Safety and Tolerability of AP 12009, Administered I.V. in Patients With Advanced Tumors Known to Overproduce TGF-beta-2
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Purpose
In this national Phase I dose-escalation study the safety and tolerability of AP 12009 is evaluated in adult patients with advanced tumors known to overproduce TGF-β2, who are not or no longer amenable to established therapies.
| Condition | Intervention | Phase |
|---|---|---|
|
Pancreatic Neoplasms Melanoma Colorectal Neoplasms |
Drug: AP 12009 |
Phase 1 |
| Study Type: | Interventional |
| Study Design: | Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | An Open-Label, Multicenter Dose-Escalation Study to Evaluate the Safety and Tolerability of AP 12009 (Trabedersen), Administered Intravenously in Patients With Advanced Tumors Known to Overproduce TGF-β2. |
- To determine the maximum tolerated dose (MTD) as well as the dose-limiting toxicity (DLT) of two cycles of AP 12009 administered intravenously at weekly intervals and for four days every other week. [ Designated as safety issue: Yes ]
- To determine the safety and tolerability of AP 12009 administered intravenously at weekly intervals and for four days every other week. [ Designated as safety issue: Yes ]
- To assess the plasma pharmacokinetic profile of AP 12009 administered intravenously at weekly intervals and for four days every other week. [ Designated as safety issue: Yes ]
- To establish a suitable determination method and to assess the urine pharmacokinetic profile of AP 12009 administered intravenously for four days every other week. [ Designated as safety issue: Yes ]
- To determine the effect of AP 12009 administered intravenously at weekly intervals and for four days every other week on TGF-β2 plasma concentration levels. [ Designated as safety issue: No ]
- To determine the potential antitumor activity of AP 12009 administered intravenously at weekly intervals and for four days every other week, as assessed by the effect on tumor size and tumor markers. [ Designated as safety issue: No ]
| Enrollment: | 62 |
| Study Start Date: | January 2005 |
| Study Completion Date: | November 2011 |
| Primary Completion Date: | November 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: AP 12009 |
Drug: AP 12009
Initial scheme: AP 12009 (trabedersen), dose escalation scheme, continuous intravenous infusion (7 days), every other week, up to 10 cycles. Modified scheme: AP 12009 (trabedersen), dose escalation scheme, continuous intravenous infusion (4 days), every other week, up to 10 cycles |
Detailed Description:
The purpose of this dose-finding study is to evaluate the safety and tolerability of AP 12009. Two fixed dose-escalation schemes with predefined steps and increasing increments have been selected to determine the maximum tolerated dose (MTD) as well as the dose-limiting toxicity (DLT). At least two cycles of AP 12009 are administered intravenously in adult patients with no further acknowledged treatment options.
AP 12009 (trabedersen) is a phosphorothioate antisense oligodeoxynucleotide specific for the mRNA of human Transforming Growth Factor beta 2 (TGF-beta-2). The growth factor TGF-beta plays a key role in malignant progression of various tumors by inducing proliferation, invasion, metastasis, angiogenesis, and escape from immunosurveillance. In patients with pancreatic cancer, colorectal cancer, and metastatic melanoma the TGF-beta-2 overexpression is associated with disease stage, clinical prognosis, and the immunodeficient state of the patients.
Eligibility| Ages Eligible for Study: | 18 Years to 75 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Written informed consent.
- Age: 18-75 years.
- Male or non-pregnant, non-lactating female.
a.Pancreatic cancer: Histologically or cytologically confirmed diagnosis, stage IVA or IVB (AJCC, 1997).
b. Melanoma: Histologically or cytologically confirmed diagnosis, stage III or IV (AJCC, UICC).
c. Colorectal cancer: Histologically or cytologically confirmed diagnosis, stage III or IV (AJCC, UICC), excluded from the last cohort.
- Patient is not or no longer amenable to established forms of therapy.
- At least one measurable lesion.
- Karnofsky performance status of at least 80%.
- Recovery from acute toxicity caused by any previous therapy.
Adequate organ function as assessed by the following laboratory values:
- Serum creatinine and urea < 2 times the upper limit of normal (ULN).
- ALT and AST < 3 ULN (in case of a liver metastasis: < 5x ULN); alkaline phosphatase < 3 ULN; and bilirubin < 2.5 mg/dL.
- Prothrombin time < 1.5 INR and PTT < 1.5 times the upper limit of normal.
- Hemoglobin > 9 g/dL.
- Platelets > 100 x 10E9/L.
- WBC > 3.0 x 10E9/L.
- Absolute Neutrophil Count (ANC) > 1.5 x 10E9/L.
Exclusion Criteria:
- Patient unable to comply with the protocol regulations.
- Pregnant or lactating female.
- Antitumor radiation therapy within 12 weeks, tumor surgery within 4 weeks or any other therapy with established antitumor effects within 2 weeks prior to study entry.
- The patient takes or is likely to need other prohibited concomitant medication. Administration of corticosteroids should be strictly avoided during the course of the study.
- Patient's participation in another clinical trial with investigational medication within 30 days prior to study entry.
- History of brain metastases. In the case of suspected brain metastases a CT scan of the skull will be performed (not mandatory in asymptomatic patients).
- Clinically significant cardiovascular abnormalities such as refractory hypertension, congestive heart failure, unstable angina, or poorly controlled arrhythmia, or a myocardial infarction within 6 months prior to treatment.
- Gastric or duodenal ulcers within 6 months before study entry or is at risk of gastrointestinal ulceration due to high consumption of NSAIDs.
- An active infection with HIV, HBV, or HCV.
- Clinically significant acute viral, bacterial, or fungal infection.
- Acute medical problems that may be considered to become an unacceptable risk, or any conditions that might be contraindications for starting study treatment.
- History of allergies to reagents used in this study.
- Drug abuse or extensive use of alcohol.
- Significant psychiatric disorders/ legal incapacity or limited legal capacity.
- History of Long QT Syndrome or QTc time ≥ 480 msec in screening/baseline ECGs. The average QTc time is to be calculated from three separate ECGs performed prior to start of infusion: two ECGs performed at Screening/Baseline (with a minimum 1-hour interval in between) and one performed within 1 hour prior to start of infusion.
Contacts and Locations| Germany | |
| Universitätsmedizin Berlin Charité | |
| Berlin, Germany, 10117 | |
| Universitätsklinik und Poliklinik für Innere Medizin I | |
| Halle (Saale), Germany, 06120 | |
| Hautklinik der Ruprecht-Karls-Universität Heidelberg | |
| Heidelberg, Germany, 69115 | |
| Universitätsklinikum Schleswig-Holstein | |
| Kiel, Germany, 24105 | |
| Krankenhaus rechts der Isar, II. Medizinische Klinik und Poliklinik | |
| München, Germany, 81675 | |
| Universität Münster, Klinik und Poliklinik für Hautkrankheiten | |
| Münster, Germany, 48149 | |
| Klinik und Poliklinik für Dermatologie | |
| Regensburg, Germany, 93053 | |
| Klinik und Poliklinik für Innere Medizin I | |
| Regensburg, Germany, 93042 | |
| Universitäts-Hautklinik, Sektion Dermatologische Onkologie | |
| Tübingen, Germany, 72076 | |
| Universitätsklinikum Ulm, Zentrum für Innere Medizin | |
| Ulm, Germany, 89081 | |
| Study Chair: | Helmut Oettle, MD | Charité Berlin Campus Virchow-Klinikum |
More Information
Additional Information:
No publications provided
| Responsible Party: | Antisense Pharma |
| ClinicalTrials.gov Identifier: | NCT00844064 History of Changes |
| Other Study ID Numbers: | AP 12009-P001 |
| Study First Received: | February 12, 2009 |
| Last Updated: | November 18, 2011 |
| Health Authority: | Germany: Federal Institute for Drugs and Medical Devices |
Keywords provided by Antisense Pharma:
|
Pancreatic cancer Metastatic melanoma Advanced tumor Targeted therapy |
Antisense Transforming Growth Factor beta 2 Dose escalation |
Additional relevant MeSH terms:
|
Neoplasms Colorectal Neoplasms Melanoma Pancreatic Neoplasms Intestinal Neoplasms Gastrointestinal Neoplasms Digestive System Neoplasms Neoplasms by Site Digestive System Diseases Gastrointestinal Diseases Colonic Diseases Intestinal Diseases Rectal Diseases |
Neuroendocrine Tumors Neuroectodermal Tumors Neoplasms, Germ Cell and Embryonal Neoplasms by Histologic Type Neoplasms, Nerve Tissue Nevi and Melanomas Endocrine Gland Neoplasms Pancreatic Diseases Endocrine System Diseases Trabedersen Antineoplastic Agents Therapeutic Uses Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 23, 2013