Imatinib Mesylate in Treating Patients With Gastrointestinal Stromal Tumor That Has Been Completely Removed During Surgery

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
National Cancer Institute (NCI)
ClinicalTrials.gov Identifier:
NCT00025246
First received: October 11, 2001
Last updated: February 19, 2013
Last verified: January 2013
  Purpose

This phase II trial is studying how well imatinib mesylate works in treating patients with gastrointestinal stromal tumor that was completely removed during surgery. Imatinib mesylate may stop the growth of cancer cells by blocking the enzymes necessary for cancer cell growth


Condition Intervention Phase
Gastrointestinal Stromal Tumor
Drug: imatinib mesylate
Other: laboratory biomarker analysis
Phase 2

Study Type: Interventional
Study Design: Endpoint Classification: Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Phase II Study of Adjuvant STI571 (Gleevec TM) Therapy in Patients Following Completely Resected High-risk Primary GastroIntestinal Stromal Tumor (GIST)

Resource links provided by NLM:


Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Determination whether patients with completely resected high-risk primary GIST who undergo adjuvant treatment with imatinib mesylate have prolonged survival compared to historical controls [ Time Frame: Up to 5 years ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Prevalence of recurrence free survival [ Time Frame: 2 years ] [ Designated as safety issue: No ]
    Marginal point and two-sided 95% (pointwise) confidence bands, based on Kaplan-Meier estimator will be produced.

  • Prevalence of recurrence [ Time Frame: 5 years ] [ Designated as safety issue: No ]
    Marginal point and two-sided 95% (pointwise) confidence bands, based on Kaplan-Meier estimator will be produced.

  • Overall survival [ Time Frame: Up to 5 years ] [ Designated as safety issue: No ]
    Marginal point and two-sided 95% (pointwise) confidence bands, based on Kaplan-Meier estimator will be produced.

  • Toxicities, graded according to the National Cancer Institute Common Toxicity Criteria [ Time Frame: Up to 10 years ] [ Designated as safety issue: Yes ]

Enrollment: 89
Study Start Date: September 2001
Primary Completion Date: November 2007 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Treatment (imatinib mesylate)
Patients receive oral imatinib mesylate daily beginning within 84 days of surgical resection. Treatment continues for 1 year in the absence of disease recurrence or unacceptable toxicity.
Drug: imatinib mesylate
Given orally
Other Names:
  • CGP 57148
  • Gleevec
  • Glivec
Other: laboratory biomarker analysis
Correlative studies

Detailed Description:

PRIMARY OBJECTIVES:

I. To ascertain whether patients with completely resected high-risk primary GIST who undergo adjuvant treatment with STI571 have prolonged survival compared to historical controls.

SECONDARY OBJECTIVES:

I. To determine the 2 and 5-year prevalence of recurrence in patients treated with adjuvant STI571 following complete resection of high-risk primary GIST.

II. To obtain from patients with GIST: tumor tissue (before therapy with STI571 and at the time of recurrence), blood specimens (before therapy with STI571), and serum specimens (before therapy with STI571, after completing therapy with STI571, and at the time of recurrence) for scientific correlative analyses.

III. To assess the toxicity of oral STI571 therapy when used in the adjuvant setting.

OUTLINE:

Patients receive oral imatinib mesylate daily beginning within 84 days of surgical resection. Treatment continues for 1 year in the absence of disease recurrence or unacceptable toxicity.

After completion of study treatment, patients are followed periodically for up to 10 years.

  Eligibility

Ages Eligible for Study:   16 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patient must have an ECOG/Zubrod performance status of ≤ 2
  • Patient must have a diagnosis of high-risk primary GIST; NOTE: High risk is defined as tumor size ≥ 10 cm in maximum dimension, or the presence of tumor rupture before or during surgery, intraperitoneal hemorrhage or multifocal (< 5) intraperitoneal tumors
  • Patient must have undergone complete gross resection (includes R0 [negative microscopic margins] and R1 [positive microscopic margins] resections) of a primary GIST within 70 days prior to registration
  • Patient must have a histologic diagnosis of GIST that is confirmed by central pathology review
  • Patient's tumor must stain positive for the Kit receptor tyrosine kinase on immunohistochemistry as determined by the central pathologist using the Dako (Dako Corp., Carpinteria, CA) anti-CD 117 antibody
  • Patient must have a chest x-ray completed within 28 days prior to registration
  • Patient must have a post-operative CT scan with IV and PO contrast or MRI with contrast (if allergic to CT contrast) of abdomen and pelvis within 28 days prior to registration
  • Creatinine ≤ 1.5 times the institution ULN
  • WBC ≥ 2,000/mm^3
  • Platelet ≥ 100,000/mm^3
  • Total bilirubin ≤ 1.5 times the institution ULN
  • AST and ALT ≤ 2.5 times the institution ULN
  • Female of childbearing potential must have negative serum pregnancy test
  • Patient or the patient's legally acceptable representative must provide a signed and dated written informed consent prior to registration and any study related procedures
  • If patient is a cancer survivor, each of the following criteria must apply:

    • Patient has undergone potentially curative therapy for all prior malignancies,
    • No evidence of any prior malignancies for at least 5 years with no evidence of recurrence (except for effectively treated basal cell or squamous carcinoma of the skin, carcinoma in-situ of the cervix that has been effectively treated by surgery alone, or lobular carcinoma in-situ of the ipsilateral or contralateral breast treated by surgery alone)
    • Patient is deemed by their treating physician to be at low risk for recurrence from prior malignancies

Exclusion Criteria:

  • Patient has received post-operative chemotherapy
  • Patient has received post-operative radiation therapy
  • Patient has received post-operative investigational treatment
  • Patient has received prior therapy with STI571
  • Patient has had an active infection requiring antibiotics within 14 days prior to registration
  • Patient has objective evidence of residual disease on the post-operative CT scan or MRI of the abdomen or pelvis
  • Patient, if female and breastfeeding; NOTE: It is not known whether STI571 or its metabolites are excreted in human milk; however, in lactating female rats administered 100 mg/kg, a dose approximately equal to the maximum clinical dose of 800 mg/day based on body surface area, STI571 and/or its metabolites were extensively excreted in milk; it is estimated that approximately 1.5% of a maternal dose is excreted into milk, which is equivalent to a dose to the infant of 30% the maternal dose per unit body weight; because many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants, women should be advised against breastfeeding while taking STI571
  • Patient has New York Heart Association class 3 or 4 cardiac disease
  • Patient is taking full dose warfarin; NOTE: The use of mini-dose warfarin (1 mg orally per day) for prevention of central line-associated deep venous thrombosis is permitted
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00025246

Locations
United States, North Carolina
American College of Surgeons Oncology Group
Durham, North Carolina, United States, 27705
Sponsors and Collaborators
Investigators
Principal Investigator: Ronald DeMatteo American College of Surgeons
  More Information

No publications provided by National Cancer Institute (NCI)

Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00025246     History of Changes
Other Study ID Numbers: NCI-2012-03079, ACOSOG-Z9000, U10CA076001, CDR0000068942
Study First Received: October 11, 2001
Last Updated: February 19, 2013
Health Authority: United States: Food and Drug Administration

Additional relevant MeSH terms:
Gastrointestinal Stromal Tumors
Gastrointestinal Neoplasms
Digestive System Neoplasms
Neoplasms by Site
Neoplasms
Digestive System Diseases
Gastrointestinal Diseases
Imatinib
Antineoplastic Agents
Therapeutic Uses
Pharmacologic Actions
Protein Kinase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action

ClinicalTrials.gov processed this record on July 28, 2014