TF2- Small Cell Lung Cancer Radio Immunotherapy
Primary Purpose
Small Cell Lung Cancer, CEA-expressing Non Small Cell Lung Carcinoma (NSCLC)
Status
Completed
Phase
Phase 1
Locations
France
Study Type
Interventional
Intervention
Antibody TF2
IMP-288-Lutetium
IMP-288-Indium
Sponsored by
About this trial
This is an interventional treatment trial for Small Cell Lung Cancer focused on measuring Small Cell Lung Cancer or CEA-expressing Non Small Cell Lung Carcinoma (NSCLC), Radio Immunotherapy, Lutetium, patient ≥ 18 years of age with CEA-positive SCLC in partial response, or who failed at least two lines of standard radiation and/or chemotherapy, or Patients with histologic diagnosis of NSCLC
Eligibility Criteria
Inclusion Criteria:
• Patients with histologic diagnosis of SCLC who are in partial response or who have failed at least two lines of standard radiation and/or chemotherapy. Outside formal contra-indication, patients must have received at least one prior platinum-based chemotherapy.
or
- Patients with histologic diagnosis of NSCLC (without activating mutation of EGFR gene) who have failed at least one line of chemotherapy (platinum in combination with a third generation drug or combination of 2 third generation drug +/-bevacizumab in case of predominance of non-squamous tumor)
- Age ≥ 18 years
- At least 4-weeks after the previous treatment and have recovered from previous radio- or chemotherapy
- Women of child-bearing potential must have a negative pregnancy test.
- Karnofsky performance status ≥ 60 or ECOG performance status 0-2Karnofsky
- Minimum life expectancy of 3 months
- Positive CEA on immunohistology or plasma CEA ≥ 10 ng/mL
- At least one measurable lesion by CT
- At least one abnormal focus by FDG-PET
- Imaging studies must be performed within 1-4 weeks before PRAIT study to document extent of disease
- Signed informed consent form.
Exclusion Criteria:
- Pregnant or lactating woman. Women of child-bearing potential will be asked to practice adequate means of birth control for a minimum of 12 months after treatment.
- Male patient refusing effective contraception for a minimum of 12 months after treatment.
- Brain metastases but patients with brain metastases controlled after treatment by Surgery or radiotherapy since more than 4 weeks are eligibles for the study. An treatment by associated corticotherapy is authorized for these patients.
- Known HIV or hepatitis
- Any serious active disease or comorbid medical condition (according to the investigator's decision and information provided in the IDB)
- Severe disorders of hemostasis or anticoagulant treatment cure
- Extensive irradiation to more than 25% of their red marrow
- Bone marrow involvement to more than 25%
- External radiation to specific organs or areas at the maximum tolerated level
- EGFR gene mutation in tumor (only for NSCLC)
- Febrile aplasia during a previous chemotherapy
- Neutrophils < 1.5 G/l
- Platelets < 100 G/l
- Uncontrolled diabetes
- Poor renal function (creatinine level > 2.5 maximum normal level)
- Poor hepatic function (total bilirubin level > 30 mmol/l, transaminases > 2.5 maximum normal level)
- Treatment with any investigational drug within 30 days before planned PRAIT and during the study
- Any history of cancer during the last 5 years, with the exception of non-melanoma skin tumors or stage 0 (in situ) cervical carcinoma,
- Presence of anti-antibody reactivity
- Known hypersensitivity to murine antibodies or proteins
- Adult patient unable to give informed consent because of intellectual impairment.
Sites / Locations
- CHU d'Angers
- CHU
- Centre Jean Perrin
- Hôpital La tronche
- Hotel Dieu
- Centre René Gauducheau
Outcomes
Primary Outcome Measures
Primary endpoint of study plan I: To determine the optimal TF2 protein dose for pretargeting IMP-288.
Primary endpoint of study plan II • the maximum tolerated dose (MTD) for the TF2-pretargeted 177Lu-IMP-288 under optimal pretargeting conditions.
Secondary Outcome Measures
Full Information
NCT ID
NCT01221675
First Posted
October 11, 2010
Last Updated
August 30, 2016
Sponsor
Centre René Gauducheau
1. Study Identification
Unique Protocol Identification Number
NCT01221675
Brief Title
TF2- Small Cell Lung Cancer Radio Immunotherapy
Official Title
Prospective Multicentric Optimization and Phase I/II Study of Pretargeted Radioimmunotherapy (PRAIT) Using Anti-CEA x Anti-HSG TF2 Bispecific Antibody (bsMAb) and 177Lu-IMP-288 Peptide in Patients With CEA-expressing Small Cell Lung Carcinoma (SCLC) or CEA-expressing Non Small Cell Lung Carcinoma (NSCLC)
Study Type
Interventional
2. Study Status
Record Verification Date
April 2016
Overall Recruitment Status
Completed
Study Start Date
June 2011 (undefined)
Primary Completion Date
April 2016 (Actual)
Study Completion Date
April 2016 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Centre René Gauducheau
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
Lung cancer is currently the leading cause of cancer death in both men and women in Europe, with an estimated 250000 new cases diagnosed in 2005. The continued poor outcome of patients indicates that the current recommended regimens are falling short. In addition, many of the commonly used chemotherapy agents are associated with severe nonhematologic toxicities that are often cumulative and nonreversible and impair quality of life in this essentially palliative setting. Therefore, agents with novel mechanisms of action and superior safety profiles need to be investigated. More than 50% of lung cancer shows carcinoembryonic antigen (CEA) expression and anti-CEA radioimmunotherapy (RAIT) could be used. The investigators group showed that pretargeted RAIT (PRAIT) using bispecific antibody (bsMAb) can deliver a higher radiation dose to a tumor than a directly radiolabeled anti-CEA antibody, and shows improved anti-tumor efficacy. This clinical trial is designed to assess PRAIT using an entirely new recombinant anti-CEA bsMAb and a 177Lu-labeled peptide for the treatment of CEA-expressing small cell lung cancers (SCLC) or CEA-expressing Non Small Cell Lung Carcinoma (NSCLC)
Detailed Description
The purpose of this open-label prospective optimization and phase I/II clinical trial is to examine the safety, optimal dose, targeting, dosimetry and efficacy of PRAIT using the humanized anti-CEA x anti-HSG bsMAb TF2 and the 177Lu-IMP-288 peptide pretargeted in patients with CEA-positive SCLC or CEA-expressing Non Small Cell Lung Carcinoma (NSCLC)
This study has 2 parts: Study plan I (Optimization study) and Study plan II (Escalating activity phase I/II study).
The Study plan I is designed to optimize the pretargeting procedure using blood pharmacokinetics (Pk) and dosimetry in 9 patients receiving escalating doses of TF2 followed 2 to 4 days later by 1.1 GBq/m2 of 177Lu-IMP-288.
The study plan II is designed to determined MTD of 177Lu-IMP-288 using dosimetry and toxicity data in a phase I/II study performed in patients receiving optimal dose of TF2 bsMAb (determined in study plan I) followed 2 to 4 days by escalating activity of 177Lu-IMP-288.
A pre-therapy imaging study (using TF2 followed 2 to 4 days later by 185 MBq of 111In-IMP-288) is performed in the two study plans to qualify a patient for treatment with the subsequent therapy dose.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Small Cell Lung Cancer, CEA-expressing Non Small Cell Lung Carcinoma (NSCLC)
Keywords
Small Cell Lung Cancer or CEA-expressing Non Small Cell Lung Carcinoma (NSCLC), Radio Immunotherapy, Lutetium, patient ≥ 18 years of age with CEA-positive SCLC in partial response, or who failed at least two lines of standard radiation and/or chemotherapy, or Patients with histologic diagnosis of NSCLC
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
18 (Actual)
8. Arms, Groups, and Interventions
Intervention Type
Drug
Intervention Name(s)
Antibody TF2
Intervention Description
preciblage with an antibody
Intervention Type
Radiation
Intervention Name(s)
IMP-288-Lutetium
Intervention Description
Internal Radiation
Intervention Type
Radiation
Intervention Name(s)
IMP-288-Indium
Intervention Description
Imaging
Primary Outcome Measure Information:
Title
Primary endpoint of study plan I: To determine the optimal TF2 protein dose for pretargeting IMP-288.
Title
Primary endpoint of study plan II • the maximum tolerated dose (MTD) for the TF2-pretargeted 177Lu-IMP-288 under optimal pretargeting conditions.
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
• Patients with histologic diagnosis of SCLC who are in partial response or who have failed at least two lines of standard radiation and/or chemotherapy. Outside formal contra-indication, patients must have received at least one prior platinum-based chemotherapy.
or
Patients with histologic diagnosis of NSCLC (without activating mutation of EGFR gene) who have failed at least one line of chemotherapy (platinum in combination with a third generation drug or combination of 2 third generation drug +/-bevacizumab in case of predominance of non-squamous tumor)
Age ≥ 18 years
At least 4-weeks after the previous treatment and have recovered from previous radio- or chemotherapy
Women of child-bearing potential must have a negative pregnancy test.
Karnofsky performance status ≥ 60 or ECOG performance status 0-2Karnofsky
Minimum life expectancy of 3 months
Positive CEA on immunohistology or plasma CEA ≥ 10 ng/mL
At least one measurable lesion by CT
At least one abnormal focus by FDG-PET
Imaging studies must be performed within 1-4 weeks before PRAIT study to document extent of disease
Signed informed consent form.
Exclusion Criteria:
Pregnant or lactating woman. Women of child-bearing potential will be asked to practice adequate means of birth control for a minimum of 12 months after treatment.
Male patient refusing effective contraception for a minimum of 12 months after treatment.
Brain metastases but patients with brain metastases controlled after treatment by Surgery or radiotherapy since more than 4 weeks are eligibles for the study. An treatment by associated corticotherapy is authorized for these patients.
Known HIV or hepatitis
Any serious active disease or comorbid medical condition (according to the investigator's decision and information provided in the IDB)
Severe disorders of hemostasis or anticoagulant treatment cure
Extensive irradiation to more than 25% of their red marrow
Bone marrow involvement to more than 25%
External radiation to specific organs or areas at the maximum tolerated level
EGFR gene mutation in tumor (only for NSCLC)
Febrile aplasia during a previous chemotherapy
Neutrophils < 1.5 G/l
Platelets < 100 G/l
Uncontrolled diabetes
Poor renal function (creatinine level > 2.5 maximum normal level)
Poor hepatic function (total bilirubin level > 30 mmol/l, transaminases > 2.5 maximum normal level)
Treatment with any investigational drug within 30 days before planned PRAIT and during the study
Any history of cancer during the last 5 years, with the exception of non-melanoma skin tumors or stage 0 (in situ) cervical carcinoma,
Presence of anti-antibody reactivity
Known hypersensitivity to murine antibodies or proteins
Adult patient unable to give informed consent because of intellectual impairment.
Facility Information:
Facility Name
CHU d'Angers
City
Angers
ZIP/Postal Code
49100
Country
France
Facility Name
CHU
City
Brest
ZIP/Postal Code
29000
Country
France
Facility Name
Centre Jean Perrin
City
Clermont Ferrand
Country
France
Facility Name
Hôpital La tronche
City
Grenoble
ZIP/Postal Code
38000
Country
France
Facility Name
Hotel Dieu
City
Nantes
ZIP/Postal Code
44093
Country
France
Facility Name
Centre René Gauducheau
City
Saint Herblain
ZIP/Postal Code
44805
Country
France
12. IPD Sharing Statement
Citations:
PubMed Identifier
26640780
Citation
Bodet-Milin C, Ferrer L, Rauscher A, Masson D, Rbah-Vidal L, Faivre-Chauvet A, Cerato E, Rousseau C, Hureaux J, Couturier O, Salaun PY, Goldenberg DM, Sharkey RM, Kraeber-Bodere F, Barbet J. Pharmacokinetics and Dosimetry Studies for Optimization of Pretargeted Radioimmunotherapy in CEA-Expressing Advanced Lung Cancer Patients. Front Med (Lausanne). 2015 Nov 27;2:84. doi: 10.3389/fmed.2015.00084. eCollection 2015.
Results Reference
derived
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TF2- Small Cell Lung Cancer Radio Immunotherapy
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