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Immunotherapy With Racotumomab Versus Support Treatment in Advanced Non-small Cell Lung Cancer Patients

Primary Purpose

Advanced Non-small Cell Lung Cancer

Status
Completed
Phase
Phase 2
Locations
Argentina
Study Type
Interventional
Intervention
racotumomab
Best support treatment
Sponsored by
Laboratorio Elea Phoenix S.A.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Advanced Non-small Cell Lung Cancer focused on measuring NSCLC, lung cancer, small-cell, advanced lung cancer

Eligibility Criteria

21 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. The patient (aged over 21 years, either sex) can comply with the protocol and scheduled appointments and sign voluntarily the informed consent form
  2. Diagnosis of Non-small cell lung cancer (NSCLC) stages IIIA (surgically unresectable), IIIB or IV, according to the TNM classification (Tumor-Nodes-Metastases) version 6a, confirmed by cytology or histology, if possible available for determination of ganglioside expression
  3. Patients may enter the study if they have accomplished an objective response (complete response or partial response) or disease stabilisation (by Response Evaluation Criteria In Solid Tumours [RECIST]) after completion of standard onco-specific treatment. In all cases, response should be documented.

    For stage IIIA and IIIB without pleural effusion ("dry IIIB") standard treatment is considered as follows: 2 - 4 cycles of platinum-based chemotherapy and/or radiotherapy with curative intent in accordance with National Comprehensive Cancer Network (NCCN) guidelines For stage IIIB with pleural effusion ("wet IIIB") and stage IV standard treatment is considered as follows: 4 - 6 cycles of chemotherapy based on platinum. In case of pleural or pericardial effusion requiring local treatment, it will be provided prior to study entry.

  4. Patients with an interval greater than 30 and not more than 90 days between the completion of oncospecific treatment and study entry. Completion of treatment is defined as the last day of administration of chemotherapy or the last day of radiotherapy. Patients should have recovered from any related episode of acute toxicity of degree greater than 1 (except alopecia). Patients who have received a monoclonal antibody (eg bevacizumab) should also have discontinued its use for at least 30 days before inclusion.
  5. The subject is male or female, aged greater than or equal to 21 years
  6. Performance status (Eastern Cooperative Oncology Group [ECOG]) less than or equal to 1
  7. Acceptable organ functionality as defined by the following parameters:

    • Electrocardiogram (ECG) without significant abnormalities, performed within 14 days prior to admission
    • Haemoglobin greater than or equal to 90 g/L
    • Total leukocyte count greater than or equal to 3.0 x 10^9/L
    • Absolute neutrophil count greater than or equal to 1.5 x 10^9/L
    • Total bilirubin less than or equal to 1.5 times upper limit of normal or twice the limit normal than in case liver metastases are present
    • Serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase (SGPT) less than or equal to 2.5 times upper limit of normal (less than or equal to five times the normal maximum in case liver metastases are present)
    • Creatinine less than or equal to 2 mg/dL
  8. Life expectancy of at least four months

Exclusion Criteria:

  1. Patient is pregnant or breastfeeding
  2. Has received chemotherapy, radiotherapy, immunotherapy or surgery within 30 days prior to inclusion
  3. Hypersensitivity to any component of the formulation
  4. Patients of childbearing potential of either sex who are not using an adequate method of contraception during treatment to avoid pregnancy (own or of partner). For females: intrauterine devices, hormonal contraceptives, barrier methods or sterilisation. For males: vasectomy or condoms with spermicide.
  5. Patients receiving or having received other investigational drugs 30 days prior to study entry
  6. History of autoimmune diseases
  7. Decompensated chronic diseases
  8. Acute allergic disorders or history of severe allergic reactions
  9. Known brain metastases uncontrolled with surgery and/or radiation therapy or under current corticosteroid therapy
  10. History of inflammatory or demyelinating disease of the central or peripheral nervous system
  11. Uncontrolled intercurrent illnesses, including active infection, symptomatic congestive heart failure, unstable angina or cardiac arrhythmia and psychiatric diseases implying patient incompetence
  12. Other malignancies, with the exception of basal cell carcinoma, in situ cervical carcinoma, incidental prostate cancer (T1a, Gleason less than or equal to 6, prostate specific antigen [PSA] less than 0.5 ng/ml), tumour or any other tumour adequately treated and with a disease-free period greater than or equal to 5 years
  13. Chronic treatment with systemic corticosteroids at doses greater than 0.5 mg/kg/day or a maximum of 40 mg/day of prednisone or equivalent
  14. The subject has a history of drug abuse (illicit drugs) or alcohol abuse (defined as regular or periodic ingestion of more than four drinks a day) in the last 2 years
  15. Positive serology for hepatitis B, C or known human immunodeficiency virus (HIV) infection
  16. Uncontrolled hypercalcaemia greater than or equal to 2.9 mmol/L (or grade greater than 1 according to the Common Terminology Criteria for Adverse Events [CTCAE] version 3.0)

Sites / Locations

  • Instituto de Oncología "Angel H. Roffo"

Arms of the Study

Arm 1

Arm 2

Arm Type

Other

Experimental

Arm Label

Best support treatment

Racotumomab vaccine

Arm Description

Outcomes

Primary Outcome Measures

Number of Participants with Adverse events as a measure of safety and tolerability
Safety will be evaluated at each study visit according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 3.0 and will include physical examination with vital signs, performance status as per the Eastern Cooperative Oncology Group scale(ECOG scale), laboratory tests and clinical history.
Evaluation of the reactivity if the antibodies against X63 tumor line
Determination of T supressor cell (Treg cell) frequency by immunostaining and flow cytometry.
Evaluation of the reactivity of the antibodies against the patients tumoral tissue (whenever samples are available)
Determination of gamma interferon by ELISPOT (enzyme-linked immunosorbent spot) assay.
Measurement of pro-inflammatory and anti-inflammatory cytokines
Determination of T supressor cell (Treg cell) frequency by immunostaining and flow cytometry.
Determination of T supressor cell (Treg cell) frequency by immunostaining and flow cytometry.
Determination of T supressor cell (Treg cell) frequency by immunostaining and flow cytometry.
Determination of T supressor cell (Treg cell) frequency by immunostaining and flow cytometry.
Determination of IgM and IgG antibody titers against N-Glycolil-GM3 ganglioside
Evaluation of the reactivity of the antibodies against the patients tumoral tissue (whenever samples are available)
Measurement of pro-inflammatory and anti-inflammatory cytokines.
Determination of IgM and IgG antibody titers against N-Glycolil-GM3 ganglioside
Determination of IgM and IgG antibody titers against N-Glycolil-GM3 ganglioside
Determination of IgM and IgG antibody titers against N-Glycolil-GM3 ganglioside
Determination of IgM and IgG antibody titers against N-Glycolil-GM3 ganglioside
Determination of IgM and IgG antibody titers against N-Glycolil-GM3 ganglioside
Evaluation of the reactivity if the antibodies against X63 tumor line
Evaluation of the reactivity if the antibodies against X63 tumor line
Evaluation of the reactivity if the antibodies against X63 tumor line
Evaluation of the reactivity if the antibodies against X63 tumor line
Evaluation of the reactivity if the antibodies against X63 tumor line
Evaluation of the reactivity of the antibodies against the patients tumoral tissue (whenever samples are available)
Evaluation of the reactivity of the antibodies against the patients tumoral tissue (whenever samples are available)
Evaluation of the reactivity of the antibodies against the patients tumoral tissue (whenever samples are available)
Evaluation of the reactivity of the antibodies against the patients tumoral tissue (whenever samples are available)
Determination of gamma interferon by ELISPOT (enzyme-linked immunosorbent spot) assay.
Determination of gamma interferon by ELISPOT (enzyme-linked immunosorbent spot) assay.
Determination of gamma interferon by ELISPOT (enzyme-linked immunosorbent spot) assay.
Determination of gamma interferon by ELISPOT (enzyme-linked immunosorbent spot) assay.
Determination of gamma interferon by ELISPOT (enzyme-linked immunosorbent spot) assay.
Measurement of pro-inflammatory and anti-inflammatory cytokines
Measurement of pro-inflammatory and anti-inflammatory cytokines
Measurement of pro-inflammatory and anti-inflammatory cytokines
Measurement of pro-inflammatory and anti-inflammatory cytokines
Measurement of pro-inflammatory and anti-inflammatory cytokines

Secondary Outcome Measures

Survival
On average, during 17 months
Progression free survival
Tumour evaluations will be performed every 2 months and evaluated as per Response Evaluation Criteria in Solid Tumors (RECIST).

Full Information

First Posted
September 23, 2010
Last Updated
July 9, 2014
Sponsor
Laboratorio Elea Phoenix S.A.
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1. Study Identification

Unique Protocol Identification Number
NCT01240447
Brief Title
Immunotherapy With Racotumomab Versus Support Treatment in Advanced Non-small Cell Lung Cancer Patients
Official Title
A Prospective, Randomised, Open Label Phase II Study of Active Specific Immunotherapy With Racotumomab Versus Support Treatment in Patients With Advanced Non-small Cell Lung Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
July 2014
Overall Recruitment Status
Completed
Study Start Date
September 2009 (undefined)
Primary Completion Date
August 2012 (Actual)
Study Completion Date
June 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Laboratorio Elea Phoenix S.A.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This study is designed to evaluate safety and immunogenicity of racotumomab in patients with advanced Non-small Cell Lung Cancer (NSCLC), in concomitance with chemotherapy (docetaxel) when a second-line therapy is indicated. The study will also compare survival and progression free survival on both study arms.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Advanced Non-small Cell Lung Cancer
Keywords
NSCLC, lung cancer, small-cell, advanced lung cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
7 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Best support treatment
Arm Type
Other
Arm Title
Racotumomab vaccine
Arm Type
Experimental
Intervention Type
Biological
Intervention Name(s)
racotumomab
Other Intervention Name(s)
1E10
Intervention Description
Patients will receive best support treatment and vaccination with racotumomab. The vaccination schedule is as follows: 5 doses (1mg/mL each), subcutaneously, every 2 weeks (induction period) followed by monthly vaccinations until any criteria for discontinuation are met. If disease progression occurs and a second line therapy is indicated, the patient will only be able to continue in the study if the drug indicated is docetaxel. Vaccination will not be interrupted during docetaxel administration unless criteria for vaccine discontinuation are met.
Intervention Type
Other
Intervention Name(s)
Best support treatment
Intervention Description
Patients will receive best support treatment as indicated by the investigator. In case a second line therapy is indicated, docetaxel is the only drug allowed to continue in the study.
Primary Outcome Measure Information:
Title
Number of Participants with Adverse events as a measure of safety and tolerability
Description
Safety will be evaluated at each study visit according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 3.0 and will include physical examination with vital signs, performance status as per the Eastern Cooperative Oncology Group scale(ECOG scale), laboratory tests and clinical history.
Time Frame
Until death, on average during 17 months
Title
Evaluation of the reactivity if the antibodies against X63 tumor line
Time Frame
Baseline
Title
Determination of T supressor cell (Treg cell) frequency by immunostaining and flow cytometry.
Time Frame
Baseline
Title
Evaluation of the reactivity of the antibodies against the patients tumoral tissue (whenever samples are available)
Time Frame
Baseline
Title
Determination of gamma interferon by ELISPOT (enzyme-linked immunosorbent spot) assay.
Time Frame
Baseline
Title
Measurement of pro-inflammatory and anti-inflammatory cytokines
Time Frame
Baseline
Title
Determination of T supressor cell (Treg cell) frequency by immunostaining and flow cytometry.
Time Frame
Month 2
Title
Determination of T supressor cell (Treg cell) frequency by immunostaining and flow cytometry.
Time Frame
Month 4
Title
Determination of T supressor cell (Treg cell) frequency by immunostaining and flow cytometry.
Time Frame
Month 8
Title
Determination of T supressor cell (Treg cell) frequency by immunostaining and flow cytometry.
Time Frame
Month 12
Title
Determination of IgM and IgG antibody titers against N-Glycolil-GM3 ganglioside
Time Frame
Baseline
Title
Evaluation of the reactivity of the antibodies against the patients tumoral tissue (whenever samples are available)
Time Frame
Month 2
Title
Measurement of pro-inflammatory and anti-inflammatory cytokines.
Time Frame
Baseline
Title
Determination of IgM and IgG antibody titers against N-Glycolil-GM3 ganglioside
Time Frame
Month 2
Title
Determination of IgM and IgG antibody titers against N-Glycolil-GM3 ganglioside
Time Frame
Month 8
Title
Determination of IgM and IgG antibody titers against N-Glycolil-GM3 ganglioside
Time Frame
Month 4
Title
Determination of IgM and IgG antibody titers against N-Glycolil-GM3 ganglioside
Time Frame
Month 12
Title
Determination of IgM and IgG antibody titers against N-Glycolil-GM3 ganglioside
Time Frame
Every 4 months (after the first year, on average during 17 months)
Title
Evaluation of the reactivity if the antibodies against X63 tumor line
Time Frame
Month 2
Title
Evaluation of the reactivity if the antibodies against X63 tumor line
Time Frame
Month 12
Title
Evaluation of the reactivity if the antibodies against X63 tumor line
Time Frame
Every 4 months (after the first year, on average during 17 months)
Title
Evaluation of the reactivity if the antibodies against X63 tumor line
Time Frame
Month 4
Title
Evaluation of the reactivity if the antibodies against X63 tumor line
Time Frame
Month 8
Title
Evaluation of the reactivity of the antibodies against the patients tumoral tissue (whenever samples are available)
Time Frame
Month 4
Title
Evaluation of the reactivity of the antibodies against the patients tumoral tissue (whenever samples are available)
Time Frame
Month 8
Title
Evaluation of the reactivity of the antibodies against the patients tumoral tissue (whenever samples are available)
Time Frame
Month 12
Title
Evaluation of the reactivity of the antibodies against the patients tumoral tissue (whenever samples are available)
Time Frame
Every 4 months (after the first year, on average during 17 months)
Title
Determination of gamma interferon by ELISPOT (enzyme-linked immunosorbent spot) assay.
Time Frame
Month 2
Title
Determination of gamma interferon by ELISPOT (enzyme-linked immunosorbent spot) assay.
Time Frame
Month 4
Title
Determination of gamma interferon by ELISPOT (enzyme-linked immunosorbent spot) assay.
Time Frame
Month 8
Title
Determination of gamma interferon by ELISPOT (enzyme-linked immunosorbent spot) assay.
Time Frame
Month 12
Title
Determination of gamma interferon by ELISPOT (enzyme-linked immunosorbent spot) assay.
Time Frame
Every 4 months (after the first year, on average during 17 months)
Title
Measurement of pro-inflammatory and anti-inflammatory cytokines
Time Frame
Month 2
Title
Measurement of pro-inflammatory and anti-inflammatory cytokines
Time Frame
Month 4
Title
Measurement of pro-inflammatory and anti-inflammatory cytokines
Time Frame
Month 8
Title
Measurement of pro-inflammatory and anti-inflammatory cytokines
Time Frame
Month 12
Title
Measurement of pro-inflammatory and anti-inflammatory cytokines
Time Frame
Every 4 months (after the first year, on average during 17 months)
Secondary Outcome Measure Information:
Title
Survival
Description
On average, during 17 months
Time Frame
Until date of death or last censored observation
Title
Progression free survival
Description
Tumour evaluations will be performed every 2 months and evaluated as per Response Evaluation Criteria in Solid Tumors (RECIST).
Time Frame
Until first progression of disease

10. Eligibility

Sex
All
Minimum Age & Unit of Time
21 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: The patient (aged over 21 years, either sex) can comply with the protocol and scheduled appointments and sign voluntarily the informed consent form Diagnosis of Non-small cell lung cancer (NSCLC) stages IIIA (surgically unresectable), IIIB or IV, according to the TNM classification (Tumor-Nodes-Metastases) version 6a, confirmed by cytology or histology, if possible available for determination of ganglioside expression Patients may enter the study if they have accomplished an objective response (complete response or partial response) or disease stabilisation (by Response Evaluation Criteria In Solid Tumours [RECIST]) after completion of standard onco-specific treatment. In all cases, response should be documented. For stage IIIA and IIIB without pleural effusion ("dry IIIB") standard treatment is considered as follows: 2 - 4 cycles of platinum-based chemotherapy and/or radiotherapy with curative intent in accordance with National Comprehensive Cancer Network (NCCN) guidelines For stage IIIB with pleural effusion ("wet IIIB") and stage IV standard treatment is considered as follows: 4 - 6 cycles of chemotherapy based on platinum. In case of pleural or pericardial effusion requiring local treatment, it will be provided prior to study entry. Patients with an interval greater than 30 and not more than 90 days between the completion of oncospecific treatment and study entry. Completion of treatment is defined as the last day of administration of chemotherapy or the last day of radiotherapy. Patients should have recovered from any related episode of acute toxicity of degree greater than 1 (except alopecia). Patients who have received a monoclonal antibody (eg bevacizumab) should also have discontinued its use for at least 30 days before inclusion. The subject is male or female, aged greater than or equal to 21 years Performance status (Eastern Cooperative Oncology Group [ECOG]) less than or equal to 1 Acceptable organ functionality as defined by the following parameters: Electrocardiogram (ECG) without significant abnormalities, performed within 14 days prior to admission Haemoglobin greater than or equal to 90 g/L Total leukocyte count greater than or equal to 3.0 x 10^9/L Absolute neutrophil count greater than or equal to 1.5 x 10^9/L Total bilirubin less than or equal to 1.5 times upper limit of normal or twice the limit normal than in case liver metastases are present Serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase (SGPT) less than or equal to 2.5 times upper limit of normal (less than or equal to five times the normal maximum in case liver metastases are present) Creatinine less than or equal to 2 mg/dL Life expectancy of at least four months Exclusion Criteria: Patient is pregnant or breastfeeding Has received chemotherapy, radiotherapy, immunotherapy or surgery within 30 days prior to inclusion Hypersensitivity to any component of the formulation Patients of childbearing potential of either sex who are not using an adequate method of contraception during treatment to avoid pregnancy (own or of partner). For females: intrauterine devices, hormonal contraceptives, barrier methods or sterilisation. For males: vasectomy or condoms with spermicide. Patients receiving or having received other investigational drugs 30 days prior to study entry History of autoimmune diseases Decompensated chronic diseases Acute allergic disorders or history of severe allergic reactions Known brain metastases uncontrolled with surgery and/or radiation therapy or under current corticosteroid therapy History of inflammatory or demyelinating disease of the central or peripheral nervous system Uncontrolled intercurrent illnesses, including active infection, symptomatic congestive heart failure, unstable angina or cardiac arrhythmia and psychiatric diseases implying patient incompetence Other malignancies, with the exception of basal cell carcinoma, in situ cervical carcinoma, incidental prostate cancer (T1a, Gleason less than or equal to 6, prostate specific antigen [PSA] less than 0.5 ng/ml), tumour or any other tumour adequately treated and with a disease-free period greater than or equal to 5 years Chronic treatment with systemic corticosteroids at doses greater than 0.5 mg/kg/day or a maximum of 40 mg/day of prednisone or equivalent The subject has a history of drug abuse (illicit drugs) or alcohol abuse (defined as regular or periodic ingestion of more than four drinks a day) in the last 2 years Positive serology for hepatitis B, C or known human immunodeficiency virus (HIV) infection Uncontrolled hypercalcaemia greater than or equal to 2.9 mmol/L (or grade greater than 1 according to the Common Terminology Criteria for Adverse Events [CTCAE] version 3.0)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gabriela Cinat, MD
Organizational Affiliation
Instituto de Oncología "Angel H. Roffo"
Official's Role
Principal Investigator
Facility Information:
Facility Name
Instituto de Oncología "Angel H. Roffo"
City
Buenos Aires
ZIP/Postal Code
C1417DTB
Country
Argentina

12. IPD Sharing Statement

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Immunotherapy With Racotumomab Versus Support Treatment in Advanced Non-small Cell Lung Cancer Patients

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