This is an international (France, Austria and Germany), randomized, double-blind, placebo-controlled, phase II study to evaluate the efficacy and safety of regorafenib in patients with histologically proven metastatic and/or unresectable Soft Tissue Sarcoma (STS) after failure or intolerance to doxorubicin (or other anthracycline). Five cohorts will be defined: Cohort A: Liposarcoma Cohort B: Leiomyosarcoma Cohort C: Synovial sarcoma Cohort D: other sarcomas (see Appendix C) Cohort E: Leiomyosarcoma, Synovial sarcoma and other sarcomas listed in Appendix C previously treated with pazopanib Approximately 226 patients who meet the eligibility criteria will be randomly assigned in a 1:1 ratio to one of the treatment groups.
The standard of care for metastatic soft tissue sarcoma is doxorubicin +/- ifosfamide. After failure or intolerance to doxorubicin, there is no standard of care. In Europe, two are currently approved for the treatment of soft tissue sarcoma after failure/intolerance to doxorubicin: trabectedin (Yondelis®) for all histological subtype and pazopanib (Votrient ®) for all subtypes excluding liposarcomas. Nevertheless, none of these drugs improve the overall survival over placebo. The study is composed of 3 periods: 1. A Screening Period, 2. A Treatment Period, 3. And a Survival Follow-up Period. Patients randomized to be treated with regorafenib will receive the treatment orally for 3 weeks of every 4 week (28 days) cycle (ie, 3 weeks on/1 week off). Patients randomized to the placebo arm will be treated for 3 weeks of every 4 weeks cycle (ie, 3 weeks on/1 week off). In addition to the regorafenib and placebo treatments, patients will receive best supportive care. Best supportive care includes any method to preserve the comfort and dignity of the patients and excludes any disease-specific anti-neoplastic therapy such as any kinase inhibitor,chemotherapy, radiation therapy, or surgical intervention. Patients receiving placebo, who experience disease progression may be offered open-label regorafenib(cross-over option).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
219
Regorafenib (160 mg/d) once daily for three weeks on / one week off plus Best Supportive Care (BSC)until progression (according to RECIST 1.1), intolerance or consent withdrawal.
Placebo plus BSC until progression (according to RECIST 1.1) or unacceptable toxicity. Patients who have received placebo may be offered open-label regorafenib (cross-over option) after objective tumor progression
Medizinische Universität Graz
Graz, Austria
Universitätsklinik für Innere Medizin I
Innsbruck, Austria
LKH
Klagenfurt, Austria
Krankenhaus der Barmherzigen Schwestern Linz
Linz, Austria
AKH-Wien
Vienna, Austria
Hôpital St Jacques
Besançon, France
Institut Bergonié
Bordeaux, France
Centre François Baclesse
Caen, France
Centre GF Leclercq
Dijon, France
Centre Oscar Lambret
Lille, France
...and 15 more locations
Progression-free survival (PFS)
Progression-Free Survival will be measured from the date of randomization until the date of radiological progression or death (if death occurs before progression). Progression-free rate at 3 and 6 months (PFR-3 and PFR-6), time to progression, response rate and duration of response, overall survival according to RECIST 1.1 criteria
Time frame: Up to 2 years
Growth modulation index
Growth modulation index in patients receiving regorafenib after randomization
Time frame: Up to 2 years
Toxicity according to NCI-CTC AE V4.0.
The monitoring of the toxicity of the regorafenib which can have a liver toxicity for exemple.
Time frame: Baseline, every 4 weeks, up to the end of study
Progression-free rate at 3 and 6 months (PFR-3 and PFR-6)
According to the RECIST 1.1
Time frame: At month 3 and at month 6
Time to progression
According to the RECIST 1.1 Every 4 weeks, Up to 2 years
Time frame: Up to 2 years
Overall survival
Time from the date of randomization to the date of death from any cause
Time frame: Up to 2 years
Response rate
the proportion of patients with the best overall tumor response of partial response (PR) or complete response (CR) according to RECIST 1.1 guidelines that is achieved during treatment or within 30 days after termination of study medication.
Time frame: Up to 2 years
Duration of response
the number of days from the date of first documented objective response of PR or CR, whichever is noted earlier, to first disease progression or death before progression. Patients without progression or death before progression at the time of analysis will be censored at the date of their last tumor assessment.
Time frame: Up to 2 years
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