Dose Escalation Study of I-131-CLR1404 in Subjects With Cancer That Does Not Respond to Treatment or Has Returned
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Purpose
The purpose of this study is to determine the recommended dose of I-131-CLR1404, a radiolabeled therapy compound, for treating subjects with cancer that does not respond to treatment or has returned. The identified recommended dose in this study will be used as the optimal dose of I-131-CLR1404 in subsequent clinical trials conducted for later phase clinical development.
Subjects who meet study entry criteria will receive I-131-CLR1404. For each subject, the study will be conducted in two phases, dosimetric and therapy. In the dosimetric phase, subjects will receive one 5 mCi dose of the study drug and undergo whole body imaging on on the day of infusion and on post-infusion days 1, 2, 3, and 6 for assessment of biodistribution of I-131-CLR1404. If normal and expected biodistribution are demonstrated, the subject will begin the therapy phase. In the therapy phase, the first cohort of subjects will receive a dose of 12.5 mCi/m2. Dose escalation in subsequent cohorts will initially be in increments of 12.5 mCi/m2. Subjects will be followed and observed for unacceptable toxicity through 56 days after the therapy dose infusion with follow-up for up to one year.
All subjects will be prescribed thyroid protection medication to be taken 24 hours prior to injection of the dosimetric dose, and continuing for 14 days after the administration of the therapy dose.
| Condition | Intervention | Phase |
|---|---|---|
|
Cancer |
Drug: I-131-CLR1404 |
Phase 1 |
| Study Type: | Interventional |
| Study Design: | Endpoint Classification: Safety Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Phase 1, Multi-Center, Open-Label, Dose Escalation Study of I-131-CLR1404 in Subjects With Relapsed or Refractory Advanced Solid Malignancies |
- Determination of the recommended dose of I-131-CLR1404 in treating subjects with relapsed or refractory advanced solid malignancies [ Time Frame: Until non-tolerated dose is defined; dose escalation descision made upon review of data from a complete cohort (56 days after all subjects in cohort have received therapy infusion) ] [ Designated as safety issue: Yes ]Largest administered dose with at most a 20% dose limiting toxicity rate
- Expansion of the safety profile of I-131-CLR1404 [ Time Frame: Pre-infusion and 6 days after dosimetry infusion; weekly until 56 days after therapy infusion and then monthly for one year ] [ Designated as safety issue: Yes ]Assesment by physical examination, vital signs, ECG, laboratory changes over time, and adverse events
- Expansion of the pharmacokinetic profile of I-131-CLR1404 [ Time Frame: Pre-infusion and 144 hours post-dosimetry infusion; pre-infusion, 5, 15, 60 minutes, 5, 24, 72 hours, 6, 14, 21, 28, 35, 42, 49 and 56 days post-therapy infusion ] [ Designated as safety issue: No ]
Determination of the following pharmacokinetic parameters of I-131-CLR1404:
- Area under the plasma concentration versus time curve (AUC)
- Maximum (peak) plasma concentration (Cmax)
- Time required to reduce the plasma concentration to one half its initial value (t1/2)
- Volume of distribution (Vd)
- Clearance of the drug from plasma (Cl)
- Preliminary antitumor activity of I-131-CLR1404 [ Time Frame: Baseline at screening, 56 days post-therapy infusion, every 2 months in follow-up period up to one year ] [ Designated as safety issue: No ]CT imaging (response and progression will be evaluated using RECIST 1.1) and tumor marker evaluation in subjects with applicable tumors (performed at screening, 28 and 56 days post-therapy infusion)
- Tumor dosimetry of I-131-CLR1404 in a subset of subjects with non-hepatic lesions measuring at least 2 cm in one dimension [ Time Frame: 72 hours, 6, 14, and 21 days post-therapy infusion ] [ Designated as safety issue: No ]SPECT or SPECT/CT
| Estimated Enrollment: | 24 |
| Study Start Date: | December 2011 |
| Estimated Study Completion Date: | December 2014 |
| Estimated Primary Completion Date: | December 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Single Group |
Drug: I-131-CLR1404
Description:
Other Name: 18-(p-[I-131]-iodophenyl)octadecyl phosphocholine
|
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Relapsed or refractory advanced solid malignancy or choice not to pursue standard treatment. Tumor types allowed: non-small cell lung, triple negative breast, soft tissue sarcoma, colorectal, gastric, esophageal, prostate, ovarian cancer
- At least one lesion that qualifies as a "target lesion" based on RECIST 1.1
- Ambulatory with ECOG performance status of 0 to 2 and an estimated life expectancy of at least 4 months
- 18 years of age or older
- Judged by Investigator to have initiative and means to be compliant with protocol and within geographical proximity to make required study visits
- Ability to read, understand and provide written informed consent for initiation of any study related procedures (subject or legal representative)
- Brain metastasis are acceptable if clinical condition has been stable for at least 1 month. Subjects with brain metastasis who require steroids must have been on a stable or tapering dose of corticosteroids for at least 1 month prior to enrollment
- Negative serum pregnancy test within 24 hours of enrollment (Female subjects of childbearing potential)
- Agreement to use an effective method of contraception (oral contraceptives, double-barrier methods such as condom and diaphragm, intrauterine device, Norplant, Depo-Provera) during the study and for 90 days following last dose of study drug
Exclusion Criteria:
- Subject or physician plans concomitant chemotherapy, therapeutic radiation and/or biological treatment for cancer including immunotherapy while on study. Localized palliative radiation therapy for bone pain is allowed during study period if clinically indicated. Ongoing hormonal therapy may be continued
- Received more than three previous cytotoxic chemotherapy regimens
- Received more than 25% of total bone marrow irradiated, total body or hemi-body irradiation or prior radioisotope therapy (except for benign thyroid disease)
- Diffuse lung disease or interstitial spread of carcinoma
- Prior radiation therapy or chemotherapy within 4 weeks of start of study
- Extradural tumor in contact with spinal cord or tumor located where swelling in response to therapy may impinge upon spinal cord
- Another active medical condition(s) or organ disease(s) that may compromise subject safety or interfere with safety and/or outcome evaluation of study drug
- Laboratory abnormalities, including but not limited to: WBC < 3000/uL, Absolute neutrophil count < 1500/uL, Platelets < 150,000/uL, Hemoglobin ≤ 9.0 gm/dL, Total bilirubin > 1.5 x upper limit of normal for age, SGOT or SGPT > 3 x upper limit of normal for age if no liver metastases or > 5 x upper limit of normal for age in the presence of liver metastases, Serum creatinine > 1.5 x upper limit of normal for age, INR ≥ 2.0, 2+ proteinuria or casts indicative of intrinsic renal disease
- Treatment with investigational drug, investigational biologic, or investigational therapeutic device within 28 days of initiating study treatment
- Received severely marrow toxic drugs (e.g. nitrosoureas, mitomycin)
- Received blood transfusions or hematopoietic growth factor therapy within 30 days of study start
- Received prior stem cell transplantation
- Clinically significant cardiac co-morbidities including congestive heart failure (New York Heart Association class III-IV heart disease), left ventricular ejection fraction < 40%, unstable angina pectoris, serious cardiac arrhythmia requiring medication or pacemaker, myocardial infarction within past 6 months
- Concurrent or recent (within 1 month) use of thrombolytic agents, or full-dose anticoagulants (except to maintain patency of preexisting, permanent indwelling IV catheters). Therapy with low-molecular weight heparin is acceptable as long as INR < 2.0
- Uncontrolled hypertension as defined by systolic blood pressure > 150 mm/Hg, diastolic blood pressure > 100 mm/Hg or uncontrolled diabetes that would compromise subject safety or interfere with safety and/or outcome evaluation of study drug
- Grade II-IV peripheral vascular disease or peripheral vascular surgery within past year
- Major surgery within 4 weeks of enrollment
- Poor venous access and unable to receive study drug into a peripheral venous catheter
- Significant traumatic injury within past 4 weeks
- Ongoing or active infection requiring antibiotics or with fever >38.1º C (>101º F) within 3 days of first scheduled day of dosing
- Receiving concurrent hemodialysis or peritoneal dialysis
- Known positive for HIV, Hepatitis C (active, previously treated or both), or is Hepatitis B core antigen positive
- Pregnant or lactating
- Hospitalized
Contacts and Locations| Contact: Jill Irwin | 608-327-8126 | jirwin@novelos.com |
| United States, California | |
| City of Hope National Medical Center | Recruiting |
| Duarte, California, United States, 91010 | |
| Principal Investigator: Joanne Mortimer, M.D., FACP | |
| United States, District of Columbia | |
| Georgetown University Hospital | Recruiting |
| Washington, DC, District of Columbia, United States, 20007-2113 | |
| Principal Investigator: Michael Pishvaian, M.D. | |
| United States, Wisconsin | |
| University of Wisconsin Hospital and Clinics | Recruiting |
| Madison, Wisconsin, United States, 53792 | |
| Principal Investigator: Glen Liu, M.D. | |
| Principal Investigator: | Glen Liu, M.D | University of Wisconsin, Madison |
More Information
No publications provided
| Responsible Party: | Novelos Therapeutics |
| ClinicalTrials.gov Identifier: | NCT01495663 History of Changes |
| Other Study ID Numbers: | DCL-10-001 |
| Study First Received: | December 16, 2011 |
| Last Updated: | January 25, 2013 |
| Health Authority: | United States: Food and Drug Administration |
Keywords provided by Novelos Therapeutics:
|
refractory relapsed non-small cell lung cancer triple-negative breast cancer soft tissue sarcoma |
colorectal cancer esophageal cancer prostate cancer ovarian cancer |
ClinicalTrials.gov processed this record on June 18, 2013