Radiation Therapy, Sorafenib, and Surgery in Treating Patients With Soft Tissue Sarcoma
Recruitment status was Recruiting
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Purpose
RATIONALE: Radiation therapy uses high-energy x-rays to kill tumor cells. Sorafenib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth and by blocking blood flow to the tumor. Giving sorafenib together with radiation therapy before surgery may make the tumor smaller and reduce the amount of normal tissue that needs to be removed.
PURPOSE: This phase I/II trial is studying the side effects and best dose of radiation therapy given together with sorafenib followed by surgery in treating patients with soft tissue sarcoma.
| Condition | Intervention | Phase |
|---|---|---|
|
Sarcoma |
Drug: sorafenib tosylate Procedure: neoadjuvant therapy Procedure: therapeutic conventional surgery Radiation: 3-dimensional conformal radiation therapy |
Phase 1 Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Phase I/II Trial of Neoadjuvant Conformal Radiotherapy Plus Sorafenib for Patients With Soft Tissue Sarcoma of the Extremity and Body Wall |
- Maximal-tolerated dose of sorafenib tosylate when combined with conformal radiotherapy (Phase I)
- Pathological tumor response by RECIST criteria (Phase II)
- Toxicities
- Rate of R0, R1, and R2
- Radiographic response rate by RECIST criteria
- Time to local recurrence, local disease-free survival (DFS), distant DFS, overall DFS, progression-free survival, and overall survival
- Transfer constant and the initial area under the gadolinium concentration time curve (phase II)
| Estimated Enrollment: | 56 |
| Study Start Date: | May 2009 |
| Estimated Primary Completion Date: | September 2011 (Final data collection date for primary outcome measure) |
OBJECTIVES:
Primary
- To determine the maximum tolerated dose of sorafenib tosylate when combined with conformal external beam radiotherapy prior to resection with curative intent in patients with soft tissue sarcoma of the extremity or body wall. (Phase I)
- To determine the rate of near-complete (≥ 95% tumor necrosis) pathological response to this regimen in these patients. (Phase II)
Secondary
- To describe the toxicities associated with this regimen.
- To determine the rate of R0 (negative resection margin), R1 (microscopically positive resection margin), and R2 (macroscopically positive resection margin) following this regimen.
- To determine the radiographic response rate to this regimen as defined by conventional RECIST criteria.
- To obtain preliminary data regarding local disease control, distant disease control, progression-free survival, and overall survival with this regimen.
OUTLINE: This is a phase I dose-escalation study of sorafenib tosylate followed by a phase II study.
Patients receive oral sorafenib tosylate twice daily on days 1-35 and undergo conformal radiotherapy 5 days a week for 5 weeks.
Patients undergo dynamic contrast-enhanced MRI scanning at baseline and day 63 followed by surgical resection on day 70.
After completion of study therapy, patients are followed every 4 months.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
DISEASE CHARACTERISTICS:
Histologically confirmed soft tissue sarcoma located on the extremity or body wall and meeting 1 of the following criteria:
- Intermediate- or high-grade disease > 5 cm in maximal dimension
- Low-grade disease > 8 cm in maximal dimension
- No evidence of regional or distant metastatic disease
PATIENT CHARACTERISTICS:
- ECOG performance status 0-2
- Hemoglobin ≥ 9.0 g/dL
- ANC ≥ 1,500/mm^3
- Platelets ≥ 100,000/mm^3
- Total bilirubin ≤ 1.5 mg/dL (unless elevated due to Gilbert's syndrome)
- AST and ALT ≤ 2.5 times upper limit of normal (ULN)
- Creatinine ≤ 1.5 times ULN
- INR < 1.5 or PT/PTT within normal limits
- Not pregnant
- Negative pregnancy test
- Fertile patients must use effective contraception (men must use effective contraception for ≥ 3 months after completion of study treatment)
- Able to swallow whole pills
None of the following cardiac conditions:
- NYHA class III-IV congestive heart failure
- Unstable angina (i.e., anginal symptoms at rest)
- New-onset angina (beginning within the past 3 months)
- Myocardial infarction within the past 6 months
- History of cardiac ventricular arrhythmia requiring ongoing anti-arrhythmic therapy
- Uncontrolled hypertension, defined as systolic BP > 150 mm Hg or diastolic BP > 90 mm Hg, despite optimal medical management
- No prior clinical or laboratory evidence of bleeding diathesis or coagulopathy
- No thrombotic or embolic events (e.g., cerebrovascular accident including transient ischemic attacks) within the past 6 months
- No pulmonary hemorrhage or bleeding event ≥ CTCAE grade 2 within the past 4 weeks
- No other hemorrhage or bleeding event ≥ CTCAE grade 3 within the past 4 weeks
- No significant traumatic injury in the past 4 weeks
- No active malabsorption problem not controlled with medical therapy
- No active clinically serious infection > CTCAE grade 2
- No known HIV infection or chronic hepatitis B or C
- No known or suspected allergy to sorafenib tosylate or any agent given in this study
- No indwelling metal that would preclude patient from undergoing DCE-MRI
PRIOR CONCURRENT THERAPY:
- At least 4 weeks since prior major surgery
- No prior or other concurrent preoperative investigational treatment
- No other concurrent cancer-directed therapy
- No concurrent St. John's wort or rifampin
Contacts and Locations| United States, California | |
| University of California Davis Cancer Center | Recruiting |
| Sacramento, California, United States, 95817 | |
| Contact: Clinical Trials Office - University of California Davis Cancer 916-734-3089 | |
| Principal Investigator: | Robert Canter, MD | University of California, Davis |
More Information
Additional Information:
No publications provided
| Responsible Party: | Robert Canter, University of California Davis Cancer Center |
| ClinicalTrials.gov Identifier: | NCT00805727 History of Changes |
| Other Study ID Numbers: | CDR0000628781, UCDCC-216, BAYER-UCDCC-216 |
| Study First Received: | December 9, 2008 |
| Last Updated: | July 7, 2009 |
| Health Authority: | Unspecified |
Keywords provided by National Cancer Institute (NCI):
|
stage I adult soft tissue sarcoma stage II adult soft tissue sarcoma stage III adult soft tissue sarcoma |
Additional relevant MeSH terms:
|
Sarcoma Neoplasms, Connective and Soft Tissue Neoplasms by Histologic Type Neoplasms Sorafenib Antineoplastic Agents |
Therapeutic Uses Pharmacologic Actions Protein Kinase Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action |
ClinicalTrials.gov processed this record on June 17, 2013