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Effect of Talactoferrin in Adults With Non-Small Cell Lung Cancer

Primary Purpose

Non-Small Cell Lung Cancer

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Talactoferrin
Apheresis
Sponsored by
National Cancer Institute (NCI)
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Non-Small Cell Lung Cancer focused on measuring Lung Cancer, Immunity, Clinical Response, Cytokines, Elispot Assay, Non-Small Cell Lung Cancer, NSCLC

Eligibility Criteria

18 Years - 90 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers
  • INCLUSION CRITERIA:

Age greater than or equal to 18 years

Histologically or cytologically confirmed progressive, recurrent, or refractory stage IIIB or IV NSCLC; confirmation of pathologic diagnosis to be conducted at the NCI Laboratory of Pathology

Patients may not be eligible for other curative intent treatment (e.g., surgical resection). For the purpose of eligibility for this trial, the above-cited disease states are defined as follows:

  • Progressive NSCLC defined as increasing measurable disease, or the appearance of new measurable disease by RECIST criteria.
  • Recurrent NSCLC defined as the reappearance of measurable disease or the appearance of new measurable disease by RECIST criteria after prior successful treatment or complete response.
  • Refractory NSCLC defined as achieving less than a complete response and having residual measurable disease by RECIST criteria after prior treatment with chemotherapy, targeted or small molecules, monoclonal antibodies, or any combination of these.
  • Patients may enroll who are not candidates for, or who have documented refusal to receive standard therapy (e.g., chemotherapy) for their disease.

HLA-A2 allele

Patient must have evaluable or measurable disease

Total bilirubin less than or equal to 1.5 mg/dL (OR in patients with Gilbert s syndrome, a total bilirubin less than or equal to 3.0)

Creatinine less than 1.5 times Upper Limit of Normal (ULN) if greater than 1.5 times ULN, creatinine clearance on a 24 hour urine collection of greater than 60 mL/min.

AST (SGOT) and ALT (SGPT) less than or equal to 2.5 times the upper limit of normal (ULN); in case of liver metastases less than or equal to 5 x ULN

Eastern Cooperative Oncology Group (ECOG) score 0, 1, or 2

Able to understand and give informed consent

Recovered completely from any reversible toxicity associated with recent therapy. Typically this is 3-4 weeks for patients who most recently received cytotoxic therapy except for the nitrosoureas and mitomycin C for which 6 weeks is needed for recovery.

Hematological eligibility parameters (within 16 days of starting therapy):

  • Granulocyte count greater than or equal to 1,500/mm(3)
  • Platelet count greater than or equal to 75,000/mm(3)
  • Hgb greater than or equal to 9 Gm/dL

EXCLUSION CRITERIA:

Presence of brain metastases, unless the patient received brain irradiation at least 4 weeks prior to enrollment, and is stable, asymptomatic, and off steroids for at least 4 weeks prior to registration

History of allergic reactions to compounds of similar chemical or biologic composition to Talactoferrin. At this point, no specific compounds have been identified.

History of other malignancies except: (i) adequately treated basal or squamous cell carcinoma of the skin; (ii) curatively treated, a) in situ carcinoma of the uterine cervix, b) prostate cancer, or c) superficial bladder cancer; or (iii) other curatively treated solid tumor with no evidence of disease for greater than or equal to 5 years

Uncontrolled ischemic heart disease, or uncontrolled symptomatic congestive heart failure

Serious active infection

Psychiatric illness/ social situations that would limit study compliance

Other uncontrolled serious chronic disease or conditions that in the investigator s opinion could render compliance or follow-up in the protocol problematic

Concurrent radiotherapy or radiotherapy within 4 weeks prior to enrollment or previous radiotherapy to the target lesion sites (the sites that are to be followed for determination of a response)

Concurrent use of topical steroids (including steroid eye drops) or systemic steroids. Nasal or inhaled steroid use is permitted.

HIV positive

Any form of primary immunodeficiency (such as Severe Combined Immunodeficiency Disease)

History of opportunistic infections

Hepatitis B surface antigen positive or hepatitis C positive

Receipt of any investigational medication within 4 weeks prior to enrollment.

Pregnant or lactating patients, or fertile female patients with a positive pregnancy test (serum beta-human chorionic gonadotropin [beta-hCG] at screening and at baseline), or fertile female patients unwilling to use adequate contraception (including condom use, birth control pills, or IUD) during treatment and 30 days after completion of treatment

Sexually active male patients unwilling to practice contraception (condom use) while participating on the study and up to 30 days after completion of treatment

Legal incapacity or limited legal capacity, unless authorization is granted by a legal guardian

Sites / Locations

  • National Institutes of Health Clinical Center, 9000 Rockville Pike

Outcomes

Primary Outcome Measures

To evaluate the effects of talactoferrin to patients with advanced NSCLC on quantitative and functional changes in CD4, CD8, NK, and Treg populations in peripheral blood mononuclear cells (PBMC) and on the levels of cytokines and chemokines in s...

Secondary Outcome Measures

To evaluate clinical response to talactoferrin. To evaluate the safety of talactoferrin.

Full Information

First Posted
June 17, 2009
Last Updated
July 3, 2018
Sponsor
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00923741
Brief Title
Effect of Talactoferrin in Adults With Non-Small Cell Lung Cancer
Official Title
An Open Label Pilot Study to Evaluate the Effect on the Immune System of Talactoferrin in Adults With Non-Small Cell Lung Cancer (NSCLC)
Study Type
Interventional

2. Study Status

Record Verification Date
November 6, 2012
Overall Recruitment Status
Completed
Study Start Date
June 19, 2008 (undefined)
Primary Completion Date
February 1, 2010 (Actual)
Study Completion Date
February 1, 2010 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
Background: More effective therapies are needed for patients with non-small cell lung cancer (NSCLC) whose disease has advanced or spread beyond the original site following standard treatment. Talactoferrin is a genetically engineered form of the human protein lactoferrin, found in body secretions such as breast milk, tears and saliva. In previous studies, talactoferrin improved life span in patients with NSCLC without causing toxic side effects. Objectives: To examine the effects of talactoferrin on the immune system and determine its effectiveness in treating NSCLC. Eligibility: Patients with advanced NSCLC who have tissue type HLA-A2 and whose cancer has gotten worse following at least one course of treatment. Design: Talactoferrin treatment: Patients take liquid talactoferrin twice a day for 12 weeks, followed by 2 weeks off the drug. Treatment may continue in these 14-week cycles depending on the drug side effects and the response of the tumor. Evaluations: Patients are evaluated at the clinic with a physical examination, check of vital signs and blood tests every 3 weeks. CT scans: Patients have CT scans to monitor disease before starting treatment, again at 6 weeks and 12 weeks and then every 12 weeks during the duration of treatment. Apheresis: Quantities of white blood cells called lymphocytes are collected through a procedure called apheresis in order to measure the immune response to treatment. In this procedure, blood is collected through a needle placed in a vein in the arm (similar to donating blood) and circulated through a cell separator machine. The lymphocytes are extracted and the rest of the blood is returned to the body through the same needle.
Detailed Description
Background: Patients with locally advanced or metastatic NSCLC have a very poor prognosis even with surgery, chemotherapy, and radiation treatments. Patients who respond to 1st line chemotherapy invariably develop disease progression, and their median survival is between 6-8 months. Talactoferrin alfa (TLF) is a recombinant human lactoferrin. TLF displays anti-infective (against bacteria, viruses, protozoa and fungi) and anti-inflammatory properties, anti-tumor activity and anti-asthma properties. Preclinical studies have demonstrated an increase in cytokines that stimulate both innate and adaptive immunity, as well as increasing the numbers of NK-T cells and CD8+ T-lymphocytes found in Peyer s Patches. Previous studies in NSCLC have demonstrated safety and evidence of clinical activity. Objectives: Primary: To evaluate the effects of administration of talactoferrin to patients with advanced non-small cell lung cancer on the quantitative and functional changes in CD4, CD8, NK, and Treg populations in peripheral blood mononuclear cells (PBMC) and on the levels of cytokines and chemokines in serum. Secondary: To evaluate clinical response to talactoferrin. To evaluate the safety of talactoferrin. Eligibility: Patients with cytologically or histologically confirmed progressive, recurrent, or refractory stage IIIb or IV NSCLC. Patients must be HLA-A2 positive. Design: Single-arm pilot study Ten patients will be enrolled to receive daily oral talactoferrin (1.5 g/ bid) for up to 12 weeks. Patients who benefit from treatment will be able to continue on a 12 weeks on 2 weeks off schedule until progression. Evaluation will be performed every 3 weeks with CT chest, abdomen, and pelvis at baseline, week 6, and week 12. Immunologic studies (including apheresis) will be performed at baseline, week 6, and week 12.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Non-Small Cell Lung Cancer
Keywords
Lung Cancer, Immunity, Clinical Response, Cytokines, Elispot Assay, Non-Small Cell Lung Cancer, NSCLC

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
10 (Actual)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
Talactoferrin
Intervention Type
Procedure
Intervention Name(s)
Apheresis
Primary Outcome Measure Information:
Title
To evaluate the effects of talactoferrin to patients with advanced NSCLC on quantitative and functional changes in CD4, CD8, NK, and Treg populations in peripheral blood mononuclear cells (PBMC) and on the levels of cytokines and chemokines in s...
Secondary Outcome Measure Information:
Title
To evaluate clinical response to talactoferrin. To evaluate the safety of talactoferrin.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
90 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
INCLUSION CRITERIA: Age greater than or equal to 18 years Histologically or cytologically confirmed progressive, recurrent, or refractory stage IIIB or IV NSCLC; confirmation of pathologic diagnosis to be conducted at the NCI Laboratory of Pathology Patients may not be eligible for other curative intent treatment (e.g., surgical resection). For the purpose of eligibility for this trial, the above-cited disease states are defined as follows: Progressive NSCLC defined as increasing measurable disease, or the appearance of new measurable disease by RECIST criteria. Recurrent NSCLC defined as the reappearance of measurable disease or the appearance of new measurable disease by RECIST criteria after prior successful treatment or complete response. Refractory NSCLC defined as achieving less than a complete response and having residual measurable disease by RECIST criteria after prior treatment with chemotherapy, targeted or small molecules, monoclonal antibodies, or any combination of these. Patients may enroll who are not candidates for, or who have documented refusal to receive standard therapy (e.g., chemotherapy) for their disease. HLA-A2 allele Patient must have evaluable or measurable disease Total bilirubin less than or equal to 1.5 mg/dL (OR in patients with Gilbert s syndrome, a total bilirubin less than or equal to 3.0) Creatinine less than 1.5 times Upper Limit of Normal (ULN) if greater than 1.5 times ULN, creatinine clearance on a 24 hour urine collection of greater than 60 mL/min. AST (SGOT) and ALT (SGPT) less than or equal to 2.5 times the upper limit of normal (ULN); in case of liver metastases less than or equal to 5 x ULN Eastern Cooperative Oncology Group (ECOG) score 0, 1, or 2 Able to understand and give informed consent Recovered completely from any reversible toxicity associated with recent therapy. Typically this is 3-4 weeks for patients who most recently received cytotoxic therapy except for the nitrosoureas and mitomycin C for which 6 weeks is needed for recovery. Hematological eligibility parameters (within 16 days of starting therapy): Granulocyte count greater than or equal to 1,500/mm(3) Platelet count greater than or equal to 75,000/mm(3) Hgb greater than or equal to 9 Gm/dL EXCLUSION CRITERIA: Presence of brain metastases, unless the patient received brain irradiation at least 4 weeks prior to enrollment, and is stable, asymptomatic, and off steroids for at least 4 weeks prior to registration History of allergic reactions to compounds of similar chemical or biologic composition to Talactoferrin. At this point, no specific compounds have been identified. History of other malignancies except: (i) adequately treated basal or squamous cell carcinoma of the skin; (ii) curatively treated, a) in situ carcinoma of the uterine cervix, b) prostate cancer, or c) superficial bladder cancer; or (iii) other curatively treated solid tumor with no evidence of disease for greater than or equal to 5 years Uncontrolled ischemic heart disease, or uncontrolled symptomatic congestive heart failure Serious active infection Psychiatric illness/ social situations that would limit study compliance Other uncontrolled serious chronic disease or conditions that in the investigator s opinion could render compliance or follow-up in the protocol problematic Concurrent radiotherapy or radiotherapy within 4 weeks prior to enrollment or previous radiotherapy to the target lesion sites (the sites that are to be followed for determination of a response) Concurrent use of topical steroids (including steroid eye drops) or systemic steroids. Nasal or inhaled steroid use is permitted. HIV positive Any form of primary immunodeficiency (such as Severe Combined Immunodeficiency Disease) History of opportunistic infections Hepatitis B surface antigen positive or hepatitis C positive Receipt of any investigational medication within 4 weeks prior to enrollment. Pregnant or lactating patients, or fertile female patients with a positive pregnancy test (serum beta-human chorionic gonadotropin [beta-hCG] at screening and at baseline), or fertile female patients unwilling to use adequate contraception (including condom use, birth control pills, or IUD) during treatment and 30 days after completion of treatment Sexually active male patients unwilling to practice contraception (condom use) while participating on the study and up to 30 days after completion of treatment Legal incapacity or limited legal capacity, unless authorization is granted by a legal guardian
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
James L Gulley, M.D.
Organizational Affiliation
National Cancer Institute (NCI)
Official's Role
Principal Investigator
Facility Information:
Facility Name
National Institutes of Health Clinical Center, 9000 Rockville Pike
City
Bethesda
State/Province
Maryland
ZIP/Postal Code
20892
Country
United States

12. IPD Sharing Statement

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Effect of Talactoferrin in Adults With Non-Small Cell Lung Cancer

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