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Single Dose of Intravenous rhTNF-α and Liposomal Doxorubicin in Patients With Advanced Solid Tumors or Lymphomas

Primary Purpose

Solid Tumors, Lymphomas

Status
Withdrawn
Phase
Phase 1
Locations
Germany
Study Type
Interventional
Intervention
Recombinant human TNF-α
Liposomal doxorubicin
Caelyx
Recombinant human TNF-α
Sponsored by
Ludwig Institute for Cancer Research
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Solid Tumors

Eligibility Criteria

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

Inclusion Criteria:

  • Patient must have a diagnosed solid tumor malignancy or lymphoma indicated for Caelyx treatment.
  • Patient is refractory to all lines of standard therapy including biologics, chemo or other therapies, or at least one line of therapy in those patients for whom no standard treatment exists.
  • Patient has measurable disease (defined as at least one lesion whose longest diameter can be accurately measured as >1 cm).
  • At least 2 weeks has elapsed since the completion of the last cycle of chemotherapy and/or major surgery and the patient is fully recovered from this previous therapy or surgery and any post-surgical complications.
  • The patient has a normal cardiac ejection fraction on MUGA or Echocardiogram.
  • ECOG performance status of 2 or less.
  • Patient is at least 18 years of age.
  • Patient is capable of giving informed consent.
  • Patient of childbearing potential is using adequate birth control measures (e.g., abstinence, barrier method with spermicide; intrauterine device, implantable or injectable contraceptives or surgical sterilization) for the duration of the study and will continue to use such precautions for 12 months after receiving treatment.

Exclusion Criteria:

  • Positive pregnancy test or known pregnancy.
  • Participation in any other clinical trial
  • Known hypersensitivity to the active substance or to any of the excipients (Albumin).
  • Patients exposed to greater than 450 mg/m2 of doxorubicin or Caelyx.
  • Patient has a creatinine > 1.5 x the upper limit of normal, chronic renal failure requiring hemodialysis or peritoneal dialysis.
  • Platelet count equal to or less than 50,000/mm3, Hemoglobin less than 9.0 g/dL, or an ANC less than 1,000 /mm3.
  • Patient has a Sa02 of less than 93% on room air.
  • Patient with detectable ascites or portosystemic hypertension or cirrhosis.
  • Patient with bilirubin > 2.0, AST or ALT above 2.5X the upper limit of normal, an alkaline phosphatase above 2.5X the upper limit of normal.
  • Hypercalcaemia > 12 mg/dl (2.99 mmol/l).
  • Patients with contraindications to the use of vasopressor substances.
  • Patient has presence of a transplanted solid organ (with the exception of a corneal transplant > 3 months prior to screening) or bone marrow transplant.
  • Patient has a history of a significant medical illness deemed by the principal investigator or sub-investigators as unsuitable for the trial, for example: Significant cardiovascular disease, e.g. congestive heart failure (New York Heart Association Class II, III or IV), severe angina pectoris, cardiac arrhythmias, myocardial infarction within a 3 month period prior to treatment, venous thrombosis, occlusive peripheral arterial disease, recent pulmonary embolism. Severe pulmonary dysfunction. A recent history of, or active peptic ulcer. Severe ascites. Known hypotension.

Sites / Locations

  • Krankenhaus Nordwest

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm 7

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Arm Label

rhTNF-α 25 µg/m² + Caelyx 40 mg/m²

rhTNF-α 50 µg/m² + Caelyx 40 mg/m²

rhTNF-α 100 µg/m² + Caelyx 40 mg/m²

rhTNF-α 150 µg/m² + Caelyx 40 mg/m²

rhTNF-α 200 µg/m² + Caelyx 40 mg/m²

rhTNF-α 250 µg/m² + Caelyx 40 mg/m²

rhTNF-α 25 µg/m² + Caelyx 30 mg/m²

Arm Description

Cohort 2: rhTNF-α 25 µg/m² + Caelyx 40 mg/m²

Cohort 3: rhTNF-α 50 µg/m² + Caelyx 40 mg/m²

Cohort 4: rhTNF-α 100 µg/m² + Caelyx 40 mg/m²

Cohort 5: rhTNF-α 150 µg/m² + Caelyx 40 mg/m²

Cohort 6: rhTNF-α 200 µg/m² + Caelyx 40 mg/m²

Cohort 7: rhTNF-α 250 µg/m² + Caelyx 40 mg/m²

Cohort 1 rhTNF-α 25 µg/m² + Caelyx 30 mg/m²

Outcomes

Primary Outcome Measures

Maximum Tolerated Dose (MTD) of a single dose of intravenous recombinant human tumor necrosis factor-α plus liposomal doxorubicin
MTD is the dose level below the one that produces 2 or more Dose-Limiting Toxicities
Dose Limiting Toxicity (DLT) of a single dose of intravenous recombinant human tumor necrosis factor-α plus liposomal doxorubicin
Toxicity Criteria will be those listed in NCI Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. Any grade 3 cytokine release syndrome/acute infusion reaction or allergic and toxicity Grade 3 and above will be considered a DLT except: Grade 3 toxicities that recover to grade 1 or less within 48 hours after standard supportive treatment. Grade 4 neutropenia that recovers within 14 days. Grade 4 thrombocytopenia that recovers within 14 days. Grade 4 anemia that recovers within 14 days.

Secondary Outcome Measures

Overall tumor response using the international criteria proposed by the Response Evaluation Criteria in Solid Tumors (RECIST v1.1)
Caelyx/doxorubicin plasma levels
Caelyx/doxorubicin plasma levels will be measured at 0, 24, 48 and 192 hours post-dose by fluorimetry (excitation at 470nm, emission 590 nm) after liposomes have been disrupted in 70% ethanol, 0.3 N HCl

Full Information

First Posted
December 8, 2011
Last Updated
June 15, 2015
Sponsor
Ludwig Institute for Cancer Research
Collaborators
Johns Hopkins University
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1. Study Identification

Unique Protocol Identification Number
NCT01490047
Brief Title
Single Dose of Intravenous rhTNF-α and Liposomal Doxorubicin in Patients With Advanced Solid Tumors or Lymphomas
Official Title
Phase I Trial of Intravenous Recombinant Human TNF-α and Liposomal Doxorubicin in Patients With Advanced Solid Tumors or Lymphomas
Study Type
Interventional

2. Study Status

Record Verification Date
June 2015
Overall Recruitment Status
Withdrawn
Study Start Date
January 2013 (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Ludwig Institute for Cancer Research
Collaborators
Johns Hopkins University

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Assess the maximum tolerated dose (MTD) and dose limiting toxicity (DLT) of recombinant human tumor necrosis factor-α (rhTNF-α) when given as a single dose intravenously and in combination with liposomal doxorubicin in human subjects

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Solid Tumors, Lymphomas

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
rhTNF-α 25 µg/m² + Caelyx 40 mg/m²
Arm Type
Experimental
Arm Description
Cohort 2: rhTNF-α 25 µg/m² + Caelyx 40 mg/m²
Arm Title
rhTNF-α 50 µg/m² + Caelyx 40 mg/m²
Arm Type
Experimental
Arm Description
Cohort 3: rhTNF-α 50 µg/m² + Caelyx 40 mg/m²
Arm Title
rhTNF-α 100 µg/m² + Caelyx 40 mg/m²
Arm Type
Experimental
Arm Description
Cohort 4: rhTNF-α 100 µg/m² + Caelyx 40 mg/m²
Arm Title
rhTNF-α 150 µg/m² + Caelyx 40 mg/m²
Arm Type
Experimental
Arm Description
Cohort 5: rhTNF-α 150 µg/m² + Caelyx 40 mg/m²
Arm Title
rhTNF-α 200 µg/m² + Caelyx 40 mg/m²
Arm Type
Experimental
Arm Description
Cohort 6: rhTNF-α 200 µg/m² + Caelyx 40 mg/m²
Arm Title
rhTNF-α 250 µg/m² + Caelyx 40 mg/m²
Arm Type
Experimental
Arm Description
Cohort 7: rhTNF-α 250 µg/m² + Caelyx 40 mg/m²
Arm Title
rhTNF-α 25 µg/m² + Caelyx 30 mg/m²
Arm Type
Experimental
Arm Description
Cohort 1 rhTNF-α 25 µg/m² + Caelyx 30 mg/m²
Intervention Type
Drug
Intervention Name(s)
Recombinant human TNF-α
Other Intervention Name(s)
Beromun
Intervention Description
Infusion will be done over 60 minutes, preferably via central venous catheter. Will immediately follow the infusion of Liposomal doxorubicin.
Intervention Type
Drug
Intervention Name(s)
Liposomal doxorubicin
Other Intervention Name(s)
Caelyx
Intervention Description
Infusion over 60 minutes
Intervention Type
Drug
Intervention Name(s)
Caelyx
Other Intervention Name(s)
liposomal doxorubicin
Intervention Description
Administration of Caelyx® will be done first, as infusion in 250 ml D5W, followed immediately by infusion of rhTNF-α.
Intervention Type
Drug
Intervention Name(s)
Recombinant human TNF-α
Other Intervention Name(s)
Beromun
Intervention Description
Recombinant human TNF-α (Beromun) will be diluted in 250 mL of normal saline with albumin (2 mg/mL) to prevent adherence of the protein to the delivery apparatus. Infusion will be done over 60 minutes, preferably via central venous catheter, including PICC lines.
Primary Outcome Measure Information:
Title
Maximum Tolerated Dose (MTD) of a single dose of intravenous recombinant human tumor necrosis factor-α plus liposomal doxorubicin
Description
MTD is the dose level below the one that produces 2 or more Dose-Limiting Toxicities
Time Frame
Up to 22 days
Title
Dose Limiting Toxicity (DLT) of a single dose of intravenous recombinant human tumor necrosis factor-α plus liposomal doxorubicin
Description
Toxicity Criteria will be those listed in NCI Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. Any grade 3 cytokine release syndrome/acute infusion reaction or allergic and toxicity Grade 3 and above will be considered a DLT except: Grade 3 toxicities that recover to grade 1 or less within 48 hours after standard supportive treatment. Grade 4 neutropenia that recovers within 14 days. Grade 4 thrombocytopenia that recovers within 14 days. Grade 4 anemia that recovers within 14 days.
Time Frame
up to 22 days
Secondary Outcome Measure Information:
Title
Overall tumor response using the international criteria proposed by the Response Evaluation Criteria in Solid Tumors (RECIST v1.1)
Time Frame
4 weeks
Title
Caelyx/doxorubicin plasma levels
Description
Caelyx/doxorubicin plasma levels will be measured at 0, 24, 48 and 192 hours post-dose by fluorimetry (excitation at 470nm, emission 590 nm) after liposomes have been disrupted in 70% ethanol, 0.3 N HCl
Time Frame
0, 24, 48 and 192 hours post-dose

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient must have a diagnosed solid tumor malignancy or lymphoma indicated for Caelyx treatment. Patient is refractory to all lines of standard therapy including biologics, chemo or other therapies, or at least one line of therapy in those patients for whom no standard treatment exists. Patient has measurable disease (defined as at least one lesion whose longest diameter can be accurately measured as >1 cm). At least 2 weeks has elapsed since the completion of the last cycle of chemotherapy and/or major surgery and the patient is fully recovered from this previous therapy or surgery and any post-surgical complications. The patient has a normal cardiac ejection fraction on MUGA or Echocardiogram. ECOG performance status of 2 or less. Patient is at least 18 years of age. Patient is capable of giving informed consent. Patient of childbearing potential is using adequate birth control measures (e.g., abstinence, barrier method with spermicide; intrauterine device, implantable or injectable contraceptives or surgical sterilization) for the duration of the study and will continue to use such precautions for 12 months after receiving treatment. Exclusion Criteria: Positive pregnancy test or known pregnancy. Participation in any other clinical trial Known hypersensitivity to the active substance or to any of the excipients (Albumin). Patients exposed to greater than 450 mg/m2 of doxorubicin or Caelyx. Patient has a creatinine > 1.5 x the upper limit of normal, chronic renal failure requiring hemodialysis or peritoneal dialysis. Platelet count equal to or less than 50,000/mm3, Hemoglobin less than 9.0 g/dL, or an ANC less than 1,000 /mm3. Patient has a Sa02 of less than 93% on room air. Patient with detectable ascites or portosystemic hypertension or cirrhosis. Patient with bilirubin > 2.0, AST or ALT above 2.5X the upper limit of normal, an alkaline phosphatase above 2.5X the upper limit of normal. Hypercalcaemia > 12 mg/dl (2.99 mmol/l). Patients with contraindications to the use of vasopressor substances. Patient has presence of a transplanted solid organ (with the exception of a corneal transplant > 3 months prior to screening) or bone marrow transplant. Patient has a history of a significant medical illness deemed by the principal investigator or sub-investigators as unsuitable for the trial, for example: Significant cardiovascular disease, e.g. congestive heart failure (New York Heart Association Class II, III or IV), severe angina pectoris, cardiac arrhythmias, myocardial infarction within a 3 month period prior to treatment, venous thrombosis, occlusive peripheral arterial disease, recent pulmonary embolism. Severe pulmonary dysfunction. A recent history of, or active peptic ulcer. Severe ascites. Known hypotension.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Elke Jäger, MD
Organizational Affiliation
Krankenhaus Nordwest, Frankfurt, Germany
Official's Role
Principal Investigator
Facility Information:
Facility Name
Krankenhaus Nordwest
City
Frankfurt
ZIP/Postal Code
D-60488
Country
Germany

12. IPD Sharing Statement

Learn more about this trial

Single Dose of Intravenous rhTNF-α and Liposomal Doxorubicin in Patients With Advanced Solid Tumors or Lymphomas

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