A Phase III, Randomized, Double-Blind, Placebo-Controlled Study of SU011248 in the Treatment of Patients With Imatinib Mesylate (Gleevec™, Glivec®)-Resistant or Intolerant Malignant Gastrointestinal Stromal Tumor
18 Years
N/A
Both
Gastrointestinal Stromal Tumor
Trial Information
A Phase III, Randomized, Double-Blind, Placebo-Controlled Study of SU011248 in the Treatment of Patients With Imatinib Mesylate (Gleevec™, Glivec®)-Resistant or Intolerant Malignant Gastrointestinal Stromal Tumor
OBJECTIVES:
Primary
- Compare the time to tumor progression in patients with imatinib mesylate-resistant or
-intolerant malignant gastrointestinal stromal tumor treated with SU011248 vs placebo.
Secondary
- Compare other measures of antitumor efficacy of these regimens in these patients.
- Compare pain control, analgesic usage, tumor-related signs and symptoms, health status,
and performance status in patients treated with these regimens.
- Determine the safety and tolerability of SU011248 in these patients.
- Correlate plasma concentration of this drug with efficacy and safety parameters in
these patients.
- Correlate potential biomarkers with clinical outcomes in patients treated with these
regimens.
OUTLINE: This is a randomized, double-blind, placebo-controlled, multicenter study. Patients
are stratified according to prior imatinib mesylate response or intolerance (progressive
disease within 6 months of the start of therapy vs progressive disease beyond 6 months from
the start of therapy vs intolerance) and baseline MPQ score based on the median value of the
worst daily pain over a 7-day period before randomization (0 vs ≥ 1). Patients are
randomized to 1 of 2 treatment arms.
- Arm I: Patients receive oral SU011248 once daily on days 1-28.
- Arm II: Patients receive oral placebo once daily on days 1-28. In both arms, courses
repeat every 42 days in the absence of disease progression or unacceptable toxicity.
Patients in arm II with disease progression who meet all eligibility criteria for further
treatment may crossover to arm I to receive open-label treatment with SU011248.
Quality of life is assessed on days 1 and 28 of each course and at the end of study
treatment.
Patients are followed at 30 days and then every 2 months for up to 3 years.
PROJECTED ACCRUAL: A total of 357 patients (238 in arm I and 119 in arm II) will be accrued
for this study within 18 months.
Inclusion Criteria
DISEASE CHARACTERISTICS:
- Histologically confirmed malignant gastrointestinal stromal tumor
- Not amenable to surgery, radiotherapy, or combined modality therapy with curative
intent
- Imatinib mesylate-resistant or -intolerant disease (last dose administered ≥ 2 weeks
ago)
- Failed prior imatinib mesylate therapy, defined by disease progression during
treatment OR significant toxicity during treatment that precludes further
treatment
- Must have radiological confirmation of disease progression
- Intolerance to prior imatinib mesylate, defined by 1 of the following:
- Life-threatening adverse events at any dose (attempt to dose reduce or
rechallenge not required)
- Unacceptable toxicity induced by a moderate dose (e.g., 400 mg/day),
specifically grade 3 toxicity OR grade 2 toxicity that is unacceptable to
the patient (e.g., nausea) that persists despite standard countermeasures
- Unidimensionally measurable disease
- At least 1 tumor mass ≥ 20 mm by conventional radiographic techniques or MRI OR
≥ 10-16 mm by spiral CT scan
- Tumor evaluation by positron-emission tomography scan or ultrasound may not
substitute for MRI or CT scan
- The following are considered non-measurable disease:
- Bone lesions
- Ascites
- Peritoneal carcinomatosis or miliary lesions
- Pleural or pericardial effusions
- Lymphangitis of the skin or lung
- Cystic lesions
- Irradiated lesions
- Disease documented by indirect evidence only (e.g., laboratory tests, such
as alkaline phosphatase)
PATIENT CHARACTERISTICS:
Age
- 18 and over
Performance status
- ECOG 0-1
Life expectancy
- Not specified
Hematopoietic
- Absolute neutrophil count ≥ 1,500/mm ^3
- Platelet count ≥ 100,000/mm^3
- Hemoglobin ≥ 9.0 g/dL
Hepatic
- PT and PTT ≤ 1.5 times upper limit of normal (ULN)
- AST and ALT ≤ 2.5 times ULN (5 times ULN for abnormalities due to underlying
malignancy)
- Bilirubin ≤ 1.5 times ULN
- Albumin ≥ 3.0 g/dL
Renal
- Creatinine ≤ 1.5 times ULN
Cardiovascular
- LVEF > lower limit of normal by MUGA scan
- Cardiac troponin T AND/OR cardiac troponin I ≤ ULN
- No ongoing cardiac dysrhythmias ≥ grade 2
- No atrial fibrillation of any grade
- No prolongation of the QTc interval to > 450 msec for males or > 470 msec for females
- None of the following conditions within the past 12 months:
- Myocardial infarction
- Severe or unstable angina
- Symptomatic congestive heart failure
- Cerebrovascular accident
- Transient ischemic attack
- Deep vein thrombosis
- Other thromboembolic event
Pulmonary
- No pulmonary embolism within the past 12 months
Other
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception during and for 30 days after study
participation
- Amylase and lipase ≤ 1.0 times ULN
- Adrenocorticotrophic hormone (ACTH) stimulation test normal
- HIV negative
- No AIDS-related illness
- No other malignancy within the past 5 years except adequately treated basal cell or
squamous cell skin cancer or carcinoma in situ of the cervix
- No other severe acute or chronic medical or psychiatric condition or laboratory
abnormality that would preclude study participation
PRIOR CONCURRENT THERAPY:
Biologic therapy
- No immunotherapy since last dose of imatinib mesylate
- No concurrent biological response modifiers
- No concurrent immunotherapy
Chemotherapy
- No chemotherapy or chemoembolization therapy since last dose of imatinib mesylate
- No concurrent chemotherapy
Endocrine therapy
- No concurrent hormonal therapy
Radiotherapy
- See Disease Characteristics
- No prior radiotherapy to areas of measurable disease where progression has occurred
in patients with imatinib mesylate-resistant disease
- No concurrent radiotherapy to the sole site of measurable disease
- Concurrent palliative radiotherapy allowed provided no measurable lesions
(target lesions) are included in the irradiated field
Surgery
- More than 12 months since prior coronary/peripheral artery bypass graft
- No prior surgery or cryotherapy on areas of measurable disease where progression has
occurred in patients with imatinib mesylate-resistant disease
- No concurrent surgery to the sole site of measurable disease
Other
- Recovered from all prior therapy
- No investigational anticancer agent since last dose of imatinib mesylate
- No concurrent participation in another clinical trial
- No other concurrent anticancer therapy
- No other concurrent investigational drugs
Type of Study:
Interventional
Study Design:
Allocation: Randomized, Masking: Double-Blind, Primary Purpose: Treatment
Principal Investigator
Robert Maki, MD, PhD
Investigator Role:
Principal Investigator
Investigator Affiliation:
Memorial Sloan-Kettering Cancer Center
Authority:
United States: Federal Government
Study ID:
CDR0000370830
NCT ID:
NCT00085618
Start Date:
March 2004
Completion Date:
Related Keywords:
- Gastrointestinal Stromal Tumor
- gastrointestinal stromal tumor
- Gastrointestinal Stromal Tumors
Name | Location |
|---|---|
| Memorial Sloan-Kettering Cancer Center | New York, New York 10021 |
| Jonsson Comprehensive Cancer Center, UCLA | Los Angeles, California 90095-1781 |
