Status:

COMPLETED

Sorafenib, Epirubicin, Ifosfamide, and Radiation Therapy Followed By Surgery in Treating Patients With High-Risk Stage II or Stage III Soft Tissue Sarcoma

Lead Sponsor:

OHSU Knight Cancer Institute

Collaborating Sponsors:

National Cancer Institute (NCI)

Conditions:

Sarcoma

Eligibility:

All Genders

15-120 years

Phase:

PHASE1

Brief Summary

RATIONALE: Sorafenib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth and by blocking blood flow to the tumor. Drugs used in chemotherapy, such as epirubicin a...

Detailed Description

OBJECTIVES: Primary * To determine the maximum tolerated dose of sorafenib tosylate when combined with epirubicin hydrochloride, ifosfamide, and hypofractionated radiotherapy prior to surgery in pat...

Eligibility Criteria

Inclusion

  • DISEASE CHARACTERISTICS:
  • Histologically confirmed soft tissue sarcoma of the upper (including shoulder) or lower (including hip) extremities or body wall
  • Stage II or III disease, as defined by the following:
  • Tumor dimension \> 5 cm
  • Superficial or deep tumor
  • Intermediate or high-grade disease
  • No regional lymph node involvement
  • No distant metastases
  • No rhabdomyosarcoma, Ewing sarcoma, primitive neuroectodermal tumor (PNET), osteosarcoma, or gastrointestinal stromal tumor
  • Pleomorphic rhabdomyosarcoma allowed
  • No known metastases
  • Patients with neurological symptoms must undergo a CT scan or MRI of the brain to exclude brain metastases
  • PATIENT CHARACTERISTICS:
  • Eastern Cooperative Oncology Group (ECOG) performance status 0-1
  • Absolute Neutrophil Count (ANC) ≥ 1,500/μL
  • Hemoglobin ≥ 9.0 g/dL
  • Platelet count ≥ 100,000/μL
  • International Normalized Ratio (INR) \< 1.5 or Prothrombin Time/Partial Thromboplastin Time (PT/PTT) normal
  • Creatinine ≤ 1.5 times upper limit of normal (ULN)
  • Bilirubin ≤ 1.5 mg/dL
  • Aspartate Aminotransferase/Alanine Aminotransferase (AST/ALT) ≤ 1.5 times ULN
  • Left Ventricular Ejection Fraction (LVEF) ≥ 50%
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception (male patients must use effective contraception for ≥ 3 months after completion of study treatment)
  • No contraindications to limb-sparing surgery
  • No severe peripheral vascular disease
  • No concurrent uncontrolled illness including, but not limited to, the following:
  • Ongoing or active serious infection \> Common Toxicity Criteria for Adverse Effects (CTCAE) grade 2
  • Symptomatic congestive heart failure
  • Unstable angina pectoris (i.e., angina symptoms at rest) or new onset angina within the past 3 months
  • Myocardial infarction within the past 6 months
  • Cardiac ventricular arrhythmia requiring anti-arrhythmic therapy
  • Psychiatric illness/social situation that would limit compliance with study requirements
  • No uncontrolled hypertension (defined as systolic blood pressure \> 150 mm Hg or diastolic blood pressure \> 90 mm Hg, despite optimal medical management)
  • No known HIV infection or chronic hepatitis B or C infection
  • No thrombolic or embolic events (e.g., cerebrovascular accident, including transient ischemic attacks) within the past 6 months
  • No pulmonary hemorrhage or bleeding event ≥ CTCAE grade 2 within the past 4 weeks
  • No other hemorrhage or bleeding event ≥ CTCAE grade 3 within the past 4 weeks
  • No serious non-healing wound, ulcer, or bone fracture
  • No evidence or history of bleeding diathesis or coagulopathy
  • No significant traumatic injury within the past 4 weeks
  • No known or suspected allergy to sorafenib tosylate or any agent given in the study
  • No condition that would impair the ability to swallow whole pills
  • No malabsorption problem
  • No "currently active" second malignancy other than non-melanoma skin cancer
  • Not considered to have a "currently active" malignancy if patient completed therapy AND has a \< 30% risk of relapse
  • PRIOR CONCURRENT THERAPY:
  • No prior chemotherapy, radiotherapy, or biotherapy
  • More than 4 weeks since prior major surgery
  • No concurrent St. John's wort or rifampin
  • No other concurrent investigational or anticancer therapy
  • Concurrent anticoagulation with warfarin or heparin allowed

Exclusion

    Key Trial Info

    Start Date :

    February 1 2009

    Trial Type :

    INTERVENTIONAL

    Allocation :

    ACTUAL

    End Date :

    April 30 2013

    Estimated Enrollment :

    18 Patients enrolled

    Trial Details

    Trial ID

    NCT00822848

    Start Date

    February 1 2009

    End Date

    April 30 2013

    Last Update

    September 7 2018

    Active Locations (1)

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    OHSU Knight Cancer Institute

    Portland, Oregon, United States, 97239-3098