RATIONALE: Radiation therapy given before surgery of soft tissue sarcoma decreases the size of the tumor mass and the presence of malignant cells in its peripheral region. NBTXR3 and radiation therapy may kill more cancer cells and increase the tumor shrinkage rendering surgery more feasible or easier and achieve better local control of the tumor. PURPOSE: This phase II/III is a prospective randomized, multi-center, open-label and active controlled two arms study in patients with locally advanced soft tissue sarcoma (STS) of the extremity and trunk wall. Patients will be randomized to receive either NBTXR3 as intratumor injection, activated by external beam radiation therapy or external beam radiation therapy alone, as preoperative treatment. Once the radiotherapy treatment is completed, tumor surgery will be performed in all patients.
Patients who will be allocated in arm A, will receive a single intratumor injection of NBTXR3 and will receive external beam radiotherapy starting 24hrs after the injection up to completion of 5 weeks, 5 days a week of treatment (50Gy, 2Gy/fraction). Then, all patients will undergo surgical resection of the tumor 5 weeks later and will be followed for wound healing and toxicity assessment. A visit of end of treatment will take place approximately 3-4 weeks after surgery. Patients will be followed for evaluation of their disease status and adverse event until the end of study.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
180
One intratumor implantation by injection
5 weeks/50 Gy (5 x 2 Gy by week)
Capital Region Cancer Service, Canberra Hospital
Canberra, Australia
Chris O'Brien Lifehouse
Sydney, Australia
Jules Bordet Institute
Brussels, Belgium
Ghent University Hospital
Ghent, Belgium
Centre Rene Gauducheau
Nantes, Saint Herblain, France
Institut Bergonie
Pathological Complete Response Rate (pCRR)
To compare antitumor activity in terms of Pathological complete response rate (pCRR) of intratumor injection of NBTXR3 activated by external beam radiation therapy (EBRT), versus EBRT alone
Time frame: 36 months
Incidence of early and late TEAE, post-TEAE, SAE and laboratory abnormalities (NCI CTCAE V4.0)
Time frame: 36 months
Objective Response Rate (ORR) by Imaging (MRI) according to RECIST 1.1
Time frame: 36 months
Tumor volume changes (theoretical tumor volume estimated as: Length x Width x Depth
Time frame: 36 months
Resection Margins (R0, R1, R2)
Time frame: 36 months
Hyalinization, fibrosis, necrosis and tumor infarction percentage
Time frame: 36 months
Limb amputation rate
Time frame: 36 months
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Bordeaux, France
Centre Leon Berard
Lyon, France
Institut Paoli Calmettes
Marseille, France
Centre Regional de Lutte Contre Le Cancer Paul Lamarque
Montpellier, France
Centre Antoine Lacassagne
Nice, France
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