E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Patients affected by diffuse malignant peritoneal mesothelioma treated by cytoreductive surgery and hyperthermic intraperitoneal chemotherapy, without any factor precluding the performance of systemic adjuvant chemotherapy |
Pazienti affetti da mesotelioma diffuso maligno trattati con chirurgia radicale di citoriduzione associato a chemioipertermia intraperitoneale senza controindicazione a chemioterapia sistemica adiuvante |
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E.1.1.1 | Medical condition in easily understood language |
Patients affected by diffuse malignant peritoneal mesothelioma treated by radical surgery and eligible for systemic chemotherapy |
Pazienti affetti da mesotelioma diffuso maligno trattati con chirurgia radicale ed eleggibile a un trattamento chemioterapico |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 14.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10056558 |
E.1.2 | Term | Peritoneal mesothelioma malignant |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
progression free survival |
progression free survival |
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E.2.2 | Secondary objectives of the trial |
overall survival toxicity identification of prognostic factors by biologic characterization of tumor regarding the expression of tyrosine kinase receptor expression and downstream effectors validation of osteopontin and mesothelin as potential diagnostic and prognostic tool |
overall survival identificazione di fattori prognostici attraverso la caratterizzazione biologica del tumore per quanto riguarda l'expressione di ricettori tirosine chinasi e effettori a vale valutazione del valore diagnostico e prognostico dell'osteopontina e mesotelina |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. histological diagnosis of DMPM done or confirmed by the Pathology department of our institute according to a diagnostic protocol that includes a morphological evaluation (H&E) and immunohistochemical study (positivity to at least one of the following markers: CK-5-6, calretinine, podoplanin, WT-1 and at least one negativity among the followings: CEA, Ber-Ep4 and claudin; 2. age ≥ 18 years and < 71 years; 3. good performance status(ECOG<2); 4. patients that had undergone CRS + HIPEC with a complete cytoreduction; 5. surgical specimen obtained during the surgical treatment; 5. no metastatic disease; 6. signed informed consent form. |
1. diagnosi istologica di DMPM eseguita o confermata presso il Dipartimento di Anatomia Patologica della Fondazione IRCCS Istituto Nazionale Tumori di Milano, secondo un protocollo diagnostico che preveda la valutazione morfologica (sezioni colorate con ematossilina-eosina) e studi immunoistochimici (presenza di almeno 2 test positivi tra CK-5-6, calretinina, podoplanina, WT-1 e di almeno 1 test negativo tra CEA, Ber-Ep4 e claudina); 2. eta' ≥ 18 anni e < 71 anni; 3. buone condizioni generali (ECOG<2); 4. pazienti sottoposti a chirurgia CRS e HIPEC con residuo di malattia <2.5mm; 5. pazienti in cui, al momento della CRS, sono stati eseguiti prelievi tumorali per test di preclinica farmacologica e caratterizzazione biologica. 5. assenza di metastasi a distanza alla TAC postperatoria; 6. consenso informato scritto. |
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E.4 | Principal exclusion criteria |
1. well differentiated papillary or multicystic mesothelioma; 2. other malignancies detected in the past 5 years excepting cutaneous basal cell carcinoma and in situ carcinoma of the uterine cervix; 3. previous systemic treatment of diffuse malignant peritoneal mesothelioma; 4. previous intraperitoneal chemotherapy; 5. non complete cytoreduction due to unresectable disease; 5. cardiac dysfunction with Ejection fraction <40%); 6. renal failure 7. hepatic insufficiency; 8. bone marrow insufficiency; 9. pulmonar dysfunction with FEV1 < 50% or a DLCO < 40% of normal value corrected by age; 10. viral or bacterial infection; 11. cognitive or consciousness dysfunction, drug or alcohol addiction or major psycosis. |
1. diagnosi di mesotelioma di tipo multicistico o papillare ben differenziato; 2. anamnesi positiva per neoplasie negli ultimi 5 anni, ad esclusione del carcinoma basocellulare cutaneo e del carcinoma in situ della cervice uterina, trattati in modo adeguato; 3. precedente trattamento sistemico per la patologia in atto; 4. precedente trattamento di chemioterapia intra-peritoneale per la patologia in atto; 5. fallimento del tentativo di CRS e HIPEC per riscontro intraoperatorio di malattia non debulkabile. 5. alterata funzionalita' cardiaca (storia di scompenso cardiaco congestizio o FE <40%); 6. alterata funzionalita' renale (creatinina > 1.5 volte il valore normale o creatinina clearance < 60 mL/min); 7. alterata funzionalita' epatica (AST, ALT, bilirubina > 1.5 volte il valore normale); 8. alterata funzionalita' ematopoietica (leucociti < 3000/mm3; neutrofili < 1500/mm3; piastrine < 100000/mm3); 9. alterata funzionalita' polmonare (presenza di BPCO or altri deficit restrittivi polmonari con FEV1 < 50% or a DLCO < 40% del valore normale per eta'; 10. infezione batterica, virale o fungina non controllata; 11. alterazioni dello stadio di coscienza, dipendenza da alcol o sostanze psicotrope o psicosi maggiori. |
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary endpoint of the study is to evaluated in patients affected by diffuse malignant peritoneal mesothelioma treated by cytoreductive surgery and hyperthermic intraperitoneal chemotherapy the progression free survival associated with personalized adjuvant systemic chemotherapy directed on the basis of in vitro chemosensitivity assay |
End point primario di questo studio e' la valutazione della sopravvivenza libera da progressione di malattia di un gruppo sperimentale di 40 pazienti affetti da DMPM sottoposti al trattamento convenzionale di CRS + HIPEC a cui si associa una sCT, basata sul profilo di chemio sensibilita' su colture primarie di cellule tumorali prelevate al momento dell’intervento chirurgico. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
the study consists of a accrual period of 3 years and 2 years of follow-up |
lo studio prevede un periodo di reclutamento di 3 anni seguito da 2 anni di follow-up |
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E.5.2 | Secondary end point(s) |
overall survival toxicity identification of prognostic factors by biologic characterization of tumor regarding the expression of tyrosine kinase receptor expression and downstream effectors validation of osteopontin and mesothelin as potential diagnostic and prognostic tool |
overall survival identificazione di fattori prognostici attraverso la caratterizzazione biologica del tumore per quanto riguarda l'expressione di ricettori tirosine chinasi e effettori a vale valutazione del valore diagnostico e prognostico dell'osteopontina e mesotelina |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
OS: calculated from the begining of chemotherapy to the end of follow-up; toxicity: during the study; biological study: at the end of accrual; prognostic value of osteopontin and mesothelin: before the chemotherapy |
OS: calcolato dall'inizio della chemioterapia alla fine del follow-up; tossicita': durante lo studio; studio di caratterizzazione biologica del tumore: alla fine del reclutamento; valore prognostico della osteopontin e mesothelin: prima della chemioterapia |
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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 |
evaluation of tyrosine kinase receptors and downstream effectors |
valutazione di ricettori tirosin chinasi e degli effettori a vale |
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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) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Information not present in EudraCT |
E.8.2.2 | Placebo | Information not present in EudraCT |
E.8.2.3 | Other | Information not present in EudraCT |
E.8.2.4 | Number of treatment arms in the trial | 1 |
E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.4.1 | Number of sites anticipated in Member State concerned | 1 |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
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 | 5 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |