A phase Ib study of Olaparib with concomitant radiotherapy in locally advanced/unresectable soft-tissue sarcoma.
This is a multicenter, prospective phase Ib trial based on a dose escalation study design (3+3 traditional design) assessing four dose levels of Olaparib given with concomitant radiotherapy, followed by an expansion cohort.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
41
Olaparib will be administered per os bidaily, as appropriate assigned dose level, during 7.5 weeks (D1 to D52). Olaparib should be started one week before the start of radiotherapy and will be continued until the last day of radiotherapy. Beyond this period, Olaparib could be continued at the investigator's discretion and after sponsor authorization, until progression.
Radiotherapy consists of fractionated focal irradiation at a dose of 1.8 Grays (Gy) per fraction given once daily five days per week (Monday through Friday) over a period of 6.5 weeks, for a total dose of 59.4 Gy. Radiotherapy starts at D8.
Institut Bergonié
Bordeaux, France
Centre Léon Bérard
Lyon, France
Institut du Cancer de Montpellier
Montpellier, France
Institut Claudius Regaud - IUCT
Toulouse, France
Number of Participants Who Experienced Dose-Limiting Toxicities (DLTs)
We reported in the following the number of Participants who experienced DLT. A DLT is defined as an adverse event (AE) or laboratory abnormality that fulfills all the criteria below: 1/ Occurs during the period of observation of DLTs defined as the period between the first day of treatment administration and up to 6 weeks after the end of radiotherapy. 2/ Is considered to be at least possibly related to the treatment strategy (radiotherapy or Olaparib).3/ Is unrelated to disease, disease progression, inter-current illness, or concomitant medications. 4/ Meets some criteria (see protocole), graded according to NCI CTCAEv4.0
Time frame: Until to six weeks after end of radiotherapy
Maximum Tolerated Dose (MTD) of Olaparib in Association With Radiotherapy
MTD was determined by testing increasing doses up 150mg twice a day on dose escalation cohorts 1 to 4 with 3 to 11 participants each. MTD reflects the highest dose of drug that did not cause a Dose-Limiting Toxicity (DLT) in \> 33% of participants. DLTs were defined as any grade 3 or 4 adverse event according to the Common Terminology Criteria for Adverse Events version 4.0 (CTCAE 4.0) that could be related to treatment (reported in the following primary outcome measure).
Time frame: Up to 6 weeks after end of radiotherapy for each dosing cohort
Percentage of Participants With Non-progression at 6 Months as Per RECIST 1.1
6-month non progression rate is defined as the proportion of complete (CR) or partial response (PR) at 6 months confirmed ≥ 4 weeks after initial documentation, or stable disease (SD) more than 24 weeks (RECIST v1.1, as determined by investigator review of tumor assessments).
Time frame: up to 6-month after treatment onset
Percentage of Participants With Objective Responses at 6 Months as Per RECIST 1.1
6-month objective response, defined as CR or PR at 6 months confirmed ≥ 4 weeks after initial documentation, as determined by investigator review of tumor assessments using RECIST v1.1
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Time frame: up to 6-month after treatment onset
Best Response Under Treatment as Per RECIST 1.1
Best response under treatment is defined as the best response (CR, PR, SD) as per RECIST 1.1 recorded from the start of the study treatment until the end of treatment taking into account any requirement for confirmation as per RECIST v1.1 criteria. It is determined once all the data for the patient is known.
Time frame: End of treatment, approximately 13.5 weeks atfer treatment onset
Progression-free Survival (PFS) as Per RECIST 1.1
PFS is defined as the time from study treatment initiation to the first occurrence of disease progression or death (of any cause), whichever occurs first.
Time frame: 1 year after treatment onset
Overall Survival (OS)
OS is defined as the time from study treatment initiation to death (of any cause).
Time frame: 1 year after treatment onset
Musculoskeletal Tumor Society (MSTS) Functional Score
The Musculoskeletal Tumor Society (MSTS) score assesses functional outcomes before (week 2) and after (week 10) treatment with olaparib in combination with radiotherapy. It consists of six items (pain, function, emotional acceptance, and either support/walking/gait for lower limbs or positioning/dexterity/strength for upper limbs). Each item is rated 0-5, summed to a total score ranging from 0 (worst outcome) to 30 (best outcome). Higher scores represent better functional outcomes.
Time frame: Two weeks after treatment onset