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A Phase II Trial of COL-3 in Patients With HIV Related Kaposi's Sarcoma

Primary Purpose

AIDS-related Kaposi Sarcoma, HIV Infection

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
incyclinide
incyclinide
laboratory biomarker analysis
Sponsored by
National Cancer Institute (NCI)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for AIDS-related Kaposi Sarcoma

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Biopsy proven KS involving the skin , lymph nodes, oral cavity, gastrointestinal (GI) tract and/or lungs; GI and pulmonary involvement must be asymptomatic or minimally symptomatic and not require systemic cytotoxic therapy; at least five measurable, previously non-radiated, cutaneous lesions must be present which can be used as indicator lesions Serologic documentation of HIV infection at any time prior to study entry, as evidenced by positive ELISA, positive Western Blot, or other federally approved licensed HIV test Karnofsky performance status >= 60% Hemoglobin >= 8.0 gm/dl Absolute neutrophil count >= 750 cells/mm^3 Platelet count >= 75,000/mm^3 Serum creatinine =< 1.5 mg/dl or a measured creatinine clearance of > 60 ml/min Total bilirubin should be normal; if, however, the elevated bilirubin is felt to be secondary to indinavir therapy, then subjects will be allowed on protocol if bilirubin < 3.5 mg/dl, provided that the direct bilirubin is normal AST (SGOT) and ALT (SGPT) =< 2.5 times the ULN PT and PTT < 120% of normal Life expectancy of 3 months or more Ability and willingness to give informed consent All women of childbearing potential must have a negative serum beta HCG within 72 hours prior to study entry and must practice adequate birth control to prevent pregnancy while receiving study treatment and for 3 months after treatment is discontinued; all males of child fathering potential must also practice adequate birth control; pregnant or breast feeding females are excluded from participation in this study since the effects of Col-3 on an unborn or young child are unknown and may potentially be toxic Subjects must, in the opinion of the investigator, be capable of complying with this protocol Exclusion Criteria: Concurrent active opportunistic infection (OI) Concurrent neoplasia requiring cytotoxic therapy Acute treatment for an infection or other serious medical illness within 14 days prior to study entry Prior anti-neoplastic treatment for KS within 3 weeks of study entry; patients must also have completely recovered from any associated toxicity Previous local therapy of any KS indicator lesion within 60 days, unless the lesion has progressed since treatment; because of the possibility of tattooing and the difficulty in ascertaining clinically what is active KS versus residual pigment post treatment, any prior local treatment to the indicator lesions regardless of the elapsed time should not be allowed unless there is evidence of clear-cut progression of said lesion Anti-retroviral therapy is permitted but not required; if patients are taking anti-retroviral therapy, their regimen must not have changed within 4 weeks of starting the study medication; patient should be receiving an optimal and stable regimen of HAART for a minimum of 4 weeks prior to entry Subjects must not have received blood products within 4 weeks of study entry and must not have received granulocyte colony stimulating factor or erythropoietin within 2 weeks of study entry Evidence of a prior MI or cardiac ischemia

Sites / Locations

  • AIDS - Associated Malignancies Clinical Trials Consortium

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Arm I (low dose incyclinide)

Arm II (high dose incyclinide)

Arm Description

Patients receive low-dose oral COL-3 once daily. Treatment on both arms continues in the absence of disease progression or unacceptable toxicity. Quality of life is assessed.

Patients receive high-dose oral COL-3 once daily. Treatment on both arms continues in the absence of disease progression or unacceptable toxicity. Quality of life is assessed.

Outcomes

Primary Outcome Measures

Overall response rate
Binomial proportions and their 95% confidence intervals will be used to estimate the overall response rate for each treatment group.
Response duration
The Kaplan-Meier Method will be used to estimate the distribution of response duration for each treatment group.

Secondary Outcome Measures

Frequency of adverse events and their severity
Will be tabulated to evaluate tolerance of each dose level in the treatment of AIDS-related Kaposi's Sarcoma.
Time to response
The Kaplan-Meier Method will be used to estimate the distribution of time to response for each treatment group.
Quality of life
Individual composite scores will be constructed. Repeated measures and an analysis of variance will be performed on the composite scores to evaluate changes with time. Mixed models will be applied to the analysis of the composite score.
Relationship between clinical response and quantitative measures of KSHV/HHV8 and HIV viral load
These measures will be tested to determine if they are normally distributed. If the data are non-normal, the data will be transformed for analysis purposes. The logistic regression model will be used to assess the relationship between qualification of baseline levels of KSHV/HHV-8, HIV viral load and response. The proportional hazards model will be used to evaluate the relationship between the qualification of baseline KSHV/HHV8 and HIV viral load and time to progression, and response duration.

Full Information

First Posted
July 11, 2001
Last Updated
October 17, 2018
Sponsor
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00020683
Brief Title
A Phase II Trial of COL-3 in Patients With HIV Related Kaposi's Sarcoma
Official Title
A Phase II Trial of COL-3 in Patients With HIV Related Kaposi's Sarcoma
Study Type
Interventional

2. Study Status

Record Verification Date
October 2018
Overall Recruitment Status
Terminated
Why Stopped
Cancer Therapy Evaluation Program's (CTEP's) termination of drug supply
Study Start Date
March 2003 (Actual)
Primary Completion Date
November 2005 (Actual)
Study Completion Date
November 2009 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
COL-3 may stop the growth of cancer by stopping blood flow to the tumor. Randomized phase II trial to compare the effectiveness of two different regimens of COL-3 in treating patients who have HIV-related Kaposi's sarcoma.
Detailed Description
PRIMARY OBJECTIVES: I. To evaluate the tumor response rate and response duration of treatment with Col-3 at two different dose levels- 50 mg/day and 100 mg/day in subjects with HIV related KS. II. To evaluate the biologic activity of Col-3 by measuring percent apoptotic cells on tumor biopsies pre- and post-treatment. III. To evaluate the effect of Col-3 on serum levels of MMP-2 and MMP-9. SECONDARY OBJECTIVES: I. To determine the safety and toxicity of Col-3 at two different dose levels in HIV related KS. II. To evaluate the effect of Col-3 on overall quality of life. III. To evaluate the relationship between clinical response and quantitative measures of KSHV/HHV-8 and HIV viral load. OUTLINE: This is a randomized, open-label, multicenter study. Patients are randomized to 1 of 2 treatment arms. Arm I: Patients receive low-dose oral COL-3 once daily. Arm II: Patients receive high-dose oral COL-3 once daily. Treatment on both arms continues in the absence of disease progression or unacceptable toxicity. Quality of life is assessed. Patients are followed for at least 1 month. PROJECTED ACCRUAL: A total of 70 patients (35 per treatment arm) will be accrued for this study within 1.75 years.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
AIDS-related Kaposi Sarcoma, HIV Infection

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
70 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Arm I (low dose incyclinide)
Arm Type
Experimental
Arm Description
Patients receive low-dose oral COL-3 once daily. Treatment on both arms continues in the absence of disease progression or unacceptable toxicity. Quality of life is assessed.
Arm Title
Arm II (high dose incyclinide)
Arm Type
Experimental
Arm Description
Patients receive high-dose oral COL-3 once daily. Treatment on both arms continues in the absence of disease progression or unacceptable toxicity. Quality of life is assessed.
Intervention Type
Drug
Intervention Name(s)
incyclinide
Intervention Description
High dose given orally
Intervention Type
Drug
Intervention Name(s)
incyclinide
Intervention Description
Low dose given orally
Intervention Type
Other
Intervention Name(s)
laboratory biomarker analysis
Intervention Description
Correlative studies
Primary Outcome Measure Information:
Title
Overall response rate
Description
Binomial proportions and their 95% confidence intervals will be used to estimate the overall response rate for each treatment group.
Time Frame
Up to 6 years
Title
Response duration
Description
The Kaplan-Meier Method will be used to estimate the distribution of response duration for each treatment group.
Time Frame
Up to 6 years
Secondary Outcome Measure Information:
Title
Frequency of adverse events and their severity
Description
Will be tabulated to evaluate tolerance of each dose level in the treatment of AIDS-related Kaposi's Sarcoma.
Time Frame
Up to 6 years
Title
Time to response
Description
The Kaplan-Meier Method will be used to estimate the distribution of time to response for each treatment group.
Time Frame
Up to 6 years
Title
Quality of life
Description
Individual composite scores will be constructed. Repeated measures and an analysis of variance will be performed on the composite scores to evaluate changes with time. Mixed models will be applied to the analysis of the composite score.
Time Frame
Up to 6 years
Title
Relationship between clinical response and quantitative measures of KSHV/HHV8 and HIV viral load
Description
These measures will be tested to determine if they are normally distributed. If the data are non-normal, the data will be transformed for analysis purposes. The logistic regression model will be used to assess the relationship between qualification of baseline levels of KSHV/HHV-8, HIV viral load and response. The proportional hazards model will be used to evaluate the relationship between the qualification of baseline KSHV/HHV8 and HIV viral load and time to progression, and response duration.
Time Frame
Up to 6 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Biopsy proven KS involving the skin , lymph nodes, oral cavity, gastrointestinal (GI) tract and/or lungs; GI and pulmonary involvement must be asymptomatic or minimally symptomatic and not require systemic cytotoxic therapy; at least five measurable, previously non-radiated, cutaneous lesions must be present which can be used as indicator lesions Serologic documentation of HIV infection at any time prior to study entry, as evidenced by positive ELISA, positive Western Blot, or other federally approved licensed HIV test Karnofsky performance status >= 60% Hemoglobin >= 8.0 gm/dl Absolute neutrophil count >= 750 cells/mm^3 Platelet count >= 75,000/mm^3 Serum creatinine =< 1.5 mg/dl or a measured creatinine clearance of > 60 ml/min Total bilirubin should be normal; if, however, the elevated bilirubin is felt to be secondary to indinavir therapy, then subjects will be allowed on protocol if bilirubin < 3.5 mg/dl, provided that the direct bilirubin is normal AST (SGOT) and ALT (SGPT) =< 2.5 times the ULN PT and PTT < 120% of normal Life expectancy of 3 months or more Ability and willingness to give informed consent All women of childbearing potential must have a negative serum beta HCG within 72 hours prior to study entry and must practice adequate birth control to prevent pregnancy while receiving study treatment and for 3 months after treatment is discontinued; all males of child fathering potential must also practice adequate birth control; pregnant or breast feeding females are excluded from participation in this study since the effects of Col-3 on an unborn or young child are unknown and may potentially be toxic Subjects must, in the opinion of the investigator, be capable of complying with this protocol Exclusion Criteria: Concurrent active opportunistic infection (OI) Concurrent neoplasia requiring cytotoxic therapy Acute treatment for an infection or other serious medical illness within 14 days prior to study entry Prior anti-neoplastic treatment for KS within 3 weeks of study entry; patients must also have completely recovered from any associated toxicity Previous local therapy of any KS indicator lesion within 60 days, unless the lesion has progressed since treatment; because of the possibility of tattooing and the difficulty in ascertaining clinically what is active KS versus residual pigment post treatment, any prior local treatment to the indicator lesions regardless of the elapsed time should not be allowed unless there is evidence of clear-cut progression of said lesion Anti-retroviral therapy is permitted but not required; if patients are taking anti-retroviral therapy, their regimen must not have changed within 4 weeks of starting the study medication; patient should be receiving an optimal and stable regimen of HAART for a minimum of 4 weeks prior to entry Subjects must not have received blood products within 4 weeks of study entry and must not have received granulocyte colony stimulating factor or erythropoietin within 2 weeks of study entry Evidence of a prior MI or cardiac ischemia
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Bruce Dezube
Organizational Affiliation
AIDS Associated Malignancies Clinical Trials Consortium
Official's Role
Principal Investigator
Facility Information:
Facility Name
AIDS - Associated Malignancies Clinical Trials Consortium
City
Rockville
State/Province
Maryland
ZIP/Postal Code
20850
Country
United States

12. IPD Sharing Statement

Learn more about this trial

A Phase II Trial of COL-3 in Patients With HIV Related Kaposi's Sarcoma

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