase 1b/2 Study of Vorinostat in Combination With Gemcitabine and Docetaxel in Advanced Sarcoma

Clinical Trial IDs

  • ORG STUDY ID: UPCI# 12-104
  • NCT ID: NCT01879085

Conditions

  • Sarcoma

Interventions

DrugSynonymsArms
DocetaxelTaxotereCombination therapy
GemcitabineGemzarCombination therapy
VorinostatZolinzaCombination therapy
PegfilgrastimNeulastaCombination therapy

Purpose

This is a Phase Ib/II experimental, open-label, dose escalation, active treatment study designed to determine the safety, tolerability, and recommended dose of the combination. During the Phase 2 portion of the study, we will assess progression-free survival (PFS), overall survival (OS),overall response rate (ORR), correlative endpoints, DNA methylation measured by microarray, and expression level of the genes as measured by microarray

Detailed Description

      Phase 1b

        -  To determine the dose of vorinostat that can be safely combined with gemcitabine and
           docetaxel in patients with advanced sarcomas.

        -  To characterize the Pharmacokinetics (PK) and Pharmacodynamics (PD) of vorinostat when
           combined with gemcitabine and docetaxel in patients with advanced sarcomas.

      Phase 2

        -  To determine the safety and efficacy of gemcitabine and docetaxel in combination with
           vorinostat in patients with advanced sarcomas. The hypothesis is that gemcitabine and
           docetaxel + vorinostat will be safe and will improve the 6-months progression-free rates
           (PFR) of the combination by 20% (from 20% to 40%).

        -  To determine the objective response rate, progression-free, and overall survival of
           patients with advanced sarcomas treated with gemcitabine and docetaxel + vorinostat;

        -  To develop a predictive molecular signature of response to treatment in advanced
           sarcomas.
    

Trial Arms

NameTypeDescriptionInterventions
Combination therapyExperimentalDose Level\Docetaxel IV\ Gemcitabine IV\Vorinostat PO\Pegfilgrastim 1\75 mg/m2\900 mg/m2\300 mg once daily\6 mg on day 9 2\75 mg/m2\900 mg/m2\200 mg twice daily\6 mg on day 9 3\75 mg/m2\900 mg/m2\300 mg twice daily\6 mg on day 9 4\75 mg/m2\900 mg/m2\400 mg twice daily\6 mg on day 9
  • Docetaxel
  • Gemcitabine
  • Vorinostat
  • Pegfilgrastim

Eligibility Criteria

        Inclusion Criteria:

          -  Patients must have histologically confirmed soft tissue sarcoma with evidence of
             metastatic or unresectable disease.

          -  Patients must have measurable disease by RECIST 1.1.

          -  Up to 32 prior cytotoxic chemotherapy regimens in the metastatic setting are allowed.
             Adjuvant chemotherapy or targeted therapy will not be considered a prior line of
             treatment.

          -  Age ≥18 years.

          -  ECOG performance status ≤2 (Karnofsky ≥60%).

          -  Life expectancy of greater than 12 weeks.

          -  Patients must have normal organ and marrow function as defined below:

               -  leukocytes ≥3,000/µL

               -  absolute neutrophil count ≥1,500/µL

               -  platelets ≥100,000/µL

               -  total bilirubin within normal institutional limits

               -  AST(SGOT)/ALT(SGPT) ≤1.5 X institutional upper limit of normal (ULN)

               -  creatinine ≤1.5 X institutional upper limit of normal (ULN)

          -  Peripheral neuropathy, if present, should be ≤grade 1.

          -  Women of Child bearing potential MUST use contraceptives.

          -  Ability to understand and the willingness to sign a written informed consent document.

        Exclusion Criteria:

          -  The following specific histologic subtypes of soft tissue sarcomas will be excluded:
             GIST, Kaposi's sarcoma, mesothelioma, dermatofibrosarcoma, chordoma, alveolar
             soft-part sarcoma. Also, all bone sarcomas are excluded including Ewing's sarcoma,
             osteosarcoma, GIST, low grade chondrosarcoma, and chordoma.

          -  Patients who have had treatment with chemotherapy or radiotherapy within 4 weeks (6
             weeks for nitrosoureas or mitomycin C) prior to starting study treatment or those who
             have not recovered from adverse events due to agents administered more than 4 weeks
             earlier.

          -  Patients who are receiving any other investigational agents.

          -  Patients with known brain metastases.

          -  History of allergic reactions attributed to compounds of similar chemical or biologic
             composition to gemcitabine, docetaxel, vorinostat, or G-CSF.

          -  Patients who have received and progressed on the combination of gemcitabine and
             docetaxel in the metastatic setting.

          -  Uncontrolled intercurrent illness including, but not limited to, ongoing or active
             infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac
             arrhythmia, or psychiatric illness/social situations that would limit compliance with
             study requirements.

          -  Pregnant and breastfeeding women

          -  Patients taking concomitant HDAC inhibitors.

          -  HIV-positive patients on combination antiretroviral treatment
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Phase I: Recommended Phase II Dose of Vorinostat
Time Frame:Up to 12 months
Safety Issue:
Description:The dose of vorinostat that can be safely combined with gemcitabine and docetaxel in patients with advanced sarcomas. Gemcitabine and docetaxel will be given at a fixed dose while vorinostat will be dose-escalated using a standard '3+3' design. Dose-limiting toxicity (DLT) is defined as specific study drug-related events experienced during Cycle 1; only DLTs observed in a patient during the first cycle of treatment will be used for the dose escalation decision.

Secondary Outcome Measures

Measure:Progression-free survival (PFS)
Time Frame:Up to 8 years
Safety Issue:
Description:The length from the beginning of study treatment that patients remain alive without progression of their disease (cancer). Per RECIST v1.1, progressive disease (PD) is defined as at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study). In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5mm. For non-target lesions, PD: Unequivocal progression of existing non-target lesions. The appearance of one or more new lesions is also considered progression.
Measure:Overall survival (OS)
Time Frame:Up to 8 years
Safety Issue:
Description:The length of time from the start of treatment that diagnosed study participants remain alive.
Measure:Objective Response Rate (ORR)
Time Frame:Up to 8 years
Safety Issue:
Description:Complete response [CR] + partial response [PR], per RECIST v1.1 criteria . Per RECIST v1.1, CR: Disappearance of all target lesions. Any pathological lymph nodes(whether target or non-target) must have reduction in short axis to <10 mm. For non-target lesions: Disappearance of all non-target lesions and normalization of tumor marker level. All lymph nodes must be non-pathological in size (<10mm short axis);PR: At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters

Details

Phase:Phase 1/Phase 2
Primary Purpose:Interventional
Overall Status:Active, not recruiting
Lead Sponsor:Melissa Burgess, MD

Trial Keywords

  • advanced
  • metastatic
  • unresectable
  • soft
  • tissue
  • sarcomas

Last Updated

March 3, 2021