E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Progressive, advanced/metastatic well-differentiated pancreatic islet cell tumours |
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MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 9.1 |
E.1.2 | Level | HLT |
E.1.2 | Classification code | 10033632 |
E.1.2 | Term | Pancreatic neoplasms |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To compare progression-free survival (PFS) in subjects with pancreatic islet cell tumors treated with sunitinib (at a starting dose of 37.5 mg daily continuous dosing) with those treated with placebo |
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E.2.2 | Secondary objectives of the trial |
•To compare overall survival (OS) between sunitinib- and placebo-treated subjects •To compare objective response (OR) rate between sunitinib- and placebo-treated subjects •To compare duration of response (DR) between sunitinib- and placebo-treated subjects in subjects achieving a response. •To assess time to tumor response (TTR) for sunitinib- and placebo-treated subjects. •To assess safety and tolerability of sunitinib •Assess patient reported outcomes (PROs)
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1.Histologically or cytologically proven diagnosis of well-differentiated pancreatic islet cell tumor (according to WHO 2000 classification.) 2.Local, locally-advanced or metastatic disease documented as having shown progression on a scan (CT, MRI, or Octreoscan®) taken within 2 to 12 months prior to baseline compared to a previous scan (taken at any time in the past). Progression must be documented according to RECIST guidelines. Octreoscan results may be used to document progressive disease prior to study entry, but not for RECIST determination of tumor response during the study. 3.Disease that is not amenable to surgery, radiation, or combined modality therapy with curative intent. 4.Presence of at least one measurable target lesion for further evaluation according to RECIST criteria (contrast enhancing lesion with the largest diameter ≥ 20 mm, based on CT or MRI scan done within 3 weeks before the start of treatment). 5.Adequate organ function as defined by the following: • Serum aspartate aminotransferase (AST; serum glutamate-oxalate transferase [SGOT]) and serum alanine aminotransferase (ALT; serum glutamate-pyruvate transferase [SGPT]) ≤2.5 x upper limit of normal (ULN). If liver function abnormalities are due to underlying malignancy, then AST and ALT may be ≤5 x ULN • Total serum bilirubin ≤1.5 x ULN • Prothrombin time (PT) and partial thromboplastin time (PTT) ≤ 1.5 x ULN • Serum albumin ≥3.0 g/dL • Absolute neutrophil count (ANC) ≥1500/uL • Platelets ≥100,000/uL • Hemoglobin ≥9.0 g/dL • Serum creatinine ≤1.5 x ULN • Serum amylase and lipase ≤1.0 x ULN 6.ECOG Performance status 0 or 1. 7.Life expectancy ≥ 3 months. 8.Age ≥ 18 years. 9.Previous treatments with chemotherapy, loco-regional therapy (e.g., chemoembolization) or interferon are permitted providing that toxicity has resolved to ≤ grade 1 at study entry and that last treatment was at least 4 weeks prior to baseline assessment. 10.Able to swallow oral compound. 11.Signed and dated informed consent document indicating that the patient has been informed of all pertinent aspects of the trial prior to enrolment. 12.Willingness and ability to comply with scheduled visits, treatment plans, laboratory tests and other study procedures.
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E.4 | Principal exclusion criteria |
1.Patients with poorly-differentiated pancreatic neuroendocrine tumors (according to WHO 2000 classification). 2.Current treatment with any chemotherapy, chemoembolization therapy, immunotherapy, or investigational anticancer agent other than somatostatin analogues. 3.Prior treatment with any tyrosine kinase inhibitors or anti-VEGF angiogenic inhibitors. Prior treatment with non-VEGF-targeted angiogenic inhibitors is permitted. 4.Diagnosis of any second malignancy within the last 5 years, except for adequately treated basal cell or squamous cell skin cancer, or in situ carcinoma of the cervix uteri. 5.Treatment with potent CYP3A4 inhibitors and inducers within 7 and 12 days, respectively prior to study drug administration 6.Pre-existing thyroid abnormality of thyroid function that cannot be maintained in the normal range with medication. 7.Concomitant treatment with therapeutic doses of anticoagulants (low dose warfarin (Coumadin) up to 2 mg PO daily for deep vein thrombosis prophylaxis is allowed). 8.Unstable systemic diseases including uncontrolled hypertension (≥150/100 mmHg despite optimal medical therapy) or active uncontrolled infections. 9.Current treatment on another clinical trial. 10.Any of the following within the 12 months prior to study drug administration: myocardial infarction, severe/unstable angina, symptomatic congestive heart failure, cerebrovascular accident or transient ischemic attack, or pulmonary embolism. 11.Abnormal cardiac function with abnormal 12 lead ECG. Ongoing cardiac dysrhythmias of NCI CTC grade ≥2, atrial fibrillation of any grade, or prolongation of the QTc interval to ≥450 msec for males or ≥470 msec for females. 12.Symptomatic brain metastases, spinal cord compression, or new evidence of brain or leptomeningeal disease 13.Left ventricular ejection fraction (LVEF) ≤50% as measured by either multigated acquisition (MUGA) scan or echocardiogram (ECHO). 14.Pregnancy or breastfeeding. Female patients must be surgically sterile or postmenopausal, or must agree to use effective contraception during the period of therapy. All female patients with reproductive potential must have a negative pregnancy test (serum or urine) within 7 days prior to starting study drug.. Male patients must be surgically sterile or must agree to use effective contraception during the period of therapy. The definition of effective contraception will be based on the judgment of the investigator or a designated associate. 15.Positive test for human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) related illness 16.Other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or study drug administration, or may interfere with the interpretation of study results, and in the judgment of the investigator would make the patient inappropriate for entry into this study.
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E.5 End points |
E.5.1 | Primary end point(s) |
Progression Free Survival (PFS) defined as the time from date of randomization to first progression of disease (PD). |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
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E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | Yes |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 5 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 29 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
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E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 1 |
E.8.9.1 | In the Member State concerned months | 6 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 1 |
E.8.9.2 | In all countries concerned by the trial months | 6 |
E.8.9.2 | In all countries concerned by the trial days | 0 |