Clinical trial • Phase II • Oncology|Endocrinology

SACITUZUMAB GOVITECAN for Differentiated thyroid carcinoma (radioactive-iodine refractory)|Anaplastic thyroid carcinoma

Phase II trial of SACITUZUMAB GOVITECAN for Differentiated thyroid carcinoma (radioactive-iodine refractory)|Anaplastic thyroid carcinoma. open-label.

Overview

Trial Therapeutic Area
Oncology|Endocrinology
Trial Disease
Differentiated thyroid carcinoma (radioactive-iodine refractory)|Anaplastic thyroid carcinoma
Trial Stage
Phase II
Drug Modality
ADC|Monoclonal antibody

Key dates

Initial CTIS Submission Date
28-09-2023
First CTIS Authorization Date
05-02-2024

Trial design

open-label Phase II trial in Spain.

Open Label
Yes
Target Sample Size
42

Eligibility

Recruits 42 Vulnerable population flag is selected. IRB/IEC approved written informed consent is required (see inclusion criterion 1). Subject information and informed consent forms for adults and pregnant women are listed in the trial documents. No information on assent procedures or consent for minors is provided in the available records..

Pregnancy Exclusion
Female patients must either: a. Be of nonchildbearing potential: i. Postmenopausal *(defined as at least 1 year without any menses) prior to screening , or ii. Documented surgically sterile (e.g.hysterectomy, bilateral salpingectomy, bilateral oophorectomy, or bilateral tubal occlusion). *Those who are amenorrheic due to an alternative medical cause are not considered postmenopausal and must follow the criteria for childbearing potential subjects. OR b. If of childbearing potential: i. Agree not to try to become pregnant during the study and for at least 6 months after the final study drug administration, ii. And have a negative urine or serum pregnancy test within 7 days prior to Day 1 (females with false positive results and documented verification of negative pregnancy status are eligible for participation), iii. And if heterosexually active, agree to abstinence (if in line with the usual preferred lifestyle of the patient) or consistently use a condom plus 1 form of highly effective birth control (Appendix 4) per locally accepted standards starting at screening and throughout the study period and for at least 6 months after the final study drug administration.
Vulnerable Population
Vulnerable population flag is selected. IRB/IEC approved written informed consent is required (see inclusion criterion 1). Subject information and informed consent forms for adults and pregnant women are listed in the trial documents. No information on assent procedures or consent for minors is provided in the available records.

Inclusion criteria

  • {"criterion_text":"- Institutional Review Board (IRB)/Independent Ethics Committee (IEC) approved written informed consent.\n- Female patients must agree not to breastfeed or donate ovules starting at screening and throughout the study period, and for at least 6 months after the final study drug administration.\n- Male patients must not donate sperm starting at screening and throughout the study period, and for at least 6 months after the final study drug administration.\n- Male patients with a partner with childbearing potential, or who is pregnant or breastfeeding must agree to abstinence or use a condom plus 1 form of highly effective birth control throughout the study period and for at least 6 months after the final study drug administration.\n- Patient agrees not to participate in another interventional study while on treatment in the present study.\n- Patient is ≥ 18 years of age.\n- Patient has histologically confirmed metastatic or locally advanced unresectable radioactive-iodine refractory differentiated thyroid cancer (cohort A) or anaplastic thyroid carcinoma (cohort B).\n- Prior therapy in each cohort: a. Cohort A: Patients must have experienced progression on at least one previous treatment line with approved systemic therapies (Sorafenib, Lenvatinib or Cabozantinib) and a maximum of 3 prior systemic therapies. b. Cohort B: Patients should be included in first-line setting or after failure of any systemic therapy (up to 1 prior treatment lines).\n- Patient has radiographically documented and measurable metastatic or locally advanced disease at baseline.\n- An archival tumor tissue sample should be available for submission to the central laboratory for translational studies. If an archival tumor tissue sample is not available, a new biopsy tissue sample should be provided. No central pathological review will be needed to include the patient in the trial.\n- Patient has Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.\n- The following baseline laboratory data without transfusional support: a. Neutrophil count (ANC) ≥ 1,500/mm 3 . b. Platelet count ≥ 100 × 10 9/L. c. Hemoglobin ≥ 9 g/dL. d. Serum bilirubin ≤ 1.5 × upper limit of normal (ULN). Note: patients with Gilbert’s disease are excluded. e. Serum albumin > 3 g/dL. f. Creatinine clearance (CrCl) ≥ 60 mL/min as estimated by the Cockroft-Gault formula or as measured by 24 hour urine collection (GFR can also be used instead of CrCl) (see Table 10 for Cockcroft-Gault formula). g. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 2.5 × ULN or ≤ 5 xULN for patients with liver metastases.\n- Female patients must either: a. Be of nonchildbearing potential: i. Postmenopausal *(defined as at least 1 year without any menses) prior to screening , or ii. Documented surgically sterile (e.g.hysterectomy, bilateral salpingectomy, bilateral oophorectomy, or bilateral tubal occlusion). *Those who are amenorrheic due to an alternative medical cause are not considered postmenopausal and must follow the criteria for childbearing potential subjects. OR b. If of childbearing potential: i. Agree not to try to become pregnant during the study and for at least 6 months after the final study drug administration, ii. And have a negative urine or serum pregnancy test within 7 days prior to Day 1 (females with false positive results and documented verification of negative pregnancy status are eligible for participation), iii. And if heterosexually active, agree to abstinence (if in line with the usual preferred lifestyle of the patient) or consistently use a condom plus 1 form of highly effective birth control (Appendix 4) per locally accepted standards starting at screening and throughout the study period and for at least 6 months after the final study drug administration."}

Exclusion criteria

  • {"criterion_text":"- Patient has central nervous system (CNS) metastases.\n- Patient has radiotherapy or major surgery within 4 weeks prior to the first dose of study drug.\n- Patients has received a live vaccine within 30 days, or antibiotics within one week prior to the first dose of study drug.\n- Patient has had chemotherapy, biologics, investigational agents, and/or antitumor treatment with immunotherapy that is not completed 2 weeks prior to the first dose of study drug. Note: Patients participating in observational studies are eligible.\n- Patient has previously received topoisomerase 1 inhibitors.\n- Patient has known hypersensitivity to sacituzumab govitecan or to any excipient contained in the drug formulation.\n- Patient has other underlying medical conditions that, in the opinion of the investigator, would impair the ability of the patient to receive or tolerate the planned treatment and follow-up.\n- Patient has ongoing clinically significant toxicity (Grade 2 or higher with the exception of neuropathy and alopecia) associated with prior treatment (including systemic therapy, radiotherapy or surgery). Note: if patients received major surgery, they must have recovered adequately from the toxicity and/or complications from the intervention prior to starting therapy.\n- Patient has a history of another malignancy within 3 years before the first dose of study drug, or any evidence of residual disease from a previously diagnosed malignancy. Note: Patients with non melanoma skin cancer, curatively treated localized prostate cancer, or carcinoma in situ of any type (if complete resection was performed) are allowed.\n- Patient has known active Hepatitis B or active hepatitis C: a. Patients who test positive for hepatitis B surface antigen (HBsAg). Patients who test positive for hepatitis B core antibody (anti-HBc) will require HBV DNA by quantitative polymerase chain reaction (PCR) for confirmation of active disease. b. Patients who test positive for HCV antibody. Patients who test positive for HCV antibody will require HCV RNA by quantitative PCR for confirmation of active disease. Patients with a known history of HCV or a positive HCV antibody test will not require a HCV antibody at screening and will only require HCV RNA by quantitative PCR for confirmation of active disease. c. Patients who test positive for HIV antibody.\n- Patient has a known history of human immunodeficiency virus (HIV) infection (HIV 1 or 2) with detectable viral load OR taking medications that may interfere with SN-38 metabolism.\n- Patient has documented history of a cerebral vascular event (stroke or transient ischemic attack), , or the following criteria for cardiac disease: a. Myocardial infarction or unstable angina pectoris within 6 months of enrollment. b. History of serious ventricular arrhythmia (ie, ventricular tachycardia or ventricular fibrillation), high-grade atrioventricular block, or other cardiac arrhythmias requiring antiarrhythmic medications (except for atrial fibrillation that is well controlled with antiarrhythmic medication); history of QT interval prolongation. c. New York Heart Association (NYHA) class III or greater congestive heart failure or left ventricular ejection fraction of < 40%..\n- Known history of clinically significant active COPD, or other moderate-to-severe chronic respiratory illness present within 6 months prior to the first dose of study drug.\n- Patients with active chronic inflammatory bowel disease (ulcerative colitis, Crohn disease) and patients with a history of gastrointestinal obstruction or perforation within 6 months of enrollment.\n- Patient has uncontrolled hypertension or diabetes."}

Endpoints

Primary endpoints

  • {"endpoint_text":"- The primary endpoint will be objective response rate (ORR), defined as the percentage/proportion of patients with confirmed complete response (CR) or partial response (PR) as their overall best response throughout the study period. Objective responses will be assessed locally by the investigator according to RECIST, version 1.1 (Appendix 3), and indicating the change in size of tumors as compared with baseline, at the first dose of study treatment.","definition_or_measurement_approach":"ORR measured as proportion of patients with confirmed CR or PR assessed locally by investigators according to RECIST v1.1 comparing tumor size to baseline."}

Secondary endpoints

  • {"endpoint_text":"- Efficacy secondary endpoints will be analyzed per cohort: ● Disease control rate (DCR). ● Duration of the response (DoR). ● Progression free survival (PFS). ● Overall survival (OS). ● Efficacy variables will be reported for subgroups to find potential correlation between patient characteristics (i.e. age, gender, ECOG, AJCC stage, differentiation, or previous treatments) and the clinical outcomes to sacituzumab govitecan.\n- Secondary safety endpoints: ● Frequency and severity of adverse events and Treatment-related adverse events (TRAEs) assessed by NCI CTCAE v5.0. ● Frequency of AEs leading to treatment discontinuation. ● Health-related quality of life (HRQoL), assessed through the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) version 3.\n- Secondary exploratory endpoints: ● Correlation of TROP-2 expression levels with efficacy endpoints (i.e. ORR, PFS, OS). ● Correlation of tumor genetic alterations with efficacy endpoints (i.e. ORR, PFS, OS).","definition_or_measurement_approach":"Efficacy endpoints analyzed per cohort (DCR, DoR, PFS, OS) with subgroup analyses by patient characteristics. Safety endpoints assessed by NCI CTCAE v5.0; HRQoL by EORTC QLQ-C30 v3. Exploratory endpoints correlate TROP-2 expression and tumor genetic alterations with efficacy endpoints (ORR, PFS, OS)."}

Recruitment

Planned Sample Size
42
Recruitment Window Months
38
Consent Approach
IRB/IEC approved written informed consent required. Subject information and informed consent form documents for adults and pregnant women are included in the trial documents. No details provided about assent processes or consent for minors; languages of the consent documents are not specified.

Geography

Total Number Of Sites
11
Total Number Of Participants
42

Spain

Earliest CTIS Part Ii Submission Date
15-12-2023
Latest Decision Or Authorization Date
19-12-2025
Processing Time Days
735
Number Of Sites
11
Number Of Participants
42

Sites

Site Name
Area Sanitaria De Ferrol
Department Name
Oncología
Contact Person Name
Nieves Martínez
Contact Person Email
investigacion@mfar.net
Site Name
Hospital Universitario Ramon Y Cajal
Department Name
Oncología
Contact Person Name
Teresa Alonso
Contact Person Email
investigacion@mfar.net
Site Name
Hospital Unviersitario Miguel Servet
Department Name
Oncología
Contact Person Name
Javier Martínez
Contact Person Email
investigacion@mfar.net
Site Name
Hospital General Universitario Morales Meseguer
Department Name
Oncología
Contact Person Name
Alberto Carmona
Contact Person Email
investigacion@mfar.net
Site Name
MD Anderson Cancer Center
Department Name
Oncología
Contact Person Name
Ana Lucrecia Ruiz Echeverría
Contact Person Email
investigacion@mfar.net
Site Name
Hospital Universitario Central De Asturias
Department Name
Oncología
Contact Person Name
Paula Jiménez
Contact Person Email
investigacion@mfar.net
Site Name
Hospital Universitario Marques De Valdecilla
Department Name
Oncología
Contact Person Name
Carlos López
Contact Person Email
investigacion@mfar.net
Site Name
Ajuntament De L Hospitalet De Llobregat
Department Name
Oncología
Contact Person Name
María Plana
Contact Person Email
investigacion@mfar.net
Site Name
Hospital Universitario La Paz
Department Name
Oncología
Contact Person Name
Betríz Castelo
Contact Person Email
investigacion@mfar.net
Site Name
Vall D'hebron Institut De Recerca
Department Name
Oncología
Contact Person Name
Alejandro Álvarez
Contact Person Email
investigacion@mfar.net
Site Name
Hospital Clinico San Carlos
Department Name
Oncología
Contact Person Name
Gloria Marquina
Contact Person Email
investigacion@mfar.net

Sponsor

Primary sponsor

Full Name
Grupo Espanol De Tumores Neuroendocrinos
Organisation Type
Patient organisation/association
Country Of Registered Address
Spain

Third parties

  • {"country":"Spain","full_name":"Alcura Health Espana S.A.","duties_or_roles":"14","organisation_type":"Pharmaceutical company"}

Investigational products

Investigational Product Name
Trodelvy 200 mg powder for concentrate for solution for infusion
Active Substance
SACITUZUMAB GOVITECAN
Modality
ADC|Monoclonal antibody
Routes Of Administration
Intravenous
Route
Intravenous
Authorisation Status
Authorised (EU/1/21/1592/001)
Maximum Dose
10 mg/Kg

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