The purpose of this study is to explore the efficacy of nilotinib as a treatment of patients with progressive or relapsing pigmented villo-nodular synovitis / tenosynovial giant cell tumour (PVNS/TGCT) who cannot be treated by surgery. The primary objective of the study will be to determine the efficacy of 12 weeks (3 months) of nilotinib treatment as measured by the non progression rate (Complete response + Partial Response + Stable disease according to Response Evaluation Criteria In Solid Tumours - RECIST version 1.1) in patients with progressive or relapsing PVNS/TGCT who cannot be treated by surgery. this study is an international, multicentre, non-randomized, open-label phase II clinical trial with a Bayesian design. A maximum sample size of 50 patients will be included in the study
A key secondary objective of the study will be to determine the efficacy of 24 weeks (6 months) of nilotinib treatment as measured by the non progression rate (Complete response + Partial Response + Stable disease according to Response Evaluation Criteria In Solid Tumours - RECIST version 1.1) in patients with progressive or relapsing PVNS/TGCT who cannot be treated by surgery. This key secondary objective was defined for the purpose of a further analysis (not described in this protocol) which will pool the data of the PVNS study with those of a similar concomitant study conducted in the US and Australia. The other secondary objectives will be: To evaluate the efficacy of nilotinib according to: * The objective tumour response rate (Complete response + Partial Response according to RECIST version 1.1) after 12 weeks of treatment * The duration of treatment response * The best overall response obtained during the study * The progression-free survival (PFS) * The time to progression (TTP) * The time to treatment failure (TTF) * The proportion of patients with an operable tumour after nilotinib exposure according to investigator evaluation * The description of concomitant treatments use * The correlation between trough levels of nilotinib and objective tumour response To assess the safety of nilotinib for PVNS/TGCT patients An exploratory objective of the study will be to study the relationship between the objective tumour response and the following tumour characteristics (tissues collected in a prior surgery, or by biopsy, upon specific acceptance by the patient; if no tissue is available in the prior surgery, a biopsy will be done at visit 2): Presence of COL6A3/CSF1 fusion gene Presence of M-CSF, CSF1R, KIT, PDGFRA and B on immunohistochemistry Presence of phosphorylated c-fms on tumour samples Activation of the PI3K/Akt/mTor pathway, presence of activating mutations of ras, and other potential molecular alterations
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
50
The study drug is nilotinib (Tasigna®). All patients will be administered with nilotinib 400 mg twice a day for one year. The patient will begin the treatment the day of inclusion. The prescribed dose should be swallowed whole with a glass of water. Doses of 400 mg should be administered twice daily approximately 12 hours apart. Patients should not eat within two hours before and one hour after taking nilotinib and need to avoid foods such as grapefruit juice which may inhibit CYP3A4 enzymes.
Institut Bergonié
Bordeaux, France
Centre Oscar Lambret
Lille, France
Centre Léon Bérard
Lyon, France
Hôpital La Timone
Marseille, France
Institut Paoli Calmettes
Marseille, France
Institut Curie
Paris, France
Institut Claudius Regaud
Toulouse, France
Institut Gustave Roussy
Villejuif, France
Istituto Nazionale dei Tumori
Milan, Italy
Regina Elena National Cancer Institute
Roma, Italy
...and 5 more locations
the non progression rate after 12 weeks (3 months) of treatment, based on the response evaluated by CT scan or MRI according to RECIST criteria (RECIST version 1.1) and validated by a central review committee.
Time frame: after 12 weeks (3 months) of treatment
Non progression rate after 24 weeks (6 months) of treatment, based on the response evaluated by CT scan or MRI according to RECIST criteria (RECIST version 1.1).
Time frame: after 24 weeks (6 months) of treatment
Objective tumour response according to RECIST version 1.1 (CR and PR) after 12 weeks of treatment
Time frame: after 12 weeks of treatment
Duration of response
Time frame: during the study
Best overall response
Time frame: during the study
Progression-free survival
Time frame: during the study
Time to progression
Time frame: during the study
Time to treatment failure
Time frame: during the study
Non progression rate after 12 weeks of treatment, based on the response evaluated locally by the investigator in charge using CT scan or MRI and according to RECIST criteria (RECIST version 1.1)
Time frame: after 12 weeks of treatment
Proportion of patients with an operable tumour after nilotinib exposure according to investigator evaluation
Time frame: at the end of the study (last visit)
Concomitant treatment use during the study
Time frame: during the study
Correlation between trough level of nilotinib at 6 weeks and 12 weeks and objective tumour response
Time frame: at the end of the study
Safety evaluation will be based on overall safety profile characterized by type, frequency and severity (as graded using NCI-CTCAE V3.0) of adverse events.
Time frame: at the end of the study
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