A Trial of TH-302 in Combination With Doxorubicin Versus Doxorubicin Alone to Treat Patients With Locally Advanced Unresectable or Metastatic Soft Tissue Sarcoma

Overview[ - collapse ][ - ]

Purpose The purpose of this study is to determine whether TH-302 in combination with Doxorubicin is safe and effective in the treatment of Locally Advanced Unresectable or Metastatic Soft Tissue Sarcoma.
ConditionSoft Tissue Sarcoma
InterventionDrug: TH-302 in Combination with Doxorubicin
Drug: Doxorubicin
PhasePhase 3
SponsorThreshold Pharmaceuticals
Responsible PartyThreshold Pharmaceuticals
ClinicalTrials.gov IdentifierNCT01440088
First ReceivedSeptember 20, 2011
Last UpdatedMarch 6, 2014
Last verifiedMarch 2014

Tracking Information[ + expand ][ + ]

First Received DateSeptember 20, 2011
Last Updated DateMarch 6, 2014
Start DateSeptember 2011
Estimated Primary Completion DateApril 2015
Current Primary Outcome MeasuresEfficacy of TH-302 in combination with doxorubicin [Time Frame: 2 years] [Designated as safety issue: No]Efficacy will be determined by overall survival in subjects with locally advanced unresectable or metastatic soft tissue sarcoma previously untreated with chemotherapy compared with doxorubicin alone
Current Secondary Outcome MeasuresSafety of TH-302 in combination with doxorubicin in subjects with locally advanced unresectable or metastatic soft tissue sarcoma compared with doxorubicin alone [Time Frame: 2 years] [Designated as safety issue: Yes]To investigate the pharmacokinetics of TH-302, Br-IPM, doxorubicin, and doxorubicinol in plasma

Descriptive Information[ + expand ][ + ]

Brief TitleA Trial of TH-302 in Combination With Doxorubicin Versus Doxorubicin Alone to Treat Patients With Locally Advanced Unresectable or Metastatic Soft Tissue Sarcoma
Official TitleA Randomized Phase 3, Multicenter, Open-Label Study Comparing TH-302 in Combination With Doxorubicin vs. Doxorubicin Alone in Subjects With Locally Advanced Unresectable or Metastatic Soft Tissue Sarcoma
Brief Summary
The purpose of this study is to determine whether TH-302 in combination with Doxorubicin is
safe and effective in the treatment of Locally Advanced Unresectable or Metastatic Soft
Tissue Sarcoma.
Detailed Description
TH-302 is designed to target the hypoxic regions of tumors which are generally located
distant from tumor vessels. Doxorubicin has poor tissue penetration and targets the regions
of tumors that are located in proximity to the tumor vessels. The presence of hypoxia in
solid tumors is associated with a more malignant phenotype and resistance to chemotherapy.
The hypoxia-activated prodrug, TH-302, is designed to selectively target the hypoxic
microenvironment. Soft tissue sarcomas have evidence supporting the presence of hypoxia
based on pO2 histography, F-MISO and gene expression profiling. There is an absence of
therapeutic options for subjects with soft tissue sarcoma. Combining doxorubicin with
TH-302 may enable the targeting of both the normoxic and hypoxic regions of soft tissue
sarcoma.
Study TypeInterventional
Study PhasePhase 3
Study DesignAllocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
ConditionSoft Tissue Sarcoma
InterventionDrug: TH-302 in Combination with Doxorubicin
300 mg/m2 of TH-302 will be administered by IV infusion over 30-60 minutes on Days 1 and 8 of a 21-day cycle.
Doxorubicin may be delivered as a bolus administration or as a continuous infusion administration; administration schedule must be specified prior to enrollment.
Doxorubicin bolus administration: 75 mg/m2 administered by bolus injection starting on Day 1 of a 21-day cycle.
Doxorubicin continuous administration: 75 mg/m2 administered by continuous IV infusion over 48-96 hours starting on Day 1 of a 21-day cycle.
Doxorubicin administration will start between 2 to 4 hours after completion of the TH-302 infusion when used in combination with TH-302.
Drug: Doxorubicin
Doxorubicin may be delivered as a bolus administration or as a continuous infusion administration; administration schedule must be specified prior to enrollment.
Doxorubicin bolus administration: 75 mg/m2 administered by bolus injection starting on Day 1 of a 21-day cycle.
Doxorubicin continuous administration: 75 mg/m2 administered by continuous IV infusion over 48-96 hours starting on Day 1 of a 21-day cycle.
Study Arm (s)
  • Experimental: TH-302 in Combination with Doxorubicin
  • Active Comparator: Doxorubicin

Recruitment Information[ + expand ][ + ]

Recruitment StatusActive, not recruiting
Estimated Enrollment620
Estimated Completion DateApril 2015
Estimated Primary Completion DateJune 2014
Eligibility Criteria
Inclusion Criteria:

- Male or female ≥ 15 years of age

- Ability to understand the purposes and risks of the study and has signed or, if
appropriate, the subject's parent or legal guardian has signed a written informed
consent form approved by the investigator's IRB/Ethics Committee

- Pathologically confirmed diagnosis of soft tissue sarcoma of the following
histopathologic types:

- Synovial sarcoma

- High grade fibrosarcoma

- Undifferentiated sarcoma; sarcoma not otherwise specified (NOS)

- Liposarcoma

- Leiomyosarcoma (excluding GIST)

- Angiosarcoma (excluding Kaposi's sarcoma)

- Malignant peripheral nerve sheath tumor

- Pleomorphic Rhabdomyosarcoma

- Myxofibrosarcoma

- Epithelioid sarcoma

- Undifferentiated pleomorphic sarcoma/malignant fibrous histiocytoma (MFH)
(including pleomorphic, giant cell, myxoid and inflammatory forms)

- Locally advanced unresectable or metastatic disease with no standard curative therapy
available and for whom treatment with single agent doxorubicin is considered
appropriate.

- Recovered from reversible toxicities of prior therapy

- Measurable disease by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1

- Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1

- Life expectancy of at least 3 months

- Acceptable liver, renal, hematological and cardiac function

- All women of childbearing potential must have a negative serum pregnancy test and all
subjects must agree to use effective means of contraception

Exclusion Criteria:

- Prior systemic therapy for advanced or metastatic disease (neoadjuvant therapy
followed by surgical resection and adjuvant therapy permitted). Palliative
radiotherapy to non-target lesions is allowed if completed at least two weeks prior
to study entry

- Low grade tumors according to standard grading systems

- Prior therapy with ifosfamide or cyclophosphamide or other nitrogen mustards

- Prior therapy with an anthracycline or anthracenedione

- Prior mediastinal/cardiac radiotherapy

- Current use of drugs with known cardiotoxicity or known interactions with doxorubicin

- Anti-cancer treatment with radiation therapy, neoadjuvant or adjuvant chemotherapy,
targeted therapies, immunotherapy, hormones or other antitumor therapies within 4
weeks prior to study entry (6 weeks for nitrosoureas or mitomycin C). Palliative
radiotherapy to non-target lesions is allowed, is completed at least two weeks prior
to study entry.

- Significant cardiac dysfunction precluding treatment with doxorubicin

- Seizure disorders requiring anticonvulsant therapy unless seizure-free for the last
year

- Known brain metastases (unless previously treated and well controlled for a period of
≥ 3 months)

- Previously treated malignancies, except for adequately treated non-melanoma skin
cancer, in situ cancer, or other cancer from which the subject has been disease-free
for at least 5 years

- Severe chronic obstructive or other pulmonary disease with hypoxemia or in the
opinion of the investigator any physiological state likely to cause normal tissue
hypoxia

- Major surgery, other than diagnostic surgery, within 4 weeks prior to Day 1, without
complete recovery

- Active, uncontrolled bacterial, viral, or fungal infections, requiring systemic
therapy

- Prior therapy with a hypoxic cytotoxin

- Subjects who participated in an investigational drug or device study within 28 days
prior to study entry

- Known infection with HIV, hepatitis B, or hepatitis C

- Subjects who have exhibited allergic reactions to a structural compound similar to
TH-302,doxorubicin or their excipients

- Females who are pregnant or breast-feeding

- Concomitant disease or condition that could interfere with the conduct of the study,
or that would, in the opinion of the investigator, pose an unacceptable risk to the
subject in this study

- Unwillingness or inability to comply with the study protocol for any reason
GenderBoth
Ages15 Years
Accepts Healthy VolunteersNo
ContactsNot Provided
Location CountriesUnited States, Austria, Belgium, Canada, Denmark, France, Germany, Hungary, Israel, Italy, Poland, Russian Federation, Spain

Administrative Information[ + expand ][ + ]

NCT Number NCT01440088
Other Study ID NumbersTH-CR-406/SARC021
Has Data Monitoring CommitteeYes
Information Provided ByThreshold Pharmaceuticals
Study SponsorThreshold Pharmaceuticals
CollaboratorsSarcoma Alliance for Research through Collaboration (SARC)
Investigators Principal Investigator: William Tap, MD Memorial Sloan-Kettering Cancer Center
Verification DateMarch 2014

Locations[ + expand ][ + ]

Mayo Arizona
Scottsdale, Arizona, United States, 85259
Arizona Cancer Center
Tucson, Arizona, United States, 85719
University of California, Los Angeles
Los Angeles, California, United States, 90095-6901
USC-Norris Comprehensive Cancer Center
Los Angeles, California, United States, 90033
Sarcoma Oncology Center
Santa Monica, California, United States, 90403
Stanford Comprehensive Cancer Center
Stanford, California, United States, 94305
Georgetown University Hospital
Washington, District of Columbia, United States, 20007
Washington Cancer Institute
Washington, District of Columbia, United States, 20010
South Florida Center for Gynecologic Oncology
Boca Raton, Florida, United States, 33487
Mayo Clinic-Florida-Cancer Clinical Studies Unit
Jacksonville, Florida, United States, 32224
MD Anderson Cancer Center Orlando
Orlando, Florida, United States, 32806
H.Lee Moffitt Cancer Center and Research Institute
Tampa, Florida, United States, 33612
Winship Cancer Institute of Emory University, Midtown Campus
Atlanta, Georgia, United States, 30322
Kootenai Health - Kootenai Cancer Center
Coeur d`Alene, Idaho, United States, 83814
Northwestern University
Chicago, Illinois, United States, 60611
Rush University Medical Center
Chicago, Illinois, United States, 60612
Oncology Specialists
Park Ridge, Illinois, United States, 60068
Indiana University Simon Cancer Center
Indianapolis, Indiana, United States, 46202
University of Iowa Health Care - University of Iowa Hospital
Iowa City, Iowa, United States, 52242
Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Hospital
Baltimore, Maryland, United States, 21287
Dana Farber Cancer Institute Center for Sarcoma and Bone Oncology
Boston, Massachusetts, United States, 02215
University of Michigan Cancer Center
Ann Arbor, Michigan, United States, 48109
Mayo Rochester
Rochester, Minnesota, United States, 55905
Washington University School of Medicine
St. Louis, Missouri, United States, 63110
Montefiore
Bronx, New York, United States, 10461
Roswell Park Cancer Institute
Buffalo, New York, United States, 14263
Memorial Sloan-Kettering Cancer Center
New York, New York, United States, 10031
Columbia University Medical Center
NY, New York, United States, 10032
Carolinas Hematology-oncology Associates-Blumenthal Cancer Center
Charlotte, North Carolina, United States, 28203
Duke University Medical Center
Durham, North Carolina, United States, 27710
Wake Forest University Baptist Medical Center
Winston Salem, North Carolina, United States, 27157
Cleveland Clinic Foundation
Cleveland, Ohio, United States, 44195
University Hospitals Seidman Cancer Center
Cleveland, Ohio, United States, 44106
The Arthur G. James Cancer Hospital and Richard J Solove Research Institue, The Ohio State University Comprehensive Cancer Center
Columbus, Ohio, United States, 43202
Oregon Health and Science University
Portland, Oregon, United States, 97239
Pennsylvania Oncology Hematology Associates
Philadelphia, Pennsylvania, United States, 19106
Fox Chase Cancer Center
Philadelphia, Pennsylvania, United States, 19111
University of Pittsburg Medical Center
Pittsburg, Pennsylvania, United States, 15232
MUSC - Hollings Cancer Center
Charleston, South Carolina, United States, 29425
Vanderbilt-Ingram Cancer Center
Nashville, Tennessee, United States, 37232
University of Vermont
Burlington, Vermont, United States, 05405
Virginia Commonwealth Universtiy-Massey Cancer Center
Richmond, Virginia, United States, 23298
University of Washington Cancer Center
Seattle, Washington, United States, 98109
Medical College of Wisconsin
Milwaukee, Wisconsin, United States, 53226
University Klinikum Graz
Graz, Austria, A-8036
Univ. Klinik fur Innere Medizin I Internistische Onkologie Medizinische Universitat Innsbruck
Innsbruck, Austria, A-6020
Allgemeines Krankenhaus Wien
Wien, Austria, A-1090
Universitaire Ziekenhuizen (UZ) Leuven - Gasthuisberg
Leuven, Belgium, 3000
Juravinski Cancer Centre at Hamilton Health Sciences - Department of Medicine
Hamilton, Ontario, Canada, L8V5C2
McGill University Health Centre
Montreal, Quebec, Canada, H3G 1A4
Tom Baker Cancer Centre
Calgary, Canada, T2N4N2
Cross Cancer Institute
Edmonton, Canada, T6G1Z2
Ottawa Health Research Institue
Ottawa, Canada, K1H8L6
BCCA- Vancouver Cancer Centre - Division of Medical Oncology
Vancouver, Canada, V5Z4E6
Cancer Care Manitoba
Winnipeg, Canada, R3E0V9
University Hospital Herlev at Copenhagen
Herlev, Copenhagen, Denmark, 2730
ICO Rene Gauducheau
Saint Herblain Cedex, Nantes, France, 44805
Institut Bergonie
Bordeaux, France, 33076
Departement d'Oncologie Medicale
Dijon, France, 21079
Centre Leon Berard
Lyon, France, 69008
Département d'Oncologie Moléculaire, Institut Paoli-Calmettes (IPC) and U119 Inserm
Marseille, France, 13009
Centre Antoine Lacassagne
Nice, France
CHU Strasbourg
Strasbourg, France, 67098
Institut Claudius Regaud
Toulouse Cedex, France, 31052
Helios Klinikum Bad Saarow, Department of Hematology, Oncology, and Palliative Care, Sarcoma Center Berlin-Brandenburg
Berlin, Germany, 15526
HELIOS Klinikum Berlin-Buch
Berlin, Germany, 13125
Universitätsklinikum Essen
Essen, Germany, 45122
Krankenhaus Nordwest GmbH
Frankfurt, Germany
Medizinische Hochschule Hannover (MHH) - Klinik fuer Haemonstaseologie, Onkologie und Stammzelltransplantation
Hannover, Germany, 30625
Div. of Surgical Oncology & Thoracic Surgery, Mannheim University Medical Center
Mannheim, Germany, D-68165
Wilhelm's University, Universitatsklinikum Muenster, Medizinische Klinik und Poliklinik A, Albert-Schweitzer-Campus 1
Munster, Germany, 48149
Magyar Honvedseg Honvedkorhaz, Onkologiai Osztaly
Budapest, Hungary, H-1062
Jasz-Nagykun-Szolnok Megyei Hetenyi Geza Korhaz-Rendelointezet, Megyei Onkologiai Kozpont
Szolnok, Hungary, H-5004
Sharette Institute of Oncology, Hadassah-Hebrew University Medical Center, Hadassah Medical Org-Ein Karem
Kiryat Hadassah, Jerusalem, Israel, 91120
IRCCS Centro di Riferimento Oncologico-Struttura Operativa
Aviano, Pordenone, Italy, 33081
Fondazione del Piemonte per l'Oncologia, Instituto per la Ricerca e la Cura del cancro (I.R.C.C.), Dipartimento Oncologico, Direzione Operativa Oncologia Medica a Direzione Universitaria
Candiolo, Torino, Italy, 10060
Centro di Riferimento Oncologico (CRO)
Aviano, Italy, 33081
Azienda Ospedaliera Garibaldi
Catania, Italy, 95122
Azienda Ospedaliero Universitaria-Policlinico Paolo Giacco
Palermo, Italy, 90127
ASL TO/2 di TORINO_Presidio Sanitario Gradenigo, S.C. di Oncologia
Torino, Italy, 10149
Wojewodzkie Centrum Onkologii
Gdansk, Poland, 80-219
Centrum Onkologii Instytut im M. Sklodowskiej-Curie
Krakow, Poland, 31-115
Centrum Onkologii-Instytut im. M. Sklodowskiej-Curie
Warszawa, Poland, 02-781
GUZ "Regional Oncology Dispensay", Kazan
Kazan, Russian Federation, 420029
ROTSN RAMS them. Н.Н.Блохина NN Blokhin
Moscow, Russian Federation, 115478
FGU Moscow Research Institute of Oncology named after P.A. Hertzen of Rosmedtechnology
Moscow, Russian Federation, 125284
H.U. Canarias, Hospital Universitario de Canarias. Servicio de Oncología Médica
Tenerife, Canarias, Spain, 38320
Institut Catala d'Oncologia
Barcelona, Spain, 08907
Hospital Sant Joan de Deu, Department de Oncologia
Barcelona, Spain, 08950
Hospital de la Santa Creu i Sant Pau
Barcelona, Spain, 08041
Hospital Universitario Ramón y Cajal.
Madrid, Spain, 28034
Universidad Complutense Madrid Facultad de Medicina - Hospital Universitario 12 de Octubre, Servicio de Oncologia Medica Hospital Universitario 12 de Octubre
Madrid, Spain, 28034