Clinical trial • Phase II • Oncology

TREOSULFAN for Ewing sarcoma

Phase II trial of TREOSULFAN for Ewing sarcoma. open-label, none/not specified-controlled. 60 participants.

Overview

Trial Therapeutic Area
Oncology
Trial Disease
Ewing sarcoma
Trial Stage
Phase II
Drug Modality
Small molecule
Paediatric Trial
Yes

Key dates

Initial CTIS Submission Date
29-10-2024
First CTIS Authorization Date
09-12-2024

Trial design

open-label, none/not specified-controlled Phase II trial across 9 sites in Italy.

Open Label
Yes
Comparator
None/Not specified
Target Sample Size
60
Trial Duration For Participant
1095

Eligibility

Recruits 60 paediatric patients.

Pregnancy Exclusion
Pregnant or breastfeeding women;
Vulnerable Population
Paediatric participants are included (paediatric patients <18 years). Informed consent must be signed by the patient and/or by the parents/legal guardian (inclusion criterion). Specific subject information and consent forms exist for parents, for adolescents 13-17 years, for children 8-12 years, and for adult patients (multiple consent documents listed in the dossier). Paediatric patients (<18 years) must be treated in accredited centres for paediatric cancer patients.

Inclusion criteria

  • {"criterion_text":"- Primary diagnosed and histologically confirmed, localized or metastatic, Ewing sarcoma (ES) of bone or soft tissue, or ‘Ewing-like’ sarcoma but negative for EWSR1 gene rearrangement;"}
  • {"criterion_text":"- Patients with disseminated ES are included if any of the following conditions are present: a) 0-5 bone lesions at age < 14 years; b) 0-1 bone lesion at age > 14 years; c) bone marrow (BM) involvement; d) Extraosseous metastases + BM involvement or + bone lesion(s) with the aforementioned age-cut-offs;"}
  • {"criterion_text":"- Informed consent signed by the patient and/or by the parents/legal guardian;"}
  • {"criterion_text":"- Age < 50 years. Paediatric patients (< 18 years old) must be treated in accredited centers for the treatment of paediatric cancer patients"}
  • {"criterion_text":"- Registration to the protocol ≤ 45 days from diagnostic biopsy/surgery"}
  • {"criterion_text":"- Karnofsky > 50% for participants > 16 years old or Lansky Play Score > 50% for paediatric participants ≤ 16 years old or ECOG ≤ 2 for adult participants;"}
  • {"criterion_text":"- Adequate bone marrow function, defined as: Peripheral absolute neutrophil count (ANC) > 0.75 ×10 9 /L •\tHaemoglobin > 8.0 g/dL (transfusion allowed) • Platelet count > 75 × 10 9 /L (transfusion allowed)"}
  • {"criterion_text":"- Adequate organ function (serum creatinine < 1.5 x upper limit of normal (ULN), calculated creatinine clearance > 60 ml/min as determined by Cockcroft-Gault or according to age and sex as determined by Schwartz’s Formula, serum bilirubin ≤ 1.5 × ULN, except for Gilbert’s Syndrome, serum lipase and amylase ≤ 1.5 × ULN, ALT and AST≤ 2.5 × ULN or ≤ 5.0 × ULN for patients with hepatic metastases, normal ventricular ejection function as LVEF > 50% and SF > 28%);"}
  • {"criterion_text":"- A negative pregnancy test before enrolment and once a month during therapy for female participants of potential childbearing; for patients sexually active, it is mandatory to use an effective contraception throughout the treatment and up to 6 months beyond its end. A woman is considered of childbearing potential, i.e. fertile, following menarche and until becoming post-menopausal unless permanently sterile. Permanent sterilisation methods include hysterectomy, bilateral salpingectomy and bilateral oophorectomy."}

Exclusion criteria

  • {"criterion_text":"- The presence of > 5 bone lesions at age < 14 years or > 1 bone lesion at age > 14 years. Bone lesions must be confirmed by CT scan, MRI, PET scan or, in doubtful cases, by biopsy;"}
  • {"criterion_text":"- Presence of concomitant bone metastases + bone marrow involvement (at least one site positive for metastatic infiltration);"}
  • {"criterion_text":"- Prior or concurrent chemotherapy or radiotherapy;"}
  • {"criterion_text":"- Any other severe concomitant comorbiditiesthat, according to the opinion of the Investigator, makes the enrollment in the study inappropriate for the patient, in particular: o myocardial infarction/unstable angina/congestive heart failure within 6 months before enrollment, LVEF less than the lower limit of normal per local institutional standards, history of clinically significant atrial arrhythmia or any history of ventricular arrhythmia; o uncontrolled hypertension, according to age values (patients with hypertension should be under treatment on study entry to carry out blood pressure control); o cerebrovascular accident or transient ischemic attack within 6 months before enrollment, any history of peripheral arterial occlusive disease requiring revascularization, venous thromboembolism including deep venous thrombosis or pulmonary embolism within 6 months before enrolment; o uncontrolled metabolic alterations (such as hypertriglyceridemia); o severe active uncontrolled infection; o history of bleeding disorder; o history of acute pancreatitis (within 1 year before study entry) or history of chronic pancreatitis; o history of alcohol abuse;"}
  • {"criterion_text":"- Second malignancy;"}
  • {"criterion_text":"- Pregnant or breastfeeding women;"}
  • {"criterion_text":"- Neuropsychiatric, social, geographic or severe family problems that make it difficult for the patient to participate in the study."}

Endpoints

Primary endpoints

  • {"endpoint_text":"- • Frequency, duration, and severity of Adverse Effects (AEs) and Serious Adverse Effects (SAEs) according to CTCAE v. 5.0","definition_or_measurement_approach":"Assessment of AEs and SAEs using CTCAE v.5.0 (frequency, duration, severity)."}
  • {"endpoint_text":"- • Event-Free Survival at 36 months defined as the time from the start of chemotherapy to disease progression, relapse, second malignancies, death from treatment-related complications, or the last follow-up","definition_or_measurement_approach":"Event-Free Survival at 36 months measured from start of chemotherapy to disease progression, relapse, second malignancies, death from treatment-related complications, or last follow-up."}

Secondary endpoints

  • {"endpoint_text":"- Overall Survival at 36 months defined as the time from the start of chemotherapy to death or the last follow-up","definition_or_measurement_approach":"Overall Survival at 36 months measured from start of chemotherapy to death or last follow-up."}

Recruitment

Planned Sample Size
60
Recruitment Window Months
84
Consent Approach
Informed consent must be signed by the patient and/or by the parents/legal guardian. Multiple subject information and consent forms are provided, including documents for parents, for adolescent patients (13-17 years), for children (8-12 years), and for adult patients (several versions listed). Consent materials and versions are provided as protocol documents (document list includes parent and age-specific consent forms).

Geography

Total Number Of Sites
9
Total Number Of Participants
60

Italy

Earliest CTIS Part Ii Submission Date
29-10-2024
Latest Decision Or Authorization Date
09-02-2026
Processing Time Days
468
Number Of Sites
9
Number Of Participants
60

Sites

Site Name
Policlinico Universitario Agostino Gemelli IRCCS Università Cattolica Del Sacro Cuore
Department Name
Oncologia Pediatrica
Principal Investigator Name
Antonio Ruggiero
Principal Investigator Email
antonio.ruggiero@unicatt.it
Contact Person Name
Antonio Ruggiero
Contact Person Email
antonio.ruggiero@unicatt.it
Site Name
Azienda Ospedaliero-Universitaria di Modena (AOU Modena) - Policlinico di Modena
Department Name
Oncoematologia Pediatrica
Principal Investigator Name
Giovanni Palazzi
Principal Investigator Email
palazzi.giovanni@aou.mo.it
Contact Person Name
Giovanni Palazzi
Contact Person Email
palazzi.giovanni@aou.mo.it
Site Name
Istituto Tumori Bari Giovanni Paolo II
Department Name
U.O.S.D. Tumori Rari e Melanoma
Principal Investigator Name
Sabino Strippoli
Principal Investigator Email
s.strippoli@oncologico.bari.it
Contact Person Name
Sabino Strippoli
Contact Person Email
s.strippoli@oncologico.bari.it
Site Name
Azienda Ospedaliero Universitaria Pisana
Department Name
UO Oncoematologia Pediatrica
Principal Investigator Name
Luca Coccoli
Principal Investigator Email
l.coccoli@ao-pisa.toscana.it
Contact Person Name
Luca Coccoli
Contact Person Email
l.coccoli@ao-pisa.toscana.it
Site Name
Azienda Ospedaliera Santobono Pausilipon
Department Name
Oncologia Pediatrica
Principal Investigator Name
Maria Grazia Pionelli
Principal Investigator Email
pionellimariagrazia@gmail.com
Contact Person Name
Maria Grazia Pionelli
Contact Person Email
pionellimariagrazia@gmail.com
Site Name
IRCCS Istituto Nazionale Tumori Fondazione Pascale
Department Name
Sarcomi e Tumori Rari
Principal Investigator Name
Salvatore Tafuto
Principal Investigator Email
s.tafuto@istitutotumori.na.it
Contact Person Name
Salvatore Tafuto
Contact Person Email
s.tafuto@istitutotumori.na.it
Site Name
Azienda Ospedaliero Universitaria Ospedali Riuniti Umberto I G M Lancisi G Salesi
Department Name
Oncoematologia Pediatrica
Principal Investigator Name
Paola Coccia
Principal Investigator Email
paola.coccia@ospedaliriuniti.marche.it
Contact Person Name
Paola Coccia
Site Name
Azienda Ospedaliero Universitaria Consorziale Policlinico di Bari
Department Name
Oncoematologia Pediatrica
Principal Investigator Name
Francesco De Leonardis
Principal Investigator Email
FDL111@libero.it
Contact Person Name
Francesco De Leonardis
Contact Person Email
FDL111@libero.it
Site Name
Azienda Ospedaliera Universitaria Integrata Verona
Department Name
Oncoematologia Pediatrica
Principal Investigator Name
Simone Cesaro
Principal Investigator Email
simone.cesaro@aovr.veneto.it
Contact Person Name
Simone Cesaro
Contact Person Email
simone.cesaro@aovr.veneto.it

Sponsor

Primary sponsor

Full Name
Fondazione Santobono Pausilipon Onlus
Organisation Type
Patient organisation/association
Country Of Registered Address
Italy

Investigational products

Investigational Product Name
Trecondi 1 g powder for solution for infusion
Active Substance
TREOSULFAN
Modality
Small molecule
Routes Of Administration
INTRAVENOUS USE
Route
INTRAVENOUS USE
Authorisation Status
Authorised (marketing authorisation EU/1/18/1351/002)
Maximum Dose
36000 mg/m2
Investigational Product Name
Trecondi 5 g powder for solution for infusion
Active Substance
TREOSULFAN
Modality
Small molecule
Routes Of Administration
INTRAVENOUS USE
Route
INTRAVENOUS USE
Authorisation Status
Authorised (marketing authorisation EU/1/18/1351/004)
Maximum Dose
36000 mg/m2
Investigational Product Name
MELPHALAN
Active Substance
MELPHALAN
Modality
Small molecule
Routes Of Administration
INTRAVENOUS USE
Route
INTRAVENOUS USE
Authorisation Status
Authorised
Maximum Dose
140 mg/m2
Investigational Product Name
DOXORUBICIN HYDROCHLORIDE
Active Substance
DOXORUBICIN HYDROCHLORIDE
Modality
Small molecule
Routes Of Administration
INTRAVENOUS USE
Route
INTRAVENOUS USE
Authorisation Status
Authorised
Maximum Dose
75 mg/m2
Investigational Product Name
CYCLOPHOSPHAMIDE
Active Substance
CYCLOPHOSPHAMIDE
Modality
Small molecule
Routes Of Administration
INTRAVENOUS
Route
INTRAVENOUS
Authorisation Status
Authorised
Maximum Dose
1200 mg/m2
Investigational Product Name
IFOSFAMIDE
Active Substance
IFOSFAMIDE
Modality
Small molecule
Routes Of Administration
INTRAVENOUS USE
Route
INTRAVENOUS USE
Authorisation Status
Authorised
Maximum Dose
9000 mg/m2
Investigational Product Name
VINCRISTINE
Active Substance
VINORELBINE
Modality
Small molecule
Routes Of Administration
INJECTION
Route
INJECTION
Authorisation Status
Authorised
Maximum Dose
2 mg/m2
Investigational Product Name
ETOPOSIDE
Active Substance
ETOPOSIDE
Modality
Small molecule
Routes Of Administration
INTRAVENOUS USE
Route
INTRAVENOUS USE
Authorisation Status
Authorised
Maximum Dose
500 mg/m2
Combination Treatment
Yes

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