Skip to main content
Top
Published in: BMC Cancer 1/2019

Open Access 01-12-2019 | osteosarcoma | Study protocol

Gemcitabine and docetaxel combination chemotherapy for advanced bone and soft tissue sarcomas: protocol for an open-label, non-randomised, Phase 2 study

Authors: Hitomi Hara, Teruya Kawamoto, Naomasa Fukase, Yohei Kawakami, Toshiyuki Takemori, Shuichi Fujiwara, Kazumichi Kitayama, Kotaro Nishida, Ryosuke Kuroda, Toshihiro Akisue

Published in: BMC Cancer | Issue 1/2019

Login to get access

Abstract

Background

The prognosis of patients with metastatic or advanced sarcomas is poor and there are few options for treatment. Several studies have shown that gemcitabine and docetaxel (GD) combination chemotherapy has antitumor activity against various subtypes of sarcoma. Recently, some studies have shown a favourable outcome for GD combination chemotherapy for relapsed high-grade osteosarcoma and spindle cell sarcoma of bone. If the effectiveness of GD is proven, this will result in new treatment options for advanced bone and soft tissue sarcomas (STS). The aim of this prospective Phase 2 study is to evaluate the efficacy and toxicity of the GD combination in patients with advanced bone sarcomas and STS.

Methods

This is a Phase 2, single-arm, open-label study to investigate the efficacy and safety of combination chemotherapy with GD for advanced bone sarcomas and STS and will enrol 20 patients. The patients will receive gemcitabine 900 mg/m2 on Days 1 and 8, and docetaxel 70 mg/m2 on Day 8 in 3-week cycles until disease progression or other evidence of treatment failure. The primary aim of this study is to analyse GD’s effect on progression-free survival (PFS). The secondary objectives are to analyse treatment efficacy and safety in terms of response rate, tumour control rate, overall survival, and adverse event rate. The length of follow-up will be 5 years.

Discussion

This study will evaluate the efficacy and safety of combination therapy with gemcitabine and docetaxel for bone sarcomas and STS. If this combination proves to be acceptable, it could be used for as second, third, or later line therapy for patients with sarcomas (especially bone sarcomas). In the future, the role of various treatments, including GD therapy, will be clarified for specific subtypes of sarcoma.

Trial registration

This study was registered as UMIN000031004 (University Hospital Medical Information Network-Clinical Trial Registry: UMIN-CTR) on 1 March 1 2018 and with the Japan Registry of Clinical Trials (jRCT) as jRCTs051180042 on 30 January 2019. The posted information will be updated as needed to reflect protocol amendments and study progress.
Appendix
Available only for authorised users
Literature
1.
go back to reference Edmonson JH, Ryan LM, Falkson CI, Hicks DG, Blum RH. Phase II study of Ifosfamide+doxorubicin in patients with advanced synovial sarcomas (E1793): a trial of the eastern cooperative oncology group. Sarcoma. 2003;7:9–11.CrossRef Edmonson JH, Ryan LM, Falkson CI, Hicks DG, Blum RH. Phase II study of Ifosfamide+doxorubicin in patients with advanced synovial sarcomas (E1793): a trial of the eastern cooperative oncology group. Sarcoma. 2003;7:9–11.CrossRef
2.
go back to reference Frustaci S, Foladore S, Buonadonna A, De Paoli A, Crivellari D, Carbone A, Sorio R, Morassut S, Monfardini S. Epirubicin and ifosfamide in advanced soft tissue sarcomas. Ann Oncol. 1993;4:669–72.CrossRef Frustaci S, Foladore S, Buonadonna A, De Paoli A, Crivellari D, Carbone A, Sorio R, Morassut S, Monfardini S. Epirubicin and ifosfamide in advanced soft tissue sarcomas. Ann Oncol. 1993;4:669–72.CrossRef
3.
go back to reference Geller DS, Gorlick R. Osteosarcoma: a review of diagnosis, management, and treatment strategies. Clin Adv Hematol Oncol. 2010;8:705–18.PubMed Geller DS, Gorlick R. Osteosarcoma: a review of diagnosis, management, and treatment strategies. Clin Adv Hematol Oncol. 2010;8:705–18.PubMed
4.
go back to reference Verma V, Denniston KA, Lin CJ, Lin C. A comparison of pediatric vs. adult patients with the Ewing sarcoma family of tumors. Front Oncol. 2017;8:82: 1–9. Verma V, Denniston KA, Lin CJ, Lin C. A comparison of pediatric vs. adult patients with the Ewing sarcoma family of tumors. Front Oncol. 2017;8:82: 1–9.
5.
go back to reference Hensley ML, Maki R, Venkatraman E, Geller G, Lovegren M, Aghajanian C, Sabbatini P, Tong W, Barakat R, Spriggs DR. Gemcitabine and docetaxel in patients with unresectable leiomyosarcoma: results of a phase II trial. J Clin Oncol. 2002;20:2824–31.CrossRef Hensley ML, Maki R, Venkatraman E, Geller G, Lovegren M, Aghajanian C, Sabbatini P, Tong W, Barakat R, Spriggs DR. Gemcitabine and docetaxel in patients with unresectable leiomyosarcoma: results of a phase II trial. J Clin Oncol. 2002;20:2824–31.CrossRef
6.
go back to reference Maki RG, Wathen JK, Patel SR, Priebat DA, Okuno SH, Samuels B, Fanucchi M, Harmon DC, Schuetze SM, Reinke D, Thall PF, Benjamin RS, Baker LH, Hensley ML. Randomized phase II study of gemcitabine and docetaxel compared with gemcitabine alone in patients with metastatic soft tissue sarcomas: results of sarcoma alliance for research through collaboration study 002 [corrected]. J Clin Oncol. 2007;25:2755–63.CrossRef Maki RG, Wathen JK, Patel SR, Priebat DA, Okuno SH, Samuels B, Fanucchi M, Harmon DC, Schuetze SM, Reinke D, Thall PF, Benjamin RS, Baker LH, Hensley ML. Randomized phase II study of gemcitabine and docetaxel compared with gemcitabine alone in patients with metastatic soft tissue sarcomas: results of sarcoma alliance for research through collaboration study 002 [corrected]. J Clin Oncol. 2007;25:2755–63.CrossRef
7.
go back to reference Bay JO, Ray-Coquard I, Fayette J, Leyvraz S, Cherix S, Piperno-Neumann S, Chevreau C, Isambert N, Brain E, Emile G, Le Cesne A, Cioffi A, Kwiatkowski F, Coindre JM, Bui NB, Peyrade F, Penel N, Blay JY, Groupe Sarcome Français. Docetaxel and gemcitabine combination in 133 advanced soft-tissue sarcomas: a retrospective analysis. Int J Cancer. 2006;119:706–11.CrossRef Bay JO, Ray-Coquard I, Fayette J, Leyvraz S, Cherix S, Piperno-Neumann S, Chevreau C, Isambert N, Brain E, Emile G, Le Cesne A, Cioffi A, Kwiatkowski F, Coindre JM, Bui NB, Peyrade F, Penel N, Blay JY, Groupe Sarcome Français. Docetaxel and gemcitabine combination in 133 advanced soft-tissue sarcomas: a retrospective analysis. Int J Cancer. 2006;119:706–11.CrossRef
8.
go back to reference Leu KM, Ostruszka LJ, Shewach D, Zalupski M, Sondak V, Biermann JS, Lee JS, Couwlier C, Palazzolo K, Baker LH. Laboratory and clinical evidence of synergistic cytotoxicity of sequential treatment with gemcitabine followed by docetaxel in the treatment of sarcoma. J Clin Oncol. 2004;22:1706–12.CrossRef Leu KM, Ostruszka LJ, Shewach D, Zalupski M, Sondak V, Biermann JS, Lee JS, Couwlier C, Palazzolo K, Baker LH. Laboratory and clinical evidence of synergistic cytotoxicity of sequential treatment with gemcitabine followed by docetaxel in the treatment of sarcoma. J Clin Oncol. 2004;22:1706–12.CrossRef
9.
go back to reference Lee EM, Rha SY, Lee J, Park KH, Ahn JH. Phase II study of weekly docetaxel and fixed dose rate gemcitabine in patients with previously treated advanced soft tissue and bone sarcoma. Cancer Chemother Pharmacol. 2012;69:635–42.CrossRef Lee EM, Rha SY, Lee J, Park KH, Ahn JH. Phase II study of weekly docetaxel and fixed dose rate gemcitabine in patients with previously treated advanced soft tissue and bone sarcoma. Cancer Chemother Pharmacol. 2012;69:635–42.CrossRef
10.
go back to reference Lee HY, Shin SJ, Kim HS, Hong SJ, Han JW, Lim ST, Roh JK, Rha SY. Weekly gemcitabine and docetaxel in refractory soft tissue sarcoma: a retrospective analysis. Cancer Res Treat. 2012;44:43–9.CrossRef Lee HY, Shin SJ, Kim HS, Hong SJ, Han JW, Lim ST, Roh JK, Rha SY. Weekly gemcitabine and docetaxel in refractory soft tissue sarcoma: a retrospective analysis. Cancer Res Treat. 2012;44:43–9.CrossRef
11.
go back to reference Lee JA, Jeon DG, Cho WH, Song WS, Yoon HS, Park HJ, Park BK, Choi HS, Ahn HS, Lee JW, Yoo KH, Sung KW, Koo HH, Kang HJ, Park KD, Shin HY, Koh KN, Im HJ, Seo JJ, Lim YJ, Baek HJ, Kook H. Higher gemcitabine dose was associated with better outcome of osteosarcoma patients receiving gemcitabine-docetaxel chemotherapy. Pediatr Blood Cancer. 2016;63:1552–6.CrossRef Lee JA, Jeon DG, Cho WH, Song WS, Yoon HS, Park HJ, Park BK, Choi HS, Ahn HS, Lee JW, Yoo KH, Sung KW, Koo HH, Kang HJ, Park KD, Shin HY, Koh KN, Im HJ, Seo JJ, Lim YJ, Baek HJ, Kook H. Higher gemcitabine dose was associated with better outcome of osteosarcoma patients receiving gemcitabine-docetaxel chemotherapy. Pediatr Blood Cancer. 2016;63:1552–6.CrossRef
12.
go back to reference Palmerini E, Jones RL, Marchesi E, Paioli A, Cesari M, Longhi A, Meazza C, Coccoli L, Fagioli F, Asaftei S, Grignani G, Tamburini A, Pollack SM, Picci P, Ferrari S. Gemcitabine and docetaxel in relapsed and unresectable high-grade osteosarcoma and spindle cell sarcoma of bone. BMC Cancer. 2016;20:280.CrossRef Palmerini E, Jones RL, Marchesi E, Paioli A, Cesari M, Longhi A, Meazza C, Coccoli L, Fagioli F, Asaftei S, Grignani G, Tamburini A, Pollack SM, Picci P, Ferrari S. Gemcitabine and docetaxel in relapsed and unresectable high-grade osteosarcoma and spindle cell sarcoma of bone. BMC Cancer. 2016;20:280.CrossRef
13.
go back to reference Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, Dancey J, Arbuck S, Gwyther S, Mooney M, Rubinstein L, Shankar L, Dodd L, Kaplan R, Lacombe D, Verweij J. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer. 2009;45:228–47.CrossRef Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, Dancey J, Arbuck S, Gwyther S, Mooney M, Rubinstein L, Shankar L, Dodd L, Kaplan R, Lacombe D, Verweij J. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer. 2009;45:228–47.CrossRef
Metadata
Title
Gemcitabine and docetaxel combination chemotherapy for advanced bone and soft tissue sarcomas: protocol for an open-label, non-randomised, Phase 2 study
Authors
Hitomi Hara
Teruya Kawamoto
Naomasa Fukase
Yohei Kawakami
Toshiyuki Takemori
Shuichi Fujiwara
Kazumichi Kitayama
Kotaro Nishida
Ryosuke Kuroda
Toshihiro Akisue
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2019
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-019-5923-7

Other articles of this Issue 1/2019

BMC Cancer 1/2019 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine