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Study of the Trifunctional Antibody Catumaxomab to Treat Recurrent Symptomatic Malignant Ascites

Primary Purpose

Malignant Ascites

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
catumaxomab
Sponsored by
Neovii Biotech
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Malignant Ascites focused on measuring Ascites, Epithelial Cancer, Epithelial Carcinoma, Epithelial Ovarian Cancer, Epithelial Ovarian Carcinoma, Fallopian Tube Cancer, Fallopian Tube Carcinoma, Malignant Ascites, Ovarian Cancer, Ovarian Carcinoma, Ovarian Epithelial Cancer, Ovarian Epithelial Carcinoma, Peritoneal Cancer, Peritoneal Carcinoma, Recurrent Ascites, Recurrent Malignant Ascites, Recurrent Symptomatic Malignant Ascites, Symptomatic Malignant Ascites, Symptomatic Ascites, Neoplasms, Glandular and Epithelial, Ovarian Neoplasms, Fallopian Tube Neoplasms, Peritoneal Neoplasms

Eligibility Criteria

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

Inclusion Criteria: Signed and dated informed consent Histologically confirmed diagnosis of epithelial ovarian cancer, peritoneal cancer, or fallopian tube cancer; any stage at diagnosis [International Federation of Gynecology and Obstetrics (FIGO) Stages I through IV]. Progression on or ≤ 12 months after primary platinum-based systemic or intraperitoneal (IP) chemotherapy OR relapse following reinduction ≥ 12 months after primary chemotherapy. Have refused, failed, or have been deemed not suitable candidates for gemcitabine or liposomal doxorubicin. Recurrent symptomatic malignant ascites requiring therapeutic paracentesis At least 1 therapeutic paracentesis within 4 weeks prior to baseline paracentesis Age ≥ 18 years Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2 Life expectancy ≥ 16 weeks Serum creatinine ≤ 1.5 x upper limit of normal (ULN) Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2.5 x ULN, and total bilirubin ≤ 1.5 x ULN Absolute neutrophil count (ANC) ≥ 1,500/mm3 and platelet count ≥ 75,000/mm3 Negative serum pregnancy test result at screening in women of childbearing potential (applies to patients without documented menopause or sterility). Willingness of patients of childbearing potential to use an effective contraceptive method (i.e., oral contraceptive, cervical cap, diaphragm with spermicide, condom with spermicide, or intrauterine device) during the study and for at least 6 months after the last infusion. Exclusion Criteria: Acute or chronic systemic infection Exposure to investigational drugs, chemotherapy or radiotherapy 21 days prior to the first dose of catumaxomab Major surgery 2 weeks prior to first dose Previous treatment with mouse or rat antibodies Known or suspected hypersensitivity to catumaxomab or other monoclonal antibodies Body mass index (BMI) < 19 (body weight after paracentesis to be used for calculation of BMI) Serum albumin level < 2.0 g/dL Reduced nutritional status requiring predominantly parenteral nutrition (> 50% of energy intake). Permanent naso-gastric (NG) feeding tube. Ileus in a location that precludes paracentesis Extensive liver metastases (> 70% organ volume comprises malignancy) Documented brain metastases History of myocardial infarction, congestive heart failure or relevant cardiac arrhythmia 3 months prior to the first dose of catumaxomab Portal vein obstruction or portal vein thrombosis diagnosed by computed tomography (CT) scan at screening Persistent massive pleural effusion or inadequate respiratory function of any other etiology (except if related to ascites symptoms) in the opinion of the investigator Any other condition which, according to the investigator, results in an undue risk to the patient by participating in the study Prior exposure to catumaxomab

Sites / Locations

  • University of Arizona Cancer Center
  • University of San Diego
  • Stanford University Hospital and Clinics
  • University of Miami
  • Florida Hospital Cancer Center
  • Northern Indiana Cancer Research Consortium
  • University of Louisville Cancer Center
  • Johns Hopkins Medical Institute
  • Dana Farber Cancer Institute
  • Massachusetts General Hospital
  • Wayne State University
  • Dartmouth-Hitchock Medical Center
  • Columbia University Cancer center
  • Wake-Forest University
  • University of Oklahoma Health Science Center
  • Magee Women's Hospital, University of Pittsburgh
  • The Methodist Hospital
  • Huntsman Cancer Institute

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Catumaxomab

Arm Description

Outcomes

Primary Outcome Measures

The Proportion of Patients Who Achieved at Least a 4-fold Increase of Puncture/Paracentesis-free Interval Following Catumaxomab Relative to Their Pre-treatment Interval.
The parameter to be estimated is the proportion of patients who achieve at least a 4-fold increase in their puncture/paracentesis-free interval. The pretreatment interval is defined as the length of time between the patient's most recent paracentesis (baseline) and the subsequent paracentesis necessitated by her increasing ascites-related symptoms. The post-treatment interval is defined as the time between the last dose of catumaxomab plus 1 day to the time of recurrence of ascites requiring therapeutic paracentesis or death, whichever occurred sooner.
Increase of Paracentesis/Puncture-free Interval (Ratio)
The parameter to be tested is the ratio of the post-treatment puncture/paracentesis-free interval divided by the pre-treatment puncture/paracentesis-free interval. The pre-treatment interval is defined as the length of time between the patient's most recent paracentesis (baseline) and the subsequent paracentesis necessitated by her increasing ascites-related symptoms. The post-treatment interval is defined as the time between the last dose of catumaxomab plus 1 day to the time of recurrence of ascites requiring therapeutic paracentesis or death, whichever occurred sooner.

Secondary Outcome Measures

Puncture/Paracentesis-free Survival (PuFS)
Puncture/Paracentesis-free Survival (PuFS), Defined as the Number of Days Between the Date of Last Dose and the Date of Documented End of Study (EoS) Paracentesis or Death, Whichever Occurred First
Overall Survival (OS)
Overall survival is defined as the interval from the date of first dose to the date of death.
Ascites Signs and Symptoms
Patient-reported ascites symptoms were to be assessed using the patient questionnaire, Functional Assessment of Chronic Illness Therapy - Ascites Index (FACIT-AI). At 6 months following catumaxomab administration, the patient was requested to assess the severity of the following parameters during the past week using a 5-point scale with scores from "0 = not at all" to "4 = very much": anorexia, insomnia, decreased mobility, dyspnea, nausea, vomiting, abdominal pain, abdominal distention, fatigue, early satiety, urinary frequency, constipation, and emotional distress. For the parameters anorexia, insomnia, and decreased mobility, high scores mean good response, for the other parameters low scores mean good response.
Ascites Volume
Ascites volume measurement were to be performed at screening (= prior to baseline), at baseline (= before start of therapy with catumaxomab) and during the 6-month follow-up period when the patient had recurrence of symptomatic ascites requiring therapeutic paracentesis. At each paracentesis, drainage to dryness was to be achieved and the exact volume was to be measured and documented.

Full Information

First Posted
May 15, 2006
Last Updated
September 18, 2018
Sponsor
Neovii Biotech
Collaborators
Fresenius Biotech North America
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1. Study Identification

Unique Protocol Identification Number
NCT00326885
Brief Title
Study of the Trifunctional Antibody Catumaxomab to Treat Recurrent Symptomatic Malignant Ascites
Official Title
A Single-Arm, Open-Label, Phase II Study to Assess the Safety and Efficacy of the Trifunctional Antibody Catumaxomab (Anti-EpCAM x Anti-CD3) Administered Intraperitoneally in Ovarian Cancer Patients With Recurrent Symptomatic Malignant Ascites
Study Type
Interventional

2. Study Status

Record Verification Date
September 2018
Overall Recruitment Status
Completed
Study Start Date
June 2006 (undefined)
Primary Completion Date
December 2009 (Actual)
Study Completion Date
August 2010 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Neovii Biotech
Collaborators
Fresenius Biotech North America

4. Oversight

5. Study Description

Brief Summary
The purpose of this study is to determine whether the investigational drug catumaxomab is a safe and effective treatment for recurrent symptomatic malignant ascites.
Detailed Description
A multi-center, phase II study of catumaxomab in ovarian cancer patients with recurrent symptomatic malignant ascites requiring therapeutic paracentesis. Each eligible patient will receive four ascending doses of catumaxomab, administered intraperitoneally via an indwelling catheter. Catumaxomab will be administered as a 3-hour constant rate infusion with a dosing interval of 3-4 days. Each patient will participate in this study for up to 7 months (includes the baseline therapeutic paracentesis and screening period, 11 to 21 days treatment period, and up to 180 days/6 months follow-up), with monthly post-study follow-up for the lifetime of the patient. Catumaxomab is a trifunctional antibody targeting EpCAM on tumor cells and CD3 on T cells. Trifunctional antibodies represent a new concept for targeted anticancer therapy. This new antibody class has the capability to redirect T cells and accessory cells (e.g. macrophages, dendritic cells (DCs) and natural killer (NK) cells) to the tumor site. According to preclinical data, trifunctional antibodies activate these different immune effector cells, which can trigger a complex anti-tumor immune response.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Malignant Ascites
Keywords
Ascites, Epithelial Cancer, Epithelial Carcinoma, Epithelial Ovarian Cancer, Epithelial Ovarian Carcinoma, Fallopian Tube Cancer, Fallopian Tube Carcinoma, Malignant Ascites, Ovarian Cancer, Ovarian Carcinoma, Ovarian Epithelial Cancer, Ovarian Epithelial Carcinoma, Peritoneal Cancer, Peritoneal Carcinoma, Recurrent Ascites, Recurrent Malignant Ascites, Recurrent Symptomatic Malignant Ascites, Symptomatic Malignant Ascites, Symptomatic Ascites, Neoplasms, Glandular and Epithelial, Ovarian Neoplasms, Fallopian Tube Neoplasms, Peritoneal Neoplasms

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
32 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Catumaxomab
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
catumaxomab
Intervention Description
Catumaxomab is administered intraperitoneally via an indwelling catheter (or port) as a 3-hour infusion 4 times (Days 0, 3, 7, and 10) in ascending doses (10 mcg, 20 mcg, 50 mcg, and 150 mcg, respectively).
Primary Outcome Measure Information:
Title
The Proportion of Patients Who Achieved at Least a 4-fold Increase of Puncture/Paracentesis-free Interval Following Catumaxomab Relative to Their Pre-treatment Interval.
Description
The parameter to be estimated is the proportion of patients who achieve at least a 4-fold increase in their puncture/paracentesis-free interval. The pretreatment interval is defined as the length of time between the patient's most recent paracentesis (baseline) and the subsequent paracentesis necessitated by her increasing ascites-related symptoms. The post-treatment interval is defined as the time between the last dose of catumaxomab plus 1 day to the time of recurrence of ascites requiring therapeutic paracentesis or death, whichever occurred sooner.
Time Frame
6 months
Title
Increase of Paracentesis/Puncture-free Interval (Ratio)
Description
The parameter to be tested is the ratio of the post-treatment puncture/paracentesis-free interval divided by the pre-treatment puncture/paracentesis-free interval. The pre-treatment interval is defined as the length of time between the patient's most recent paracentesis (baseline) and the subsequent paracentesis necessitated by her increasing ascites-related symptoms. The post-treatment interval is defined as the time between the last dose of catumaxomab plus 1 day to the time of recurrence of ascites requiring therapeutic paracentesis or death, whichever occurred sooner.
Time Frame
180 days
Secondary Outcome Measure Information:
Title
Puncture/Paracentesis-free Survival (PuFS)
Description
Puncture/Paracentesis-free Survival (PuFS), Defined as the Number of Days Between the Date of Last Dose and the Date of Documented End of Study (EoS) Paracentesis or Death, Whichever Occurred First
Time Frame
≥6 months
Title
Overall Survival (OS)
Description
Overall survival is defined as the interval from the date of first dose to the date of death.
Time Frame
≥ 6 months
Title
Ascites Signs and Symptoms
Description
Patient-reported ascites symptoms were to be assessed using the patient questionnaire, Functional Assessment of Chronic Illness Therapy - Ascites Index (FACIT-AI). At 6 months following catumaxomab administration, the patient was requested to assess the severity of the following parameters during the past week using a 5-point scale with scores from "0 = not at all" to "4 = very much": anorexia, insomnia, decreased mobility, dyspnea, nausea, vomiting, abdominal pain, abdominal distention, fatigue, early satiety, urinary frequency, constipation, and emotional distress. For the parameters anorexia, insomnia, and decreased mobility, high scores mean good response, for the other parameters low scores mean good response.
Time Frame
6 months
Title
Ascites Volume
Description
Ascites volume measurement were to be performed at screening (= prior to baseline), at baseline (= before start of therapy with catumaxomab) and during the 6-month follow-up period when the patient had recurrence of symptomatic ascites requiring therapeutic paracentesis. At each paracentesis, drainage to dryness was to be achieved and the exact volume was to be measured and documented.
Time Frame
6 months

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Signed and dated informed consent Histologically confirmed diagnosis of epithelial ovarian cancer, peritoneal cancer, or fallopian tube cancer; any stage at diagnosis [International Federation of Gynecology and Obstetrics (FIGO) Stages I through IV]. Progression on or ≤ 12 months after primary platinum-based systemic or intraperitoneal (IP) chemotherapy OR relapse following reinduction ≥ 12 months after primary chemotherapy. Have refused, failed, or have been deemed not suitable candidates for gemcitabine or liposomal doxorubicin. Recurrent symptomatic malignant ascites requiring therapeutic paracentesis At least 1 therapeutic paracentesis within 4 weeks prior to baseline paracentesis Age ≥ 18 years Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2 Life expectancy ≥ 16 weeks Serum creatinine ≤ 1.5 x upper limit of normal (ULN) Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2.5 x ULN, and total bilirubin ≤ 1.5 x ULN Absolute neutrophil count (ANC) ≥ 1,500/mm3 and platelet count ≥ 75,000/mm3 Negative serum pregnancy test result at screening in women of childbearing potential (applies to patients without documented menopause or sterility). Willingness of patients of childbearing potential to use an effective contraceptive method (i.e., oral contraceptive, cervical cap, diaphragm with spermicide, condom with spermicide, or intrauterine device) during the study and for at least 6 months after the last infusion. Exclusion Criteria: Acute or chronic systemic infection Exposure to investigational drugs, chemotherapy or radiotherapy 21 days prior to the first dose of catumaxomab Major surgery 2 weeks prior to first dose Previous treatment with mouse or rat antibodies Known or suspected hypersensitivity to catumaxomab or other monoclonal antibodies Body mass index (BMI) < 19 (body weight after paracentesis to be used for calculation of BMI) Serum albumin level < 2.0 g/dL Reduced nutritional status requiring predominantly parenteral nutrition (> 50% of energy intake). Permanent naso-gastric (NG) feeding tube. Ileus in a location that precludes paracentesis Extensive liver metastases (> 70% organ volume comprises malignancy) Documented brain metastases History of myocardial infarction, congestive heart failure or relevant cardiac arrhythmia 3 months prior to the first dose of catumaxomab Portal vein obstruction or portal vein thrombosis diagnosed by computed tomography (CT) scan at screening Persistent massive pleural effusion or inadequate respiratory function of any other etiology (except if related to ascites symptoms) in the opinion of the investigator Any other condition which, according to the investigator, results in an undue risk to the patient by participating in the study Prior exposure to catumaxomab
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jonathan Berek, MD MMSc
Organizational Affiliation
Stanford University Hospital and Clinics, Department of Obstetrics and Gynecology
Official's Role
Study Chair
Facility Information:
Facility Name
University of Arizona Cancer Center
City
Tucson
State/Province
Arizona
Country
United States
Facility Name
University of San Diego
City
La Jolla
State/Province
California
Country
United States
Facility Name
Stanford University Hospital and Clinics
City
Stanford
State/Province
California
Country
United States
Facility Name
University of Miami
City
Miami
State/Province
Florida
Country
United States
Facility Name
Florida Hospital Cancer Center
City
Orlando
State/Province
Florida
Country
United States
Facility Name
Northern Indiana Cancer Research Consortium
City
South Bend
State/Province
Indiana
Country
United States
Facility Name
University of Louisville Cancer Center
City
Louisville
State/Province
Kentucky
Country
United States
Facility Name
Johns Hopkins Medical Institute
City
Baltimore
State/Province
Maryland
Country
United States
Facility Name
Dana Farber Cancer Institute
City
Boston
State/Province
Massachusetts
Country
United States
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
Country
United States
Facility Name
Wayne State University
City
Detroit
State/Province
Michigan
Country
United States
Facility Name
Dartmouth-Hitchock Medical Center
City
Lebanon
State/Province
New Hampshire
Country
United States
Facility Name
Columbia University Cancer center
City
New York
State/Province
New York
Country
United States
Facility Name
Wake-Forest University
City
Winston-Salem
State/Province
North Carolina
Country
United States
Facility Name
University of Oklahoma Health Science Center
City
Oklahoma City
State/Province
Oklahoma
Country
United States
Facility Name
Magee Women's Hospital, University of Pittsburgh
City
Pittsburgh
State/Province
Pennsylvania
Country
United States
Facility Name
The Methodist Hospital
City
Houston
State/Province
Texas
Country
United States
Facility Name
Huntsman Cancer Institute
City
Salt Lake City
State/Province
Utah
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
15906359
Citation
Heiss MM, Strohlein MA, Jager M, Kimmig R, Burges A, Schoberth A, Jauch KW, Schildberg FW, Lindhofer H. Immunotherapy of malignant ascites with trifunctional antibodies. Int J Cancer. 2005 Nov 10;117(3):435-43. doi: 10.1002/ijc.21165.
Results Reference
background
PubMed Identifier
11588051
Citation
Ruf P, Lindhofer H. Induction of a long-lasting antitumor immunity by a trifunctional bispecific antibody. Blood. 2001 Oct 15;98(8):2526-34. doi: 10.1182/blood.v98.8.2526.
Results Reference
background
PubMed Identifier
11410615
Citation
Riesenberg R, Buchner A, Pohla H, Lindhofer H. Lysis of prostate carcinoma cells by trifunctional bispecific antibodies (alpha EpCAM x alpha CD3). J Histochem Cytochem. 2001 Jul;49(7):911-7. doi: 10.1177/002215540104900711.
Results Reference
background
PubMed Identifier
10901380
Citation
Zeidler R, Mysliwietz J, Csanady M, Walz A, Ziegler I, Schmitt B, Wollenberg B, Lindhofer H. The Fc-region of a new class of intact bispecific antibody mediates activation of accessory cells and NK cells and induces direct phagocytosis of tumour cells. Br J Cancer. 2000 Jul;83(2):261-6. doi: 10.1054/bjoc.2000.1237.
Results Reference
background
PubMed Identifier
10415020
Citation
Zeidler R, Reisbach G, Wollenberg B, Lang S, Chaubal S, Schmitt B, Lindhofer H. Simultaneous activation of T cells and accessory cells by a new class of intact bispecific antibody results in efficient tumor cell killing. J Immunol. 1999 Aug 1;163(3):1246-52.
Results Reference
background
PubMed Identifier
20473913
Citation
Heiss MM, Murawa P, Koralewski P, Kutarska E, Kolesnik OO, Ivanchenko VV, Dudnichenko AS, Aleknaviciene B, Razbadauskas A, Gore M, Ganea-Motan E, Ciuleanu T, Wimberger P, Schmittel A, Schmalfeldt B, Burges A, Bokemeyer C, Lindhofer H, Lahr A, Parsons SL. The trifunctional antibody catumaxomab for the treatment of malignant ascites due to epithelial cancer: Results of a prospective randomized phase II/III trial. Int J Cancer. 2010 Nov 1;127(9):2209-21. doi: 10.1002/ijc.25423.
Results Reference
background
PubMed Identifier
20565453
Citation
Ruf P, Kluge M, Jager M, Burges A, Volovat C, Heiss MM, Hess J, Wimberger P, Brandt B, Lindhofer H. Pharmacokinetics, immunogenicity and bioactivity of the therapeutic antibody catumaxomab intraperitoneally administered to cancer patients. Br J Clin Pharmacol. 2010 Jun;69(6):617-25. doi: 10.1111/j.1365-2125.2010.03635.x.
Results Reference
background
PubMed Identifier
25254563
Citation
Berek JS, Edwards RP, Parker LP, DeMars LR, Herzog TJ, Lentz SS, Morris RT, Akerley WL, Holloway RW, Method MW, Plaxe SC, Walker JL, Friccius-Quecke H, Krasner CN. Catumaxomab for the treatment of malignant ascites in patients with chemotherapy-refractory ovarian cancer: a phase II study. Int J Gynecol Cancer. 2014 Nov;24(9):1583-9. doi: 10.1097/IGC.0000000000000286.
Results Reference
derived

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Study of the Trifunctional Antibody Catumaxomab to Treat Recurrent Symptomatic Malignant Ascites

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