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    Clinical Trial Results:
    Efficacy and Safety of PD-0332991 in Patients with Advanced Gastrointestinal Stromal Tumors Refractory to Imatinib and Sunitinib: A Phase 2 study

    Summary
    EudraCT number
    2013-000283-28
    Trial protocol
    FR  
    Global end of trial date
    01 Feb 2019

    Results information
    Results version number
    v1(current)
    This version publication date
    20 Jan 2022
    First version publication date
    20 Jan 2022
    Other versions
    Summary report(s)
    Study protocol

    Trial information

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    Trial identification
    Sponsor protocol code
    IB_2013–01
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01907607
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Institut Bergonié
    Sponsor organisation address
    229 cours de l'Argonne, Bordeaux, France, 33076
    Public contact
    Regulatory Affairs Management Desk, Institut Bergonié, drci@bordeaux.unicancer.fr
    Scientific contact
    Regulatory Affairs Management Desk, Institut Bergonié, drci@bordeaux.unicancer.fr
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    01 Feb 2019
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    01 Dec 2016
    Global end of trial reached?
    Yes
    Global end of trial date
    01 Feb 2019
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To assess the antitumor activity of PD-0332991 in terms of non-progression at 16 weeks (after centralized review) in patients with documented disease progression while on therapy with imatinib and sunitinib for unresectable and/or metastatic GIST.
    Protection of trial subjects
    A supervisory committee is constitued to evaluate the benefit/risk ratio along the study period.
    Background therapy
    The treatment of advanced GIST patients is based on imatinib followed with sunitinib in case of resistance/intolerance. However, the median progression-free survival (PFS) on sunitinib is frequently short, and after failure with both imatinib and sunitinib, treatment remains controversial. Previous studies on GISTs have linked 9p21 alterations to tumor progression (El-Rifai et al. 2000; Kim et al., 2000; Schneider-Stock et al., 2003; Schneider-Stock et al., 2005; Romeo et al. 2009; Haller et al., 2008) but the driver gene was not positively identified (CDKN2A, CDKN2B, or MTAP) (Astolfi et al., 2010; Belinsky et al., 2009; Perrone et al., 2005; Assamaki et al. 2007; Huang et al., 2009). A recent study has shown that homozygous 9p21 deletions target CDKN2A and more specifically p16INK4a 4. Most of the CINSARC genes are known to be under the transcriptional control of E2F. RB1 sequesters E2F, which is released from the complex upon RB1 phosphorylation by CDK4. CDK4 is, in turn, inhibited by p16INK4a. Hence, we hypothesize that alteration of the restriction point via deletion of p16INK4a (and more rarely of RB1: 20% of cases) gene in GISTs is likely to be a causative event that leads to the overexpression of CINSARC genes, which in turn induce chromosome instability and ultimately metastasis. Low p16INK4a expression was associated with response to PD-0332991 in several in vitro tumor model(Konecny et al. 2011; Katsumi et al. 2011; Finn et al. 2009). Considering our molecular data, we believed that PD-0332991 warrants clinical investigation in advanced gastrointestinal stromal tumors with alteration of p16INK4a. This alteration is detectable by comparative genomic hybridization which is a technique highly manageable in the context of routine clinical care and clinical trial.
    Evidence for comparator
    Not applicable / no comparator
    Actual start date of recruitment
    01 Aug 2013
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    France: 29
    Worldwide total number of subjects
    29
    EEA total number of subjects
    29
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    14
    From 65 to 84 years
    15
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Between February 2014 and July 2016, 71 patients were screened across 8 French Sarcoma Group centers–29 (41%) met the molecular eligibility criteria and started treatment, of whom 23 were assessable for the primary efficacy endpoint.

    Pre-assignment
    Screening details
    Adults with metastatic or unresectable locally advanced, histologically confirmed malignant GIST, previously treated with at least imatinib and sunitinib, measurable and documented progression as per RECIST 1.1, and CDKN2A gene deletion centrally assessed by array-comparative genomic hybridization (CGH) were eligible.

    Period 1
    Period 1 title
    Baseline Period (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Non-randomised - controlled
    Blinding used
    Not blinded
    Blinding implementation details
    Not applicable / SIngle-arm trial / no blinding

    Arms
    Arm title
    PD-0332991
    Arm description
    -
    Arm type
    Experimental

    Investigational medicinal product name
    PD-0332991
    Investigational medicinal product code
    Other name
    Palbociclib
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    PD-0332991 is formulated as gelatin capsules of 100 mg and 25 mg respectively. PD-0332991 will be administrated orally, formulated as gelatin capsules of 100 mg and 25 mg respectively.: PD-0332991 dosed on a flat scale of 125 mg (1 capsule x 100 mg/day, 1 capsule x25 mg/day) will be administrated orally o.d on a 21 days on / 7 days off dosing schedule. One cycle is considered to consist of 4 weeks of PD-0332991 administration.

    Number of subjects in period 1
    PD-0332991
    Started
    29
    Completed
    29

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    PD-0332991
    Reporting group description
    -

    Reporting group values
    PD-0332991 Total
    Number of subjects
    29 29
    Age categorical
    Units: Subjects
        In utero
    0
        Preterm newborn infants (gestational age < 37 wks)
    0
        Newborns (0-27 days)
    0
        Infants and toddlers (28 days-23 months)
    0
        Children (2-11 years)
    0
        Adolescents (12-17 years)
    0
        Adults (18-64 years)
    0
        From 65-84 years
    0
        85 years and over
    0
    Age continuous
    Units: years
        median (full range (min-max))
    66 (40 to 81) -
    Gender categorical
    Units: Subjects
        Female
    7 7
        Male
    22 22

    End points

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    End points reporting groups
    Reporting group title
    PD-0332991
    Reporting group description
    -

    Subject analysis set title
    Population evaluable for efficacy
    Subject analysis set type
    Modified intention-to-treat
    Subject analysis set description
    All patients eligible and for whom the following conditions are satisfied: (i) Received at least one complete or two incomplete treatment cycles, (ii) At least one disease measurement recorded not less than four weeks after treatment onset.

    Primary: Number of Participants With Non Progression at 4 Months

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    End point title
    Number of Participants With Non Progression at 4 Months [1]
    End point description
    End point type
    Primary
    End point timeframe
    16 weeks after first administration of treatment
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Single -arm trial - No statistical test was performed.
    End point values
    Population evaluable for efficacy
    Number of subjects analysed
    23
    Units: Subjects
    3
    No statistical analyses for this end point

    Secondary: Progression-free Survival Time

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    End point title
    Progression-free Survival Time
    End point description
    Progression-free survival time is defined as the time from the first administration of treatment to progression (as per RECIST v1.1) or death of any cause, whichever occurs first. Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions.
    End point type
    Secondary
    End point timeframe
    up to 18 months following first administration of treatment
    End point values
    Population evaluable for efficacy
    Number of subjects analysed
    23
    Units: years
        median (confidence interval 95%)
    1.74 (0.92 to 3.45)
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    up to 24 months following first administration of treatment
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    10
    Reporting groups
    Reporting group title
    All included subjects
    Reporting group description
    -

    Serious adverse events
    All included subjects
    Total subjects affected by serious adverse events
         subjects affected / exposed
    12 / 29 (41.38%)
         number of deaths (all causes)
    3
         number of deaths resulting from adverse events
    0
    Investigations
    Neutropenia
         subjects affected / exposed
    1 / 29 (3.45%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Disease progression
         subjects affected / exposed
    1 / 29 (3.45%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Vascular disorders
    Left ilio femoral phebilits
         subjects affected / exposed
    1 / 29 (3.45%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pulmonary embolism
         subjects affected / exposed
    1 / 29 (3.45%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Phlebitis
         subjects affected / exposed
    1 / 29 (3.45%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Anemia
         subjects affected / exposed
    4 / 29 (13.79%)
         occurrences causally related to treatment / all
    2 / 4
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Flu-like syndrom
         subjects affected / exposed
    1 / 29 (3.45%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Sudden death at home
         subjects affected / exposed
    1 / 29 (3.45%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Gastrointestinal disorders
    Hemoperitoneum
         subjects affected / exposed
    1 / 29 (3.45%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastric hemorrhage
         subjects affected / exposed
    1 / 29 (3.45%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastric pain
         subjects affected / exposed
    1 / 29 (3.45%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Dyspnea
         subjects affected / exposed
    1 / 29 (3.45%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    Renal insuficiency
         subjects affected / exposed
    1 / 29 (3.45%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Deterioration of renal function
         subjects affected / exposed
    1 / 29 (3.45%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Bladder globe
         subjects affected / exposed
    1 / 29 (3.45%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal insufficiency
         subjects affected / exposed
    1 / 29 (3.45%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Musculoskeletal and connective tissue disorders
    Bone pain
         subjects affected / exposed
    1 / 29 (3.45%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Urinary infection
         subjects affected / exposed
    1 / 29 (3.45%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Metabolism and nutrition disorders
    Hypercalcemia
         subjects affected / exposed
    1 / 29 (3.45%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    All included subjects
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    29 / 29 (100.00%)
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Tumor pain
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    2
    Neoplasms benign, malignant and unspecified (incl cysts and polyps) - Other
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    2
    Vascular disorders
    Hypertension
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    2
    Phlebitis
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    2
    Thromboembolic event
         subjects affected / exposed
    3 / 29 (10.34%)
         occurrences all number
    3
    General disorders and administration site conditions
    Edema limbs
         subjects affected / exposed
    4 / 29 (13.79%)
         occurrences all number
    4
    Fatigue
         subjects affected / exposed
    10 / 29 (34.48%)
         occurrences all number
    11
    Fever
         subjects affected / exposed
    3 / 29 (10.34%)
         occurrences all number
    3
    Flu like symptoms
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    2
    Pain
         subjects affected / exposed
    3 / 29 (10.34%)
         occurrences all number
    3
    General disorders and administration site conditions
         subjects affected / exposed
    3 / 29 (10.34%)
         occurrences all number
    3
    Respiratory, thoracic and mediastinal disorders
    Dyspnea
         subjects affected / exposed
    3 / 29 (10.34%)
         occurrences all number
    3
    Voice alteration
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    2
    Psychiatric disorders
    Insomnia
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    2
    Investigations
    Creatinine increased
         subjects affected / exposed
    3 / 29 (10.34%)
         occurrences all number
    3
    Neutrophil count decreased
         subjects affected / exposed
    12 / 29 (41.38%)
         occurrences all number
    17
    Platelet count increased
         subjects affected / exposed
    4 / 29 (13.79%)
         occurrences all number
    4
    White blood cell decreased
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    2
    Cardiac disorders
    Sinus tachycardia
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    2
    Blood and lymphatic system disorders
    Anemia
         subjects affected / exposed
    17 / 29 (58.62%)
         occurrences all number
    22
    Eye disorders
    Eye disorders - Other, specify
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    2
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    5 / 29 (17.24%)
         occurrences all number
    5
    Constipation
         subjects affected / exposed
    7 / 29 (24.14%)
         occurrences all number
    7
    Diarrhea
         subjects affected / exposed
    3 / 29 (10.34%)
         occurrences all number
    3
    Dysphagia
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    2
    Gastrointestinal pain
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    2
    Mucositis oral
         subjects affected / exposed
    5 / 29 (17.24%)
         occurrences all number
    6
    Nausea
         subjects affected / exposed
    6 / 29 (20.69%)
         occurrences all number
    7
    Stomach pain
         subjects affected / exposed
    3 / 29 (10.34%)
         occurrences all number
    3
    Vomiting
         subjects affected / exposed
    3 / 29 (10.34%)
         occurrences all number
    3
    Gastrointestinal disorders - Other
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    2
    Skin and subcutaneous tissue disorders
    Dry skin
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    2
    other
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    2
    Renal and urinary disorders
    Urinary retention
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    2
    Renal and urinary disorders - Other
         subjects affected / exposed
    4 / 29 (13.79%)
         occurrences all number
    4
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    3 / 29 (10.34%)
         occurrences all number
    4
    Myalgia
         subjects affected / exposed
    3 / 29 (10.34%)
         occurrences all number
    3
    Musculoskeletal and connective tissue disorder - Other
         subjects affected / exposed
    4 / 29 (13.79%)
         occurrences all number
    4
    Metabolism and nutrition disorders
    Anorexia
         subjects affected / exposed
    4 / 29 (13.79%)
         occurrences all number
    4
    Hyperglycemia
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    2
    Hypertriglyceridemia
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    2

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? No

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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