ClinicalTrials.gg
CompletedNCT02607202AGNOSTOSUpdated Jan 26, 2024

A Study of Nab-paclitaxel-based Doublet as First Line Therapy in Patients With Cancer of Unknown Primary (CUP)

A Phase 2 interventional study of nab-paclitaxel and Carboplatin in Unknown Primary Tumors, sponsored by Fondazione del Piemonte per l'Oncologia. Completed at 10 sites in Italy. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-01-26.

Sponsored by Fondazione del Piemonte per l'Oncologia · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
57
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Agnostos Trial is a multicentric phase 2 randomized trial with a 'pick-the-winner design' in chemonaive patients with cancer of unknown primary. It will assess the efficacy of the two best active single agent - carboplatin or gemcitabine - added to an innovative taxane back bone (nab-Paclitaxel). Agnostos trial is a part of a larger clinical and translational initiative to improve the outlook of patients with cancer of unknown primary through evaluation of novel chemotherapeutic regimens.

Read the detailed description

Treatment-naïve patients with CUP diagnosis confirmed according to CUP Diagnostic Guidelines, will be enrolled into AGNOSTOS trial. Patients will be randomized upfront to receive a nab-paclitaxel-based duplet adding either carboplatin or gemcitabine until progression or unacceptable toxicity (randomization 1:1, n= 120; 60 per arm).

02

Conditions studied

  • Unknown Primary Tumors
03

In context

Neoplasms, Unknown Primary

101 studies on the registry are indexed under Neoplasms, Unknown Primary; 19 are open to participants now.

This study's enrollment of 57 is close to the median of 52 across 63 interventional studies indexed under Neoplasms, Unknown Primary.

Browse Neoplasms, Unknown Primary studies →

Lead sponsor

Fondazione del Piemonte per l'Oncologia is the lead sponsor of 39 studies on the registry; 18 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Provision of written .
  • Patients must be ≥ 18 years of age.
  • Diagnosis of CUP according to CUP Diagnostic Guidelines derived from ESMO 2011 and NCCN 2015 guidelines.
  • Sufficient archived tissue from a surgical or core needle biopsy required to perform the CUP multiplex assay.
  • performance status ≤ 2.
  • No previous systemic therapy.
  • At least one by Criteria.
  • Good liver, cardiac, lung and marrow bone function.
  • Evidence of non-childbearing status for female patients: negative urine or serum pregnancy test within 21 days of study treatment for women of , or status.
  • Patients of child bearing potential and their partners, who are sexually active, must agree to the use of highly effective forms of throughout their participation in the study.
  • Patient is willing and able to comply with the protocol for the duration of the study, including undergoing treatment and scheduled visits and examinations.

Exclusion criteria

Exclusion Criteria:

  • Patients with second primary cancer, except: adequately treated non-melanoma skin cancer, curatively treated in-situ cancer of the cervix, breast Ductal Carcinoma in Situ (DCIS), stage 1 grade 1 endometrial carcinoma.
  • Specific treatable CUP syndromes including: extragonadal germ cell syndrome; neuroendocrine carcinoma; adenocarcinoma isolated to axillary lymph nodes (women cancer); peritoneal carcinomatosis (women - ovarian cancer); squamous carcinoma limited to cervical, supraclavicular, or inguinal lymph nodes; single resectable .
  • Patients receiving any radiotherapy (except for palliative reasons), within 2 weeks from the last dose prior to study entry.
  • Patients with symptomatic uncontrolled .
  • Major surgery within 2 weeks of starting the study and patients must have recovered from any effects of any major surgery.
  • Patients considered a poor medical risk due to a serious, uncontrolled medical disorder, non-malignant systemic disease or active, uncontrolled infection. Examples include, but are not limited to, uncontrolled ventricular arrhythmia, recent (within 6 months) myocardial infarction, uncontrolled major seizure disorder, unstable spinal cord compression, superior vena cava syndrome, or any psychiatric disorder that prohibits obtaining .
  • Pregnant or breast feeding women.
  • patients, eg, patients who are known to be serologically positive for (HIV).
  • Patients with known hepatic disease (eg, or C).
  • Previous cancer treatment.
  • Patients currently enrolled in another clinical tria, except AGNOSTOS PROFILING.
  • Patients that are receiving chemotherapy, hormonal therapy (HRT is acceptable) or other novel agents.
  • Patients receiving live virus and bacterial vaccines.
Terms in these criteria, in plain language(13)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Measurable disease

The amount of disease can be tracked with a defined measurement, so the study can see whether it shrinks or grows. It might be a tumour measured on a scan or, in some blood cancers such as myeloma, a marker measured in blood or urine.

The criteria or the study team say which measurement counts — having no tumour visible on a scan does not by itself rule you out.

RECIST

The standard rules for measuring tumours on CT or MRI scans, to tell whether a cancer is shrinking, stable or growing during treatment.

“Measurable disease per RECIST 1.1” usually means at least one tumour 10 mm or more at its longest on a CT scan, or a lymph node 15 mm or more across its short axis.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Postmenopausal

Periods have stopped for good: usually no period for 12 months in a row without another medical reason, sometimes confirmed by a blood test (FSH).

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

Brain metastases

Cancer deposits in the brain from a cancer that started elsewhere in the body (CNS metastases include the spinal cord).

Studies differ: some leave out any brain metastases, some accept ones treated and stable for some weeks. Check what this study allows.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
57 participants (actual)

Study arms

  • Experimental
    Arm A

    nab-paclitaxel 125 mg/m2 on Days 1 and 8 by IV administration over 30 minutes without premedication, followed by gemcitabine 1000 mg/m2 on Days 1 and 8 by IV administration over 30 minutes. Treatment to be repeated Q21 days.

    Drug: nab-paclitaxel · Drug: Gemcitabine

  • Experimental
    Arm B

    nab-paclitaxel 125 mg/m2 on Days 1 and 8 by IV administration over 30 minutes without premedication, followed by carboplatin AUC 2 on Day 1 and 8 by IV administration over 60 minutes. Treatment to be repeated Q21 days.

    Drug: nab-paclitaxel · Drug: Carboplatin

Interventions

06

What researchers measure

Primary outcomes

  1. Objective response rate (ORR) as evaluated according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 guidelines.

    Time frame: 42 months

Secondary outcomes

  1. duration of response according to RECIST version 1.1.

    Time frame: 42 months

  2. time to progression

    Time frame: 42 months

  3. overall survival

    Time frame: 42 months

  4. toxicity according to Common Terminology Criteria for Adverse Events - CTCAE version 4.03.

    Time frame: 42 months

07

Study locations

10 sites
  • Investigative Clinical Oncology (Oncologia Medica 2)
    Candiolo, Turin 10060, Italy
  • AOU Policlinoco S Orsola - Malpighi
    Bologna, Italy
  • Ospedali Galliera
    Genova, Italy
  • Istituto Europeo di Oncologia - IEO
    Milano, Italy
  • Istituto Nazionale dei Tumori
    Milano, Italy
  • Ospedale Niguarda Cà Granda
    Milano, Italy
  • Istituto Oncologico Veneto - IOV
    Padova, Italy
  • Fondazione IRCCS Policlinico San Matteo
    Pavia, Italy
  • Policlinico Universitario Campus Biomedico
    Roma, Italy
  • A.O.U S.Giovanni Battista
    Torino, 10126, Italy
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jan 26, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT02607202
Lead sponsor
Fondazione del Piemonte per l'Oncologia
Responsible party
Sponsor
First posted
Nov 17, 2015
Start date
Mar 2015
Primary completion
May 4, 2021
Completion
Jan 31, 2022
Last update
Jan 26, 2024

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Jan 2024. You cannot join it, but the record below documents what was studied.

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