Doxorubicin With Upfront Dexrazoxane for the Treatment of Advanced or Metastatic Soft Tissue Sarcoma

NCT02584309 | Completed Phase 2 Results DMC FDA Drug

• 1 other identifier: 201510049
• Study Type: interventional
• Target: 73
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this research study is to look at whether giving a drug called dexrazoxane with standard of care doxorubicin affects the progression of the disease. Dexrazoxane is often given at the same time as doxorubicin to help reduce the incidence and severity of disease of the heart muscle (which can be caused by doxorubicin). In January 2019 Eli Lilly and Company reported that the results of the Phase 3 study of olaratumab (Lartruvo), in combination with doxorubicin in patients with advanced or metastatic soft tissue sarcoma, did not confirm the clinical benefit of olaratumab in combination with doxorubicin as compared to doxorubicin alone. Therefore olaratumab is being removed from the front line standard of care regimen. Amendment #9 was made to the protocol to reflect these changes to the standard of care treatment.

Conditions

Sarcoma, Soft Tissue; Soft Tissue Sarcoma; Undifferentiated Pleomorphic Sarcoma; Leiomyosarcoma; Liposarcoma; Synovial Sarcoma; Myxofibrosarcoma; Angiosarcoma; Fibrosarcoma; Malignant Peripheral Nerve Sheath Tumor; Epithelioid Sarcoma

Outcome Measures

Primary Outcomes (1)

• Progression-free Survival (PFS) (Arm 1 Only)

  * PFS is defined as the time from on study to the first occurrence of progression or death, whichever occurs first. * If no event exists, the PFS will be censored at the last follow-up. * Progressive disease - At least a 20% increase in the sum of the 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 5 mm. (Note: the appearance of one or more new lesions is also considered progressions).

  Up to 5 years

Secondary Outcomes (4)

• Cardiac-related Mortality

  Up to 12 months

• Percentage of Patients With Heart Failure or Cardiomyopathy

  Up to 12 months

• Ability of 3D Echocardiogram to Serve as an Early Marker of Cardiac Dysfunction Compared to 2D Echocardiogram Modified Simpson's Biplane Method of LVEF

  Baseline and day 1 of each odd numbered cycle (each cycle is 21 days) up to 1 year

• Early Detection of Cardiac Dysfunction by 2D Echocardiography Ventricular Strain Compared to 2D Echocardiography Ejection Fraction

  Baseline and day 1 of each odd numbered cycle (each cycle is 21 days) up to 1 year

Study Arms (2)

Arm 1: Doxorubicin and Upfront Dexrazoxane

EXPERIMENTAL

* Dexrazoxane will be given intravenously on an outpatient basis over 15 minutes on each day that doxorubicin is given. * Dexrazoxane should be given no more than 30 minutes prior to administration of doxorubicin, which is typically given on Day 1 of a 21-day cycle. * Dosing is a 10:1 ratio of dexrazoxane to doxorubicin; doxorubicin is typically given at 75 mg/m2, so dexrazoxane dosing would be 750 mg/m2. * In the event of a national shortage of dexrazoxane, 72-hour infusional doxorubicin can be used instead of dexrazoxane and bolus doxorubicin..

Drug: Dexrazoxane; Drug: Doxorubicin

Arm 2: control (Doxorubicin and Standard of Care Dexrazoxane)

ACTIVE COMPARATOR

* Doxorubicin is given as standard of care. Doxorubicin is typically given at 75 mg/m2 on Day 1 of a 21-day cycle. * Starting with cycle 5, standard of care dexrazoxane (75 mg/m2) will be given for 4 cycles. * The last 10 patients enrolled after completion of enrollment to Arm 1 will be enrolled to Arm 2.

Drug: Dexrazoxane; Drug: Doxorubicin

Interventions

Dexrazoxane DRUG

Also known as: Zinecard®, Totect®

Arm 1: Doxorubicin and Upfront Dexrazoxane; Arm 2: control (Doxorubicin and Standard of Care Dexrazoxane)

Doxorubicin DRUG

Also known as: Adriamycin, Hydroxydaunomycin Hydrochloride, Hydroxydoxorubicin Hydrochloride, Rubex

Arm 1: Doxorubicin and Upfront Dexrazoxane; Arm 2: control (Doxorubicin and Standard of Care Dexrazoxane)

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Histologically confirmed grade 2 or 3 soft tissue sarcoma that is unresectable or metastatic. Surgery for primary or metastatic disease after chemotherapy following a response is allowed. Patients with the following tumor types are eligible:
• Undifferentiated pleomorphic sarcoma
• Leiomyosarcoma
• Malignant fibrous histiocytoma
• Liposarcoma (myxoid/round cell, pleomorphic or dedifferentiated)
• Synovial sarcoma
• Myxofibrosarcoma
• Angiosarcoma
• Fibrosarcoma
• Malignant peripheral nerve sheath tumor
• Epithelioid sarcoma
• Unclassified high-grade sarcoma (not otherwise specified)
• Soft tissue sarcoma for which treatment with an anthracycline is appropriate at the approval of the Principal Investigator (PI)
• Measurable disease according to RECIST 1.1; that is, measurable disease defined as lesions that can be accurately measured in at least one dimension (longest diameter to be recorded) as ≥ 10 mm with CT scan, as ≥ 20 mm by chest x-ray, or ≥ 10 mm with calipers by clinical exam.
• Planning to initiate treatment with doxorubicin (starting dose 75 mg/m2) as routine care.

You may not qualify if:

• Myocardial infarction within the past 12 months, or stable or unstable angina.
• Systolic heart failure defined as left ventricular ejection fraction ≤ 45%.
• Symptomatic valvular heart disease.
• Prior chemotherapy for advanced or metastatic disease.
• Known brain metastases.
• Prior or second primary malignancies within the last two years (except carcinoma in situ of the cervix, non-metastatic prostate cancer, or basal cell or squamous cell carcinoma of the skin which were treated with local resection only; prior adjuvant androgen deprivation therapy in the case of prostate cancer is permitted, but current adjuvant androgen deprivation therapy is not).
• Currently receiving any investigational agents.
• A history of allergic reactions attributed to compounds of similar chemical or biologic composition to dexrazoxane or other agents used in the study.
• Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, or psychiatric illness/social situations that would limit compliance with study requirements.
• Pregnant and/or breastfeeding. Patient must have a negative pregnancy test within 14 days of study entry.
• Known HIV-positivity on combination antiretroviral therapy because of the potential for pharmacokinetic interactions with dexrazoxane. In addition, these patients are at increased risk of lethal infections when treated with marrow-suppressive therapy. Appropriate studies will be undertaken in patients receiving combination antiretroviral therapy when indicated.
• Prior treatment with anthracyclines.

Sponsors & Collaborators

• Washington University School of Medicine: lead

Study Sites (1)

Washington University School of Medicine

St Louis, Missouri, 63110, United States

Location

Related Links

• Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine

MeSH Terms

Conditions

Sarcoma; Histiocytoma, Malignant Fibrous; Leiomyosarcoma; Liposarcoma; Sarcoma, Synovial; Dermatofibrosarcoma; Hemangiosarcoma; Fibrosarcoma; Neurofibrosarcoma

Interventions

Dexrazoxane; Razoxane; Doxorubicin

Condition Hierarchy (Ancestors)

Neoplasms, Connective and Soft Tissue; Neoplasms by Histologic Type; Neoplasms; Histiocytoma; Neoplasms, Fibrous Tissue; Neoplasms, Connective Tissue; Neoplasms, Muscle Tissue; Neoplasms, Adipose Tissue; Neoplasms, Vascular Tissue; Neurofibroma; Nerve Sheath Neoplasms; Neoplasms, Nerve Tissue; Peripheral Nervous System Neoplasms; Nervous System Neoplasms; Nervous System Diseases; Peripheral Nervous System Diseases; Neuromuscular Diseases

Intervention Hierarchy (Ancestors)

Diketopiperazines; Piperazines; Heterocyclic Compounds, 1-Ring; Heterocyclic Compounds; Daunorubicin; Anthracyclines; Naphthacenes; Polycyclic Aromatic Hydrocarbons; Hydrocarbons, Aromatic; Hydrocarbons, Cyclic; Hydrocarbons; Organic Chemicals; Polycyclic Compounds; Aminoglycosides; Glycosides; Carbohydrates

Results Point of Contact

• Title: Brian A. Van Tine, M.D., Ph.D.
• Organization: Washington University School of Medicine

bvantine@wustl.edu

314-747-8475

Study Officials

• Brian A Van Tine, M.D., Ph.D.

  Washington University School of Medicine

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: October 12, 2015
• First Posted: October 22, 2015
• Study Start: February 22, 2016
• Primary Completion: July 17, 2022
• Study Completion: July 17, 2022
• Last Updated: November 7, 2023
• Results First Posted: November 7, 2023

Record last verified: 2023-10

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)