Dose finding study for CRLX301 in solid tumors
Phase 1/2a Dose-Escalation Study of CRLX301 in Patients with Advanced Solid Tumor Malignancies
BlueLink Pharmaceuticals a subsidiary of NewLink Genetics
118 participants
Dec 16, 2014
Interventional
Conditions
Summary
The purpose of this study is to determine the highest dose of a new drug known as CRLX301 that can safely be given to patients with advanced solid tumours. Who is it for? You may be eligible to join this study if you are aged 18 years or above, and have a confirmed diagnosis of advanced solid tumor malignancy that is refractory (i.e. has not responded to treatment), or not a candidate for standard therapy. Study details All participants in this study will be treated with the study drug, CRLX301, which is administered intravenously (i.e. directly into the vein). CRLX301 is a combination of a chemotherapy drug called "docetaxel" and a polymer (group of the same molecules bound together). The docetaxel is attached to the polymer and forms into tiny beads called nanoparticles. The nanoparticles circulate in the blood stream and may eventually build up in tumours, allowing more of the chemotherapy drug, docetaxel, to get into tumour cells and kill them. The CRLX301 nanoparticle with docetaxel inside is larger than docetaxel alone. Therefore, it is hoped that less of it may enter normal healthy cells, so that normal healthy cells are not harmed. The study has 2 parts. In the first part of the study (Part 1) participant groups will receive increasing doses of CRLX301 once every 3-weeks or once a week schedule if tolerated. If the dose causes significant side effects that are intolerable for patients, then no additional patients will be enrolled at a higher dose. In the second part of the study (Part 2), participants will receive the highest dose of CRLX301 which is not expected to cause significant side effects that would require stopping the dosing of study drug. Participation in the study will require frequent clinic visits (at least weekly), to assess participants’ health and monitor side effects. Some visits may take up to 8 hours. Most other visits will last 2 - 3 hours depending on procedures required. These may be include: blood and urine sampling; physical examination; vital signs; medical history, performance status, concomitant medications and adverse events (AE) assessment; CT and bone scans; ECG; and tumour biopsy (second part of study only). After receiving CRLX301, additional blood samples will be required for some participants at 1 and 3 days; and 1 and possibly 2 weeks. Participants will continue to receive CRLX301 once every 3-weeks or weekly, unless they experience adverse events, in which case their CRLX301 may be delayed/given at a lower dose, or they may stop CRLX301. If participants experience unacceptable toxicity or disease progression, CRLX301 will be stopped and the participant will return for a safety follow up visit. It is hoped that CRLX301 can be used to treat people with more chemotherapy in the tumour and with fewer effects on normal cells than with docetaxel alone.
Eligibility
Inclusion Criteria17
- Male or female adult patients older than or equal to 18 years of age
- Diagnosis of histologically or cytologically confirmed, advanced solid tumour malignancy:
- a) For Phase 1: that is refractory to standard therapy and/or for whom no further standard therapy is available, especially for those for whom taxane chemotherapy may be a reasonable therapeutic choice, in the opinion of the Investigator.
- b) For Phase 2a: advanced/metastatic tumours considered responsive to taxanes
- c) For prostate cancer patients in Phase 2a: that is castration resistant prostate cancer (CRPC*) and has not been previously treated with taxanes but has been treated with abiraterone and/or enzalutamide.
- For patients enrolled in Phase 2a only: at least one measurable target lesion as defined by RECIST 1.1 criteria for solid tumours, except for patients with advanced prostate cancer (in which case as per the PCWG2 criteria). Tumours within a previously irradiated field should be designated as “non-target” unless progression is documented or a biopsy is obtained to confirm persistence at least 90 days following completion of radiation therapy.
- If Patient has received:
- a) approved chemotherapy or small molecule targeted therapy; it has been at least 2 weeks since last dose before CRLX301 first dose.
- b) investigational therapy; it has been more than 30 days before first dose
- c) local palliative radiation; it has been more than 14 days prior to first dose
- d) radiation or invasive surgery requiring general anesthesia; it has been more than 30 days prior to first dose
- e) chemotherapy with nitrosoureas or mitomycin C; it has been more than 45 days before first dose
- ECOG Performance Status of 0 or 1
- Life expectancy in opinion of Investigator of more than 12 weeks
- Patients with acceptable pre-study hematology and biochemistry labs less than 72 hours prior to first dose
- Fertile males or females of childbearing potential agree to use adequate contraception prior to study entry and for 30 days following last dose of study drug
- Negative urine pregnancy test less than 72 hours prior to first dose (women of childbearing potential Only)
Exclusion Criteria26
- Uncontrolled grade 2 or greater toxicity except alopecia related to any prior treatment (i.e. chemotherapy, targeted therapy, radiation or surgery) within 7 days prior to first dose unless approved by the Medical Monitor
- Prolongation of QT/QTc interval
- Women who are pregnant or nursing
- Any known HIV infection or AIDS or any concurrent infection requiring IV antibiotics
- Any chronic or concurrent acute liver disease, including viral hepatitis
- Primary brain malignant tumors
- Known metastases to the brain
- Uncontrolled hypertension more than 150/100 mmHg
- Concurrent participation in any other investigational study, unless non-interventional study and approved by Sponsor
- Concurrent treatment with anticoagulation medication, except low molecular weight heparin, and approved by Sponsor
- History of stroke, deep venous thrombosis (DVT), or transient ischemic attack (TIA), within 6 months prior to first dose
- History of other cancer type, except for cutaneous basal cell or squamous cell carcinoma, or cervical in situ or very low/low risk prostate cancer, within the last 2 years prior to first dose.
- Uncontrolled concurrent disease or illness including but not limited to:
- a. symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia
- b. unstable or untreated cardiac conditions or ejection fraction of less than 50% as determined by echocardiogram (ECHO) or multiple gated acquisition scan (MUGA)
- c. diabetes mellitus
- d. coagulation disorder
- e. psychiatric illness that would limit compliance with study requirements, as determined by the Investigator
- History of severe hypersensitivity reaction to taxanes.
- For Phase 2a Stage 2: treatment with a taxane within 6 months of first dose; advanced prostate cancer patients must be taxane-naive
- Peripheral neuropathy
- Other severe, acute, or chronic medical or psychiatric condition or laboratory
- abnormality that may increase the risk associated with study participation or study
- drug administration or that may interfere with the interpretation of study results and,
- in the judgment of the investigator, would make the patient inappropriate for the
- study.
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Interventions
All participants will receive an intravenous infusion of CRLX301 once every 3 weeks or once a week. The dosage of CRLX301 will be dependent on the cohort to which the participant is recruited. In Phase I, participants will be recruited to dose escalation cohorts in a step wise manner at increasing doses of CRLX301 until MTD (maximum tolerated dose). Provisional doses are: Schedule 1 (once every 3 weeks dosing) Cohort 1: 7.5 mg/m2 Cohort 2: 15 mg/m2 Cohort 3: 30* mg/m2 Cohort 4: 45* mg/m2 Cohort 5: 60 mg/m2 Cohort 6: 75 mg/m2 Cohort 7: 90 mg/m2 Cohort 8: 105 mg/m2 Cohort 9: 120 mg/m2 Cohort 10 (plus additional cohorts): 135 mg/m2 (increase dose levels by 15 mg/m2 for additional cohorts) *The Safety Review Committee (SRC) is allowed to dose escalate from 30 mg/m2 to as high as 60 mg/m2. Schedule 2 (once a week dosing) Cohort -1: 20 mg/m2 Cohort 1: 25 mg/m2 Cohort 2: 30 mg/m2 Cohort 3: 35 mg/m2 Cohort 4: 40 mg/m2 Cohort 5: 45 mg/m2 Cohort 6: 50 mg/m2 Additional cohorts: increase dose levels by 5 mg/m2 for additional cohorts or as recommended by SRC In Phase 2a, all subjects will be treated at the dose determined in Phase 1 and cohort recruitment will be dependent on tumor type. Treatment continues until progression of disease, dose limiting toxicity, or other protocol specified reason for study discontinuation.
Locations(4)
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ACTRN12614001292662