Clinical trial • Phase III • Oncology|Rare Disease

ONFEKAFUSP ALFA for Soft tissue sarcoma|Advanced soft tissue sarcoma|Metastatic soft tissue sarcoma

Phase III trial of ONFEKAFUSP ALFA for Soft tissue sarcoma|Advanced soft tissue sarcoma|Metastatic soft tissue sarcoma.

Overview

Trial Therapeutic Area
Oncology|Rare Disease
Trial Disease
Soft tissue sarcoma|Advanced soft tissue sarcoma|Metastatic soft tissue sarcoma
Trial Stage
Phase III
Drug Modality
Other antibody|Small molecule
Orphan Drug
Yes

Key dates

Initial CTIS Submission Date
29-03-2024
First CTIS Authorization Date
03-05-2024

Trial design

Randomised, open-label, arm 1: doxorubicin alone (doxorubicin administered on day 1 every 3 weeks; doxorubicin product detailed as 2 mg/ml solution for injection; dosing units mg/m2, max daily dose 75 mg/m2, max total dose 450 mg/m2). arm 2: doxorubicin (day 1 every 3 weeks) plus l19tnf (fibromun) given on days 1, 3 and 5 every 3 weeks; maintenance (investigator discretion) consisting of l19tnf on day 1 of every 21-day maintenance cycle until 18 months after study treatment start.-controlled Phase III trial in Germany, Spain, France and others.

Randomised
Yes
Open Label
Yes
Comparator
Arm 1: Doxorubicin alone (Doxorubicin administered on Day 1 every 3 weeks; Doxorubicin product detailed as 2 mg/ml Solution for Injection; dosing units mg/m2, max daily dose 75 mg/m2, max total dose 450 mg/m2). Arm 2: Doxorubicin (Day 1 every 3 weeks) plus L19TNF (Fibromun) given on Days 1, 3 and 5 every 3 weeks; maintenance (investigator discretion) consisting of L19TNF on Day 1 of every 21-day maintenance cycle until 18 months after study treatment start.
Target Sample Size
118
Trial Duration For Participant
540

Eligibility

Recruits 118 No vulnerable populations selected. Participants are adults (18-75 years) and must provide signed and dated informed consent. Adult information and consent forms are provided; there are no assent procedures for minors (minors are excluded by age criteria)..

Pregnancy Exclusion
17. Pregnancy or breast-feeding.
Vulnerable Population
No vulnerable populations selected. Participants are adults (18-75 years) and must provide signed and dated informed consent. Adult information and consent forms are provided; there are no assent procedures for minors (minors are excluded by age criteria).

Inclusion criteria

  • {"criterion_text":"- 1. Age 18 - 75 years.\n- 2. Patients must have histological evidence of advanced unresectable and/or metastatic high-grade soft tissue sarcoma (grade 2 – 3 according to the FNCLCC grading system) not amenable to curative treatment with surgery or radiotherapy and for which doxorubicin treatment is considered appropriate. Participants with Osteosarcoma, Chondrosarcoma, Ewing Sarcoma/ Primitive Neuroectodermal Tumor (PNET), Kaposi’s Sarcoma, Dermatofibrosarcoma protuberans, and Gastrointestinal Stromal Tumors (GIST) will be excluded\n- 3. Patients must have at least one unidimensionally measurable lesion by computed tomography as defined by RECIST criteria 1.1. This lesion should not have been irradiated during previous treatments.\n- 4. Life expectancy of at least 3 months.\n- 5. ECOG ≤ 2.\n- 6. Documented negative test for HIV-HBV-HCV. For HBV serology: the determination of HBsAg and anti-HBcAg-Ab is required. In patients with serology documenting previous exposure to HBV, negative serum HBV-DNA is required. For HCV: HCV-RNA or HCV antibody test. Subjects with a positive test for HCV antibody but no detection of HCV-RNA indicating no current infection are eligible.\n- 7. Female patients: negative serum pregnancy test at screening for women of childbearing potential (WOCBP)*. WOCBP must agree to use, from the screening to six months following the last administration of L19TNF and/or Doxorubicin, highly effective contraception methods, as defined by the \"Recommendations for contraception and pregnancy testing in clinical trials\" issued by the Head of Medicine Agencies' Clinical Trial Facilitation Group (www.hma.eu/ctfg.html) and which include, for instance, progesterone-only or combined (estrogen- and progesterone-containing) hormonal contraception associated with inhibition of ovulation, intrauterine devices, intrauterine hormone-releasing systems, bilateral tubal occlusion, vasectomized partner or sexual abstinence. Male patients: Male subjects able to father children must agree to use two acceptable methods of contraception from the screening to four months following the last administration of L19TNF and/or Doxorubicin (e.g. condom with spermicidal gel). Double-barrier contraception is required.\n- 8. Informed consent signed and dated to participate in the study\n- 9. Willingness and ability to comply with the scheduled visits, treatment plan, laboratory tests and other study procedures. * Women of childbearing potential are defined as females who have experienced menarche, are not postmenopausal (12 months with no menses without an alternative medical cause) and are not permanently sterilized (e.g., tubal occlusion, hysterectomy, bilateral oophorectomy or bilateral salpingectomy)"}

Exclusion criteria

  • {"criterion_text":"- 1. Prior therapy (except surgery and radiation) for unresectable or metastatic malignant soft tissue sarcoma.\n- 10. History within the last year of acute or subacute coronary syndromes including myocardial infarction, unstable or severe stable angina pectoris.\n- 11. Heart insufficiency (> Grade II, New York Heart Association (NYHA) criteria).\n- 12. Clinically significant cardiac arrhythmias or requiring permanent medication.\n- 13. Uncontrolled hypertension, despite optimal therapy.\n- 14. Ischemic peripheral vascular disease (Grade IIb-IV according to Leriche-Fontaine classification).\n- 15. Severe diabetic retinopathy such as severe non-proliferative retinopathy and proliferative retinopathy.\n- 16. Major trauma including major surgery (such as abdominal/cardiac/thoracic surgery) within 4 weeks of administration of study treatment.\n- 17. Pregnancy or breast-feeding.\n- 18. Requirement of chronic administration of corticosteroids or other immunosuppressant drugs. Limited use of corticosteroids to treat or prevent acute hypersensitivity reactions is not considered an exclusion criterion.\n- 19. Presence of active and uncontrolled infections or other severe concurrent disease, which, in the opinion of the investigator, would place the patient at undue risk or interfere with the study.\n- 2. Previous treatment with anthracycline-containing chemotherapy.\n- 20. Known active or latent tuberculosis (TB).\n- 21. Concurrent malignancies other than Soft Tissue Sarcoma, unless the patient has been disease-free for at least 2 years.\n- 22. Growth factors or immunomodulatory agents within 7 days prior to the administration of study treatment.\n- 23. Serious, non-healing wound, ulcer or bone fracture.\n- 24. Allergy to study medication or excipients in study medication.\n- 25. Deep vein thrombosis, pulmonary embolism or other acute vascular events within 6 months.\n- 26. Anticoagulation therapy with P2Y12 antagonists (e.g., clopidogrel, ticagrelor) and vitamin K antagonists (e.g., phenprocoumon, warfarin)\n- 27. Concurrent use of other anti-cancer treatments or agents other than study medication.\n- 3. Radiotherapy within 4 weeks prior to therapy\n- 4. Known history of allergy to TNFα, anthracyclines or other intravenously administered human proteins/peptides/antibodies.\n- 5. Previous therapy with recombinant TNF.\n- 6. Absolute neutrophil count (ANC) < 1.5 x 109/L, platelets < 100 x 109/L and haemoglobin (Hb) < 9.0 g/dl.\n- 7. Chronically impaired renal function as expressed by creatinine ≥ 2.0 x ULN.\n- 8. Inadequate liver function (ALT, AST, ALP or total bilirubin ≥ 2.5 x ULN).\n- 9. Any severe concomitant condition which makes it undesirable for the patient to participate in the study or which could jeopardize compliance with the protocol."}

Endpoints

Primary endpoints

  • {"endpoint_text":"- The following efficacy endpoint will be considered: − Progression-free survival (PFS)","definition_or_measurement_approach":"Progression-free survival (PFS) assessed using radiologic tumour assessments per RECIST 1.1 (CT imaging as required by inclusion criterion 3)."}

Secondary endpoints

  • {"endpoint_text":"- To assess the efficacy, the following measurements will be considered: − Overall survival (OS) − Median Progression Free Survival (mPFS) − Median Overall Survival (mOS) − Overall Response Rate (ORR, consisting of CR and PR) and Best Overall Response Rate (BORR)","definition_or_measurement_approach":"Efficacy measured by survival endpoints (OS, mOS) and time-to-event analysis for PFS; tumour response endpoints (ORR, BORR) assessed by RECIST 1.1 via CT imaging."}
  • {"endpoint_text":"- To assess the safety profile of L19TNF combined with doxorubicin. The following safety endpoints will be considered: − Adverse Events (AEs) assessment based on CTCAE v.4.03. − Standard laboratory (haematology, biochemistry and urinalysis) parameters. − Physical examination findings including assessment of vital signs and physical measurements.","definition_or_measurement_approach":"Safety assessed by AE reporting graded per CTCAE v4.03, routine laboratory testing (haematology, biochemistry, urinalysis), and physical examinations/vital signs."}

Recruitment

Planned Sample Size
118
Recruitment Window Months
98
Consent Approach
Participants must provide signed and dated informed consent prior to participation. Only adult consent forms are provided (L1_ICF documents for adults). Informed consent materials are available in multiple languages (English, German, French, Italian, Spanish and Polish translations of protocol/ICF documents are present). No assent for minors is provided as inclusion is age 18-75.

Geography

Total Number Of Sites
27
Total Number Of Participants
118

Germany

Earliest CTIS Part Ii Submission Date
10-04-2024
Latest Decision Or Authorization Date
03-02-2026
Processing Time Days
664
Number Of Sites
10
Number Of Participants
59

Sites

Site Name
University Medical Center Hamburg-Eppendorf
Department Name
Oncology, Hematology and Bone Marrow Transplantation & Laboratory of Radiology
Principal Investigator Name
Jana Käthe Striefler
Principal Investigator Email
j.striefler@uke.de
Contact Person Name
Jana Käthe Striefler
Contact Person Email
j.striefler@uke.de
Site Name
Universitaetsklinikum Frankfurt AöR
Department Name
Hamatologie, Onkologie
Principal Investigator Name
Marit Ahrens
Principal Investigator Email
m.ahrens@med.uni-frankfurt.de
Contact Person Name
Marit Ahrens
Contact Person Email
m.ahrens@med.uni-frankfurt.de
Site Name
Universitaetsklinikum Muenster AöR
Department Name
Medicine A
Principal Investigator Name
Christoph Schliemann
Principal Investigator Email
Christoph.Schliemann@ukmuenster.de
Contact Person Name
Christoph Schliemann
Site Name
HELIOS Klinikum Bad Saarow GmbH
Department Name
nternal Medicine and Hematology and Oncology
Principal Investigator Name
Daniel Pink
Principal Investigator Email
daniel.pink@helios-gesundheit.de
Contact Person Name
Daniel Pink
Site Name
Max Planck Institut Fuer Neurologische Forschung Mit Klaus Joachim Zuelch Laboratorien Der Max Planck Gesellschaft Und Der Medizinischen Fakultaet Der Universitaet Zu Koeln
Department Name
Oncology
Principal Investigator Name
Roland Ulrich
Principal Investigator Email
roland.ullrich@uk-koeln.de
Contact Person Name
Roland Ulrich
Contact Person Email
roland.ullrich@uk-koeln.de
Site Name
Klinikum rechts der Isar der TU Muenchen AöR
Department Name
Oncology
Principal Investigator Name
Krischan Braitsch
Principal Investigator Email
Krischan.Braitsch@mri.tum.de
Contact Person Name
Krischan Braitsch
Contact Person Email
Krischan.Braitsch@mri.tum.de
Site Name
Universitaetsmedizin der Johannes Gutenberg-Universitaet Mainz KöR
Department Name
Hämatologie und Medizinische Onkologie
Principal Investigator Name
Marius Fried
Principal Investigator Email
Marius.Fried@unimedizin-mainz.de
Contact Person Name
Marius Fried
Site Name
Charite Universitaetsmedizin Berlin KöR
Department Name
Hamatologie, Oncology, Tumor Immunology
Principal Investigator Name
Anne Floercken
Principal Investigator Email
anne.floercken@charite.de
Contact Person Name
Anne Floercken
Contact Person Email
anne.floercken@charite.de
Site Name
Universitaetsklinikum Duesseldorf AöR
Department Name
Medicine A
Principal Investigator Name
Judith Strapatsas
Principal Investigator Email
Judith.Strapatsas@med.uni-duesseldorf.de
Contact Person Name
Judith Strapatsas
Site Name
Universitaetsklinikum Heidelberg AöR
Department Name
KLINIK FÜR HÄMATOLOGIE, ONKOLOGIE, RHEUMATOLOGIE
Principal Investigator Name
Gerlinde Egerer
Principal Investigator Email
Gerlinde.Egerer@med.uni-heidelberg.de
Contact Person Name
Gerlinde Egerer

Spain

Earliest CTIS Part Ii Submission Date
10-04-2024
Latest Decision Or Authorization Date
09-02-2026
Processing Time Days
670
Number Of Sites
7
Number Of Participants
34

Sites

Site Name
Hospital Universitario Fundacion Jimenez Diaz
Department Name
Medical Oncology
Principal Investigator Name
Javier Martin Broto
Principal Investigator Email
jmartin@atbsarc.org
Contact Person Name
Javier Martin Broto
Contact Person Email
jmartin@atbsarc.org
Site Name
Hospital Universitari Vall D Hebron
Department Name
Medical Oncology
Principal Investigator Name
Claudia Maria Valverde Morales
Principal Investigator Email
cvalverde@vhio.net
Contact Person Name
Claudia Maria Valverde Morales
Contact Person Email
cvalverde@vhio.net
Site Name
Hospital Universitario Virgen De Las Nieves
Department Name
Oncologia Medica
Principal Investigator Name
Lucía Castillo Portellano
Principal Investigator Email
luportellano@gmail.com
Contact Person Name
Lucía Castillo Portellano
Contact Person Email
luportellano@gmail.com
Site Name
Hospital Unviersitario Miguel Servet
Department Name
Oncologia Medica
Principal Investigator Name
Javier Martinez Trufero
Principal Investigator Email
jmtrufero@seom.org
Contact Person Name
Javier Martinez Trufero
Contact Person Email
jmtrufero@seom.org
Site Name
University Clinical Hospital Virgen De La Arrixaca
Department Name
Oncologia
Principal Investigator Name
Jerónimo Martínez García
Principal Investigator Email
jeronimo@seom.org
Contact Person Name
Jerónimo Martínez García
Contact Person Email
jeronimo@seom.org
Site Name
Hospital General Universitario Gregorio Maranon
Department Name
Medical Oncology
Principal Investigator Name
Rosa Maria Alvarez
Principal Investigator Email
rosa.alvarez.al@gmail.com
Contact Person Name
Rosa Maria Alvarez
Contact Person Email
rosa.alvarez.al@gmail.com
Site Name
Hospital Universitario Fundacion Jimenez Diaz (duplicate entry in listing?)
Department Name
Medical Oncology
Principal Investigator Name
Javier Martin Broto
Principal Investigator Email
jmartin@atbsarc.org
Contact Person Name
Javier Martin Broto
Contact Person Email
jmartin@atbsarc.org

France

Earliest CTIS Part Ii Submission Date
10-04-2024
Latest Decision Or Authorization Date
02-02-2026
Processing Time Days
663
Number Of Sites
5
Number Of Participants
12

Sites

Site Name
Centre Leon Berard
Department Name
Medical Oncology
Principal Investigator Name
Jean-Yves Blay
Principal Investigator Email
Jean-Yves.Blay@lyon.unicancer.fr
Contact Person Name
Jean-Yves Blay
Site Name
Institut Gustave Roussy
Department Name
Medical Oncology
Principal Investigator Name
Axel Le Cesne
Principal Investigator Email
Axel.LECESNE@gustaveroussy.fr
Contact Person Name
Axel Le Cesne
Contact Person Email
Axel.LECESNE@gustaveroussy.fr
Site Name
Centre Antoine Lacassagne
Department Name
CLCC Unicancer
Principal Investigator Name
Agnès Ducoulombier
Principal Investigator Email
Agnes.DUCOULOMBIER@nice.unicancer.fr
Contact Person Name
Agnès Ducoulombier
Site Name
Centr Georges Francois Leclerc
Department Name
Medical Oncology
Principal Investigator Name
Alice Hervieu
Principal Investigator Email
ahervieu@cgfl.fr
Contact Person Name
Alice Hervieu
Contact Person Email
ahervieu@cgfl.fr
Site Name
Institut Bergonie
Department Name
Medical Oncology
Principal Investigator Name
Antoine Italiano
Principal Investigator Email
A.Italiano@bordeaux.unicancer.fr
Contact Person Name
Antoine Italiano

Poland

Earliest CTIS Part Ii Submission Date
10-04-2024
Latest Decision Or Authorization Date
08-02-2026
Processing Time Days
669
Number Of Sites
1
Number Of Participants
6

Sites

Site Name
Narodowy Instytut Onkologii Im. Marii Sklodowskiej-Curie Panstwowy Instytut Badawczy
Department Name
Oncology
Principal Investigator Name
Piotr Rutkowski
Principal Investigator Email
Piotr.Rutkowski@pib-nio.pl
Contact Person Name
Piotr Rutkowski
Contact Person Email
Piotr.Rutkowski@pib-nio.pl

Italy

Earliest CTIS Part Ii Submission Date
10-04-2024
Latest Decision Or Authorization Date
04-02-2026
Processing Time Days
665
Number Of Sites
4
Number Of Participants
7

Sites

Site Name
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
Department Name
Medical Oncology
Principal Investigator Name
Michela Quirino
Principal Investigator Email
michela.quirino@policlinicogemelli.it
Contact Person Name
Michela Quirino
Site Name
Azienda Ospedaliero-Universitaria San Luigi Gonzaga
Department Name
Medical Oncology
Principal Investigator Name
Lorenzo D'Ambrosio
Principal Investigator Email
lorenzo.dambrosio@unito.it
Contact Person Name
Lorenzo D'Ambrosio
Contact Person Email
lorenzo.dambrosio@unito.it
Site Name
Istituto Ortopedico Rizzoli
Department Name
Medical Oncology
Principal Investigator Name
Toni Ibrahim
Principal Investigator Email
toni.ibrahim@ior.it
Contact Person Name
Toni Ibrahim
Contact Person Email
toni.ibrahim@ior.it
Site Name
Istituto Di Candiolo Fondazione Del Piemonte Per Loncologia IRCCS
Department Name
Medical Oncology
Principal Investigator Name
Sandra Aliberti
Principal Investigator Email
sandra.aliberti@ircc.it
Contact Person Name
Sandra Aliberti
Contact Person Email
sandra.aliberti@ircc.it

Sponsor

Primary sponsor

Full Name
Philogen S.p.A.
Organisation Type
Pharmaceutical company
Country Of Registered Address
Italy

Third parties

  • {"country":"Italy","full_name":"Opis S.r.l.","duties_or_roles":"Sponsor duties (code: 1)","organisation_type":"Pharmaceutical company"}
  • {"country":"Spain","full_name":"Sofpromed Investigacion Clinica S.L.","duties_or_roles":"Sponsor duties (code: 1)","organisation_type":"Hospital/Clinic/Other health care facility"}

Investigational products

Investigational Product Name
Fibromun
Active Substance
ONFEKAFUSP ALFA
Modality
Other antibody
Routes Of Administration
INTRAVENOUS INFUSION
Route
INTRAVENOUS INFUSION
Authorisation Status
MIA number: aM 132/2019
Orphan Designation
Yes
Frequency
L19TNF (Fibromun) on Days 1, 3 and 5 every 3 weeks; maintenance (investigator discretion) L19TNF on Day 1 of every 21-day maintenance cycle until 18 months after study treatment start
Maximum Dose
13 µg/Kg (max daily); max total 468 µg/Kg
Investigational Product Name
Doxorubicin 2 mg/ml Solution for Injection.
Active Substance
DOXORUBICIN HYDROCHLORIDE
Modality
Small molecule
Routes Of Administration
SOLUTION FOR INFUSION
Route
SOLUTION FOR INFUSION
Authorisation Status
Marketing authorisation: PL 00057/ 0970
Frequency
Doxorubicin on Day 1 every 3 weeks
Maximum Dose
75 mg/m2 per administration (max daily); max total 450 mg/m2
Combination Treatment
Yes

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