רדאר קליני AI | ||
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הניסוי הקליני NCT04195399 עבור פיברומטוזיס דסמואידי, פיברומטוזיס דסמואידי חוזר, Unresectable Desmoid Fibromatosis הוא פעיל, לא מגייס. לכל הפרטים, עיינו בתצוגת הכרטיסים של רדאר ניסויים קליניים ובכלי הגילוי של AI. אפשר גם לשאול כל דבר כאן. | ||
A Study of a New Drug, Nirogacestat, for Treating Desmoid Tumors That Cannot be Removed by Surgery שלב II 35
I. To estimate the 2-year progression-free survival (PFS) rate in patients with progressive, surgically unresectable desmoid tumor treated with nirogacestat.
II. To describe the toxicities of nirogacestat in children and adolescents with desmoid tumor.
III. To characterize the pharmacokinetics (PK) of nirogacestat in children and adolescents.
SECONDARY OBJECTIVE:
I. To determine the objective...
הצג עודA Safety, Pharmacokinetic and Efficacy Study of a y-Secretase Inhibitor, Nirogacestat (PF-03084014), in Children and Adolescents With Progressive, Surgically Unresectable Desmoid Tumors
- ARST1921
- NCI-2019-07498 (מזהה רישום) (CTRP (Clinical Trial Reporting Program))
- ARST1921 (מזהה אחר) (Children's Oncology Group)
- ARST1921 (מזהה אחר) (CTEP)
- U10CA180886 (מענק/חוזה של NIH בארה"ב)
| קבוצת משתתפים/זרוע | התערבות/טיפול |
|---|---|
ניסיTreatment (nirogacestat) Patients receive nirogacestat PO BID on days 1-28. Cycles repeats every 28 days in the absence of disease progression or unacceptable toxicity. Patients undergo ECHO and CT or MRI on study. Patients may also undergo x-ray imaging and blood sample collection on study. | איסוף דגימות ביולוגיות Undergo blood sample collection טומוגרפיה ממוחשבת Undergo CT Echocardiography Test Undergo ECHO הדמיית תהודה מגנטית Undergo MRI Nirogacestat Given PO הערכת איכות-חיים Ancillary studies ניהול שאלון Ancillary studies הדמיית רנטגן Undergo x-ray |
| מדד תוצאה | תיאור המדידה | טווח זמן |
|---|---|---|
Progression-free survival (PFS) | Will be estimated using the Kaplan-Meier method with the 95% confidence interval estimated by the Peto-Peto method. | From initiation of treatment to occurrence of disease progression or death from any cause, assessed up to 2 years |
Incidence of adverse events | Will be graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0. All grade 3 or above toxicities deemed related to study drug will be summarized. All grade 1 and 2 toxicities observed in \> 5% of participants and deemed related to study drug will be reported. | Up to 2 years |
Pharmacokinetic (PK) parameter: systemic exposure | PK parameters of nirogacestat will be defined to quantify systemic exposure, drug clearance, terminal half-life and other pharmacokinetic characteristics. These PK parameters will be summarized with descriptive statistics, including means, medians, ranges, and standard deviations. | Up to Cycle 3 (each cycle lasts 28 days) |
PK parameter: drug clearance | PK parameters of nirogacestat will be defined to quantify systemic exposure, drug clearance, terminal half-life and other pharmacokinetic characteristics. These PK parameters will be summarized with descriptive statistics, including means, medians, ranges, and standard deviations. | Up to Cycle 3 (each cycle lasts 28 days) |
PK parameter: half-life | PK parameters of nirogacestat will be defined to quantify systemic exposure, drug clearance, terminal half-life and other pharmacokinetic characteristics. These PK parameters will be summarized with descriptive statistics, including means, medians, ranges, and standard deviations. | Up to Cycle 3 (each cycle lasts 28 days) |
| מדד תוצאה | תיאור המדידה | טווח זמן |
|---|---|---|
Objective response rate | Defined by the rate of a complete response or partial response by Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. | Up to 24 months |
Patients must be > 12 months and < 18 years of age at the time of enrollment
Patients must have a body surface area of > 0.3 m^2 at the time of enrollment
Existing or recurrent desmoid tumor that is deemed not amenable to surgery without significant morbidity and progressed by >= 10% as assessed by RECIST version (v)1.1 within the 6-month period prior to study enrollment
- Patients must have had histologic verification of the desmoid tumor
- Patients must have measurable disease by RECIST v1.1 criteria
- Patient must have received at least one prior course of systemic therapy for desmoid tumor
Patients must have a Lansky (for patients =< 16 years of age) or Karnofsky (for patients > 16 years of age) performance status score of >= 50. Patients who are unable to walk because of paralysis, but who are up in a wheelchair, will be considered ambulatory for the purpose of assessing performance score
Patients must have fully recovered from the acute toxic effects of all prior chemotherapy, immunotherapy, surgery or radiotherapy prior to entering this study. Patients may not be using or anticipate using these treatments after the observed progression or within the time period stated below
- Cytotoxic chemotherapy: must not have received within 2 weeks of entry onto this study (4 weeks if prior nitrosourea)
- Small molecule tyrosine kinase inhibitors (e.g., sorafenib, pazopanib, imatinib), rapalogs (e.g., temsirolimus, everolimus, sirolimus) or anti estrogen therapy (e.g., tamoxifen): may not have received within 28 days prior to the first dose of study treatment
- Antibodies: >= 21 days must have elapsed from infusion of last dose of antibody, and toxicity related to prior antibody therapy must be recovered to grade =< 1
- Biologic (anti-neoplastic agent): at least 7 days since the completion of therapy with a biologic agent
- Local regional tumor directed therapy, including, but not limited to small port radiation therapy (RT), radiofrequency ablation, cryotherapy, surgery: at least 2 weeks since these therapies and all toxicity must have resolved to grade =< 1. If prior craniospinal RT or if >= 50% radiation of pelvis then >= 6 months must have elapsed. If other substantial bone marrow (BM) radiation, then >= 6 weeks must have elapsed
- Stem cell transplant (SCT): No evidence of active graft versus (vs.) host disease. For allogeneic SCT, >= 6 months must have elapsed
- No prior gamma-secretase, Notch or beta-catenin inhibitor
- Investigational drugs: must not have received investigational drug within 4 weeks of study entry, and all toxicities related to prior therapy must be resolved to grade =< 1 or baseline
Concomitant Medication Restrictions
- Growth factor(s): must not have received within 1 week of entry onto this study
- Patients who are currently receiving drugs that are strong inducers or moderate or strong inhibitors of CYP3A4 are not eligible. Strong inducers or moderate or strong inhibitors of CYP3A4 are not allowed from 14 days prior to enrollment to the end of protocol therapy. Note: CYP3A4 inducing anti-epileptic drugs on a stable dose, are allowed
- Must not be receiving non-steroidal anti-inflammatory drugs (NSAIDs) as treatment for desmoid tumor after the observed progression and patient agrees to not use NSAIDs while on study. Occasional use (defined as =< 3 times per week) for treatment of pain is permitted
Peripheral absolute neutrophil count (ANC) >= 1000/uL (within 7 days prior to enrollment)
Platelet count >= 100,000/uL (transfusion independent) (within 7 days prior to enrollment)
Hemoglobin >= 9.0 g/dL (may receive red blood cell \[RBC\] transfusions) (within 7 days prior to enrollment)
Creatinine clearance or radioisotope glomerular filtration rate (GFR) >= 70 mL/min/1.73 m^2 or a serum creatinine based on age/gender as follows (within 7 days prior to enrollment):
- Age: Maximum serum creatinine (mg/dL)
- Age: 1 to < 2 years; Maximum serum creatinine (mg/dL): 0.6 (male and female)
- Age: 2 to < 6 years; Maximum serum creatinine (mg/dL): 0.8 (male and female)
- Age: 6 to < 10 years; Maximum serum creatinine (mg/dL): 1 (male and female)
- Age: 10 to < 13 years; Maximum serum creatinine (mg/dL): 1.2 (male and female)
- Age: 13 to < 16 years; Maximum serum creatinine (mg/dL): 1.5 (male); 1.4 (female)
- Age: >= 16 years; Maximum serum creatinine (mg/dL): 1.7 (male); 1.4 (female)
Adequate liver function defined as:
Total bilirubin =< 1.5 x upper limit of normal (ULN) for age (unless secondary to previously diagnosed Gilbert's syndrome) (within 7 days prior to enrollment)
Serum glutamate pyruvate transaminase (SGPT) (alanine aminotransferase \[ALT\]) =< 135 U/L
- Note: For the purpose of this study, the ULN for SGPT (ALT) has been set to the value of 45 U/L (within 7 days prior to enrollment)
Adequate cardiac function defined as:
- Corrected QT (QTc) interval < 470 ms
- No history of congenital or acquired prolonged QTc syndrome
- No history of clinically significant cardiac arrhythmias, congestive heart failure, stroke or myocardial infarction within 6 months prior to study entry
All patients and/or their parents or legal guardians must sign a written informed consent
All institutional, Food and Drug Administration (FDA), and National Cancer Institute (NCI) requirements for human studies must be met
Active or chronic infection within 7 days prior to study entry
Presence of non-healing fracture
- Note: patients with pathologic fracture related to tumor are eligible
Use of corticosteroids within 21 days of enrollment, except in the following situations:
- Physiologic steroid replacement for adrenal insufficiency
- Topical, ocular, intra-articular, intranasal, or inhaled corticosteroid with minimal systemic absorption
- Short course (=< 7 days) of corticosteroid prescribed prophylactically (eg, for contrast dye allergy) or for the treatment of a non-autoimmune condition (eg, delayed-type hypersensitivity reaction caused by contact allergen), or exacerbation of asthma
Patients with gastrointestinal conditions that might predispose for drug intolerability or poor drug absorption (e.g., inability to take oral medication, prior surgical procedures affecting absorption (e.g., gastric bypass), malabsorption syndrome, and active peptic ulcer disease)
Patients with ulcerative colitis, inflammatory bowel disease, or a partial or complete small bowel obstruction
Known active infection with hepatitis B, hepatitis C or human immunodeficiency virus (HIV)
Patients with a prior history of malignancy, with the exceptions of desmoid tumor(s) and non-melanoma skin cancer, who are not in remission for more than 3 years
Patients who are unable to swallow tablets. Tablets must not be crushed or chewed. Administration of nirogacestat via gastrostomy tube or nasogastric tube is not allowed
Patients who in the opinion of the investigator may not be able to comply with the safety monitoring requirements of the study
Sexually active female patients of reproductive potential who have not agreed to use 1 method of highly effective contraceptive (including copper-containing intrauterine device, condom with spermicidal foam/gel/film/cream/suppository, bilateral tubal ligation, established use of inserted, injected or implanted hormonal method of contraception, abstinence, or male sterilization) for the duration of their study participation and for at least 6 months after last dose of nirogacestat. A second form of contraception (i.e. barrier method) is required for patients who are using hormonal contraception as nirogacestat may reduce the efficacy of hormonal contraceptives
Sexually active male patients of reproductive potential who have not agreed to use a condom and their female partner who have not agreed to use one of the highly effective methods of contraception mentioned above during treatment and for at least 90 days after the last dose of nirogacestat
Female patients who are breastfeeding
Female patients who are pregnant. These patients are excluded because there is no available information regarding the effects of nirogacestat on the developing human fetus and inhibition of gamma-secretase is known to be teratogenic
Female patients of childbearing potential unless a negative pregnancy test result has been obtained
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