ClinicalTrials.gg
RecruitingNCT07787429DragonflyUpdated Oct 7, 2026

Evaluation of the Safety and Efficacy of Mifamurtide Versus Standard Treatment With Sorafenib in Patients With High-risk Osteosarcoma

A Phase 2 interventional study of Mifamurtide and Sorafenib in Osteosarcoma, sponsored by Anna Raciborska. Recruiting at 1 site in Poland. Open to participants aged 5 Months to 30 Years. Per ClinicalTrials.gov, last updated 2026-10-07.

Sponsored by Anna Raciborska · Phase 2, Interventional, and Treatment

From the registry’s dates

  • Registered 4 months after the study started (first participant enrolled Apr 2026, registered Aug 2026).
  • Started Apr 2026; still recruiting 7 months later.
Phase
Phase 2
Study type
Interventional
Enrollment
40
Allocation
Randomized
Ages
5 Months to 30 Years
Sex
All
01

Study summary

Prospective, open, interventional, randomized, non-commercial trial

Read the detailed description

The DRAGONFLY study includes:

  1. Perform molecular and immunohistochemical studies from tumor tissue from biopsy or archival material.
  2. Perform molecular tests from blood - ctDNA analysis (liquid biopsy).
  3. Assess the stage of progression by performing standard tests to evaluate the extent of the disease and the capacity of the various organs
  4. In patients classified in the high-risk group, modification of therapy. Patients will be randomly assigned in proportions (1:1) to the experimental (M) and standard (S) groups.

    The M (experimental) group will receive immunotherapy - mifamurtide along with standard conventional chemotherapy, and the S (standard) group will receive standard conventional treatment containing sorafenib.

  5. Correlate the results of the obtained genetic tests with clinical data (preliminary assessment of the impact of mutations on the clinical picture, course of treatment and prognosis).
  6. Comparison of the usefulness of molecular/immunohistochemical profile assessment as a prognostic factor with other recognized prognostic factors.
  7. Conduct a reanalysis of patients according to the intention-to-treat (ITT) principle.
02

Conditions studied

  • Osteosarcoma

Browse trials for

Keywords

  • Osteosarcoma
03

In context

Osteosarcoma

488 studies on the registry are indexed under Osteosarcoma; 124 are open to participants now.

This study's planned enrollment of 40 is close to the median of 40 across 354 interventional studies indexed under Osteosarcoma.

Browse Osteosarcoma studies →

Lead sponsor

Anna Raciborska is the lead sponsor of 5 studies on the registry; 2 are open to participants now.

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

04

Who can participate

Ages eligible
5 Months to 30 Years
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

Part I:

  1. Age ≥ 5 to ≤ 30 years at the time of qualification.
  2. Histopathologically confirmed osteosarcoma based on previous diagnostic tests.
  3. Provision of written, to participate in the study, including treatment with mifamurtide and sorafenib, in accordance with current legal regulations, prior to the initiation of any study procedures.

Part II:

  1. Participants of the Part I classified as high-risk.
  2. Expected survival of at least 12 weeks from the time of signing informed consent.
  3. Patient deemed capable of receiving systemic treatment.
  4. Patient able to swallow tablets.
  5. Disease in complete remission or stable disease per WHO criteria before randomization.
  6. Major surgery performed ≥ 2 weeks and radiotherapy ≥ 4 weeks before inclusion in the mifamurtide group.
  7. Recovery from adverse effects of prior surgery and/or radiotherapy.
  8. Signed informed consent to participate in the study (including mifamurtide and sorafenib treatment) in accordance with applicable legal regulations.
  9. Agreement to use effective throughout the study period and for at least one year after discontinuing treatment for patients of reproductive age.

Exclusion criteria

Exclusion Criteria:

  1. Failure to meet any of the inclusion criteria.
  2. Previous treatment with mifamurtide.
  3. to the drug or any of its components (including mifamurtide and sorafenib).
  4. Concurrent treatment with drugs that may interact with mifamurtide, sorafenib, or other cytostatics.
  5. Persistent toxicity from prior therapy that precludes treatment with mifamurtide or sorafenib.
  6. Significant cardiac conduction abnormalities, including a known family history of long syndrome or a corrected QT interval (QTc) > 480 ms.
  7. Symptoms of congestive heart failure or a \< 50%.
  8. Need or probable need for at doses > 10 mg of prednisone (or equivalent) daily or other drugs.
  9. Uncontrolled blood pressure.
  10. Arterial or venous thromboembolic events, such as stroke (including ), deep vein thrombosis, or pulmonary embolism within 6 months before the first administration of the investigational drug.
  11. Active or C or chronic hepatitis B or C requiring antiviral therapy.
  12. Any bleeding or hemorrhagic event ≥ v5 grade 3 within 4 weeks before the first administration of the investigational drug.
  13. Diagnosis of other prior to study entry.
  14. Pregnancy planning, current pregnancy, or breastfeeding.
  15. Other acute or persistent disorders, behaviors, or abnormal laboratory results that may increase the risk associated with participation in this clinical study or receiving the investigational drug, may impact study results interpretation, or, in the investigator's opinion, disqualify the patient from study participation
Terms in these criteria, in plain language(12)

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.

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.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

QT and QTc

On an ECG, the QT interval is the time the heart’s lower chambers take to activate electrically and recover in each beat. QTc is that time adjusted for heart rate (QTcF by Fridericia’s formula, QTcB by Bazett’s). Some medicines lengthen it, and a long QTc can raise the risk of a dangerous heart rhythm.

The study may name a correction formula and a limit in milliseconds, often around 450–480.

LVEF (left ventricular ejection fraction)

The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

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.

TIA (transient ischaemic attack)

A “mini-stroke”: temporary stroke-like symptoms caused by reduced blood flow to part of the brain, spinal cord or eye, without signs of a new stroke on a scan.

Stroke symptoms need emergency care at once, even if they go away.

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.

CTCAE grade

The US National Cancer Institute’s scale of how severe an adverse event is — any unwanted medical event during a study, such as a symptom, an illness or an abnormal test result, whether or not a treatment caused it. Whether it did is judged separately.

1
Mild.
2
Moderate.
3
Severe.
4
Life-threatening.
5
Death due to the event.

“Side effects of earlier treatment resolved to grade 1 or less” means they have settled to mild or gone.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

05

Study design

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

Study arms

  • Experimental
    Experimental

    The experimental group will receive immunotherapy-mifamurtide along with standard conventional chemotherapy.Treatment with mifamurtide will continue for no longer than 36 weeks or until disease progression (PD), patient death, unacceptable toxicities, or study closure. In these cases,the participant will end treatment in the clinical trial.

    Drug: Mifamurtide

  • Other
    Standard

    patients will receive standard conventional treatment containing sorafenib

    Drug: Sorafenib

Interventions

  • Mifamurtide is a synthetic analog of muramyl dipeptide, which works by stimulating the immune system to destroy cancer cells. The exact mechanism of this activation in humans is unknown. The MEPACT product is a liposomal form of mifamurtide specifically formulated to reach macrophages in vivo after administration by intravenous infusion.

    Also known as: Mepact

  • Sorafenib is a small-molecule, broad-spectrum tyrosine kinase inhibitor that slows cancer cell growth and reduces angiogenesis. Sorafenib is unique among new kinase inhibitors as it simultaneously inhibits the Raf, Mek, and Erk kinase pathways.

06

What researchers measure

Primary outcomes

  1. Event-Free Survival (EFS)

    EFS (Event-Free Survival) - the time from randomization to the first event, i.e., death, disease progression, or disease relapse, whichever occurs first. Assessment will be conducted from the date of randomization until the date of the event or the date of the last available assessment

    Time frame: 10,3 months

Secondary outcomes

  1. Overall Survival (OS)

    Defined as the time from randomization to death from any cause.

    Time frame: 5,5 years

  2. Progression-Free Survival (PFS)

    Defined as the time from randomization to documented disease progression or death as assessed by RECIST v1.1.

    Time frame: 5,5 years

  3. Overall Response Rate (ORR)

    Defined as the percentage of patients achieving the best overall response of Complete Response (CR) or Partial Response (PR) as assessed by RECIST v1.1.

    Time frame: 5,5 years

07

Study locations

1 of 1 sites recruiting
08

Timeline

1 registry update since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Apr 2026 (actual). Primary completion is estimated for Jul 2033, 87 months after the start.

Of 72 non-industry phase 2 interventional studies under Osteosarcoma, half reached primary completion within 66 months of starting (the median), counting those still running; a quarter within 41 and three quarters within 94. This study's planned 87 months is above that.

Counting every sponsor, half of 76 studies reached it within 65 months; a quarter within 40 and three quarters within 94.

How these figures are worked out, and which studies are left out of them.

Registered
Aug 19, 2026
First posted
Aug 26, 2026
StartActual
Apr 1, 2026
Primary completionEst.
Jul 31, 2033
CompletionEst.
Jul 31, 2033
Last update
Oct 7, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
Minor edits
Nothing that changes what the study is or who can join. Edited: verification date
1 update, last Oct 7, 2026
Show all 1 update
  1. Oct 7, 2026
    Minor edits only
    + 1 other change: verification date

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

09

Registry details

Key details

Study ID
NCT07787429
Lead sponsor
Anna Raciborska
Collaborators
Maria Sklodowska-Curie National Research Institute of Oncology
Responsible party
Anna Raciborska (Prof. Anna Raciborska, Institute of Mother and Child, Warsaw, Poland) — Sponsor-investigator
First posted
Aug 26, 2026
Start date
Apr 1, 2026
Primary completion
Jul 31, 2033 (estimated)
Completion
Jul 31, 2033 (estimated)
Last update
Oct 7, 2026

Study contacts

Anna Raciborska, Prof.
Contact
klinika.onkologii@imid.med.pl
+48 22 32 77 205
Beata Skarbek-Wolska
Contact
beata.wolska@imid.med.pl
+48 22 32 77 117

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drug tested here: Mifamurtide

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