62 Participants Needed

Lurbinectedin + Doxorubicin for Leiomyosarcoma

Recruiting at 5 trial locations
GC
Overseen ByGregory Cote, M.D. Ph.D
Age: 18+
Sex: Any
Trial Phase: Phase 1 & 2
Sponsor: Massachusetts General Hospital
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

Trial Summary

What is the purpose of this trial?

This trial is testing a new drug, lurbinectedin, combined with an existing chemotherapy drug, doxorubicin, in patients with advanced leiomyosarcoma. The goal is to see if this combination is safe and more effective than doxorubicin alone. Both drugs work by damaging the DNA in cancer cells, leading to their death. Lurbinectedin is a synthetic marine-derived anticancer agent that has shown promise in treating certain types of cancer.

Will I have to stop taking my current medications?

The trial does not specify if you must stop taking your current medications, but you cannot take medications that strongly affect certain liver enzymes (CYP3A, CYP2D6) or P-gp. It's important to discuss your current medications with the study team to avoid any interactions.

Is the combination of Lurbinectedin and Doxorubicin safe for humans?

Doxorubicin, a component of the treatment, is known to cause heart-related side effects, but there are formulations like Myocet® and Doxil® that are designed to be less harmful to the heart. Common side effects include neutropenia (low white blood cell count) and some eye-related issues, but these are usually temporary. Dexrazoxane is sometimes used to protect the heart when using Doxorubicin.12345

What makes the drug combination of Lurbinectedin and Doxorubicin unique for treating leiomyosarcoma?

The combination of Lurbinectedin and Doxorubicin is unique because it has shown promising results in controlling leiomyosarcoma, a type of soft tissue cancer, with a 35% objective response rate and a 40% disease control rate at 24 weeks. This combination leverages Lurbinectedin's ability to inhibit cancer cell transcription and Doxorubicin's established chemotherapy effects, offering a novel approach compared to standard treatments.678910

Research Team

Member Detail - DF/HCC

Gregory Cote, MD

Principal Investigator

Massachusetts General Hospital

Eligibility Criteria

Adults with measurable soft tissue sarcoma, specifically leiomyosarcoma, who have no curative treatment options available. They must be over 18, not pregnant or breastfeeding, willing to use contraception, and have adequate organ function and bone marrow reserves. Prior cancer treatments are restricted.

Inclusion Criteria

My hepatitis B virus load is undetectable with treatment.
My organs and bone marrow are functioning well.
Ability to understand and the willingness to sign a written informed consent document
See 10 more

Exclusion Criteria

I am not taking strong or moderate drugs that affect enzyme activity.
I have had interstitial pneumonitis or pulmonary fibrosis.
Pregnant women
See 15 more

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Phase 1b Treatment

Participants receive lurbinectedin with doxorubicin to determine the maximum tolerated dose (MTD) and recommended phase 2 dose (RP2D)

21 days per cycle
Outpatient basis

Phase 2 Treatment

Randomized study to compare the efficacy of lurbinectedin with doxorubicin versus doxorubicin alone

Up to 12 months

Follow-up

Participants are monitored for safety and effectiveness after treatment

Up to 5 years

Treatment Details

Interventions

  • Doxorubicin
  • Lurbinectedin
Trial OverviewThe trial is testing the combination of lurbinectedin and doxorubicin versus lurbinectedin alone for treating leiomyosarcoma. It has two parts: one for tolerability assessment and another randomized part to compare effectiveness.
Participant Groups
3Treatment groups
Experimental Treatment
Active Control
Group I: Lurbinectedin + Doxorubicin at RP2DExperimental Treatment2 Interventions
The randomized two arm phase 2 trial will begin following the determination of the RP2D for lurbinectedin and doxorubicin. * Participants will be randomized 1:1 to enroll to either Arm 1 or Arm 2 * Participants enrolled to Arm 1 will receive Lurbinectedin with Doxorubicin at the RP2D defined during the phase 1b portion of the trial.
Group II: Lurbinectedin + Doxorubicin Phase IExperimental Treatment2 Interventions
The phase 1b trial will follow a standard 3+3 design. Upon determination of the maximum tolerated dose (MTD) and recommended phase 2 dose (RP2D) of lurbinectedin plus doxorubicin. A treatment cycle will be defined as 21 consecutive days. Treatment will be administered on an outpatient basis * Lurbinectedin * Doxorubicin
Group III: Doxorubicin MonotherapyActive Control1 Intervention
The randomized two arm phase 2 trial will begin following the determination of the RP2D for lurbinectedin and doxorubicin. * Participants will be randomized 1:1 to enroll to either Arm 1 or Arm 2 * Participants enrolled to Arm 2 will receive Doxorubicin at the standard dose of 75 mg/m2

Doxorubicin is already approved in United States, European Union, Canada, Japan for the following indications:

🇺🇸
Approved in United States as Adriamycin for:
  • Breast cancer
  • Ovarian cancer
  • Bladder cancer
  • Lymphomas
  • Leukemias
  • Multiple myeloma
  • Kaposi's sarcoma
  • Soft tissue sarcomas
🇪🇺
Approved in European Union as Doxorubicin for:
  • Breast cancer
  • Ovarian cancer
  • Bladder cancer
  • Lymphomas
  • Leukemias
  • Multiple myeloma
  • Kaposi's sarcoma
  • Soft tissue sarcomas
🇨🇦
Approved in Canada as Doxorubicin for:
  • Breast cancer
  • Ovarian cancer
  • Bladder cancer
  • Lymphomas
  • Leukemias
  • Multiple myeloma
  • Kaposi's sarcoma
  • Soft tissue sarcomas
🇯🇵
Approved in Japan as Doxorubicin for:
  • Breast cancer
  • Ovarian cancer
  • Bladder cancer
  • Lymphomas
  • Leukemias
  • Multiple myeloma
  • Kaposi's sarcoma
  • Soft tissue sarcomas

Find a Clinic Near You

Who Is Running the Clinical Trial?

Massachusetts General Hospital

Lead Sponsor

Trials
3,066
Recruited
13,430,000+

Jazz Pharmaceuticals

Industry Sponsor

Trials
252
Recruited
35,100+
Bruce C. Cozadd profile image

Bruce C. Cozadd

Jazz Pharmaceuticals

Chief Executive Officer since 2009

BA in Economics from Yale University, MBA from Stanford University

Dr. Austin profile image

Dr. Austin

Jazz Pharmaceuticals

Chief Medical Officer since 2023

MD from the Royal College of Surgeons in Ireland

Findings from Research

Paeonol (Pae) has been shown to protect against doxorubicin (Dox)-induced cardiotoxicity in both rat models and primary cardiomyocytes by enhancing mitochondrial fusion and restoring cardiac function.
The protective mechanism involves the PKCε-Stat3-Mfn2 signaling pathway, where Pae activates Stat3 to promote Mfn2-mediated mitochondrial fusion, without compromising the anticancer efficacy of Dox.
Paeonol protects against doxorubicin-induced cardiotoxicity by promoting Mfn2-mediated mitochondrial fusion through activating the PKCε-Stat3 pathway.Ding, M., Shi, R., Fu, F., et al.[2023]
Myocet®, a non-pegylated liposome-encapsulated form of doxorubicin, is designed to enhance the effectiveness of doxorubicin while reducing its cardiotoxicity, making it a safer option for breast cancer and other tumors.
Clinical evidence indicates that Myocet® has a lower incidence of hematological toxicity compared to conventional doxorubicin, and it effectively reduces the severity of cardiac events associated with treatment.
[Non-pegylated doxorubicin (Myocet®) as the less cardiotoxic alternative of free doxorubicin].Nagykálnai, T.[2018]
Doxorubicin is associated with ocular adverse reactions, with conjunctivitis being the most common, but these reactions typically resolve quickly after stopping the drug, often within 24 hours.
The infrequent occurrence and rapid resolution of ocular side effects suggest that doxorubicin can be cautiously reintroduced in patients if further cancer treatment is necessary, despite the potential for these reactions.
Ocular adverse reactions associated with adriamycin (doxorubicin).Curran, CF., Luce, JK.[2019]

References

Paeonol protects against doxorubicin-induced cardiotoxicity by promoting Mfn2-mediated mitochondrial fusion through activating the PKCε-Stat3 pathway. [2023]
[Non-pegylated doxorubicin (Myocet®) as the less cardiotoxic alternative of free doxorubicin]. [2018]
Ocular adverse reactions associated with adriamycin (doxorubicin). [2019]
Anticancer and cardio-protective effects of liposomal doxorubicin in the treatment of breast cancer. [2020]
Cardioprotection by dexrazoxane in rats treated with doxorubicin and paclitaxel. [2015]
A phase II multi-strata study of lurbinectedin as a single agent or in combination with conventional chemotherapy in metastatic and/or unresectable sarcomas. [2022]
Doxorubicin plus lurbinectedin in patients with advanced endometrial cancer: results from an expanded phase I study. [2022]
A model-based head-to-head comparison of single-agent lurbinectedin in the pivotal ATLANTIS Study. [2023]
Antitumor activity of lurbinectedin (PM01183) and doxorubicin in relapsed small-cell lung cancer: results from a phase I study. [2022]
10.United Statespubmed.ncbi.nlm.nih.gov
First-in-human phase I study of Lurbinectedin (PM01183) in patients with advanced solid tumors. [2022]