Clinical trial • Phase II • Oncology

RETIFANLIMAB for Undifferentiated pleomorphic sarcoma | Retroperitoneal sarcoma

Phase II trial of RETIFANLIMAB for Undifferentiated pleomorphic sarcoma | Retroperitoneal sarcoma.

Overview

Trial Therapeutic Area
Oncology
Trial Disease
Undifferentiated pleomorphic sarcoma | Retroperitoneal sarcoma
Trial Stage
Phase II
Drug Modality
Monoclonal antibody | Small molecule

Key dates

Initial CTIS Submission Date
08-08-2024
First CTIS Authorization Date
02-09-2024

Trial design

Randomised, neoadjuvant chemotherapy (doxorubicin + ifosfamide) as control arm; experimental arm: retifanlimab (incmga00012) in combination with doxorubicin + ifosfamide. dose and schedule not specified in available data. Phase II trial in France.

Randomised
Yes
Comparator
Neoadjuvant chemotherapy (Doxorubicin + Ifosfamide) as control arm; experimental arm: Retifanlimab (INCMGA00012) in combination with Doxorubicin + Ifosfamide. Dose and schedule not specified in available data.
Target Sample Size
66

Eligibility

Recruits 66 No vulnerable population selected. Participants must be adults (Age ≥ 18 years) and provide voluntarily signed and dated written informed consent prior to any study-specific procedure. Persons under judicial protection or deprived of liberty are explicitly excluded..

Pregnancy Exclusion
Women who are pregnant or breast feeding,
Vulnerable Population
No vulnerable population selected. Participants must be adults (Age ≥ 18 years) and provide voluntarily signed and dated written informed consent prior to any study-specific procedure. Persons under judicial protection or deprived of liberty are explicitly excluded.

Inclusion criteria

  • {"criterion_text":"- Patients with grade 2 or grade 3 undifferentiated pleomorphic sarcoma (limb, trunk wall, retroperitoneum) histologically confirmed and reviewed by the RRePS Network (Réseau de Référence en Pathologie des Viscères et des tissus mous) as recommended by the French National Cancer Institute(Inca),\n- Patients must have measurable disease (lesion in previously irradiated field can be considered as measurable if progressive at inclusion according to RECIST v1.1) defined as per RECIST v1.1 with at least one lesion that can be measured in at least one dimension (longest diameter to be recorded) as ≥10 mm with spiral CT scan.\n- Adequate hematological, renal, metabolic and hepatic function: a. Hemoglobin ≥ 8.0 g/dl; leucocytes ≥ 2.0 G/l, absolute neutrophil count (ANC) > 1.0 G/l and platelet count > 100 G/l, b. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 2.5 x upper limit of normality (ULN) , c. Total bilirubin ≤ 1.5 x ULN d. Albumin ≥ 25g/l e. Serum creatinine ≤ 1.5 x ULN OR Calculated creatinine clearance (CrCl) ≥ 60 ml/min (calculated per institutional standard) for subject with creatinine levels > 1.5 x ULN. f. Thyroid function within normal laboratory ranges (TSH, free T3, free T4)\n- Left ventricular ejection fraction (LVEF) ≥ 50% assessed by ECHO or MUGA within 6 months from study entry,\n- Women of childbearing potential must have a negative serum pregnancy test within 7 days prior to study entry. Pregnancy test (serum or urine) should be repeated within 72 hours prior to receiving the first dose of trial medication.\n- Both women and men must agree to use a highly effective method of contraception throughout the treatment period and for one year after discontinuation of treatment for women and 4 months for men.\n- No prior or concurrent malignant disease diagnosed or treated in the last 2 years except for adequately treated in situ carcinoma of the cervix, concomitant endometrial carcinoma stage IA grade 1, basal or squamous skin cell carcinoma, or in situ transitional bladder cell carcinoma,\n- Recovery to grade ≤ 1 from any adverse event (AE) derived from previous treatment (excluding alopecia of any grade and non-painful peripheral neuropathy grade ≤ 2) according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE, version 5),\n- Voluntarily signed and dated written informed consent prior to any study specific procedure,\n- Patients with a social security in compliance with the French law,\n- Patients for whom an indication of neoadjuvant chemotherapy has been confirmed during a sarcoma multidisciplinary tumor board labelled by the French NCI (Réseau NETSARC+).\n- Deleted MSA4.\n- Deleted MSA4.\n- Non-metastatic and resectable disease,\n- At least one lesion that can be biopsied for research purpose,\n- No prior treatment for the disease under study,\n- Age ≥ 18 years,\n- Eastern Cooperative Oncology Group (ECOG) performance status (PS) ≤ 1,\n- Life expectancy > 3 months"}

Exclusion criteria

  • {"criterion_text":"- Previous treatment for sarcoma including surgery, chemotherapy or radiotherapy\n- Patient unable to follow and comply with the study procedures because of any geographical, social or psychological reasons,\n- Has received a live attenuated vaccine or a live vaccine within 30 days prior to the first dose of trial treatment, Note: the killed virus vaccines used for seasonal influenza vaccines for injection are allowed; however intranasal influenza vaccines (e.g., FluMist®) are live attenuated vaccines and are not allowed.\n- Uncontrolled or significant cardiovascular disease including, but not limited to, any of the following: a. Myocardial infarction or stroke/transient ischemic attack within the 6 months prior to study entry. b. Uncontrolled angina within the 3 months prior to study entry. c. Any history of clinically significant arrhythmias (such as ventricular tachycardia, ventricular fibrillation, or torsades de pointes, or poorly controlled atrial fibrillation). d. Corrected QT (QTc) prolongation > 480 msec. e. History of other clinically significant cardiovascular disease (i.e., cardiomyopathy, congestive heart failure with New York Heart Association [NYHA] functional classification III-IV, pericarditis, significant pericardial effusion, significant coronary stent occlusion, poorly controlled venous thrombus).\n- Uncontrolled or significant renal disease including, but not limited to, any of the following: a. Acute or uncontrolled urinary infection at study entry, b. Hemorrhagic cystitis at study entry, c. Presence of blood on dipstick at study entry, d. Vesical atony, e. Known urinary tract obstruction.\n- Patients with known history of active inflammatory bowel diseases, including those with small or large intestine inflammation, such as Crohn’s disease or ulcerative colitis, will be excluded from the study,\n- Has received systemic antibiotics within 14 days before the first dose of study treatment. Participants receiving prophylactic antibiotics (e.g., for prevention of a urinary tract infection or chronic obstructive pulmonary disease) are eligible.\n- History of organ transplant, including allogeneic stem cell transplantation.\n- Receiving probiotics as of the first dose of study treatment.\n- Has an active autoimmune disease - Patients with diabetes type I, vitiligo, psoriasis, hypo- or hyperthyroid disease not requiring immunosuppressive treatment are eligible, - Patients requiring hormone replacement with corticosteroids are eligible if the steroids are administered only for the purpose of hormonal replacement and at dose ≤ 10 mg or 10 mg equivalent prednisone day, - Administration of steroids through a route known to result in a minimal systemic exposure (topical, intranasal, intra-ocular, intra-articular or inhalation) are acceptable.\n- Evidence of interstitial lung disease, history of interstitial lung disease, or active, noninfectious pneumonitis.\n- Previous treatments with doxorubicin, daunorubicin, epirubicin, idarubicin and/or other anthracyclines or anthracenediones at the maximum cumulative dose,\n- Palliative radiation therapy administered within 1 week of first dose of study treatment or radiation therapy in the thoracic region that is > 30 Gy within 6 months of the first dose of study treatment. Note: Participants must have recovered from all radiation-related toxicities (to Grade >1 or baseline), not require corticosteroids for this purpose, and not have had radiation pneumonitis.\n- Person under judicial protection or deprived of liberty.\n- Known hypersensitivity to any involved study drug or any of its formulation components,\n- Has an active or ongoing infection requiring systemic therapy,\n- Known central nervous system malignancy (CNS),\n- Women who are pregnant or breast feeding,\n- Has known active hepatitis B or hepatitis C,\n- Has a known history of Human Immunodeficiency Virus (HIV),\n- Previous enrolment in the present study"}

Endpoints

Primary endpoints

  • {"endpoint_text":"- The antitumor activity of retifanlimab (INCMGA00012) when prescribed in association with neoadjuvant chemotherapy (Doxorubicin + Ifosfamide) will be assessed based on histological response defined as less than 10% of viable tumor cells on surgical sample.","definition_or_measurement_approach":"Histological response defined as less than 10% of viable tumor cells on surgical sample; primary efficacy endpoint is histological response based on surgical sample."}

Secondary endpoints

  • {"endpoint_text":"- Progression-free survival (PFS) is defined as the time from study treatment initiation to the first occurrence of disease progression or death (of any cause), whichever occurs first. 1- and 3-year PFS rates and median PFS will be reported.","definition_or_measurement_approach":"PFS defined as time from study treatment initiation to first occurrence of disease progression or death (any cause); 1- and 3-year PFS rates and median PFS reported."}
  • {"endpoint_text":"- Overall Survival (OS) is defined as the time from study treatment initiation to death (of any cause). 1- and 3-year OS rates and median OS will be reported.","definition_or_measurement_approach":"OS defined as time from study treatment initiation to death (any cause); 1- and 3-year OS rates and median OS reported."}
  • {"endpoint_text":"- Safety will be assessed using the Common Terminology Criteria for Adverse Events (CTCAE) from the NCI v5.0. Toxicity will be graded using the CTCAE v5.0. Adverse events, serious and non-serious, will be coded as per the MedDRA dictionary.","definition_or_measurement_approach":"Safety assessed using NCI CTCAE v5.0; AEs graded per CTCAE v5.0 and coded using MedDRA."}

Recruitment

Registry Or Advocacy Recruitment
True, NETSARC+ (sarcoma multidisciplinary tumor board network labelled by the French NCI)
Planned Sample Size
66
Recruitment Window Months
72
Consent Approach
Voluntarily signed and dated written informed consent is required prior to any study-specific procedure. Participants must be adults (Age ≥ 18 years). No pediatric assent procedures indicated. No languages for consent forms specified in available documents.

Geography

Total Number Of Sites
2
Total Number Of Participants
66

France

Earliest CTIS Part Ii Submission Date
08-08-2024
Latest Decision Or Authorization Date
23-09-2025
Processing Time Days
411
Number Of Sites
2
Number Of Participants
66

Sites

Site Name
Centre Leon Berard
Department Name
Oncologie médicale
Principal Investigator Name
Medhi BRAHMI
Principal Investigator Email
medhi.brahmi@lyon.unicancer.fr
Contact Person Name
Medhi BRAHMI
Contact Person Email
medhi.brahmi@lyon.unicancer.fr
Site Name
Institut Bergonie
Department Name
Oncologie médicale
Principal Investigator Name
Antoine ITALIANO
Principal Investigator Email
a.italiano@bordeaux.unicancer.fr
Contact Person Name
Antoine ITALIANO

Sponsor

Primary sponsor

Full Name
Institut Bergonie
Organisation Type
Hospital/Clinic/Other health care facility
Country Of Registered Address
France

Investigational products

Investigational Product Name
Retifanlimab (INCMGA00012)
Active Substance
RETIFANLIMAB
Modality
Monoclonal antibody
Routes Of Administration
INTRAVENIOUS INFUSION
Route
Intravenous infusion
Maximum Dose
375 mg
Investigational Product Name
HOLOXAN 2000 mg, poudre pour usage parentéral (Ifosfamide)
Active Substance
IFOSFAMIDE
Modality
Small molecule
Routes Of Administration
INTRAVENIOUS INFUSION
Route
Intravenous infusion
Authorisation Status
Marketing authorisation (France)
Maximum Dose
9000 mg/m2
Investigational Product Name
DOXORUBICINE ACCORD 2 mg/ml, solution pour perfusion (Doxorubicin hydrochloride)
Active Substance
DOXORUBICIN HYDROCHLORIDE
Modality
Small molecule
Routes Of Administration
INTRAVENIOUS INFUSION
Route
Intravenous infusion
Authorisation Status
Marketing authorisation (France)
Maximum Dose
60 mg/m2
Combination Treatment
Yes

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