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SarcomaPhase 2NCT00073983

Gemcitabine and Docetaxel in Treating Patients With Recurrent Osteosarcoma (Closed to Accrual as of 12/21/06) or Ewing's Sarcoma or Unresectable or Locally Recurrent Chondrosarcoma

A Phase 2 study testing filgrastim, pegfilgrastim and docetaxel in people with Sarcoma, run by Sarcoma Alliance for Research through Collaboration.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

RATIONALE: Drugs used in chemotherapy, such as gemcitabine and docetaxel, work in different ways to stop tumor cells from dividing so they stop growing or die. Combining gemcitabine with docetaxel may kill more tumor cells. Read more about this study

Who is it for?
Ages 4 years and older
Conditions the study is for
Sarcoma
What is being tested?
filgrastim, pegfilgrastim and docetaxel
How many people
54 participants
Where
No sites listed yet
Study dates
Oct 2006to Dec 2010
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 4 years and older
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

DISEASE CHARACTERISTICS:

  • Histologically confirmed* diagnosis of 1 of the following:
  • Recurrent high-grade osteosarcoma (closed to accrual as of 12/21/06) or Ewing's sarcoma
  • Progressive disease after standard therapy
  • Received no more than 2 additional salvage regimens
  • Chondrosarcoma
  • Unresectable OR locally recurrent and unable to be completely resected NOTE: *Biopsy required for isolated pulmonary recurrences
  • Measurable disease
  • At least 1 unidimensionally measurable lesion by medical imaging techniques
  • Ascites, pleural effusions, and bone marrow disease are not considered measurable disease

PATIENT CHARACTERISTICS:

Age

  • 4 and over

Performance status

  • ECOG (Eastern Cooperative Oncology Group) 0-2 (≥ 18 years of age)
  • Karnofsky 50-100% (11-17 years of age)
  • Lansky 50-100% (≤ 10 years of age)

Life expectancy

  • Not specified

Hematopoietic

  • Absolute neutrophil count ≥ 1,500/mm^3
  • Platelet count ≥ 100,000/mm^3 (transfusion independent)
  • Hemoglobin ≥ 8.0 g/dL (transfusion allowed)

Hepatic

  • Bilirubin ≤ upper limit of normal (ULN) (except for patients with Gilbert's syndrome)
  • ALT ≤ 2.5 times ULN

Renal

  • Creatinine clearance or radioisotope glomerular filtration rate > 70 mL/min/1.73 m^2 OR
  • Serum creatinine ≤ ULN for age:
  • Ages 5 and under ≤ 0.8 mg/dL
  • Ages 6 to 10 ≤ 1.0 mg/dL
  • Ages 11 to 15 ≤ 1.2 mg/dL
  • Ages 16 to 18 ≤ 1.5 mg/dL

Other

  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for 3 months after study participation
  • Sensory or motor neuropathy due to prior chemotherapy ≤ grade 1
  • Sensory or motor neuropathy due to prior surgery or tumor involvement ≤ grade 2 AND stable or improving
  • No active or uncontrolled infection
  • No known hypersensitivity reaction to docetaxel or other polysorbate 80-formulated agents

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • At least 72 hours since prior filgrastim (G-CSF)
  • No prior allogeneic transplantation
  • No concurrent immunotherapy

Chemotherapy

  • At least 2 weeks since prior myelosuppressive therapy
  • At least 6 months since prior myeloablative therapy
  • No prior gemcitabine
  • No prior taxanes
  • No other concurrent chemotherapy

Endocrine therapy

  • Concurrent hormonal therapy allowed

Radiotherapy

  • At least 6 weeks since prior local radiotherapy
  • At least 4 months since prior extensive radiotherapy to more than 50% of the pelvis
  • At least 4 months since prior cranial spinal radiotherapy
  • At least 6 months since prior total body irradiation
  • No concurrent radiotherapy

Surgery

  • No concurrent surgery

Other

  • Recovered from all prior therapy
  • No other concurrent investigational anticancer therapy

About this study

Official title: Phase II Study Of Sequential Gemcitabine Followed By Docetaxel For Recurrent Ewing's Sarcoma, Osteosarcoma, Or Unresectable Or Locally Recurrent Chondrosarcoma [SARC Study]

RATIONALE: Drugs used in chemotherapy, such as gemcitabine and docetaxel, work in different ways to stop tumor cells from dividing so they stop growing or die. Combining gemcitabine with docetaxel may kill more tumor cells.

PURPOSE: Phase II trial to study the effectiveness of combining gemcitabine with docetaxel in treating patients who have recurrent osteosarcoma, recurrent Ewing's sarcoma, or unresectable or locally recurrent chondrosarcoma.

Read the detailed description

OBJECTIVES:

Primary

  • Determine the objective response rate in patients with recurrent osteosarcoma or Ewing's sarcoma or unresectable or locally recurrent chondrosarcoma treated with sequential gemcitabine and docetaxel.

Secondary

  • Determine the time to progression in patients treated with this regimen.
  • Assess the toxicity of this regimen in these patients.
  • Compare the pharmacokinetics of this regimen vs gemcitabine alone in these patients.
  • Obtain tumor samples for cDNA microarray analysis of gene expression and development of cell lines and xenotransplantation models.

OUTLINE: This is a nonrandomized, multicenter study.

Patients are stratified according to diagnosis recurrent osteosarcoma vs recurrent Ewing's sarcoma vs unresectable or locally recurrent chondrosarcoma).

Patients receive gemcitabine intravenously over 90 minutes on days 1 and 8 and docetaxel intravenously over 1 hour on day 8. Patients also receive filgrastim (G-CSF) subcutaneously (SC) beginning on day 9 and continuing until blood counts recover. Patients may receive pegfilgrastim SC on day 9 (once per course) as an alternative to G-CSF. Treatment repeats every 21 days in the absence of disease progression or unacceptable toxicity.

Optional blood samples are collected at baseline and periodically during study for pharmacokinetics studies. Optional tumor tissue samples from biopsy or surgical resection are analysed for cDNA microarray analysis of gene expression.

Patients are followed every 3 months for 1 year and then every 6 months for 1 year.

PROJECTED ACCRUAL: A maximum of 120 patients (40 per stratum) will be accrued for this study within 17-24 months.

Conditions
Sarcoma
Being tested
filgrastim, pegfilgrastim, docetaxel, gemcitabine hydrochloride, microarray analysis
Keywords
recurrent Ewing sarcoma/peripheral primitive neuroectodermal tumor, chondrosarcoma, recurrent osteosarcoma
Medical subject headings
Sarcoma, Neuroectodermal Tumors, Primitive, Peripheral, Chondrosarcoma, Osteosarcoma

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • filgrastimBiological

    filgrastim

  • pegfilgrastimBiological

    pegfilgrastim

  • docetaxelDrug

    docetaxel

  • gemcitabine hydrochlorideDrug

    gemcitabine hydrochloride

  • microarray analysisGenetic

    microarray analysis

  • laboratory biomarker analysisOther

    laboratory biomarker analysis

  • pharmacokinetic studyOther

    pharmacokinetic study

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Objective Response Rate

    Patients will be evaluated up to 4 time points(after 2,4,8 and 12 cycles of therapy), each cycle is 21 days. Per RECIST 1.0 and assessed by CT/MRI disease status will be categorized as R=CR/PR(response), F=progressive disease or death(failure), or S(stable disease=neither R nor F) based on the change from baseline. A patient with outcome R or F at any stage is scored as having that overall outcome, a patient with outcome S is re-evaluated after subsequent cycles of therapy. Patients who receive more than 14 cycles of therapy will be scored as the outcome at completion of cycle 14.

    Measured: After 2, 4, 8 and 12 cycles of therapy, each cycle is 21 days

Secondary outcomes (3)

  1. Time to Progression

    Stable disease is measured from the start of the treatment until the criteria for disease progression are met, taking as reference the smallest measurements recorded since the treatment started. The clinical relevance of the duration of stable disease varies for different tumor types and grades. Bayesian statistical model is used. Timepoints for evaluation are post-cycle 2, 4, 8 and 12 using RECIST 1.0 criteria.

    Measured: post-cycle 2, 4, 8 and 12

  2. Toxicity as Assessed by NCI CTCAE v3.0

    Toxicity was graded according to Common Terminology Criteria for Adverse Events v.3.0 (CTCAE v.3.0). For gemcitabine or docetaxel related grade 3 or 4 non-hematological toxicities or hematological toxicities (grade 3 or 4 neutropenia for ≥ 7 days, grade 4 thrombocytopenia, or any platelet transfusion), both agents were withheld until the toxicity was ≤ grade 1. If the toxicity recovered to ≤ grade 1 by cycle day 35, the dose of both agents was reduced for all subsequent cycles. If the toxicity did not resolve by day 35, protocol therapy was discontinued.

    Measured: Throughout the study

  3. Pharmacokinetics of Gemcitabine Alone and Gemcitabine Followed by Docetaxel at Protocol Specified Timeframe in Participants Enrolled on Study

    Blood samples for the determination of gemcitabine (and its metabolite dFdU) will be obtained prior to infusion, at 75 and 85 minutes (steady state), and 95 105 and 120 minutes, after the start of the 90 minute infusion on day 1 and day 8 of cycle 1. On day 8, docetaxel pharmacokinetics will be performed prior to infusion, 55 minutes (5 minutes prior to the end of infusion), 30 minutes post infusion, 5 hr and 24hr post infusion.

    Measured: Gemcitibine: 0hr, 75, 85, 95, 105 and 120 min after the start of the 90 minute infusion; docetaxel: 0hr, 55 min, 30 min post infusion, 5hr and 24hr post infusion.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted11 Dec 2003 (estimated)
  2. Study startOct 2006
  3. Primary completionJan 2010
  4. Study completionDec 2010

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
54 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00073983
Sponsor's protocol ID
SARC003
Status last verified
Feb 2012
First submitted
10 Dec 2003
Last updated
12 Mar 2012
Data monitoring committee
Yes

Publications

  • Kilgour-Christie J, Czarnecki A: Pulmonary adverse drug reactions in patients treated with gemcitabine and a combination of gemcitabine and a taxane. [Abstract] J Clin Oncol 23 (Suppl 16): A-8274, 796s, 2005.

  • Fox E, Patel S, Wathen JK, Schuetze S, Chawla S, Harmon D, Reinke D, Chugh R, Benjamin RS, Helman LJ. Phase II study of sequential gemcitabine followed by docetaxel for recurrent Ewing sarcoma, osteosarcoma, or unresectable or locally recurrent chondrosarcoma: results of Sarcoma Alliance for Research Through Collaboration Study 003. Oncologist. 2012;17(3):321. doi: 10.1634/theoncologist.2010-0265. Epub 2012 Feb 23.

    PubMed 22363068

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing filgrastim, pegfilgrastim and docetaxel in people with Sarcoma, run by Sarcoma Alliance for Research through Collaboration.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 12 Mar 2012. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 12 Mar 2012). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Objective Response Rate (time frame: After 2, 4, 8 and 12 cycles of therapy, each cycle is 21 days). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00073983, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Mar 2012.

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