HyperTET: Hyper-Thermia Enhanced Anti-tumor Efficacy of Trabectedin
Study Details
Study Description
Brief Summary
This trial compares trabectedin alone to trabectedin in combination with regional hyperthermia in patients with high-risk soft tissue sarcoma. The study is designed to demonstrate a significant benefit for sarcoma-therapy by adding regional hyperthermia.
Condition or Disease | Intervention/Treatment | Phase |
---|---|---|
|
Phase 2 |
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
---|---|
Experimental: Trabectedin with regional hyperthermia Trabectedin 1.5 mg/m², 24 hrs continuous i.v. infusion, repetition after 21 days, until progress of disease. Additional treatment with regional hyperthermia (RHT): RHT treatment of the tumor area and the surrounding tissue (41-44°C for 60 min treatment time) is applied at the end of Trabectedin infusion (+/- 4 hrs). |
Drug: Trabectedin
Other Names:
Genetic: DNA double-strand breaks
The rationale for combining Tr and RHT is based on immune mechanisms induced by local heating of which are independent of the anti-tumor effects of Tr. Recent results demonstrate that an acute inflammation at the site of the heated tumor area and "danger signals" are responsible for immune reactions against tumor and metastases (Frey 2012). Abscopal effects after local radiation of tumors with response of distant metastases are induced by similar mechanisms like heat stress (Formenti 2013, Golden 2015). The long-term results for soft-tissue sarcoma are consistent with abscopal effects induced by RHT in a randomized trial compared to chemotherapy alone (Issels 2018).
|
Active Comparator: Trabectedin Trabectedin 1.5 mg/m², 24 hrs continuous i.v. infusion, repetition after 21 days, until progress of disease. |
Drug: Trabectedin
Other Names:
Genetic: DNA double-strand breaks
The rationale for combining Tr and RHT is based on immune mechanisms induced by local heating of which are independent of the anti-tumor effects of Tr. Recent results demonstrate that an acute inflammation at the site of the heated tumor area and "danger signals" are responsible for immune reactions against tumor and metastases (Frey 2012). Abscopal effects after local radiation of tumors with response of distant metastases are induced by similar mechanisms like heat stress (Formenti 2013, Golden 2015). The long-term results for soft-tissue sarcoma are consistent with abscopal effects induced by RHT in a randomized trial compared to chemotherapy alone (Issels 2018).
|
Outcome Measures
Primary Outcome Measures
- Progression-free Survival (PFS) [planned after 46 events after start of recruitment which are expected to occur after 27 month]
Secondary Outcome Measures
- Radiological response according to RECIST [planned after 46 events after start of recruitment which are expected to occur after 27 month]
- Overall Survival (OS) [planned after 46 events after start of recruitment which are expected to occur after 27 month]
- Treatment related toxicity (hematological, renal, hepatic, others) [planned after 46 events after start of recruitment which are expected to occur after 27 month]
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Age > 18 years
-
Histologically confirmed STS (primary or recurrent), except: Ewing sarcoma, osteosarcoma, skeletal chondrosarcoma (extraskeletal chondrosacomas are included), GIST, dermatofibrosarcoma protuberans, malignant mesothelioma, rhabdomyosarcoma
-
Patients after failure of first-line chemotherapy (anthracyclines with/without ifosfamide) with or without RHT
-
Progressive or recurrent tumor which is unresectable or only resectable with adverse functional outcome
-
After macroscopic incomplete resection or marginal resection (tumor-free margins < 1 cm)
-
Prior chemotherapy, including anthracyclines with/without ifosfamide (with or without RHT) or patients who cannot be given these medicines
-
At least one tumor manifestation which is eligible for hyperthermia
-
Performance status (ECOG) 0,1 or 2
-
More than 3 weeks from last treatment
-
Neutrophil count ≥ 1,5 G/l, hemoglobin ≥ 9 g/dl, platelets ≥ 100 G/l
-
Albumin ≥ 25 g/l, total bilirubin ≤ 1 x ULN, ALT/AST ≤ 2.5 x ULN, AP ≤ 2.5 x ULN, Cockroft and Gault's calculated creatinine clearance ≥ 30 ml/min, CPK ≤ 2.5 x ULN
-
Patients with the ability to follow study instructions and likely to attend and complete all required visits
-
Written informed consent of the subject
Exclusion Criteria:
-
Uncontrolled infection (e.g. active viral hepatitis)
-
Unstable cardiac status
-
Peripheral neuropathy > grade 2
-
Known or persistent abuse of medications, drugs or alcohol
-
Other malignancy during the last 5 years (exclusion of basal cell carcinoma or adequately treated cervical carcinoma in situ)
-
Prior therapy with Tr or known history of hypersensitivity to drugs with a similar chemical structure
-
Pregnancy or breast-feeding
-
Females of childbearing potential, who are not using and not willing to use medically reliable methods of contraception for the entire study duration
-
Uncontrolled CNS-metastases
-
Medical or technical impossibility for hyperthermia to heat the major target lesion
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
---|---|---|---|---|---|
1 | Ludwig-Maximilians University of Munich, Klinikum Großhadern | Munich | Bavaria | Germany | 81377 |
2 | Helios Klinikum Bad Saarow | Bad Saarow | Germany | ||
3 | Charité - Universitätsmedizin Berlin | Berlin | Germany | ||
4 | Helios Klinikum Berlin-Buch | Berlin | Germany | ||
5 | Universitätsklinikum Erlangen | Erlangen | Germany |
Sponsors and Collaborators
- Ludwig-Maximilians - University of Munich
Investigators
- Principal Investigator: Rolf Issels, MD, Ludwig-Maximilians - University of Munich
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- HyperTET