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A Phase 1-2 Study of CF102 in Patients With Advanced Hepatocellular Carcinoma

Primary Purpose

Hepatocellular Carcinoma

Status
Completed
Phase
Phase 1
Locations
Israel
Study Type
Interventional
Intervention
CF102
Sponsored by
Can-Fite BioPharma
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hepatocellular Carcinoma focused on measuring Hepatocellular carcinoma, Hepatoma, HCC

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Diagnosis of HCC:

    • For patients without underlying cirrhosis, diagnosis of HCC documented by cytology and/or histology
    • For patients with underlying cirrhosis, diagnosis of HCC established according to the American Association for the Study of Liver Diseases Practice Guideline algorithm (Appendix V).
  2. HCC is advanced, refractory, or metastatic, and no standard therapies are expected to be curative.
  3. At least 18 years of age.
  4. For subjects in the dose-confirmation (RP2D) phase only: Measurable disease, using Response Evaluation Criteria in Solid Tumors (RECIST, Appendix IV). (Note that a lesion that has been subjected to radiotherapy or chemoembolization cannot be used as a target lesion.)
  5. Eastern Collaborative Oncology Group (ECOG) performance status (PS) of 0, 1, or 2 at baseline.
  6. The following laboratory values must be documented within 3 days prior to initiation of study drug:

    • Absolute neutrophil count (ANC) greater than or equal to 1 x 109/L
    • Platelet count greater than or equal to 50 x 109/L
    • Serum creatinine less than or equal to 2.0 mg/dL
    • Aspartic aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 5 × upper limit of normal.
    • Total bilirubin ≤ 3.0 mg/dL.
    • Serum albumin ≥ 3.0 g/dL.
    • International normalized ratio (INR) ≤ 2.3.
  7. Esophageal bleeding and varices, if present, have been sclerosed or banded, and no bleeding episodes have occurred during the prior 6 months.
  8. Life expectancy of ≥ 12 weeks.
  9. For women of childbearing potential, negative serum pregnancy test result.
  10. Absence of active malignancy other than HCC within 2 years of entry, with the exception of basal cell carcinoma and squamous cell carcinoma of the skin.
  11. Provide written informed consent to participate.
  12. Willing to comply with scheduled visits, treatment plans, laboratory assessments, and other study related procedures.

    -

Exclusion Criteria:

  1. Any chemotherapy, immunomodulatory drug therapy, immunosuppressive therapy, corticosteroids > 20 mg/day prednisone or equivalent, or growth factor treatment (e.g., erythropoietin) within 14 days prior to initiation of study drug.
  2. Major surgery or radiation therapy within 28 days prior to initiation of study drug.
  3. Severe liver dysfunction (Child-Pugh Class C or hepatic encephalopathy).
  4. Active infection requiring systemic therapy.
  5. Uncontrolled congestive heart failure (New York Heart Association Classification 3 or 4), angina, myocardial infarction, cerebrovascular accident, coronary/peripheral artery bypass graft surgery, transient ischemic attack, or pulmonary embolism within 3 months prior to initiation of study drug.
  6. History of or ongoing cardiac dysrhythmias requiring treatment, atrial fibrillation of any grade, or persistent prolongation of the QTc (Fridericia) interval to > 450 msec for males or > 470 msec for females.
  7. Pregnant or lactating female.
  8. Women of childbearing potential, unless they agree to use dual contraceptive methods which, in the opinion of the Principal Investigator (PI), are effective and adequate for that patient's circumstances while on study drug.
  9. Men who partner with a woman of childbearing potential, unless they agree to use effective, dual contraceptive methods (i.e., a condom, with female partner using oral, injectable, or barrier method) while on study drug.
  10. Known human immunodeficiency virus- or acquired immunodeficiency syndrome-related illness.
  11. Any severe, acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or study drug administration, may interfere with the informed consent process and/or with compliance with the requirements of the study, or may interfere with the interpretation of study results and, in the investigator's opinion, would make the patient inappropriate for entry into this study.

    -

Sites / Locations

  • Rabin Medical Center

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

CF102 1mg

CF102 5mg

CF102 25mg

Arm Description

An open-label trial in 28-day cycles.

An open-label trial in 28-day cycles.

An open-label trial in 28-day cycles.

Outcomes

Primary Outcome Measures

Dose Limiting Toxicity
Dose-limiting toxicity was defined as a clinically significant AE or laboratory abnormality occurring in Cycle 1
Maximum Tolerated Dose
The MTD was defined as the highest dose level at which < 2 of 6 patients developed Cycle 1 DLT.
Maximum Plasma Concentration of CF102 (Cmax)
Blood samples were collected and plasma concentrations determined using a high-pressure liquid chromatography method.

Secondary Outcome Measures

Number of Subjects With Objective Tumor Response
Therapeutic effect of CF102 in hepatocellular carcinoma measured by number of subjects with objective tumor response
Relationship Between Biomarkers of Peripheral Blood Mononuclear Cell (PBMC) Adenosine A3 Receptor (A3AR) Expression and Clinical Effects of CF102
The Peripheral Blood Mononuclear Cells (PBMC) were to be collected at Baseline and Day 28 in order to evaluate the Adenosine A3 receptor (A3AR) and PBMC biomarkers, and clinical effects of CF102.

Full Information

First Posted
November 11, 2008
Last Updated
April 23, 2022
Sponsor
Can-Fite BioPharma
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1. Study Identification

Unique Protocol Identification Number
NCT00790218
Brief Title
A Phase 1-2 Study of CF102 in Patients With Advanced Hepatocellular Carcinoma
Official Title
A Phase 1-2, Open-label, Dose-escalation Study Evaluating the Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of Orally Administered CF102 in Patients With Advanced Hepatocellular Carcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
April 2022
Overall Recruitment Status
Completed
Study Start Date
February 2009 (Actual)
Primary Completion Date
December 2012 (Actual)
Study Completion Date
December 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Can-Fite BioPharma

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This trial will test the safety and efficacy of CF102 in patients with advanced liver cancer. Successive groups of patients will be given higher doses of CF102 by mouth on a twice-daily basis. Treatment will be assessed for adverse effects and for effects on the tumor.
Detailed Description
This is a multicenter, open-label, non-randomized, dose-escalation study, to be conducted in 2 phases: a dose-escalation phase, to determine the MTD of CF102 and to evaluate its safety/tolerability, PK, pharmacodynamic, and preliminary clinical activity; and a dose-confirmation phase, which will be a cohort expansion at or below the MTD (ie, the RP2D) of CF102. Subjects will be treated with oral doses of CF102 in consecutive, 28-day cycles. The initial dose of CF102 will be 1 mg twice daily (BID), with subsequent escalations to 5 and 25 mg BID, unless limited by toxicity. Subjects will be evaluated weekly for the first cycle, every 2 weeks for Cycles 2 and 3, and at the end of each subsequent cycle, up to 6 cycles of CF102 treatment. Subjects will return for a follow-up visit 28 days after completion of the last dose of study drug.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hepatocellular Carcinoma
Keywords
Hepatocellular carcinoma, Hepatoma, HCC

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Sequential Assignment
Model Description
Study Arms: CF102 (1, 5, and 25 mg BID) in 28-day cycles.
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
19 (Actual)

8. Arms, Groups, and Interventions

Arm Title
CF102 1mg
Arm Type
Experimental
Arm Description
An open-label trial in 28-day cycles.
Arm Title
CF102 5mg
Arm Type
Experimental
Arm Description
An open-label trial in 28-day cycles.
Arm Title
CF102 25mg
Arm Type
Experimental
Arm Description
An open-label trial in 28-day cycles.
Intervention Type
Drug
Intervention Name(s)
CF102
Other Intervention Name(s)
2-Chloro-N6-(3-iodobenzyl)adenosine-5'-N-methyluronamide, Cl-IB-MECA
Intervention Description
CF102 capsules twice daily by mouth
Primary Outcome Measure Information:
Title
Dose Limiting Toxicity
Description
Dose-limiting toxicity was defined as a clinically significant AE or laboratory abnormality occurring in Cycle 1
Time Frame
From start of treatment until Day 28 of Cycle 1
Title
Maximum Tolerated Dose
Description
The MTD was defined as the highest dose level at which < 2 of 6 patients developed Cycle 1 DLT.
Time Frame
first 28 days (Cycle 1)
Title
Maximum Plasma Concentration of CF102 (Cmax)
Description
Blood samples were collected and plasma concentrations determined using a high-pressure liquid chromatography method.
Time Frame
Dose Escalation Phase on Day 1 and Day 29 pre-dose and at 1, 2, 3, 4, 6, 8 hours post-dose
Secondary Outcome Measure Information:
Title
Number of Subjects With Objective Tumor Response
Description
Therapeutic effect of CF102 in hepatocellular carcinoma measured by number of subjects with objective tumor response
Time Frame
6 months
Title
Relationship Between Biomarkers of Peripheral Blood Mononuclear Cell (PBMC) Adenosine A3 Receptor (A3AR) Expression and Clinical Effects of CF102
Description
The Peripheral Blood Mononuclear Cells (PBMC) were to be collected at Baseline and Day 28 in order to evaluate the Adenosine A3 receptor (A3AR) and PBMC biomarkers, and clinical effects of CF102.
Time Frame
Baseline to Day 28

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Diagnosis of HCC: For patients without underlying cirrhosis, diagnosis of HCC documented by cytology and/or histology For patients with underlying cirrhosis, diagnosis of HCC established according to the American Association for the Study of Liver Diseases Practice Guideline algorithm (Appendix V). HCC is advanced, refractory, or metastatic, and no standard therapies are expected to be curative. At least 18 years of age. For subjects in the dose-confirmation (RP2D) phase only: Measurable disease, using Response Evaluation Criteria in Solid Tumors (RECIST, Appendix IV). (Note that a lesion that has been subjected to radiotherapy or chemoembolization cannot be used as a target lesion.) Eastern Collaborative Oncology Group (ECOG) performance status (PS) of 0, 1, or 2 at baseline. The following laboratory values must be documented within 3 days prior to initiation of study drug: Absolute neutrophil count (ANC) greater than or equal to 1 x 109/L Platelet count greater than or equal to 50 x 109/L Serum creatinine less than or equal to 2.0 mg/dL Aspartic aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 5 × upper limit of normal. Total bilirubin ≤ 3.0 mg/dL. Serum albumin ≥ 3.0 g/dL. International normalized ratio (INR) ≤ 2.3. Esophageal bleeding and varices, if present, have been sclerosed or banded, and no bleeding episodes have occurred during the prior 6 months. Life expectancy of ≥ 12 weeks. For women of childbearing potential, negative serum pregnancy test result. Absence of active malignancy other than HCC within 2 years of entry, with the exception of basal cell carcinoma and squamous cell carcinoma of the skin. Provide written informed consent to participate. Willing to comply with scheduled visits, treatment plans, laboratory assessments, and other study related procedures. - Exclusion Criteria: Any chemotherapy, immunomodulatory drug therapy, immunosuppressive therapy, corticosteroids > 20 mg/day prednisone or equivalent, or growth factor treatment (e.g., erythropoietin) within 14 days prior to initiation of study drug. Major surgery or radiation therapy within 28 days prior to initiation of study drug. Severe liver dysfunction (Child-Pugh Class C or hepatic encephalopathy). Active infection requiring systemic therapy. Uncontrolled congestive heart failure (New York Heart Association Classification 3 or 4), angina, myocardial infarction, cerebrovascular accident, coronary/peripheral artery bypass graft surgery, transient ischemic attack, or pulmonary embolism within 3 months prior to initiation of study drug. History of or ongoing cardiac dysrhythmias requiring treatment, atrial fibrillation of any grade, or persistent prolongation of the QTc (Fridericia) interval to > 450 msec for males or > 470 msec for females. Pregnant or lactating female. Women of childbearing potential, unless they agree to use dual contraceptive methods which, in the opinion of the Principal Investigator (PI), are effective and adequate for that patient's circumstances while on study drug. Men who partner with a woman of childbearing potential, unless they agree to use effective, dual contraceptive methods (i.e., a condom, with female partner using oral, injectable, or barrier method) while on study drug. Known human immunodeficiency virus- or acquired immunodeficiency syndrome-related illness. Any severe, acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or study drug administration, may interfere with the informed consent process and/or with compliance with the requirements of the study, or may interfere with the interpretation of study results and, in the investigator's opinion, would make the patient inappropriate for entry into this study. -
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Michael H Silverman, MD
Organizational Affiliation
Can-Fite BioPharma Ltd
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Salomon Shtemmer, MD
Organizational Affiliation
Rabin Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Rabin Medical Center
City
Tel Aviv
Country
Israel

12. IPD Sharing Statement

Citations:
PubMed Identifier
18636149
Citation
Bar-Yehuda S, Stemmer SM, Madi L, Castel D, Ochaion A, Cohen S, Barer F, Zabutti A, Perez-Liz G, Del Valle L, Fishman P. The A3 adenosine receptor agonist CF102 induces apoptosis of hepatocellular carcinoma via de-regulation of the Wnt and NF-kappaB signal transduction pathways. Int J Oncol. 2008 Aug;33(2):287-95.
Results Reference
background
PubMed Identifier
23299770
Citation
Stemmer SM, Benjaminov O, Medalia G, Ciuraru NB, Silverman MH, Bar-Yehuda S, Fishman S, Harpaz Z, Farbstein M, Cohen S, Patoka R, Singer B, Kerns WD, Fishman P. CF102 for the treatment of hepatocellular carcinoma: a phase I/II, open-label, dose-escalation study. Oncologist. 2013;18(1):25-6. doi: 10.1634/theoncologist.2012-0211. Epub 2013 Jan 8.
Results Reference
derived
Links:
URL
http://www.canfite.com
Description
Can-Fite BioPharma Ltd

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A Phase 1-2 Study of CF102 in Patients With Advanced Hepatocellular Carcinoma

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