Gastrointestinal Stromal Tumor (GIST)

Researchers are evaluating the combination of CGT9486 and sunitinib compared to sunitinib alone in patients with locally advanced, unresectable, or metastatic Gastrointestinal Stromal Tumors GIST. This Phase 3, open-label international trial involves multiple parts, including dose confirmation, drug interaction assessments, and efficacy comparisons. The study also includes substudies focusing on drug-drug interaction potential and first-line treatment in patients with specific genetic mutations KIT exon 9. Approximately 482 patients will participate across these parts.

Researchers are investigating the safety and effectiveness of 5 years of adjuvant imatinib treatment in patients with gastrointestinal stromal tumors GIST who have a high risk of recurrence. This includes patients with tumor rupture defined by Nishida classification or those with tumors 10cm or larger and a high mitotic index. The study builds on previous findings that showed benefits of shorter imatinib treatment durations and aims to improve long-term outcomes for high-risk patients. Participants will receive imatinib mesylate orally at a dose of 400 mg once daily for 5 years. This treatment extends the current standard 3-year adjuvant therapy by an additional 2 years. The study focuses on patients who have had complete surgical removal of their tumor and meet specific high-risk criteria. The trial is a phase 2, open-label study without randomization or placebo. Throughout the 5-year treatment period, participants will be monitored for progression-free survival as the primary outcome. Researchers will assess tumor status and overall health through regular visits and laboratory tests to evaluate safety and response. The study will also monitor organ function and patient performance status to ensure ongoing suitability for treatment. Participation may last up to 5 years, including follow-ups to observe long-term effects of the therapy.

Researchers are studying patients with soft tissue sarcoma of the extremity, trunk, or retroperitoneum to evaluate a shorter, five-day course of preoperative radiation therapy. This approach is being compared to the standard preoperative radiation given over 25 days to assess safety and effectiveness. The study is a Phase 2 trial sponsored by Stanford University focusing on treatment for this type of cancer. Participants will receive external beam radiotherapy delivering a total dose of 30 Gy divided into five equal daily fractions of 6 Gy each over 5 to 10 business days before surgery. This abbreviated radiation schedule aims to reduce the treatment duration while still targeting the tumor and any areas where microscopic disease might exist. During the study, participants will be monitored for post-operative complications up to 120 days after surgery. Researchers will also evaluate the rates of local cancer recurrence at 2 and 5 years following surgical removal. The study includes assessments of health status, and participants must attend scheduled visits for treatment and follow-up as part of their involvement, which continues until at least the primary outcome measurement is completed.

Researchers are evaluating the use of 68Ga-DOTATATE digital PETCT imaging in diagnosing soft tissue sarcomas. This study aims to assess the feasibility and potential clinical benefits of this imaging method, which may improve image quality compared to existing PET techniques. It also explores tumor uptake kinetics and the possibility of using imaging results to plan future peptide receptor radionuclide therapy for patients with specific tumor types. Participants receive an intravenous injection of gallium Ga 68-HA-DOTA-TATE and undergo digital PETCT scanning for 60 minutes within two weeks after starting standard chemotherapy. About 24 hours later, they are given a fludeoxyglucose F-18 injection, followed by another 60-minute digital PETCT scan. The study uses advanced PET detector technology to evaluate tumor characteristics and simulate imaging with lower doses or faster acquisition times. During the study, participants undergo imaging assessments to measure regions with increased tracer uptake. Researchers monitor safety by tracking adverse events up to seven days after imaging. The study involves standard chemotherapy alongside the imaging procedures. The total participation duration varies but includes the imaging sessions around chemotherapy and safety follow-up shortly after. This research is sponsored by Ohio State University Comprehensive Cancer Center.

Soft Tissue Sarcoma STS is a cancer that forms in soft tissues like muscles, tendons, fat, blood vessels, and nerves. These tumors often have a protein called PDGFRb1, which is targeted by treatments such as olaratumab. This trial is evaluating a new imaging agent, 89Zr-TLX300-CDx, which combines olaratumab with a radioactive metal, zirconium-89, to help detect STS and identify patients who might benefit from future PDGFRb1-targeted therapies. Participants will receive a single injection of 89Zr-TLX300-CDx and undergo whole-body imaging at various times depending on the study part. Part A and B include imaging at about 6 days after injection, with optional imaging at 4 hours. Part C involves imaging at 24 hours, 4 days, and 7 days post-injection, plus optional early dynamic imaging. Blood samples will be taken before injection and at multiple time points afterwards to study how the drug moves through the body. During the study, participants will have imaging scans and blood collections to assess safety, how the drug spreads and is processed, radiation exposure, and tumor targeting. The primary outcomes include safety and tolerability over 30 days, biodistribution and radiation dosimetry at 6 days, and pharmacokinetics. The study will help guide the future use of olaratumab as a radiopharmaceutical for STS. Participation involves visits for injections, imaging, and blood tests, with monitoring continuing for up to 30 days.

Researchers are studying a new type of scan called FAPI-PETCT to see how well it detects metastases in patients with advanced gastric cancer. The study aims to find out if this scan can better identify cancer spread, leading to changes in treatment plans such as avoiding unnecessary surgeries or shifting to comfort-focused care. It also evaluates whether the scan causes less burden for patients compared to current methods. Participants will receive the standard care for gastric cancer and undergo one additional FAPI-PETCT scan, where a small amount of 18F-FAPI-74 is given intravenously about 60 minutes before a PETCT scan lasting around 20 minutes. The results from this scan will help doctors decide on further tests or surgery needed. The study monitors changes in diagnosis and treatment decisions based on the scan. During the study, participants will complete questionnaires taking about 4 hours total and spend approximately 2 hours for the extra scan. Researchers will measure outcomes such as changes in treatment intent, diagnostic work-up, scan accuracy, incidental findings, patient burden, quality of life, and safety over about one year. Follow-up includes quality of life assessments and cost evaluations at multiple time points after staging.

Researchers are evaluating the preliminary effectiveness of intratumoural tigilanol tiglate in patients with advanced or metastatic soft tissue sarcoma located in the extremities and body wall. This Phase IIa open-label study aims to assess tumour destruction following one or more treatments and the overall disease control beyond injected tumours. Additional goals include assessing safety, tolerability, systemic exposure, immune response, and progression-free survival in certain stages of the study. Participants will receive one or multiple injections of tigilanol tiglate directly into their tumours at a dose up to 3.6 mgm2 based on body surface area. The treatment is administered intratumourally and may be guided by palpation or ultrasound. The study is open label with a single treatment arm, and the effects of the drug on injected and sometimes non-injected tumours will be monitored over time. Throughout the study, participants will undergo various assessments including tumour response evaluations at 3 and 6 months after initial treatment. Researchers will monitor adverse events for safety up to 6 months and perform pharmacokinetic testing after the first dose. Additional exploratory assessments include tumour microenvironment analysis, immune response, local recurrence rates, and metabolic profiling. Overall, participant involvement includes treatment, follow-up visits, safety monitoring, and outcome measurements lasting at least 6 months.

Researchers are investigating the safety of laparoscopic surgery to remove gastric gastrointestinal stromal tumors GIST that are 5 cm or larger. This prospective, multicenter cohort study aims to compare the clinical outcomes of laparoscopic resection of large gastric GISTs with those of smaller tumors less than 5 cm. The main focus is to evaluate overall postoperative complications within 30 days after surgery or upon discharge if the hospital stay is longer. The study involves two groups patients undergoing laparoscopic removal of gastric GISTs 5 cm or larger, and those with tumors smaller than 5 cm receiving the same procedure. The laparoscopic approach is expected to achieve complete tumor removal R0 resection. Various postoperative measures will be observed, including rates of complications during and after surgery, conversion to open surgery, surgical margin status, and changes in blood tests such as white blood cell count, hemoglobin, and C-reactive protein. Participants will be closely monitored after surgery through assessments of recovery milestones like time to first movement, bowel function, diet progression, and duration of hospital stay. Long-term outcomes including 3-year overall survival, disease-free survival, and recurrence patterns will also be recorded. The total follow-up spans up to 36 months, with detailed postoperative evaluations conducted up to 30 days and blood tests monitored before and after surgery at specified intervals.

Researchers are evaluating mass-based response testing MRT to guide personalized hyperthermic intraperitoneal chemotherapy HIPEC for patients with peritoneal metastases from high-grade appendiceal adenocarcinomas and colorectal cancer. This study aims to improve treatment selection for patients who have unresectable disease or extensive cancer spread within the abdomen. The study evaluates whether MRT can help choose effective chemotherapy drugs tailored to the individual patients tumor. Participants with unresectable peritoneal metastases will have tissue biopsies tested with MRT to identify optimal chemotherapy drugs. Those with unresectable disease will receive iterative HIPEC IHIPEC, which combines repeated cycles of heated chemotherapy delivered inside the abdomen with systemic chemotherapy. The IHIPEC cycles start about three weeks after laparoscopy and are repeated approximately three times with six weeks between each treatment. During the study, participants will be monitored for up to 12 months. Researchers will assess the feasibility of using MRT to select personalized HIPEC regimens, overall survival, treatment complications, quality of life, financial impacts, tumor response, and chemotherapy delivery success. Assessments include tissue biopsies, laparoscopy, laboratory tests, and questionnaires every three months. This detailed monitoring helps evaluate the treatment process and its effects over time.

Researchers are evaluating a new T-cell membrane-anchored tumor targeted IL12 attIL12-T cell therapy combined with cyclophosphamide in patients with advanced or metastatic soft tissue or bone sarcomas. This phase 1 trial aims to find the best dose for treatment and to understand the safety, tolerability, and early signs of disease control, especially in patients with recurrent unresectable osteosarcoma. The study also explores immune responses and tumor cell changes related to the therapy. Participants will receive attIL12-T cell therapy combined with cyclophosphamide administered intravenously. The study includes two parts Part A focuses on finding the safe and recommended dose, starting with the lowest dose, while Part B involves treating patients with osteosarcoma at the recommended dose found in Part A. Treatment schedules depend on the participants group and study phase. During the trial, participants will undergo tumor biopsies when possible and provide blood samples to assess immune changes. Researchers will monitor adverse events to evaluate safety for about one year. The main measurement is the incidence of side effects, and disease control will also be assessed over four months. Participants must meet specific health and organ function criteria and will be closely followed up throughout the study period.