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Trial record 1 of 1 for:    03785964
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Nirogacestat for Adults With Desmoid Tumor/Aggressive Fibromatosis (DT/AF) (DeFi)

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ClinicalTrials.gov Identifier: NCT03785964
Recruitment Status : Active, not recruiting
First Posted : December 24, 2018
Last Update Posted : May 4, 2021
Sponsor:
Information provided by (Responsible Party):
SpringWorks Therapeutics, Inc.

Tracking Information
First Submitted Date  ICMJE December 17, 2018
First Posted Date  ICMJE December 24, 2018
Last Update Posted Date May 4, 2021
Actual Study Start Date  ICMJE May 15, 2019
Estimated Primary Completion Date December 31, 2021   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: April 29, 2021)
Number of progression free survival (PFS) events as defined as the time from randomization until date of assessment of progression or death by any cause. [ Time Frame: On the first day of every 3 cycles (each cycle is 28 days) until disease progression is observed or death, whichever comes first, assessed up to approximately 2 years ]
Progression will be determined radiographically using RECIST v1.1 criteria by an independent, blinded, central radiologic review, or clinically as assessed by the Investigator.
Original Primary Outcome Measures  ICMJE
 (submitted: December 20, 2018)
Number of progression free survival (PFS) events as defined as the time from randomization until date of assessment of progression or death by any cause using Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1 Criteria. [ Time Frame: On the first day of every 3 cycles (each cycle is 28 days) until disease progression is observed or death, whichever comes first, assessed up to approximately 2 years ]
The documented date of progression will be determined by an independent, blinded, central radiologic review.
Change History
Current Secondary Outcome Measures  ICMJE
 (submitted: April 29, 2021)
  • The incidence of adverse events (AEs) according to toxicities graded by National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0. [ Time Frame: Weekly for cycle 1, last day of cycle 2, first day of cycle 4 and then the first day of every 3 cycles (each cycle is 28 days) through study completion, an average of 2 years ]
  • Overall response rate using RECIST Version 1.1 criteria. [ Time Frame: On the first day of every 3 cycles (each cycle is 28 days) through study completion, an average of 2 years ]
    Overall response rate is defined as the proportion of participants with complete response (CR) + partial response (PR) assessed by central reader using RECIST v1.1 criteria.
  • Duration of response for participants whose best response is CR or PR. [ Time Frame: On the first day of every 3 cycles (each cycle is 28 days) through study completion, an average of 2 years ]
  • Tumor volume changes from baseline as measured by MRI volumetric. [ Time Frame: On the first day of every 6 cycles (each cycle is 28 days) through study completion, an average of 2 years ]
  • Change from baseline in patient reported outcome (PRO) scores using the GOunder/Desmoid Tumor Research Tumor Foundation (DTRF) DEsmoid Symptom Scale (GODDESS);. [ Time Frame: Daily for the last 7 days of every cycle (each cycle is 28 days) through study completion, an average of 2 years ]
    This PRO will measure desmoid tumor symptoms by evaluating change from baseline. The items are evaluated on an 11-point numeric rating scale (NRS) form 0-10 measure severity from "none" to "as bad as you can imagine," with a 24-hour recall period.
  • Change from baseline in PRO scores using the Brief Pain Inventory (BPI) short form. [ Time Frame: Daily for the last 7 days of every cycle (each cycle is 28 days) through study completion, an average of 2 years ]
    This PRO will measure clinical pain by evaluating change from baseline. It consists of 9 questions and will utilize an 11-point NRS from 0-10 measure severity from "no pain" to "pain as bad as you can imagine," with a 24-hour recall period.
  • Change in baseline in PRO scores using the Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS PF) short form 10a plus 3 additional items from PROMIS item banks. [ Time Frame: On the last day of every cycle (each cycle is 28 days) through study completion, an average of 2 years ]
    This PRO will measure self-reported capability of physical activities by evaluating change from baseline. This includes the functioning of one's upper extremities (dexterity), lower extremities (walking or mobility), and central regions (neck, back), as well as instrumental activities of daily living, such as running errands. The PROMIS PF short form 10a plus (consisting) of 10 questions plus 3 additional questions from the PROMIS item bank will be used with a 7-day recall period.
  • Change from baseline in PRO scores using the GOunder/Desmoid Tumor Research Tumor Foundation (DTRF) DEsmoid Impact Scale (GODDESS); [ Time Frame: On the last day of every cycle (each cycle is 28 days) through study completion, an average of 2 years ]
    This PRO will measure desmoid tumor impacts by evaluating change from baseline. The items are evaluated either on an 11-point NRS to measure severity, or a 5-point Likert Scale ranging from "none of the time" to "all of the time" to measure frequency, with a 7-day recall period.
  • Change from baseline in PRO scores using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC) QLQ-C30. [ Time Frame: Last day of every cycle (each cycle is 28 days) through study completion, an average of 2 years ]
    This PRO will measure the health-related quality of life of cancer patients by evaluated change from baseline. It consists of 30 questions overall with a 4-point scale and incorporates 5 functional scales (physical, role, cognitive, emotional and social), 3 symptom scales (fatigue, pain, and nausea and vomiting), a global health status/quality of life scale, and a number of single items assessing additional symptoms commonly reported by cancer patients (dyspnea, loss of appetite, insomnia, constipation and diarrhea) and perceived financial impact of disease.
Original Secondary Outcome Measures  ICMJE
 (submitted: December 20, 2018)
  • The incidence of adverse events (AEs) according to toxicities graded by National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0. [ Time Frame: Weekly for cycle 1, last day of cycle 2, first day of cycle 4 and then the first day of every 3 cycles (each cycle is 28 days) through study completion, an average of 2 years ]
  • Overall response rate using RECIST Version 1.1 criteria. [ Time Frame: On the first day of every 3 cycles (each cycle is 28 days) through study completion, an average of 2 years ]
    Overall response rate is defined as the proportion of participants with complete response (CR) + partial response (PR).
  • Duration of response for participants whose best response is CR or PR. [ Time Frame: On the first day of every 3 cycles (each cycle is 28 days) through study completion, an average of 2 years ]
  • Tumor volume changes from baseline as measured by MRI volumetric. [ Time Frame: On the first day of every 6 cycles (each cycle is 28 days) through study completion, an average of 2 years ]
  • Change from baseline in patient reported outcome (PRO) scores using the Memorial Sloan Kettering/Desmoid Tumor Research Foundation Desmoid Tumor Symptom Scale (MSK/DTRF DTSS). [ Time Frame: Daily for the last 7 days of every cycle (each cycle is 28 days) through study completion, an average of 2 years ]
    This PRO will measure desmoid tumor symptoms by evaluating change from baseline. The items are evaluated on an 11-point numeric rating scale (NRS) form 0-10 measure severity from "none" to "as bad as you can imagine," with a 24-hour recall period.
  • Change from baseline in PRO scores using the Brief Pain Inventory (BPI) short form. [ Time Frame: Daily for the last 7 days of every cycle (each cycle is 28 days) through study completion, an average of 2 years ]
    This PRO will measure clinical pain by evaluating change from baseline. It consists of 9 questions and will utilize an 11-point NRS from 0-10 measure severity from "no pain" to "pain as bad as you can imagine," with a 24-hour recall period.
  • Change in baseline in PRO scores using the Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS PF) short form 10a plus 3 additional items from PROMIS item banks. [ Time Frame: On the last day of every cycle (each cycle is 28 days) through study completion, an average of 2 years ]
    This PRO will measure self-reported capability of physical activities by evaluating change from baseline. This includes the functioning of one's upper extremities (dexterity), lower extremities (walking or mobility), and central regions (neck, back), as well as instrumental activities of daily living, such as running errands. The PROMIS PF short form 10a plus (consisting) of 10 questions plus 3 additional questions from the PROMIS item bank will be used with a 7-day recall period.
  • Change from baseline in PRO scores using the Memorial Sloan Kettering/Desmoid Tumor Research Foundation Desmoid Tumor Impact Scale (MSK/DTRF DTIS). [ Time Frame: On the last day of every cycle (each cycle is 28 days) through study completion, an average of 2 years ]
    This PRO will measure desmoid tumor impacts by evaluating change from baseline. The items are evaluated either on an 11-point NRS to measure severity, or a 5-point Likert Scale ranging from "none of the time" to "all of the time" to measure frequency, with a 7-day recall period.
  • Change from baseline in PRO scores using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC) QLQ-C30. [ Time Frame: Last day of every cycle (each cycle is 28 days) through study completion, an average of 2 years ]
    This PRO will measure the health-related quality of life of cancer patients by evaluated change from baseline. It consists of 30 questions overall with a 4-point scale and incorporates 5 functional scales (physical, role, cognitive, emotional and social), 3 symptom scales (fatigue, pain, and nausea and vomiting), a global health status/quality of life scale, and a number of single items assessing additional symptoms commonly reported by cancer patients (dyspnea, loss of appetite, insomnia, constipation and diarrhea) and perceived financial impact of disease.
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE Nirogacestat for Adults With Desmoid Tumor/Aggressive Fibromatosis (DT/AF)
Official Title  ICMJE A Randomized, Double-Blind, Placebo-Controlled, Phase 3 Trial of Nirogacestat Versus Placebo in Adult Patients With Progressing Desmoid Tumors/Aggressive Fibromatosis (DT/AF)
Brief Summary This study evaluates nirogacestat in the treatment of desmoid tumor/aggressive fibromatosis (DT/AF). Half of the participants will receive nirogacestat while the other half will receive placebo.
Detailed Description

Desmoid tumors, also referred to as aggressive fibromatosis, are rare, locally invasive, slow growing soft tissue tumors. Although considered benign because of their inability to metastasize, desmoid tumors can cause significant morbidity and occasionally mortality in patients.

Nirogacestat (PF-03084014) is a potent, small molecule, selective, reversible, noncompetitive inhibitor of γ-secretase (GS) with a potential antitumor activity.

Nirogacestat is being investigated for the treatment of desmoid tumors due to its ability to bind to GS, blocking proteolytic activation of Notch receptors. Previous clinical study data have shown that Notch signaling plays an important role in cancer development. Hence, inhibition of Notch signaling is an important strategy for therapeutic treatment.

Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 3
Study Design  ICMJE Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Masking Description:
For the double-blind phase, the participant, investigator, and all other clinical site personnel will be blinded to the assigned treatment allocation. All sponsor personnel will also be blinded except for the sponsor's quality assurance designee(s), safety designee(s), and clinical supply material designee(s).
Primary Purpose: Treatment
Condition  ICMJE
  • Desmoid Tumor
  • Aggressive Fibromatosis
Intervention  ICMJE
  • Drug: Nirogacestat oral tablet
    Nirogacestat tablet
    Other Name: PF-03084014
  • Drug: Placebo Oral Tablet
    Sugar pill manufactured to mimic nirogacestat 50 mg tablet
Study Arms  ICMJE
  • Experimental: Nirogacestat
    Nirogacestat 150 mg by mouth, twice daily
    Intervention: Drug: Nirogacestat oral tablet
  • Placebo Comparator: Placebo
    Placebo 150 mg by mouth, twice daily
    Intervention: Drug: Placebo Oral Tablet
Publications * Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Active, not recruiting
Actual Enrollment  ICMJE
 (submitted: April 29, 2021)
142
Original Estimated Enrollment  ICMJE
 (submitted: December 20, 2018)
94
Estimated Study Completion Date  ICMJE March 31, 2023
Estimated Primary Completion Date December 31, 2021   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Key Inclusion Criteria:

  • Participant has histologically confirmed DT/AF (by local pathologist prior to informed consent) that has progressed by ≥ 20% as measured by RECIST v1.1 within 12 months of the screening visit scan.
  • Participant has:

    1. Treatment naïve, measurably progressing DT/AF that is deemed not amenable to surgery without the risk of significant morbidity; OR
    2. Recurrent, measurably progressing DT/AF following at least one line of therapy; OR
    3. Refractory, measurably progressing DT/AF following at least one line of therapy.
  • Participant has a DT/AF tumor where continued progressive disease will not result in immediate significant risk to the participant.
  • Participant agrees to provide archival or new tumor tissue for re-confirmation of disease.
  • If participant is currently being treated with any therapy for the treatment of DT/AF, this must be completed at least 28 days (or 5 half-lives, whichever is longer) prior to first dose of study treatment. All toxicities from prior therapy must be resolved to ≤ Grade 1 or clinical baseline.
  • Participants who are receiving chronic nonsteroidal anti-inflammatory drugs (NSAIDs) as treatment for conditions other than DT/AF must be receiving them prior to the documented DT/AF progressive disease (inclusion criteria 2) and on a stable dose for at least 28 days prior to first dose of study treatment.
  • Participant has an Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2 at screening.
  • Participant has adequate organ and bone marrow function.

Key Exclusion Criteria:

  • Participant has known malabsorption syndrome or preexisting gastrointestinal conditions that may impair absorption of nirogacestat.
  • Participant has experienced any of the following within 6 months of signing informed consent: clinically significant cardiac disease (New York Heart Association Class III or IV), myocardial infarction, severe/unstable angina, coronary/peripheral artery bypass graft, symptomatic congestive heart failure, cerebrovascular accident, transient ischemic attack, or symptomatic pulmonary embolism.
  • Participant has an abnormal QT interval at screening.
  • Participant is using concomitant medications that are known to prolong the QT/QTcF interval including Class Ia and Class III antiarrhythmics at the time of informed consent. Non-antiarrhythmic medications which may prolong the QT/QTcF interval are allowed provided the participant does not have additional risk factors for Torsades de Pointes (TdP)
  • Participant has congential long QT syndrome.
  • Participant has a history of additional risk factors for Torsades de Pointes (TdP) (e.g., heart failure, hypokalemia, family history of Long QT Syndrome).
  • Participant has had lymphoma, leukemia, or any malignancy within the past 5 years at the time of informed consent, except for any locally recurring cancer that has been treated curatively (e.g., resected basal or squamous cell skin cancer, superficial bladder cancer, carcinoma in situ of the cervix or breast), with no evidence of metastatic disease for 3 years at the time of informed consent.
  • Participant has current or chronic history of liver disease or known hepatic or biliary abnormalities (except for Gilbert's syndrome or asymptomatic gallstones).
  • Participant previously received or is currently receiving therapy with GS inhibitors or anti-Notch antibody therapy.
  • Participant is currently using any treatment for DT/AF including tyrosine kinase inhibitors (TKIs), NSAIDs (chronic daily use) or any investigational treatment 28 days (or 5 half-lives, whichever is longer) prior to the first dose of study treatment.

OR

Participant has started any treatment for DT/AF after the documented DT/AF progressive disease.

  • Participant is currently using or anticipates using food or drugs that are known strong/moderate cytochrome P450 3A4 (CYP3A4) inhibitors, or strong CYP3A inducers within 14 days prior to the first dose of study treatment.
  • Participant has a positive human immunodeficiency virus antibody test.
  • Participant has presence of Hepatitis B surface antigen at screening.
  • Participant has a positive Hepatitis C antibody or Hepatitis C ribonucleic acid (RNA) test result at screening or within 3 months prior to starting study treatment.
  • Participant is unable to tolerate MRI or for whom MRI is contraindicated.
  • Participant with active or chronic infection at the time of informed consent and during the screening period.
  • Participant has experienced other severe acute or chronic medical or psychiatric conditions within 1 year of signing informed consent.
  • Participant is unable to comply with study related procedures (including, but not limited to, the completion of electronic patient report outcomes (ePROs), or the ePRO questionnaires are not available in the participant's preferred language).
Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 18 Years and older   (Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE No
Contacts  ICMJE Contact information is only displayed when the study is recruiting subjects
Listed Location Countries  ICMJE Belgium,   Canada,   Germany,   Italy,   Netherlands,   United Kingdom,   United States
Removed Location Countries France
 
Administrative Information
NCT Number  ICMJE NCT03785964
Other Study ID Numbers  ICMJE NIR-DT-301
Has Data Monitoring Committee Yes
U.S. FDA-regulated Product
Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
IPD Sharing Statement  ICMJE
Plan to Share IPD: No
Responsible Party SpringWorks Therapeutics, Inc.
Study Sponsor  ICMJE SpringWorks Therapeutics, Inc.
Collaborators  ICMJE Not Provided
Investigators  ICMJE
Principal Investigator: Bernd Kasper, MD Mannheim University Medical Center
PRS Account SpringWorks Therapeutics, Inc.
Verification Date April 2021

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP