tTF-NGR Randomized Study - STS (TRABTRAP)

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ClinicalTrials.gov Identifier: NCT05597917

Recruitment Status : Recruiting

First Posted : October 28, 2022

Last Update Posted : December 22, 2023

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Sponsor:

Collaborator:

Anturec Pharmaceuticals GmbH

Information provided by (Responsible Party):

Universität Münster

Study Description

Brief Summary:

In this phase III open label, controlled clinical trial patients with unresectable or metastatic soft-tissue sarcoma after failure of anthracycline-containing first line therapy or with contraindications to these drugs and CD13 positivity in central histology (grade >/= 1+) are treated to evaluate whether tTF-NGR in combination with standard trabectedin chemotherapy prolongs progression-free survival (according to iRECIST), as compared with trabectedin alone. Further objectives are to evaluate the efficacy of tTF-NGR in combination with standard trabectedin chemotherapy with respect to the response rate and overall survival as well as to assess the safety profile of tTF-NGR combined with trabectedin. Before the randomized phase III part of the study, there will be a safety run-in part. The final dose of tTF-NGR established as safe in this safety run-in part will be used for the randomized (parallel 1:1; Arm 1: standard trabectedin, Arm 2: standard trabectedin plus tTF-NGR) phase III part of this trail.

Condition or disease	Intervention/treatment	Phase
Soft Tissue Sarcoma	Drug: Trabectedin Biological: tTF-NGR	Phase 3

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Detailed Description:

Rationale: tTF-NGR targets CD13 present in tumor-associated vasculature and on tumor cells of the majority of STS tissue samples examined; preclinical data on combination of tTF-NGR with anthracyclines and trabectedin; low competition of targeted or immune therapy in soft tissue sarcoma (STS)

Investigational Medicinal Product: Patients will receive a dose of the Investigational Medicinal Product (IMP) tTF-NGR determined to be safe within the safety run-in cohort of the study as 1-hour rate-controlled infusion (port central venous access, 0.9 % NaCl ad 100 mL) per day for 4 or lower number of consecutive days following each trabectedin cycle (within 1 hour interval between end of trabectedin infusion and tTF-NGR: e.g.: trabectedin on monday 8 am to tuesday 8 am followed by tTF-NGR on tuesday latest 9 am and on the following days, q d 22 x until disease progression or contraindications against further application.

Indication: Unresectable or metastatic STS after failure of anthracycline-containing first line treatment or with contraindications to these drugs; CD13 positivity in central histology (grade >/= 1+)

Primary objective and endpoints: The primary objective of the trial is to evaluate whether tTF-NGR in combination with standard trabectedin chemotherapy given for unresectable or metastatic soft tissue sarcoma after failure of anthracycline-containing first line therapy or with contraindications to these drugs prolongs progression-free survival, as compared with trabectedin alone. The following efficacy endpoint (for the randomized phase III part) will be considered:

- Progression-free survival (PFS) according to iRECIST (Seymour L, Lancet Oncol. 2017) as judged by central radiology in a blinded fashion after end of trial.

Secondary objectives and endpoints: The secondary objective of the trial is to evaluate the efficacy of tTF-NGR in combination with standard trabectedin chemotherapy given for unresectable or metastatic STS after failure of anthracycline-containing first line therapy or with contraindications to these drugs with respect to the response rate and overall survival as well as to assess the safety profile of tTF-NGR combined with trabectedin.

To assess the efficacy, the following measurements will be considered:

Overall response rate (ORR, consisting of CR and PR)
Disease control rate (DCR, consisting of CR, PR, and stable disease (SD) for >18 weeks)
Median progression-free survival (mPFS)
Median overall survival (mOS)
Overall survival (OS) rate at 12 and 18 months

To assess the safety profile of tTF-NGR combined with trabectedin (for the phase II and the phase III parts), the following safety endpoints will be considered:

Adverse Events (AEs) assessment based on CTCAE v.5.0.
Standard laboratory parameters and pharmacokinetics
Physical examination findings including assessment of vital signs
Patient reported outcomes (PRO)

Study design: Open label, randomized, controlled study in subjects with metastatic or refractory soft tissue sarcoma. Approx. 150 patients will be screened, 126 evaluable patients are enrolled and parallel assigned in a 1:1 fashion to one of two different arms, as outlined below. Randomization will be stratified into CD13+ grades 1 and 2 versus CD13+ grade 3 and number of chemotherapy regimen before entry on trial: 1 versus >1.

Safety run-in part:

Before the randomized phase III part of the study, there will be a safety cohort of a minimum of 6 patients obtaining at least 2 cycles each of the combination outlined in arm 2 (see below) to confirm safety of this combination (1.5 mg/m2 trabectedin plus a starting dose of 3 mg/m2 tTF-NGR). The patients will be treated in-house and in sequence. In case of dose-limiting toxicity (DLT) in one patient of this cohort, a dosemodification protocol for tTF-NGR to 2 mg/m2 is planned, and in case of further tolerability problems in one patient further deescalations in 0.5 mg/m2 steps of tTF-NGR and/or by a reduction of application days are planned. The safe dose is then transferred to the randomized phase III part of the study. The final dose and the final number of application days of tTF-NGR in this combination has to be applied to 6 patients with 2 cycles each without DLT to be established as safe. The randomized part of the study will be opened after judgement of the safety in the safety cohort by the DSMB, Ethics Committee and National Competenent Authority (PEI).

Randaomzied Phase III part:

ARM 1:

Trabectedin 1.5 mg/m2 as a 24-hour central intravenous (IV) infusion on day 1, q d 22 x until disease progression or contraindications against further application.

ARM 2:

Patients will receive standard trabectedin according to arm 1 plus the safe dose according to safety run-in part of tTF-NGR (1-hour ratecontrolled infusion, port central venous access, 0.9 % NaCl ad 100 mL) per day for 4 or lower number of consecutive days following each trabectedin cycle (within 1 hour interval between end of trabectedin infusion and tTF-NGR: e.g.: trabectedin on monday 8 am to tuesday 8 am followed by tTF-NGR on tuesday 9 am and on the following days, q d 22 x until disease progression or contraindications against further application.

As the evaluation of the study results is based on an intention-to-treat analysis, all patients after randomization will be part of the efficacy population as evaluated by central iRECIST evaluation after end of study.

Therapy in both arms can be given on an out-patient basis. All patients receive best supportive care (BSC) according to institutional guidelines. Anti-cancer activity (iRECIST modification) will be assessed (clinically and imaging) at week 9 and then every 9 weeks (adjusted to cycle length of 3 weeks) until confirmed progression by iRECIST (iCPD). Decision on application of next cycle at week 9 will be clinical. Imaging and clinical based decision will follow. Transfer of pseudonymized imaging pictures (CD, DVD) and imaging results of a patient to the study center has to be performed after each imaging time point.

Safety assessment will be performed on an ongoing basis during study participation, including standard laboratory assessments. The incidence of AEs will be summarized by severity in all patients with at least one study drug intake

Number of sites, countries and patients: Multicenter, up to 11 active study sites in Germany. At least 6 patients are treated in the phase II safety part, 126 patients will be randomized in a 1:1 ratio to receive open label Trabectedin (Arm 1) or Trabectedin plus tTF-NGR (Arm 2) in the phase III part.

Target population: Patients (18-75 years) with advanced or metastatic soft-tissue sarcoma after failure of anthracycline-containing first line therapy or with contraindications to these drugs.

ARM 1: Standard chemotherapy with Trabectidin (in-label)

ARM 2: Test product tTF-NGR added to standard Trabectedin

Severity grading: Hematological and chemical laboratory tests, and AEs will be graded based on CTCAE v. 5.0.

Duration of Treatment: Patients will be treated in repeated cycles until definite disease progression (iRECIST; Seymour L, Lancet Oncol. 2017) in the absence of other withdrawal criteria, and as long as neither patient nor investigator requests treatment discontinuation.

Tumor assessments: Detailed tumor assessment visits (clinical and laboratory examinations) after start of therapy are performed before treatment start, at week 9 (+/- 1 week), followed by every 9 weeks (+/- 1 week, independent from cycle length of 3 weeks) thereafter. Post-study treatment (treatment with another anti-cancer agent) is according to investigator´s choice, but is recorded in the eCRF. At iCPD (confirmed at next tumor assessment after iUPD) tumor assessments will end, but time of death will be recorded for estimation of OS. In case EOT is not determined by iCPD, tumor assessments will go on after EOT until iCPD. Survival status will be collected also for patients withdrawn from the study until death. Transfer of pseudonymized imaging pictures (CD, DVD) and imaging results of a patient to the study center has to be performed after each imaging time point.

Statistical analysis: Safety data of the safety run-in part of the study will be evaluated using descriptive statistical methods.

In the primary statistical analysis of the randomized phase III part, the primary endpoint progression-free survival (PFS) according to iRECIST as judged by central blinded radiology will be compared between the two randomized treatment groups (Arm 1 versus Arm 2). The primary statistical analysis will include all randomized patients (full analysis set) and will be performed according to the intention-to-treat principle. A stratified log-rank test with stratification according to the randomization will be applied (two-sided significance level 5%, power 80%) that provides confirmatory statistical evidence.

The timing of the study will be event-driven. The primary statistical analysis will be performed at the time when 106 events in terms of PFS have been observed in total across both treatment groups. This required number of events results from the following sample size calculation. Based on the observed PFS in previous trials, PFS is expected to be exponential, and the expected median PFS is 4.6 months in the control arm (Arm 1) and 8 months in the experimental arm (Arm 2). The corresponding expected hazard ratio is HR=0.575. In a 36 months enrolment period with a rate of 3-4 patients per month, 126 patients will be recruited and randomized. The drop-out process after randomization is expected to be exponential with an up to 25% cumulative drop-out rate at month 24 (competing with the survival process). Follow-up after the last randomized patient is planned to be 12 months, after which it is expected that the required number of 106 events in terms of PFS will have occurred.

The statistical analysis of pre-specified secondary endpoints will be performed with descriptive and inferential statistical methods. Prespecified subgroup analyses will be performed with respect to stratification, L-sarcoma vs. others, FNCLCC grade (2 vs. 3), and ECOG performance status (ECOG PS 0 vs. PS 1). Further exploratory analyses will be performed for other relevant treatment variables (e.g. sex, age, number of treatment cycles).

Safety data will be evaluated and summarized descriptively.

Withdrawal and patient replacement criteria: The patient can withdraw consent for participation in the study at any time without disadvantages for further treatment or prejudice by the therapeutic team. The investigator can withdraw a patient if, in his or her clinical judgment, it is in the best interest of the patient or if the patient cannot comply with the protocol.

Study Design

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Study Type :	Interventional (Clinical Trial)
Estimated Enrollment :	126 participants
Allocation:	Randomized
Intervention Model:	Parallel Assignment
Masking:	None (Open Label)
Primary Purpose:	Treatment
Official Title:	Phase III Study Comparing Trabectedin (T) Versus T Plus tTF-NGR to Entrap T Inside the Tumor in Patients With Metastatic and/or Refractory Soft Tissue Sarcoma (STS)
Actual Study Start Date :	October 26, 2021
Estimated Primary Completion Date :	December 2025
Estimated Study Completion Date :	December 2026

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Soft Tissue Sarcoma

Drug Information available for: Trabectedin

Genetic and Rare Diseases Information Center resources: Soft Tissue Sarcoma

U.S. FDA Resources

Arms and Interventions

Arm	Intervention/treatment
Active Comparator: Arm 1: Standard chemotherapy with trabectidin (in-label) Patients will receive standard trabectedin 1.5 mg/m2 as a 24-hour central intravenous (IV) infusion on day 1, q d 22 x until disease progression or contraindications against further application.	Drug: Trabectedin Patients will receive standard trabectedin 1.5 mg/m2 as a 24-hour central intravenous (IV) infusion on day 1, q d 22 x until disease progression or contraindications against further application. Other Name: Yondelis
Experimental: Arm 2: tTF-NGR added to standard trabectedin Patients will receive standard trabectedin according to arm 1 plus the safe dose according to safety run-in part of tTF-NGR (1-hour ratecontrolled infusion, port central venous access, 0.9 % NaCl ad 100 mL) per day for 4 or lower number of consecutive days following each trabectedin cycle (within 1 hour interval between end of trabectedin infusion and tTF-NGR: e.g.: trabectedin on monday 8 am to tuesday 8 am followed by tTF-NGR on tuesday 9 am and on the following days, q d 22 x until disease progression or contraindications against further application.	Drug: Trabectedin Patients will receive standard trabectedin 1.5 mg/m2 as a 24-hour central intravenous (IV) infusion on day 1, q d 22 x until disease progression or contraindications against further application. Other Name: Yondelis Biological: tTF-NGR Patients will receive standard trabectedin according to arm 1 plus the safe dose according to safety run-in part of tTF-NGR (1-hour ratecontrolled infusion, port central venous access, 0.9 % NaCl ad 100 mL) per day for 4 or lower number of consecutive days following each trabectedin cycle (within 1 hour interval between end of trabectedin infusion and tTF-NGR: e.g.: trabectedin on monday 8 am to tuesday 8 am followed by tTF-NGR on tuesday 9 am and on the following days, q d 22 x until disease progression or contraindications against further application.

Arm

Intervention/treatment

Active Comparator: Arm 1: Standard chemotherapy with trabectidin (in-label)

Patients will receive standard trabectedin 1.5 mg/m2 as a 24-hour central intravenous (IV) infusion on day 1, q d 22 x until disease progression or contraindications against further application.

Drug: Trabectedin

Patients will receive standard trabectedin 1.5 mg/m2 as a 24-hour central intravenous (IV) infusion on day 1, q d 22 x until disease progression or contraindications against further application.

Other Name: Yondelis

Experimental: Arm 2: tTF-NGR added to standard trabectedin

Drug: Trabectedin

Patients will receive standard trabectedin 1.5 mg/m2 as a 24-hour central intravenous (IV) infusion on day 1, q d 22 x until disease progression or contraindications against further application.

Other Name: Yondelis

Biological: tTF-NGR

Outcome Measures

Primary Outcome Measures :

Efficacy: Prolongation of progression-free survival (PFS) according to iRECIST as judged by central radiology in a blinded fashion after end of trial. [ Time Frame: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 100 months ]
The primary objective of the trial is to evaluate whether tTF-NGR in combination with standard trabectedin chemotherapy given for unresectable or metastatic soft tissue sarcoma after failure of anthracycline-containing first line therapy or with contraindications to these drugs prolongs progression-free survival, as compared with trabectedin alone.

The following efficacy endpoint (for the randomized phase III part) will be considered:

- Progression-free survival (PFS) according to iRECIST (Seymour L, Lancet Oncol. 2017) as judged by central radiology in a blinded fashion after end of trial.

Secondary Outcome Measures :

Evaluation of the efficacy of tTF-NGR in combination with standard trabectedin chemotherapy (OOR) [ Time Frame: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 100 months ]
To assess the efficacy, the following measurement will be considered:

Overall response rate (ORR, consisting of CR and PR)
Evaluation of the efficacy of tTF-NGR in combination with standard trabectedin chemotherapy (DCR) [ Time Frame: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 100 months ]
To assess the efficacy, the following measurement will be considered:

- Disease control rate (DCR, consisting of CR, PR, and stable disease (SD) for >18 weeks)
Evaluation of the efficacy of tTF-NGR in combination with standard trabectedin chemotherapy (mPFS) [ Time Frame: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 100 months ]
To assess the efficacy, the following measurement will be considered:

- Median progression-free survival (mPFS)
Evaluation of the efficacy of tTF-NGR in combination with standard trabectedin chemotherapy (mOS) [ Time Frame: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 100 months ]
To assess the efficacy, the following measurement will be considered:

- Median overall survival (mOS)
Evaluation of the efficacy of tTF-NGR in combination with standard trabectedin chemotherapy (OS) [ Time Frame: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 100 months ]
To assess the efficacy, the following measurement will be considered:

- Overall survival (OS) rate at 12 and 18 months
Evaluation of the safety profile of tTF-NGR combined with standard trabectedin chemotherapy (AE) [ Time Frame: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 100 months ]
To assess the safety profile of tTF-NGR combined with trabectedin the following safety endpoint will be considered:

- Adverse Events (AEs) assessment based on CTCAE v.5.0.
Evaluation of the safety profile of tTF-NGR combined with standard trabectedin chemotherapy (Standard laboratory parameters) [ Time Frame: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 100 months ]
To assess the safety profile of tTF-NGR combined with trabectedin the following safety endpoint will be considered:

- laboratory parameter: Troponin T hs [ng/l]
Evaluation of the safety profile of tTF-NGR combined with standard trabectedin chemotherapy (Physical examination: Height) [ Time Frame: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 100 months ]
To assess the safety profile of tTF-NGR combined with trabectedin the following safety endpoint will be considered:

- Physical examination: Height [m]
Evaluation of the safety profile of tTF-NGR combined with standard trabectedin chemotherapy (Physical examination: Weight) [ Time Frame: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 100 months ]
To assess the safety profile of tTF-NGR combined with trabectedin the following safety endpoint will be considered:

- Physical examination: Weight [kg]
Evaluation of the safety profile of tTF-NGR combined with standard trabectedin chemotherapy (Physical examination: Body surface) [ Time Frame: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 100 months ]
To assess the safety profile of tTF-NGR combined with trabectedin the following safety endpoint will be considered:

- Physical examination: Body surface area [m2]
Evaluation of the safety profile of tTF-NGR combined with standard trabectedin chemotherapy (Vital sign: breathing) [ Time Frame: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 100 months ]
To assess the safety profile of tTF-NGR combined with trabectedin the following safety endpoint will be considered:

- Physical examination: Vital sign: breathing rate by watching and counting [breaths per minute]
Evaluation of the safety profile of tTF-NGR combined with standard trabectedin chemotherapy (Vital sign: consciousness) [ Time Frame: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 100 months ]
To assess the safety profile of tTF-NGR combined with trabectedin the following safety endpoint will be considered:

- Physical examination: Vital sign: consciousness by talking to the patient
Evaluation of the safety profile of tTF-NGR combined with standard trabectedin chemotherapy (Vital sign: heart rate) [ Time Frame: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 100 months ]
To assess the safety profile of tTF-NGR combined with trabectedin the following safety endpoint will be considered:

- Physical examination: Vital sign: heart rate by pulse [beats per minute]
Evaluation of the safety profile of tTF-NGR combined with standard trabectedin chemotherapy (Physical examination: ECOG perfomance status) [ Time Frame: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 100 months ]
To assess the safety profile of tTF-NGR combined with trabectedin the following safety endpoint will be considered:

- Physical examination: ECOG perfomance status
Evaluation of the safety profile of tTF-NGR combined with standard trabectedin chemotherapy (ECG) [ Time Frame: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 100 months ]
To assess the safety profile of tTF-NGR combined with trabectedin the following safety endpoint will be considered:

- ECG (rythm, puls rate, Vector, P Wave, PQ time, QRS Complex, R progression from V1 to V6, QT Interval, PQ time, QRS time, T wave)
Evaluation of the safety profile of tTF-NGR combined with standard trabectedin chemotherapy (Echocardiography) [ Time Frame: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 100 months ]
To assess the safety profile of tTF-NGR combined with trabectedin the following safety endpoint will be considered:

- Echocardiography (diameters of both atria and left and right cardiac chambers at end-diastolic and end-systolic times [mm], ejection fraction [%], wall diameters [mm])
Evaluation of the safety profile of tTF-NGR combined with standard trabectedin chemotherapy (PRO) [ Time Frame: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 100 months ]
To assess the safety profile of tTF-NGR combined with trabectedin the following safety endpoint will be considered:

- Patient reported outcomes (PRO) by EORTC QLQ C30 questionnaire
Evaluation of the safety profile of tTF-NGR combined with standard trabectedin chemotherapy (PK) [ Time Frame: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 100 months ]
To assess the safety profile of tTF-NGR combined with trabectedin the following safety endpoint will be considered:

- pharmacokinetics: AUC [ng*h/ml]

Eligibility Criteria

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Ages Eligible for Study:	18 Years to 75 Years (Adult, Older Adult)
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Patients of all genders (female, male, diverse), with no restriction regarding ethnic or religious background age 18 - 75 years.
Patients with advanced or metastatic soft-tissue sarcoma after failure of anthracycline-containing first line therapy (or anthracycline-containing adjuvant therapy within 12 months before entry on study) or with contraindications to these drugs
Patients must have histological evidence of high-grade advanced unresectable or metastatic soft tissue sarcoma (grade 2 - 3) according to the FNCLCC grading system. The following tumor types are included:
- Dedifferentiated liposarcoma
- Myxoid liposarcoma (high grade)
- Pleomorphic liposarcoma
- Adult fibrosarcoma
- Myxofibrosarcoma (high-grade)
- Leiomyosarcoma
- Rhabdomyosarcoma (alveolar, pleomorphic)
- Angiosarcoma
- Synovial sarcoma
- Undifferentiated sarcoma
Tumor types not listed above may be included upon communication with Coordinating Investigator.

The following tumor types will not be included:
- Gastrointestinal stromal tumors (GIST)
- Epitheloid sarcoma
- Alveolar soft part sarcoma
- Desmoplastic small round cell tumor
- Chondrosarcoma
- Osteosarcoma
- Ewing sarcoma (including CIC-rearranged sarcoma and Sarcoma with BCOR alterations)
CD13 positivity with a score of ≥ 1 (20) by central pathology (GDI Münster)
Patients must have at least one unidimensionally measurable lesion by computed tomography as defined by RECIST criteria 1.1. This lesion should not have been irradiated during previous treatments
Life expectancy of at least 3 months
Eastern Cooperative Oncology Group (ECOG) Performance Status ≤ 2
No contraindications for trabectedin (see attachment)
Negative serum pregnancy test for females of childbearing potential* within 14 days of starting treatment
Informed consent signed and dated to participate in the study
Willingness and ability to comply with the scheduled visits, treatment plan, laboratory tests and other study procedures
- Women of childbearing potential (WOCBP) must be using, from the screening to 3 months following the last trabectedin (Arm 1) or the last last study drug (Arm 2) administration, highly effective contraception methods, as defined by the "Recommendations for contraception and pregnancy testing in clinical trials" issued by the Head of Medicine Agencies' Clinical Trial Facilitation Group (www.hma.eu/ctfg.html) and which include, for instance, progesteron-only or combined (estrogen- and progesteron-containing) hormonal contraception associated with inhibition of ovulation, intrauterine devices, intrauterine hormone-releasing systems, bilateral tubal occlusion, vasectomized partner or sexual abstinence. Pregnancy test will be repeated monthly. For men contraception methods should be performed for 5 months after the last application of trabectedin (Arm1) or study drug (Arm 2).Women of childbearing potential are defined as females who have experienced menarche, are not postmenopausal (12 months with no menses without an alternative medical cause) and are not permanently sterilized (e.g., tubal occlusion, hysterectomy, bilateral oophorectomy or bilateral salpingectomy)

Exclusion Criteria:

curative therapy available
clinically significant unrelated illness, which in the judgement of the investigators could compromise the patient's ability to tolerate the IMP or be likely to interfere with the study procedures or results
immobilized tumor patients (wheel chair etc.) with increased risk for DVT
known hypersensitivity reactions to prior application of E. coli-derived material
history of coronary heart disease, stroke, transitent ischemic attacks, pulmonary embolism, or deep vein thrombosis. For reason of mechanism of action of tTF-NGR, exclusion of patients with a history of any of the vascular conditions mentioned is important. Clinical suspicion of coronary heart disease must be further checked e.g. by cardiac MRI or myocardial scintigraphy to exclude coronary heart disease.
known hereditary syndromes with elevated thromboembolic risk (FV Leiden and prothrombin mutations (G20210A), hereditary antithrombin, protein C and S deficiency, and antiphospholipid syndrome) after one or more clinical thromboembolic events
patients with hereditary vascular disorders (such as Klippel-Trenauny-Weber syndrome) with increased thromboembolic risk.
patients with a Khorana score of (Khorana AA, et al. J.Clin. Oncol. 2009, 27, 4839-4847, attached to this protocol) of > 3
elevated Troponin T hs (> 50 ng/L) before entry on study
presence of active central nervous system (CNS) disease and/or CNS vascular abnormalities detected by MRI
no adequate bone marrow function, absolute neutrophil count (ANC) < 1.0 x 109/L, platelets < 50 x 109/L (for trabectedin actually < 100 x 109/L - to be decided by the investigator on an individual patient basis) and haemoglobin (Hb) < 8.0 g/dl.
chronically impaired renal function or creatinine ≥ 2.0 x upper limit of normal (ULN).
inadequate liver function (alanine aminotranserase (ALT), aspartate aminotranserase (AST), alkaline phosphatase (ALP) or total bilirubin ≥ 2.5 x ULN) unless due to liver metastasis (decision by the investigator)
fibrinogen < 150 mg/dL, and/or International Normalized Ratio (INR) > 1,5 (global coagulation parameters can be discussed with the Coordinating Investigator prior to entry on study)
female patients with child-bearing who do not agree to exclusion of potential pregnancy by adequate testing within 48 hours prior to entry on study
females of childbearing potential as well as fertile males who do not agree to use a highly effective form of contraception (Pearl Index < 1) during the study and for 3 months (females) following the last trabectedin (Arm 1) or last study drug (Arm 2) administration and 5 months (males) following the last dose of trabectedin (Arm 1) or study drug (Arm 2)
women with breast-feeding activity
concomitant use of any other investigational agent (agent for which there is currently no approved indication from regulatory authorities) or any other anti-cancer drug
concomitant enrolment in another clinical trial interfering with the endpoints of this study.
any medical condition which could compromise participation in the study according to the investigator's assessment.
prophylactic or therapeutic anticoagulation within the last 3 days (see 11)
presence of active and uncontrolled infections or other severe concurrent disease, which, in the opinion of the investigator, would place the patient at undue risk or interfere with the study
concurrent malignancies other than STS, unless the patient has been disease-free for at least 2 years
serious, non-healing wound, ulcer or bone fracture; not completed wound healing from previous wounds and/or surgery
no central venous port system in place (prerequisite for ARM 2; valid exceptions have to be discussed with the Coordinating Investigator).

NOTE: Outliers of laboratory values can be disregarded and set aside as exclusion criteria by a Coordinating Investigator´s decision. The conditions for the use of trabectedin as specified in the Summary of Product Characteristics are to be followed according to institutional guidelines for standard of care.

Contacts and Locations

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT05597917

Contacts

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Contact: Christoph Schliemann, Prof. Dr.	+49 251 83 45363	Christoph.Schliemann@ukmuenster.de
Contact: Torsten Kessler, PD Dr.	+49 251 83 45363	Torsten.Kessler@ukmuenster.de

Locations

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Austria
Medizinische Universität Graz	Recruiting
Graz, Austria, 8010
Contact: Joanna Skandera, PD 0043 316 38513115 joanna.szkandera@medunigraz.at
Principal Investigator: Joanna Skandera, PD
Germany
HELIOS Klinikum Bad Saarow	Recruiting
Bad Saarow, Germany, 15529
Contact: Daniel Pink, Dr. +49 33631 73527 daniel.pink@helios-gesundheit.de
Principal Investigator: Daniel Pink, Dr.
Sub-Investigator: Daniel Schöndube, Dr.
Sub-Investigator: Antja West, Dr.
HELIOS Klinikum Berlin-Buch	Recruiting
Berlin, Germany, 13125
Contact: Peter Reihardt, PD Dr. +49 30 940114888 peter.reichardt@helios-gesundheit.de
Principal Investigator: Peter Reihardt, PD Dr.
Sub-Investigator: Nicolas Ziegenhagen
Sub-Investigator: Benjamin Unger
TU Dresden Medizinische Fakultät Carl Gustav Carus	Recruiting
Dresden, Germany, 01307
Contact: Stephan Richter, Dr. +49 351 458 7108 Stephan.Richter@uniklinikum-dresden.de
Principal Investigator: Stephan Richter, Dr.
Sub-Investigator: Martin Wermke, Dr.
Universitätsklinikum Frankfurt	Recruiting
Frankfurt am Main, Germany, 60590
Contact: Marit Ahrens, Dr. +49 69 6301 83359 Marit.Ahrens@kgu.de
Principal Investigator: Marit Ahrens, Dr.
Sub-Investigator: Björn Steffen, Dr.
Universitätsklinikum Heidelberg	Recruiting
Heidelberg, Germany, 69120
Contact: Gerlinde Egerer, Prof. Dr. +49 6221 568029 Gerlinde.Egerer@med.uni-heidelberg.de
Principal Investigator: Gerlinde Egerer, Prof. Dr.
Sub-Investigator: Susanne Hofmann, Dr.
Universitätsmedizin Mainz	Recruiting
Mainz, Germany, 55131
Contact: Marius Fried, Dr. +49 6131 175952 Marius.Fried@unimedizin-mainz.de
Principal Investigator: Marius Fried, Dr. med.
Sub-Investigator: Thomas Kindler, Prof. Dr.
LMU Klinikum	Recruiting
Münich, Germany, 81377
Contact: Lars Lindner, Prof. Dr. +49 89 4400 77773 Lars.Lindner@med.uni-muenchen.de
Principal Investigator: Lars Lindner, Prof. Dr.
Sub-Investigator: Dorit Di Gioia, PD Dr.
University Hospital Muenster, Germany	Recruiting
Münster, Germany, 48149
Contact: Christoph Schliemann, Prof. Dr. +49 251 83 45363 Christoph.Schliemann@ukmuenster.de
Contact: Torsten Kessler, PD Dr. +49 251 83 45363 Torsten.Kessler@ukmuenster.de
Principal Investigator: Christoph Schliemann, Prof. Dr.
Sub-Investigator: Torsten Kessler, PD Dr.

Sponsors and Collaborators

Universität Münster

Anturec Pharmaceuticals GmbH

Investigators

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Principal Investigator:	Christoph Schliemann, Prof. Dr.	University Hospital Muenster (Department of Medicine A), Germany

More Information

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Responsible Party:	Universität Münster
ClinicalTrials.gov Identifier:	NCT05597917
Other Study ID Numbers:	WWU19_0007 2020-005858-21 ( EudraCT Number )
First Posted:	October 28, 2022 Key Record Dates
Last Update Posted:	December 22, 2023
Last Verified:	December 2023
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD:	Yes
Plan Description:	De-identified participant data for all primary and secondary outcome measurements will be made available within 6 months of study completion
Supporting Materials:	Study Protocol
Time Frame:	within 6 months of study completion

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Studies a U.S. FDA-regulated Drug Product:	No
Studies a U.S. FDA-regulated Device Product:	No

Keywords provided by Universität Münster:


tTF-NGR vascular targeting CD13 aminopeptidase N Trabectedin

Additional relevant MeSH terms:

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Sarcoma Neoplasms, Connective and Soft Tissue Neoplasms by Histologic Type Neoplasms Trabectedin	Antineoplastic Agents, Alkylating Alkylating Agents Molecular Mechanisms of Pharmacological Action Antineoplastic Agents

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