131I-L19SIP Radioimmunotherapy Combined With Radiochemotherapy in Patients With Locally-advanced Non Small Cell Lung Cancer (NSCLC)
Primary Purpose
Non Small Cell Lung Cancer
Status
Terminated
Phase
Phase 1
Locations
Italy
Study Type
Interventional
Intervention
131I-L19SIP Radioimmunotherapy (RIT) in Combination With External Beam Radiotherapy (EBRT) and Concurrent Chemotherapy
Sponsored by

About this trial
This is an interventional treatment trial for Non Small Cell Lung Cancer focused on measuring I131, L19, antibody, monoclonal, NSCLC, lung, tumor targeting, radioimmunotherapy, Patients with newly diagnosed inoperable, locally-advanced (stage III) NSCLC
Eligibility Criteria
Inclusion Criteria:
- Histologically or cytologically confirmed unresectable stage III NSCLC
- Males or females, age ≥ 18 years
- Measurable lung lesion defined as at least one lesion that can be accurately and serially measured per the modified RECIST criteria.
- ECOG performance status < 3
- Life expectancy of at least 12 weeks
- Patients eligible for concurrent radiochemotherapy (cisplatin/vinorelbine; 60-66 Gy EBRT) at the discretion of the clinical investigator
- Absolute neutrophil count > 1.5 x 109/L, hemoglobin > 9.0 g/dL and platelets > 100 x 109/L
- Total bilirubin ≤ 30 µmol/L (or ≤ 2.0 mg/Dl)
- ALT and AST ≤ 2.5 x the upper limit of normal (5.0 x ULN for patients with hepatic involvement with tumor
- Serum creatinine < 1.5 x ULN
- All toxic effects of prior therapy must have resolved to ≤ Grade 1 unless otherwise specified above
- Negative serum pregnancy test (for women of child-bearing potential only) at screening
Exclusion Criteria:
- Patients with metastatic disease
- Patients amenable for surgical resection of lung tumor lesions
- Previous or concurrent cancer that is distinct in primary site or histology from the cancer being evaluated in this study except cervical carcinoma in situ, treated basal cell carcinoma, superficial bladder tumors (TA, Tis & Ti) or any cancer curatively treated < 5 years prior to study entry
- History of HIV infection or infectious hepatitis B or C
- Presence of active infections (e.g. requiring antibimicrobial therapy) or other severe concurrent disease, which, in the opinion of the investigator, would place the patient at undue risk or interfere with the study.
- Inadequately controlled cardiac arrhythmias including atrial fibrillation
- Heart insufficiency (> Grade II, New York Heart Association (NYHA) criteria)
- Uncontrolled hypertension
- Ischemic peripheral vascular disease (Grade IIb-IV)
- History of an acute cardiac event such as myocardial infarction, instable angina pectoris during the last 12 months
- Severe diabetic retinopathy
- Active autoimmune disease
- History of organ allograft or stem cell transplantation
- Recovery from major trauma including surgery within 4 weeks prior to administration of study treatment
- Breast feeding female
- Previous in vivo exposure to monoclonal antibodies for biological therapy in the 6 weeks before administration of study treatment
- Growth factors or immunomodulatory agents within 7 days of the administration of study treatment (131I-L19SIP application).
- Hyperthyroidism or autonomous thyroid nodule
Sites / Locations
- University Hospital Pisa
- Irst - Istituto Scientifico Romagnolo Per Lo Studio E La Cura Dei Tumori - Meldola (Fc)
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
131I-L19SIP
Arm Description
131I-L19SIP Radioimmunotherapy (RIT) in Combination With External Beam Radiotherapy (EBRT) and Concurrent Chemotherapy: Treatment dose of 131I-L19SIP RIT is titrated in cohorts of 3 patients.
Outcomes
Primary Outcome Measures
Uptake of 131I-L19SIP or 124I-L19SIP
The selective uptake of 131I-L19SIP or 124I-L19SIP in lung lesions and dosimetric analysis
Safety and tolerability of 131I-L19SIP Radioimmunotherapy (RIT) in Combination With External Beam Radiotherapy (EBRT) and Concurrent Chemotherapy
Safety will be assessed through physical examinations, vital signs, laboratory tests (including serum chemistries, hematology parameters) and the recording of adverse events. All results from these assessments will be coded using CTCAE v.3 and presented descriptively, indicating frequency and percentage of patients with adverse events, and abnormal laboratory tests. These results will be presented by related/unrelated and overall for the study.
Dose Limiting Toxicities (DLTs) and Maximum Tolerated Dose/Recommended Dose (MTD/RD) for the combination treatment
Dose limiting toxicities and maximum tolerated dose/recommended dose for the combination treatment
Secondary Outcome Measures
Overall response rate
Intrapulmonal, extra pulmonal and overall response rate
Overall survival
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT01124812
Brief Title
131I-L19SIP Radioimmunotherapy Combined With Radiochemotherapy in Patients With Locally-advanced Non Small Cell Lung Cancer (NSCLC)
Official Title
A Prospective Non-randomized Study of 131I-L19SIP Radioimmunotherapy (RIT) in Combination With External Beam Radiotherapy (EBRT) and Concurrent Chemotherapy in Patients With Inoperable, Locally-advanced (Stage III) NSCLC
Study Type
Interventional
2. Study Status
Record Verification Date
June 2012
Overall Recruitment Status
Terminated
Study Start Date
May 2010 (undefined)
Primary Completion Date
August 2011 (Actual)
Study Completion Date
October 2012 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Philogen S.p.A.
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
The aim of this feasibility study is to determine the therapeutic potential of the L19SIP antibody, labeled with the radionuclide 131I in combination with radiochemotherapy, for the treatment of patients with newly diagnosed, unresectable, locally-advanced NSCLC following the promising results with this agent in previous clinical studies.
The L19SIP antibody is a fully human antibody, capable of preferential localization around tumor blood vessels while sparing normal tissues. The formation of new blood vessels is a rare event in the adult (with the exception of the female reproductive tract), but it is a characteristic pathological feature for most types of aggressive cancer.
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
I131, L19, antibody, monoclonal, NSCLC, lung, tumor targeting, radioimmunotherapy, Patients with newly diagnosed inoperable, locally-advanced (stage III) 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
3 (Actual)
8. Arms, Groups, and Interventions
Arm Title
131I-L19SIP
Arm Type
Experimental
Arm Description
131I-L19SIP Radioimmunotherapy (RIT) in Combination With External Beam Radiotherapy (EBRT) and Concurrent Chemotherapy: Treatment dose of 131I-L19SIP RIT is titrated in cohorts of 3 patients.
Intervention Type
Other
Intervention Name(s)
131I-L19SIP Radioimmunotherapy (RIT) in Combination With External Beam Radiotherapy (EBRT) and Concurrent Chemotherapy
Intervention Description
Lung tumor irradiation with a total dosage of between 60-66 Gy, fractionated in combination with the following concurrent chemotherapy options:
Cohorts 1, 2 & 3a is composed of cisplatin i.v. 80 mg/m2 on day 1, and vinorelbine i.v. 25 mg/m2 on day 1, 8, 15 for cycle 1 & 4. For patients with significant comorbidities, the dose of vinorelbine is reduced to 12.5 mg/m2 during cycles 2 & 3. Treatment cycles will be repeated every 28 days.
Protocol A (suggested for patients with comorbidities: Carboplatin 70 mg/m2, over 30 min iv, (Day 1-5 ) + Vinorelbine 12.5 mg/m2 as a 5-min bolus iv or short iv-infusion (Day 1, 8, 22), repeated on Day 28.
Protocol B (suggested for patients in good clinical condition): Paclitaxel 50 mg/m2 1 hour iv (Day 1, 15, 22, 29, 36, 43, 50) + Carboplatin AUC 2, 30 min iv on (Day 1, 15, 22, 29, 36, 43, 50).
Total treatment duration is 8-16 weeks
Primary Outcome Measure Information:
Title
Uptake of 131I-L19SIP or 124I-L19SIP
Description
The selective uptake of 131I-L19SIP or 124I-L19SIP in lung lesions and dosimetric analysis
Time Frame
2 days
Title
Safety and tolerability of 131I-L19SIP Radioimmunotherapy (RIT) in Combination With External Beam Radiotherapy (EBRT) and Concurrent Chemotherapy
Description
Safety will be assessed through physical examinations, vital signs, laboratory tests (including serum chemistries, hematology parameters) and the recording of adverse events. All results from these assessments will be coded using CTCAE v.3 and presented descriptively, indicating frequency and percentage of patients with adverse events, and abnormal laboratory tests. These results will be presented by related/unrelated and overall for the study.
Time Frame
13 months
Title
Dose Limiting Toxicities (DLTs) and Maximum Tolerated Dose/Recommended Dose (MTD/RD) for the combination treatment
Description
Dose limiting toxicities and maximum tolerated dose/recommended dose for the combination treatment
Time Frame
4 weeks
Secondary Outcome Measure Information:
Title
Overall response rate
Description
Intrapulmonal, extra pulmonal and overall response rate
Time Frame
1 year
Title
Overall survival
Time Frame
1 year
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Histologically or cytologically confirmed unresectable stage III NSCLC
Males or females, age ≥ 18 years
Measurable lung lesion defined as at least one lesion that can be accurately and serially measured per the modified RECIST criteria.
ECOG performance status < 3
Life expectancy of at least 12 weeks
Patients eligible for concurrent radiochemotherapy (cisplatin/vinorelbine; 60-66 Gy EBRT) at the discretion of the clinical investigator
Absolute neutrophil count > 1.5 x 109/L, hemoglobin > 9.0 g/dL and platelets > 100 x 109/L
Total bilirubin ≤ 30 µmol/L (or ≤ 2.0 mg/Dl)
ALT and AST ≤ 2.5 x the upper limit of normal (5.0 x ULN for patients with hepatic involvement with tumor
Serum creatinine < 1.5 x ULN
All toxic effects of prior therapy must have resolved to ≤ Grade 1 unless otherwise specified above
Negative serum pregnancy test (for women of child-bearing potential only) at screening
Exclusion Criteria:
Patients with metastatic disease
Patients amenable for surgical resection of lung tumor lesions
Previous or concurrent cancer that is distinct in primary site or histology from the cancer being evaluated in this study except cervical carcinoma in situ, treated basal cell carcinoma, superficial bladder tumors (TA, Tis & Ti) or any cancer curatively treated < 5 years prior to study entry
History of HIV infection or infectious hepatitis B or C
Presence of active infections (e.g. requiring antibimicrobial therapy) or other severe concurrent disease, which, in the opinion of the investigator, would place the patient at undue risk or interfere with the study.
Inadequately controlled cardiac arrhythmias including atrial fibrillation
Heart insufficiency (> Grade II, New York Heart Association (NYHA) criteria)
Uncontrolled hypertension
Ischemic peripheral vascular disease (Grade IIb-IV)
History of an acute cardiac event such as myocardial infarction, instable angina pectoris during the last 12 months
Severe diabetic retinopathy
Active autoimmune disease
History of organ allograft or stem cell transplantation
Recovery from major trauma including surgery within 4 weeks prior to administration of study treatment
Breast feeding female
Previous in vivo exposure to monoclonal antibodies for biological therapy in the 6 weeks before administration of study treatment
Growth factors or immunomodulatory agents within 7 days of the administration of study treatment (131I-L19SIP application).
Hyperthyroidism or autonomous thyroid nodule
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Giovanni Paganelli, Dr
Organizational Affiliation
IRST - ISTITUTO SCIENTIFICO ROMAGNOLO PER LO STUDIO E LA CURA DEI TUMORI - MELDOLA (FC)
Official's Role
Principal Investigator
Facility Information:
Facility Name
University Hospital Pisa
City
Pisa
State/Province
Tuscany
ZIP/Postal Code
56126
Country
Italy
Facility Name
Irst - Istituto Scientifico Romagnolo Per Lo Studio E La Cura Dei Tumori - Meldola (Fc)
City
Meldola
Country
Italy
12. IPD Sharing Statement
Learn more about this trial
131I-L19SIP Radioimmunotherapy Combined With Radiochemotherapy in Patients With Locally-advanced Non Small Cell Lung Cancer (NSCLC)
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