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A Phase II, Open-Label Study of PTK787/ZK222584 in the Treatment of Metastatic Gastrointestinal Stromal Tumors (GISTs) Resistant to Imatinib Mesylate


Phase 2
18 Years
N/A
Not Enrolling
Both
Sarcoma

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Trial Information

A Phase II, Open-Label Study of PTK787/ZK222584 in the Treatment of Metastatic Gastrointestinal Stromal Tumors (GISTs) Resistant to Imatinib Mesylate


This is an open-label, phase II study of PTK787/ZK222584 designed to determine the safety
and efficacy of PTK787/ZK222584 in the treatment of imatinib-resistant GIST. The
PTK787/ZK222584 dose used is 1250 mg daily. Six patients will first enter the study using a
two-stage approach. If clinical benefit is obtained in >1 of 6 patients, 9 and 30 additional
patients will be entered into the protocol (a maximum total number of 45 patients will be
entered). Clinical benefit is defined as the occurrence of one or more of the following 3
measures: 1) objective response to PTK787 (a confirmed or unconfirmed partial response [PR]
or a complete response [CR]); 2) metabolic response defined as >50% decrease in the
standardized uptake value (SUV) of FDG uptake in >1 FDG-avid lesions in one or more of the
patients; or 3) stabilized disease for 3 months or longer accompanied by symptomatic or
performance status improvement. Medical history, current medical conditions, weight, height,
and an electrocardiogram are recorded prior to the study entry. Other baseline examinations
include a chest X-ray, hematologic tests, a coagulation panel, serum chemistries, urine
analysis, a serum pregnancy test and a radiological assessment of the tumor. Tumor response
is monitored with imaging at 4- to 8-week intervals. Hematological tests and serum
chemistries are evaluated at 1- to 4-week intervals, and adverse events are collected
continuously. Research blood tests are collected at the times of tumor evaluations. Dose
adjustments are carried out as per the protocol. Patients who benefit from the study
treatment will be treated with PTK787/ZK222584 until treatment failure.


Inclusion Criteria:



- Patients with histologically confirmed GIST

- Imatinib resistance (primary resistance with progression, or progression after
initial response). Resistance is defined as objective evidence of progression after
at least 4 weeks of treatment with imatinib.

- Imatinib therapy has been interrupted >7 days before study entry

- Metastatic disease confirmed histologically, cytologically or radiologically

- Presence of measurable tumor lesions as determined by RECIST criteria

- Age 18 years or older

- WHO performance status of 2 or less

- Blood neutrophil count (ANC) 1.5 x 10^9/L or higher

- Platelet count 100 x 10^9/L or higher

- Serum bilirubin 1.5 x ULN (upper limit of normal) or less

- Serum creatinine 2.0 x ULN or less

- Written informed consent obtained according to local guidelines

Exclusion Criteria:

- Patients who have received chemotherapy less than 4 weeks prior to entry into this
study or who have not recovered from side effects of such therapy

- Patients who have received a cumulative dose of doxorubicin >450 mg/m2 or epirubicin
800 mg/m2

- Patients who have received immunotherapy within 2 weeks or who have not recovered
from side effects of such therapy

- Patients who have received radiotherapy within 2 weeks or who have not recovered from
side effects of such therapy

- Major surgery within 2 weeks prior to entry into this study or patients who have not
recovered from side effects of such therapy

- Patients who have received investigational drugs within 4 weeks prior to entry into
this study or who have not recovered from side effects of such therapy

- Patients who are pregnant or breast feeding, or adults of reproductive potential not
employing an effective method of birth control

- Concurrent severe and/or uncontrolled medical disease (i.e., uncontrolled diabetes,
congestive cardiac failure, myocardial infarction within 6 months, poorly controlled
hypertension, history of labile hypertension, history of poor compliance with
antihypertensive regimen, chronic renal disease, or active uncontrolled infection)
which could compromise participation in the study

- Acute or chronic liver disease (e.g., hepatitis, cirrhosis)

- Confirmed diagnosis of HIV infection

- Impairment of gastrointestinal (GI) function or GI disease that may significantly
alter the absorption of PTK787/ZK222584 (e.g., ulcerative disease, uncontrolled
nausea, vomiting, diarrhea, malabsorption syndrome, bowel obstruction, or inability
to swallow the capsules/tablets)

- Patients who are taking Coumadin (warfarin sodium); heparin is acceptable.

- Patients unwilling to, or unable to, comply with the protocol

Type of Study:

Interventional

Study Design:

Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Response rate

Outcome Time Frame:

1 year

Safety Issue:

No

Principal Investigator

Heikki Joensuu, M.D.

Investigator Role:

Principal Investigator

Investigator Affiliation:

Department of Oncology, Helsinki University Central Hospital

Authority:

Finland: Finnish Medicines Agency

Study ID:

CPTK787 A2401/300267

NCT ID:

NCT00117299

Start Date:

September 2004

Completion Date:

January 2009

Related Keywords:

  • Sarcoma
  • Gastrointestinal stromal tumor
  • GIST
  • Sarcoma
  • PTK787
  • ZK 222584
  • Tyrosine kinase inhibitor
  • Tyrosine kinase
  • VEGF
  • Vascular endothelial growth factor
  • VEGFR
  • Vascular endothelial growth factor receptor
  • KDR
  • KIT
  • c-KIT
  • Platelet derived growth factor receptor
  • PDGFR
  • Gastrointestinal Stromal Tumors
  • Sarcoma

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