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A Phase 2 Study of ASONEP™ to Treat Unresectable and Refractory Renal Cell Carcinoma

Primary Purpose

Renal Cell Carcinoma

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
ASONEP
Sponsored by
Lpath, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Renal Cell Carcinoma focused on measuring Renal cell carcinoma, Renal cell cancer, ASONEP, Sonepcizumab

Eligibility Criteria

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

Inclusion Criteria:

  • Unresectable, locally advanced recurrent or metastatic RCC
  • Histological or cytological confirmation of clear cell RCC - core tissue biopsy of either primary tumor or metastatic lesion with paraffin-embedded tissue specimens if no prior nephrectomy
  • Measurable disease by RECIST 1.1
  • Had one prior therapy for unresectable RCC with a VEGF/VEGFR targeted therapy (sunitinib, sorafenib, other VEGFR TKI or bevacizumab) - One prior treatment with an mTOR inhibitor (everolimus, temsirolimus or sirolimus) for unresectable disease permitted-Prior immunotherapy (immunomodulators such as cytokines, interleukins, vaccines, etc.) such as IL-2 also permitted
  • Male or non-pregnant, non-nursing female
  • Life expectancy ≥3 months
  • ECOG performance status of 0, 1 or 2
  • Must not be receiving any concurrent anticancer therapy
  • Baseline CT or MRI scans of measurable disease sites by RECIST 1.1 performed within 2 weeks of Day 0 - For subjects with bone metastases, baseline bone scan performed within 4 weeks of study entry
  • Adequate organ and immune function (within 7 days of Day 0):

Hemoglobin >9 g/dL-Absolute neutrophil count >1500 cells/uL without growth factors-Platelet count ≥100x10^9/L without transfusion-Serum creatinine <2.0x ULN or creatinine clearance >40 mL/min-Total bilirubin <1.5x ULN-AST/ALT <2.5x ULN (or <5.0x ULN if liver metastases present)-INR and aPTT <1.5x ULN

  • Subject lesions for arterial spin labeling (ASL) MRI ≥2.5cm by CT imaging
  • Must understand, be able and willing to fully comply with study procedures

Exclusion Criteria:

  • Prior treatment with >3 VEGF pathway and/or mTOR inhibitors for RC cancer
  • History of other CNS disease (spinal cord compression, or evidence of symptomatic brain or leptomeningeal carcinomatosis)
  • Major surgery within 4 weeks of Day 0
  • Radiation therapy within 4 weeks of baseline/infusion. Prior palliative radiation to metastatic lesions is acceptable if there is at least one measurable, non-radiated lesion
  • Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection requiring parenteral antibiotics on Day 0
  • Known or suspected intolerance or hypersensitivity to study materials or any excipients
  • Evidence of bowel obstruction because of theoretical possibility of GI perforation with an anti-angiogenesis agent
  • Severe hemorrhage within 4 weeks of screening
  • History of GI perforation
  • History of non-healing wounds including ulcer or delayed bone fractures
  • Prolonged QTc interval on baseline ECG (>450 msec for males or >470 msec for females), cardiac dysrhythmias including atrial fibrillation, torsade de pointes, ventricular tachycardia or fibrillation, pathologic sinus bradycardia (<60 bpm), heart block (excluding 1st degree block, being PR interval prolongation only), congenital long QT syndrome or new ST segment elevation or depression or new Q wave on ECG
  • Secondary malignancy within the last 5 years, except for adequately-treated basal cell carcinoma, squamous cell skin cancer, superficial bladder tumors, or in situ cervical cancer
  • Previously enrolled in an sonepcizumab study or into this study and subsequently withdrawn
  • History of alcohol or other substance abuse within the last year
  • Use of corticosteroids or other immunosuppression (if taking systemic steroids [vs. topical], at least 4 weeks must have passed since the last dose)
  • Growth factors within 1 week of screening
  • Serious medical conditions that might be aggravated by treatment or limit compliance
  • Cerebrovascular accident or transient ischemic attack, or pulmonary embolism within 6 months prior to screening
  • Participation in another clinical trial
  • Other severe or intercurrent acute or chronic medical or psychiatric condition or laboratory abnormality that may increase risk associated with study participation or study drug administration

Sites / Locations

  • City of Hope Comprehensive Cancer Center
  • Florida Cancer Specialists
  • Florida Cancer Specialists
  • Medical University of South Carolina
  • Tennessee Oncology

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

ASONEP

Arm Description

ASONEP will be administered by intravenous infusion over 90 minutes at 15 mg/kg once a week every 4 consecutive weeks per cycle

Outcomes

Primary Outcome Measures

Progression-Free Survival
The study will use a two-cohort design based on an 8-week PFS rate. Treatment will be considered promising if at least 12 out of the first 22 eligible subjects entered in the Cohort 1 of the study are progression free at Week 8. Enrollment of Cohort 2 will then proceed and be considered worthy of further evaluation if at least 25 out of 39 eligible subjects are progression free at Week 8. If no efficacy signal is observed after enrollment of 22 subjects in Cohort 1, the second cohort will not be enrolled and the clinical study may be stopped.

Secondary Outcome Measures

Safety and Tolerability - Incidence and frequency of adverse events and serious adverse events
The incidence and frequency of adverse events and serious adverse events

Full Information

First Posted
December 17, 2012
Last Updated
January 18, 2016
Sponsor
Lpath, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT01762033
Brief Title
A Phase 2 Study of ASONEP™ to Treat Unresectable and Refractory Renal Cell Carcinoma
Official Title
A Multi-Center, Open-Label, Single-Arm, Phase 2 Study of ASONEP™ (Sonepcizumab/LT1009) Administered as a Single Agent to Subjects With Refractory Renal Cell Carcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
January 2016
Overall Recruitment Status
Terminated
Study Start Date
February 2013 (undefined)
Primary Completion Date
September 2015 (Actual)
Study Completion Date
September 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Lpath, Inc.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This Phase 2a study will investigate the efficacy, safety and tolerability of ASONEP™ (sonepcizumab/LT1009) when administered intravenously once a week, every 4 weeks (or cycle), to subjects with refractory renal cell carcinoma (RCC) until the disease progresses. Subjects who have failed 3 prior treatments for RCC including vascular endothelial growth factor (VEGF) and/or mammalian target of rapamycin (mTOR) inhibitors or who have tumors that cannot be surgically removed will be eligible for screening.
Detailed Description
LT1009-Onc-002 is a Phase 2a open-label, multi-center study designed to evaluate the efficacy and safety of ASONEP (sonepcizumab/LT1009) monotherapy in subjects with advanced, unresectable, refractory RCC who have previously failed up to 3 therapies, including VEGF and/or mTOR inhibitors. Two cohorts will be enrolled for a total of up to 39 subjects. Subjects will receive an intravenous (IV) infusion of ASONEP™ over 90 minutes at 24 mg/kg once a week and progression-free survival (PFS) will be assessed after 8 weeks of treatment. Cohort 1 will enroll approximately 22 subjects. A second cohort of up to 17 subjects will be enrolled if at least 12 out of 22 subjects from Cohort 1 demonstrated PFS at 8 weeks. Weekly dosing will take place from the date of randomization until the date of first documented progression or date of death from any cause, whichever comes first.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Renal Cell Carcinoma
Keywords
Renal cell carcinoma, Renal cell cancer, ASONEP, Sonepcizumab

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
40 (Actual)

8. Arms, Groups, and Interventions

Arm Title
ASONEP
Arm Type
Experimental
Arm Description
ASONEP will be administered by intravenous infusion over 90 minutes at 15 mg/kg once a week every 4 consecutive weeks per cycle
Intervention Type
Drug
Intervention Name(s)
ASONEP
Other Intervention Name(s)
Sonepcizumab, LT1009
Intervention Description
Intravenous infusion
Primary Outcome Measure Information:
Title
Progression-Free Survival
Description
The study will use a two-cohort design based on an 8-week PFS rate. Treatment will be considered promising if at least 12 out of the first 22 eligible subjects entered in the Cohort 1 of the study are progression free at Week 8. Enrollment of Cohort 2 will then proceed and be considered worthy of further evaluation if at least 25 out of 39 eligible subjects are progression free at Week 8. If no efficacy signal is observed after enrollment of 22 subjects in Cohort 1, the second cohort will not be enrolled and the clinical study may be stopped.
Time Frame
8 weeks
Secondary Outcome Measure Information:
Title
Safety and Tolerability - Incidence and frequency of adverse events and serious adverse events
Description
The incidence and frequency of adverse events and serious adverse events
Time Frame
8 weeks
Other Pre-specified Outcome Measures:
Title
Pharmacokinetics Trough Concentrations
Description
Descriptive statistics (mean, median, standard deviation and coefficient of variation) will be used to summarize trough concentrations. For subjects testing positive for anti-drug antibodies (ADA) to ASONEP, the relationship between plasma ADA titers and ASONEP trough concentrations will be evaluated.
Time Frame
Pre-dose, weeks 1, 2, 4 of Cycle 1; pre-dose, weeks 2, 4 of Cycle 2
Title
Tumor Response Rate
Description
Imaging-based tumor assessments will be performed and response determined according to RECIST 1.1 criteria
Time Frame
8 weeks
Title
Changes in Surrogate Markers
Description
Blood samples will be drawn for lymphocyte, antibody, cytokine, VEGF and basic fibroblast growth factor (bFGF) analysis
Time Frame
8 weeks
Title
Changes in Anti-drug Antibodies
Description
Plasma samples will be evaluated for presence of ADA. If presence of ADA in plasma is confirmed, titers of anti-ASONEP will be determined.
Time Frame
8 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Unresectable, locally advanced recurrent or metastatic RCC Histological or cytological confirmation of clear cell RCC - core tissue biopsy of either primary tumor or metastatic lesion with paraffin-embedded tissue specimens if no prior nephrectomy Measurable disease by RECIST 1.1 Had one prior therapy for unresectable RCC with a VEGF/VEGFR targeted therapy (sunitinib, sorafenib, other VEGFR TKI or bevacizumab) - One prior treatment with an mTOR inhibitor (everolimus, temsirolimus or sirolimus) for unresectable disease permitted-Prior immunotherapy (immunomodulators such as cytokines, interleukins, vaccines, etc.) such as IL-2 also permitted Male or non-pregnant, non-nursing female Life expectancy ≥3 months ECOG performance status of 0, 1 or 2 Must not be receiving any concurrent anticancer therapy Baseline CT or MRI scans of measurable disease sites by RECIST 1.1 performed within 2 weeks of Day 0 - For subjects with bone metastases, baseline bone scan performed within 4 weeks of study entry Adequate organ and immune function (within 7 days of Day 0): Hemoglobin >9 g/dL-Absolute neutrophil count >1500 cells/uL without growth factors-Platelet count ≥100x10^9/L without transfusion-Serum creatinine <2.0x ULN or creatinine clearance >40 mL/min-Total bilirubin <1.5x ULN-AST/ALT <2.5x ULN (or <5.0x ULN if liver metastases present)-INR and aPTT <1.5x ULN Subject lesions for arterial spin labeling (ASL) MRI ≥2.5cm by CT imaging Must understand, be able and willing to fully comply with study procedures Exclusion Criteria: Prior treatment with >3 VEGF pathway and/or mTOR inhibitors for RC cancer History of other CNS disease (spinal cord compression, or evidence of symptomatic brain or leptomeningeal carcinomatosis) Major surgery within 4 weeks of Day 0 Radiation therapy within 4 weeks of baseline/infusion. Prior palliative radiation to metastatic lesions is acceptable if there is at least one measurable, non-radiated lesion Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection requiring parenteral antibiotics on Day 0 Known or suspected intolerance or hypersensitivity to study materials or any excipients Evidence of bowel obstruction because of theoretical possibility of GI perforation with an anti-angiogenesis agent Severe hemorrhage within 4 weeks of screening History of GI perforation History of non-healing wounds including ulcer or delayed bone fractures Prolonged QTc interval on baseline ECG (>450 msec for males or >470 msec for females), cardiac dysrhythmias including atrial fibrillation, torsade de pointes, ventricular tachycardia or fibrillation, pathologic sinus bradycardia (<60 bpm), heart block (excluding 1st degree block, being PR interval prolongation only), congenital long QT syndrome or new ST segment elevation or depression or new Q wave on ECG Secondary malignancy within the last 5 years, except for adequately-treated basal cell carcinoma, squamous cell skin cancer, superficial bladder tumors, or in situ cervical cancer Previously enrolled in an sonepcizumab study or into this study and subsequently withdrawn History of alcohol or other substance abuse within the last year Use of corticosteroids or other immunosuppression (if taking systemic steroids [vs. topical], at least 4 weeks must have passed since the last dose) Growth factors within 1 week of screening Serious medical conditions that might be aggravated by treatment or limit compliance Cerebrovascular accident or transient ischemic attack, or pulmonary embolism within 6 months prior to screening Participation in another clinical trial Other severe or intercurrent acute or chronic medical or psychiatric condition or laboratory abnormality that may increase risk associated with study participation or study drug administration
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Susan Hazel
Organizational Affiliation
Lpath, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
City of Hope Comprehensive Cancer Center
City
Duarte
State/Province
California
ZIP/Postal Code
91010
Country
United States
Facility Name
Florida Cancer Specialists
City
Fort Myers
State/Province
Florida
ZIP/Postal Code
33908
Country
United States
Facility Name
Florida Cancer Specialists
City
Inverness
State/Province
Florida
ZIP/Postal Code
34453
Country
United States
Facility Name
Medical University of South Carolina
City
Charleston
State/Province
South Carolina
ZIP/Postal Code
29425
Country
United States
Facility Name
Tennessee Oncology
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37203
Country
United States

12. IPD Sharing Statement

Learn more about this trial

A Phase 2 Study of ASONEP™ to Treat Unresectable and Refractory Renal Cell Carcinoma

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