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A Phase II Trial of Dasatinib in Advanced Sarcomas


Phase 2
13 Years
N/A
Open (Enrolling)
Both
Rhabdomyosarcoma, Malignant Peripheral Nerve Sheath Tumors, Chondrosarcoma, Sarcoma, Ewing's, Sarcoma, Alveolar Soft Part, Chordoma, Epithelioid Sarcoma, Giant Cell Tumor of Bone, Hemangiopericytoma, Gastrointestinal Stromal Tumor (GIST)

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Trial Information

A Phase II Trial of Dasatinib in Advanced Sarcomas


Further details provided by SARC (Sarcoma Alliance for Research through Collaboration):

Treatment: Subjects take Dasatinib twice daily by mouth for 28 days per 28 day cycle.

Subjects will be seen for interim medical history, physical exam and laboratory studies
prior to each cycle. Subjects will undergo tumor imaging every 2 months (8 weeks) for the
first 6 months and approximately every 3 months thereafter while on treatment.

A blood sample for collection of specimens with which to later study serum level of
Dasatinib and effects on biomarkers of drug activity will be obtained approximately 2 to 4
weeks after the start of treatment.

Central collection of archival tumor with which to later study the frequency of expression
and/or mutation of kinases inhibited by dasatinib will occur.

Subjects will be followed for approximately every 3 months until 2 years from registration
and then approximately yearly until 5 years from registration.


Inclusion Criteria:



1. Unresectable, recurrent, or metastatic histologically-confirmed soft tissue or bone
sarcoma of one of the following subtypes:

- Leiomyosarcoma --* NO LONGER ELIGIBLE*

- Liposarcoma--* NO LONGER ELIGIBLE*

- Malignant fibrous histiocytoma (MFH)/pleomorphic undifferentiated sarcoma--* NO
LONGER ELIGIBLE*

- Rhabdomyosarcoma --* NO LONGER ELIGIBLE*

- Malignant peripheral nerve sheath tumor (MPNST) --* NO LONGER ELIGIBLE*

- Osteosarcoma (skeletal or extraosseous)--* NO LONGER ELIGIBLE*

- Ewing's --* NO LONGER ELIGIBLE*

- Chondrosarcoma

- Alveolar soft part sarcoma

- Chordoma

- Epithelioid sarcoma

- Giant cell tumor of bone

- Hemangiopericytoma/solitary fibrous tumor

- Gastrointestinal Stromal Tumor (GIST) --* NO LONGER ELIGIBLE*

2. Documentation that subjects with leiomyosarcoma, liposarcoma, osteosarcoma, Ewing's,
MPNST, rhabdomyosarcoma or MFH have received, not been eligible for or refused at
least one prior chemotherapy regimen before participation in the dasatinib study.
Subjects with GIST must have received or been intolerant to imatinib; prior treatment
with other agents including sunitinib is not required.Neoadjuvant/adjuvant
chemotherapy qualifies as prior therapy.

3. Subjects must have unidimensionally measurable lesion(s) either by x-ray, computed
tomography (CT), magnetic resonance imaging (MRI) or physical examination documented
within 30 days prior to registration.

4. Prior radiation will be allowed. More than two weeks should have elapsed since the
administration of the last fraction of radiation therapy, and subjects must have
recovered from grade 2 or higher associated toxicities. Measurable lesions, which are
selected as target lesions, must be outside previously radiated fields or have
documented progression no sooner than 6 weeks after completion of radiation.

5. More than 2 weeks must have elapsed since the subject has received any prior systemic
chemotherapy (6 weeks for mitomycin C), and the patient should have recovered from
toxicities to the baseline prior to the last course of chemotherapy.

6. Adequate hematologic function within 14 days prior to registration.

7. PT (or INR) and PTT ≤ 1.5 times the institutional ULN within 14 days prior to
registration.

8. Serum creatinine ≤ 2.0 times the institutional ULN within 14 days prior to
registration.

9. Serum magnesium, potassium and adjusted (or ionized) calcium ≥ the institutional LLN.
(Supplementation of electrolytes prior to screening is allowed).

10. Left ventricular ejection fraction ≥ 45% measured by echocardiogram or multiple gated
acquisition (MUGA) within 30 days prior to registration (but must be performed after
the last dose of an anthracycline) for subjects who have received an anthracycline
(e.g. doxorubicin, epirubicin) or have a medical history of cardiac disease. The
measurement of left ventricular ejection fraction is not required of subjects whom
have not received cardiotoxic chemotherapy (e.g. anthracycline) and do not have a
medical history of cardiac disease.

11. Sexually active women and men of childbearing potential must agree to use an
effective method of birth control during the course of the study and for up to 3
months following the last dose of the study drug, in a manner such that risk of
pregnancy is minimized. Surgical sterilization, intrauterine device or barrier method
(e.g. condom and/or diaphragm with spermicidal agents) are acceptable forms of birth
control.

12. Women of childbearing potential must have a negative pregnancy test (urine or serum)
within 7 days prior to treatment. A pregnancy test is not required for registration.
Women who have not menstruated for more than 2 years will be considered
postmenopausal, thus not of childbearing potential.

13. ECOG performance score 0, 1 or 2.

14. Weight ≥ 50 kg because there is limited experience with dasatinib in subjects
weighing less than 50 kg.

15. ≥13 years of age Minors will be required to sign an assent document prior to
treatment.

16. Subjects must be able to swallow whole tablets.

17. Subjects must be informed of the investigational nature of the study and provide
written, informed consent and authorization to release protected health information
using a document(s) approved by the investigator's institution.

18. A paraffin block, either from a previous surgery or recent biopsy, should be
available for correlative studies. If a block of tumor is not available, at least 8
unstained slides of tumor sample, 1 H&E and three (3) 15 micron-thick sections in an
eppendorf tube for DNA extraction from a representative portion of the sarcoma may be
substituted after discussion with and approval from the study Principal Investigator.

Exclusion Criteria:

1. Subjects who are curable by conventional multidisciplinary management.

2. Subjects with symptomatic central nervous system metastasis.

3. Women who are pregnant or nursing/breastfeeding.

4. History of significant bleeding disorder unrelated to cancer, including:

- Diagnosed congenital bleeding disorders (e.g., von Willebrand's disease)

- Diagnosed acquired bleeding disorder within one year (e.g., acquired anti-factor
VIII antibodies)

5. Subjects currently taking medications that inhibit platelet function (i.e., aspirin,
dipyridamole, epoprostenol, eptifibatide, clopidogrel, cilostazol, abciximab,
ticlopidine, and any non-steroidal anti-inflammatory drug) because of a potential
increased risk of bleeding from dasatinib.

6. Subjects currently taking anticoagulants (warfarin, heparin/low molecular weight
heparin [e.g., danaparoid, dalteparin, tinzaparin, enoxaparin]) because of a
potential increased risk of bleeding from dasatinib.

7. Diagnosis of unstable angina or myocardial infarction within 6 months of study entry.

8. Subjects currently taking one or more of the following drugs that are generally
accepted to have a risk of causing Torsades de Pointes:

- Quinidine, procainamide, disopyramide

- Amiodarone, sotalol, ibutilide, dofetilide

- Erythromycins, clarithromycin

- Chlorpromazine, haloperidol, mesoridazine, thioridazine, pimozide

- Cisapride, bepridil, droperidol, methadone, arsenic, chloroquine, domperidone,
halofantrine, levomethadyl, pentamidine, sparfloxacin, lidoflazine.

9. Diagnosed or suspected congenital long QT syndrome.

10. Prolonged QTc interval on pre-entry electrocardiogram (> 450 msec) within 30 days
prior to study registration.

11. Subjects unable or unwilling to suspend treatment with bisphosphonates for at least
the first 8 weeks of treatment with study drug because of the risk of hypocalcemia
caused by dasatinib.

Type of Study:

Interventional

Study Design:

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

Outcome Measure:

Evaluation of all lesions for progression or response will be made at 2-month intervals for the first 6 months and then every 3 months thereafter

Outcome Time Frame:

every 2 months

Safety Issue:

Yes

Principal Investigator

Scott Schuetze, MD, PhD

Investigator Role:

Principal Investigator

Investigator Affiliation:

University of Michigan

Authority:

United States: Institutional Review Board

Study ID:

SARC009

NCT ID:

NCT00464620

Start Date:

May 2007

Completion Date:

December 2013

Related Keywords:

  • Rhabdomyosarcoma
  • Malignant Peripheral Nerve Sheath Tumors
  • Chondrosarcoma
  • Sarcoma, Ewing's
  • Sarcoma, Alveolar Soft Part
  • Chordoma
  • Epithelioid Sarcoma
  • Giant Cell Tumor of Bone
  • Hemangiopericytoma
  • Gastrointestinal Stromal Tumor (GIST)
  • Dasatinib
  • Rhabdomyosarcoma
  • Malignant peripheral nerve sheath tumor
  • Chondrosarcoma
  • Ewing's
  • Alveolar soft part sarcoma (ASPS)
  • Chordoma
  • Epithelioid sarcoma
  • Giant cell tumor of bone
  • Hemangiopericytoma/solitary fibrous tumor
  • Gastrointestinal Stromal Tumor (GIST)
  • Bone Neoplasms
  • Chondrosarcoma
  • Chordoma
  • Giant Cell Tumors
  • Hemangiopericytoma
  • Rhabdomyosarcoma
  • Sarcoma
  • Giant Cell Tumor of Bone
  • Sarcoma, Alveolar Soft Part
  • Nerve Sheath Neoplasms
  • Gastrointestinal Stromal Tumors
  • Sarcoma, Ewing's
  • Neurofibrosarcoma
  • Neurilemmoma

Name

Location

University of Michigan Ann Arbor, Michigan  48109-0624
Indiana University Cancer Center Indianapolis, Indiana  46202-5265
University of Iowa Hospitals and Clinics Iowa City, Iowa  52242
Fox Chase Cancer Center Philadelphia, Pennsylvania  19111
University of Pittsburgh Cancer Institute Pittsburgh, Pennsylvania  15213
Stanford University Stanford, California  94305
Arkansas Children's Hospital Little Rock, Arkansas  72202-3591
Massachusetts General Hospital Boston, Massachusetts  02114-2617
Washington Cancer Institute Washington, District of Columbia  20010
Pennsylvania Oncology Hematology Associates Philadelphia, Pennsylvania  19107
City of Hope Duarte, California  91010
Nebraska Methodist Hospital Omaha, Nebraska  68114
Dana Farber Cancer Institute Boston, Massachusetts  02115
Winship Cancer Institute at Emory University Atlanta, Georgia  30322
Oncology Specialists Park Ridge, Illinois  60068
MD Anderson Houston, Texas  77230
Johns Hopkins Sidney Kimmel Comprehensive Cancer Center Baltimore, Maryland  21231
Kootenai Cancer Center Post Falls, Idaho  83854
Sarcoma Oncology Center Santa Monica, California  90403
Cedars-Sinai Outpatient Cancer Center Los Angeles, California