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Phase 1/2a DTA-H19 in Patients With Unresectable Pancreatic Cancer

Primary Purpose

Pancreatic Neoplasms

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
DTA-H19
Sponsored by
Anchiano Therapeutics Israel Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pancreatic Neoplasms focused on measuring H19 gene, plasmid, diphtheria toxin, pancreatic cancer, inodiftagene vixteplasmid, BC-819

Eligibility Criteria

18 Years - 79 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Provide written informed consent and be between the ages of 18 and 79, inclusive.
  • Have unresectable, locally advanced adenocarcinoma of the pancreas proven by biopsy or cytology (defined as direct extension to the superior mesenteric artery and/or celiac axis with loss of a clear plane between tumor and these arterial structures, or loss of patent superior mesenteric-portal vein confluence). Patients who have been surgically explored and deemed unresectable on that basis are eligible, provided other entry criteria are met. Patients having potentially resectable regional lymph node involvement may be included.
  • Have a target tumor ≤ 6 cm in diameter that is accessible for intratumoral administration by PTA or EUS guidance as determined by the radiologist/gastroenterologist performing the PTA/EUS injection.
  • Have a Karnofsky performance status of ≥ 70%.
  • Have a life expectancy of >= 3 months.
  • If female and of child-bearing potential, have a negative serum pregnancy test during screening.
  • Agree to use of a barrier method of contraception if sexually active (both men and women) from the time of administration of the first treatment and for at least 8 weeks after treatment.
  • Have serum creatinine < 2.0 mg/dL, AST and ALT >= 2.5 x ULN, PT, PPT, and PT/INR within normal limits, absolute neutrophil count (ANC) > 1,500 x 103 cells/mL, platelets ≥ 100,000/mL, and hemoglobin >= 10 mg/dL.
  • Have a biopsy specimen that is positive for H19 expression (grade 2 or greater staining determined by a pathologist).
  • Have screening procedures completed within 4 weeks of starting treatment.
  • No other malignancy present that would interfere with the current intervention.
  • Commit to refrain from any concurrent chemotherapy, hormonal therapy, radiotherapy, immunotherapy or any other type of therapy for treatment of cancer while on this protocol, therefore any standard treatment should be postponed while on study.
  • Have measurable disease.

Exclusion Criteria:

  • Have distant metastatic spread (such as liver or lung metastases), peritoneal spread or malignant ascites.
  • Have prior radiation therapy for pancreatic cancer or radiation to the area of the target tumor field.
  • Endocrine tumors or lymphoma of the pancreas.
  • Have clinically significant pancreatitis within 12 weeks of treatment.
  • If female, be breast feeding.
  • Have a medical condition contraindicated for both percutaneous- and endoscopic- guided delivery or any intercurrent medical illness or other medical condition that would in the judgment of the investigator compromise patient safety or the objectives of the study.
  • Have a history of coagulopathy.
  • Have participated in any therapeutic research study within the last 4 weeks.

Sites / Locations

  • University of Maryland Medical Center
  • Hadassah University Hospital
  • Meir Hospital
  • The Chaim Sheba Medical Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

BC-819

Arm Description

Intratumoral administration of BC-819

Outcomes

Primary Outcome Measures

Maximal Tolerated Dose (MTD) & Dose Limiting Toxicity (DLT) of Intratumoral Injections of BC-819
If 2 patients in any cohort experience DLTs, then the next lower dose will be considered the MTD if there is a lower dose cohort. A DLT is defined as grade 3 or greater toxicity judged to be at least possibly related to the investigational products.

Secondary Outcome Measures

Tumor Response
Tumor response and progression were defined in accordance with RECIST v. 1.0 and assessed by radiological examination 2 weeks after the end of treatment
Tumor Resectability
The number of subjects in each cohort whose tumor was resectable at the end of the study was to be presented for the ITT and the per-protocol population.

Full Information

First Posted
July 8, 2008
Last Updated
March 8, 2019
Sponsor
Anchiano Therapeutics Israel Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT00711997
Brief Title
Phase 1/2a DTA-H19 in Patients With Unresectable Pancreatic Cancer
Official Title
Phase 1/2a, Dose-Escalation, Safety, Pharmacokinetic, and Preliminary Efficacy Study of Intratumoral Administration of DTA-H19 in Patients With Unresectable Pancreatic Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
March 2019
Overall Recruitment Status
Completed
Study Start Date
August 2009 (undefined)
Primary Completion Date
October 2010 (Actual)
Study Completion Date
December 2010 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Anchiano Therapeutics Israel Ltd.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This study is designed to assess the safety, tolerability, pharmacokinetics (PK) and preliminary efficacy of DTA-H19 administered intratumorally in patients with unresectable, locally advanced pancreatic cancer. Primary Objective: The primary objective is to determine the maximum tolerated dose (MTD) of intratumoral DTA-H19 and identify any dose limiting toxicities (DLTs). Secondary objectives include determining the adverse events (AEs) profile, effects on clinical laboratory analytes, vital signs, PK, tumor response, and possible tumor resectability after 4 intratumoral administrations of DTA-H19.
Detailed Description
DTA-H19, is a doubled stranded DNA plasmid that carries the gene for the diphtheria toxn A (DT-A) chain under the regulation of the H19 promoter sequence. This is a Patient-Oriented, Targeted Therapy as DT-A chain expression is triggered by the presence of H19 transcription factors that are upregulated in tumor cells. The selective initiation of toxin expression results in selective tumor cell destruction via inhibition of protein synthesis in the tumor cell, enabling highly targeted cancer treatment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pancreatic Neoplasms
Keywords
H19 gene, plasmid, diphtheria toxin, pancreatic cancer, inodiftagene vixteplasmid, BC-819

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
9 (Actual)

8. Arms, Groups, and Interventions

Arm Title
BC-819
Arm Type
Experimental
Arm Description
Intratumoral administration of BC-819
Intervention Type
Biological
Intervention Name(s)
DTA-H19
Other Intervention Name(s)
BC-819
Intervention Description
Cohort #1: 4 mg DTA-H19 intratumorally 2 times per week for 2 weeks Cohort #2: 8 mg DTA-H19 intratumorally 2 times per week for 2 weeks
Primary Outcome Measure Information:
Title
Maximal Tolerated Dose (MTD) & Dose Limiting Toxicity (DLT) of Intratumoral Injections of BC-819
Description
If 2 patients in any cohort experience DLTs, then the next lower dose will be considered the MTD if there is a lower dose cohort. A DLT is defined as grade 3 or greater toxicity judged to be at least possibly related to the investigational products.
Time Frame
Week 4
Secondary Outcome Measure Information:
Title
Tumor Response
Description
Tumor response and progression were defined in accordance with RECIST v. 1.0 and assessed by radiological examination 2 weeks after the end of treatment
Time Frame
4 weeks
Title
Tumor Resectability
Description
The number of subjects in each cohort whose tumor was resectable at the end of the study was to be presented for the ITT and the per-protocol population.
Time Frame
5 to 6 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
79 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Provide written informed consent and be between the ages of 18 and 79, inclusive. Have unresectable, locally advanced adenocarcinoma of the pancreas proven by biopsy or cytology (defined as direct extension to the superior mesenteric artery and/or celiac axis with loss of a clear plane between tumor and these arterial structures, or loss of patent superior mesenteric-portal vein confluence). Patients who have been surgically explored and deemed unresectable on that basis are eligible, provided other entry criteria are met. Patients having potentially resectable regional lymph node involvement may be included. Have a target tumor ≤ 6 cm in diameter that is accessible for intratumoral administration by PTA or EUS guidance as determined by the radiologist/gastroenterologist performing the PTA/EUS injection. Have a Karnofsky performance status of ≥ 70%. Have a life expectancy of >= 3 months. If female and of child-bearing potential, have a negative serum pregnancy test during screening. Agree to use of a barrier method of contraception if sexually active (both men and women) from the time of administration of the first treatment and for at least 8 weeks after treatment. Have serum creatinine < 2.0 mg/dL, AST and ALT >= 2.5 x ULN, PT, PPT, and PT/INR within normal limits, absolute neutrophil count (ANC) > 1,500 x 103 cells/mL, platelets ≥ 100,000/mL, and hemoglobin >= 10 mg/dL. Have a biopsy specimen that is positive for H19 expression (grade 2 or greater staining determined by a pathologist). Have screening procedures completed within 4 weeks of starting treatment. No other malignancy present that would interfere with the current intervention. Commit to refrain from any concurrent chemotherapy, hormonal therapy, radiotherapy, immunotherapy or any other type of therapy for treatment of cancer while on this protocol, therefore any standard treatment should be postponed while on study. Have measurable disease. Exclusion Criteria: Have distant metastatic spread (such as liver or lung metastases), peritoneal spread or malignant ascites. Have prior radiation therapy for pancreatic cancer or radiation to the area of the target tumor field. Endocrine tumors or lymphoma of the pancreas. Have clinically significant pancreatitis within 12 weeks of treatment. If female, be breast feeding. Have a medical condition contraindicated for both percutaneous- and endoscopic- guided delivery or any intercurrent medical illness or other medical condition that would in the judgment of the investigator compromise patient safety or the objectives of the study. Have a history of coagulopathy. Have participated in any therapeutic research study within the last 4 weeks.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Abraham Czerniak, MD
Organizational Affiliation
The Chaim Sheba Medical Center
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Nader Hanna, MD, FACS
Organizational Affiliation
University of Maryland
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Fred Konikoff, MD
Organizational Affiliation
Meir Medical Center
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Ayala Hubert, MD
Organizational Affiliation
Hadassah University Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Maryland Medical Center
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21201-1595
Country
United States
Facility Name
Hadassah University Hospital
City
Jerusalem
Country
Israel
Facility Name
Meir Hospital
City
Kfar Saba
Country
Israel
Facility Name
The Chaim Sheba Medical Center
City
Tel Hashomer
Country
Israel

12. IPD Sharing Statement

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Phase 1/2a DTA-H19 in Patients With Unresectable Pancreatic Cancer

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