A Phase 1b/2 Study of OMP-59R5 (Tarextumab) in Combination With Etoposide and Platinum Therapy (PINNACLE)
Primary Purpose
Stage IV Small Cell Lung Cancer
Status
Terminated
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
OMP-59R5
Etoposide
Placebo
Cisplatin or Carboplatin
Sponsored by
About this trial
This is an interventional treatment trial for Stage IV Small Cell Lung Cancer focused on measuring Newly diagnosed Stage IV Small Cell Lung Cancer
Eligibility Criteria
Inclusion Criteria:
Subjects must meet all of the following criteria to be eligible for the study:
- Histologically or cytologically documented extensive stage small cell lung cancer.
- Adults of 18 years of age or older.
- Performance Status (ECOG) of 0 or 1.
- Formalin Fixed Paraffin Embedded (FFPE) tumor tissue.
Adequate organ function:
- Adequate hematologic function (absolute neutrophil count [ANC] ≥ 1,500 cells/μL; hemoglobin ≥ 9 g/dL, platelets ≥ 100,000/μL).
- Adequate renal function (serum creatinine ≤ 1.5 mg/dL or calculated creatinine clearance ≥ 60 mL/min using Cockcroft-Gault formula).
- Adequate hepatic function (alanine aminotransferase [ALT] ≤ 3 x upper limit of normal [ULN], ALT may be ≤ 5 x ULN if due to liver metastases but cannot be associated with concurrent elevated bilirubin >1.5 times the upper limit of normal (ULN) unless it is approved by the Sponsor's Medical Monitor).
- Prothrombin Time (PT)/International Normalized Ration (INR) ≤1.5 × ULN, activated partial thromboplastin time (aPTT) ≤1.5 × ULN.
- Written consent on an Institutional Review Board (IRB)/IndependentEthics Committee (IEC)-approved Informed Consent Form prior to any study-specific evaluation.
- For women of child-bearing potential, negative serum pregnancy test at screening and use of physician-approved method of birth control from 30 days prior to the first study drug administration to 30 days following the last study drug administration or the last EP in the study, whichever is discontinued last.
- Male subjects must be surgically sterile or must agree to use physician-approved contraception during the study and for 30 days following the last study drug administration or the last EP in the study, whichever is discontinued last.
Exclusion Criteria:
Subjects who meet any of the following criteria will not be eligible for participation in the study:
- Limited stage small cell lung cancer appropriate for radical treatment with chemoradiation.
- Prior therapy including radiation, chemotherapy or surgery for newly diagnosed extensive stage small cell lung cancer.
- Presence of any serious or uncontrolled illness including, but not limited to: ongoing or active infection, symptomatic congestive heart failure unstable angina pectoris, uncontrolled cardiac arrhythmia, uncontrolled arterial thrombosis, symptomatic pulmonary embolism, and psychiatric illness that would limit compliance with study requirement.
- History of myocardial infarction, acute coronary syndromes (including unstable angina), coronary angioplasty and/or stenting within 6 months prior to the first administration of study drug.
A history of malignancy with the exception of:
- Adequately treated basal cell carcinoma, squamous cell carcinoma of the skin, or in situ cervical cancer
- Adequately treated stage I cancer from which the subject is currently in remission, or
- Any other cancer from which the subject has been disease-free for ≥ 3 years
- Known human immunodeficiency virus (HIV) infection.
- Females who are pregnant or breastfeeding.
- Concurrent use of therapeutic warfarin (prophylactic low dose of warfarin, i.e., 1 mg daily for port catheter is allowed)
Sites / Locations
- Highlands Oncology Group
- Cedars-Sinai Medical Center
- Rocky Mountain Cancer Centers
- Yale University
- Georgetown University Hospital
- Sarah Cannon
- Ocala Oncology Center, PL
- Piedmont Cancer Institute
- Georgia Cancer Specialists, PC
- Univeristy of Chicago Medical Center
- Norton Cancer Institute
- University of Maryland, Greenebaum Cancer Center
- Johns Hopkins Sidney Kimmel Comprehensive Cancer Center
- Weinberg Cancer Institute
- University of Michigan Medical Center, Clinical Trials Office
- Karmanos Cancer Institute
- Minnesota Oncology Hematology , P.A.
- Oncology Hematology West PC, dba Nebraska Cancer Specialists
- Roswell Park Cancer Institute
- Memorial Sloan-Kettering Cancer Center
- Oncology Hematology Care, Inc.
- Case Western Reserve University
- Providence Cancer Center Oncology and Hematology Care Eastside
- UPMC Cancer Pavilion
- Greenville Health System, Clinical Research Unit, Institute for Translational Oncology Research
- Tennessee Oncology, PLLC
- The Sarah Cannon Research Institute
- Texas Oncology-South Austin
- Texas Oncology-Bedford
- Texas Oncology, P.A.
- The University of Texas MD A nderson Cancer Center
- Cancer Care Network of South Texas
- Oncology and Hematology Associates of Southwest Virginia Inc.
- Virginia Cancer Specialists
- Swedish Cancer Institute
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Experimental
Arm Label
OMP-59R5 Combination with Etoposide and Cisplatin
Etoposide and Cisplatin plus Placebo
Arm Description
Outcomes
Primary Outcome Measures
Phase 1b: To Determine the Maximum Tolerated Dose (MTD) of OMP-59R5 When Administered With Etoposide and Cisplatin or Carboplatin (Number of Subjects With DLTs)
To determine the MTD of tarextumab when administered on Day 1 of each 21 day cycle along with etoposide 100 mg/m2 on Days 1, 2 and 3, and cisplatin 80 mg/m2 or carboplatin area under the curve (AUC) of 5 mg/mL•min on Day 1 in subjects with untreated extensive stage small cell lung cancer. DLT evaluable population includes all subjects who received at least 1 partial dose of OMP-59R5 during the Phase 1b dose escalation portion of the study including the carboplatin cohort and who had completed Day 21 cycle of 1 OMP-59R5 administration or had discontinued due to drug-related toxicity.
Phase 1b: Overall Response (Response Evaluable Population)
The best overall response is defined as the best Investigator-assessed response recorded from the start of the treatment until disease progression in the following order of importance: Complete Response (CR), Partial Response (PR), Stable Disease (SD), Progressive Disease (PD), Not Evaluable (NE). Response evaluable population includes subjects who received 1 partial dose of OMP-59R5 and at at least 1 post tumor assessment.
Phase 2: Progression Free Survival (ITT Population)
To determine the improvement in Progression Free Survival (PFS) resulting from the addition of tarextumab to etoposide and platinum therapy (EP) in subjects receiving first-line therapy for extensive stage small cell lung cancer. PFS is based on the Investigator-assessments of tumor response which is defined as the number of days from randomization until death or disease progression as defined by RECIST criteria for the ITT Population.
Phase 2: Best Overall Tumor Response Based on Investigator Assessment (ITT Population)
The response rate is the number of subjects per treatment arm who have either a complete response (CR) or partial response (PR) for best overall response (according to RECIST criteria) divided by the number of subjects randomized to the respective arms.
Secondary Outcome Measures
Full Information
NCT ID
NCT01859741
First Posted
May 16, 2013
Last Updated
September 7, 2020
Sponsor
OncoMed Pharmaceuticals, Inc.
1. Study Identification
Unique Protocol Identification Number
NCT01859741
Brief Title
A Phase 1b/2 Study of OMP-59R5 (Tarextumab) in Combination With Etoposide and Platinum Therapy
Acronym
PINNACLE
Official Title
A Phase 1b/2 Study of OMP-59R5 in Combination With Etoposide and Platinum Therapy in Subjects With Untreated Extensive Stage Small Cell Lung Cancer (PINNACLE)
Study Type
Interventional
2. Study Status
Record Verification Date
September 2020
Overall Recruitment Status
Terminated
Why Stopped
OMP-59R5 did not improve PFS.
Study Start Date
January 7, 2012 (Actual)
Primary Completion Date
April 18, 2017 (Actual)
Study Completion Date
May 8, 2017 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
OncoMed Pharmaceuticals, Inc.
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The study consists of a Phase1b lead-in portion to determine the maximum tolerated dose (MTD) of OMP-59R5 (tarextumab) in combination with etoposide (EP) for 6 cycles followed a Phase 2, multi center, randomized, placebo-controlled portion comparing the efficacy and safety of OMP-59R5 in combination with EP for 6 cycles followed by single agent OMP-59R5 relative to EP alone for 6 cycles in subjects receiving first-line therapy for extensive stage small cell lung cancer.
Detailed Description
The Phase 1b lead-in portion of the study was conducted to determine the MTD of OMP-59R5 administered along with EP. The Phase 2 portion of the study was multi-center, randomized, and placebo-controlled. Subjects who qualified for enrollment into the Phase 2 portion of the study were randomized in a 1:1 ratio to receive study treatment of tarextumab along with EP (Arm A) or placebo along with EP (Arm B).
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Stage IV Small Cell Lung Cancer
Keywords
Newly diagnosed Stage IV Small Cell Lung Cancer
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
172 (Actual)
8. Arms, Groups, and Interventions
Arm Title
OMP-59R5 Combination with Etoposide and Cisplatin
Arm Type
Experimental
Arm Title
Etoposide and Cisplatin plus Placebo
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
OMP-59R5
Other Intervention Name(s)
Tarextumab
Intervention Description
OMP-59R5 administered intravenously
Intervention Type
Drug
Intervention Name(s)
Etoposide
Intervention Description
administered intravenously
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
administered IV
Intervention Type
Drug
Intervention Name(s)
Cisplatin or Carboplatin
Intervention Description
administered intravenously
Primary Outcome Measure Information:
Title
Phase 1b: To Determine the Maximum Tolerated Dose (MTD) of OMP-59R5 When Administered With Etoposide and Cisplatin or Carboplatin (Number of Subjects With DLTs)
Description
To determine the MTD of tarextumab when administered on Day 1 of each 21 day cycle along with etoposide 100 mg/m2 on Days 1, 2 and 3, and cisplatin 80 mg/m2 or carboplatin area under the curve (AUC) of 5 mg/mL•min on Day 1 in subjects with untreated extensive stage small cell lung cancer. DLT evaluable population includes all subjects who received at least 1 partial dose of OMP-59R5 during the Phase 1b dose escalation portion of the study including the carboplatin cohort and who had completed Day 21 cycle of 1 OMP-59R5 administration or had discontinued due to drug-related toxicity.
Time Frame
Up to 1 year in absence of unacceptable toxicity or disease progression.
Title
Phase 1b: Overall Response (Response Evaluable Population)
Description
The best overall response is defined as the best Investigator-assessed response recorded from the start of the treatment until disease progression in the following order of importance: Complete Response (CR), Partial Response (PR), Stable Disease (SD), Progressive Disease (PD), Not Evaluable (NE). Response evaluable population includes subjects who received 1 partial dose of OMP-59R5 and at at least 1 post tumor assessment.
Time Frame
Up to 1 year in absence of unacceptable toxicity or disease progression.
Title
Phase 2: Progression Free Survival (ITT Population)
Description
To determine the improvement in Progression Free Survival (PFS) resulting from the addition of tarextumab to etoposide and platinum therapy (EP) in subjects receiving first-line therapy for extensive stage small cell lung cancer. PFS is based on the Investigator-assessments of tumor response which is defined as the number of days from randomization until death or disease progression as defined by RECIST criteria for the ITT Population.
Time Frame
Up to 1 year until disease progression or death.
Title
Phase 2: Best Overall Tumor Response Based on Investigator Assessment (ITT Population)
Description
The response rate is the number of subjects per treatment arm who have either a complete response (CR) or partial response (PR) for best overall response (according to RECIST criteria) divided by the number of subjects randomized to the respective arms.
Time Frame
Up to 1 year in absence of unacceptable toxicity or disease progression
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
90 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Subjects must meet all of the following criteria to be eligible for the study:
Histologically or cytologically documented extensive stage small cell lung cancer.
Adults of 18 years of age or older.
Performance Status (ECOG) of 0 or 1.
Formalin Fixed Paraffin Embedded (FFPE) tumor tissue.
Adequate organ function:
Adequate hematologic function (absolute neutrophil count [ANC] ≥ 1,500 cells/μL; hemoglobin ≥ 9 g/dL, platelets ≥ 100,000/μL).
Adequate renal function (serum creatinine ≤ 1.5 mg/dL or calculated creatinine clearance ≥ 60 mL/min using Cockcroft-Gault formula).
Adequate hepatic function (alanine aminotransferase [ALT] ≤ 3 x upper limit of normal [ULN], ALT may be ≤ 5 x ULN if due to liver metastases but cannot be associated with concurrent elevated bilirubin >1.5 times the upper limit of normal (ULN) unless it is approved by the Sponsor's Medical Monitor).
Prothrombin Time (PT)/International Normalized Ration (INR) ≤1.5 × ULN, activated partial thromboplastin time (aPTT) ≤1.5 × ULN.
Written consent on an Institutional Review Board (IRB)/IndependentEthics Committee (IEC)-approved Informed Consent Form prior to any study-specific evaluation.
For women of child-bearing potential, negative serum pregnancy test at screening and use of physician-approved method of birth control from 30 days prior to the first study drug administration to 30 days following the last study drug administration or the last EP in the study, whichever is discontinued last.
Male subjects must be surgically sterile or must agree to use physician-approved contraception during the study and for 30 days following the last study drug administration or the last EP in the study, whichever is discontinued last.
Exclusion Criteria:
Subjects who meet any of the following criteria will not be eligible for participation in the study:
Limited stage small cell lung cancer appropriate for radical treatment with chemoradiation.
Prior therapy including radiation, chemotherapy or surgery for newly diagnosed extensive stage small cell lung cancer.
Presence of any serious or uncontrolled illness including, but not limited to: ongoing or active infection, symptomatic congestive heart failure unstable angina pectoris, uncontrolled cardiac arrhythmia, uncontrolled arterial thrombosis, symptomatic pulmonary embolism, and psychiatric illness that would limit compliance with study requirement.
History of myocardial infarction, acute coronary syndromes (including unstable angina), coronary angioplasty and/or stenting within 6 months prior to the first administration of study drug.
A history of malignancy with the exception of:
Adequately treated basal cell carcinoma, squamous cell carcinoma of the skin, or in situ cervical cancer
Adequately treated stage I cancer from which the subject is currently in remission, or
Any other cancer from which the subject has been disease-free for ≥ 3 years
Known human immunodeficiency virus (HIV) infection.
Females who are pregnant or breastfeeding.
Concurrent use of therapeutic warfarin (prophylactic low dose of warfarin, i.e., 1 mg daily for port catheter is allowed)
Facility Information:
Facility Name
Highlands Oncology Group
City
Rogers
State/Province
Arkansas
ZIP/Postal Code
72758
Country
United States
Facility Name
Cedars-Sinai Medical Center
City
Los Angeles
State/Province
California
ZIP/Postal Code
90048
Country
United States
Facility Name
Rocky Mountain Cancer Centers
City
Denver
State/Province
Colorado
ZIP/Postal Code
80218
Country
United States
Facility Name
Yale University
City
New Haven
State/Province
Connecticut
ZIP/Postal Code
06520
Country
United States
Facility Name
Georgetown University Hospital
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20007
Country
United States
Facility Name
Sarah Cannon
City
Fort Myers
State/Province
Florida
ZIP/Postal Code
33905
Country
United States
Facility Name
Ocala Oncology Center, PL
City
Ocala
State/Province
Florida
ZIP/Postal Code
34474
Country
United States
Facility Name
Piedmont Cancer Institute
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30318
Country
United States
Facility Name
Georgia Cancer Specialists, PC
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30341
Country
United States
Facility Name
Univeristy of Chicago Medical Center
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60637
Country
United States
Facility Name
Norton Cancer Institute
City
Louisville
State/Province
Kentucky
ZIP/Postal Code
40202
Country
United States
Facility Name
University of Maryland, Greenebaum Cancer Center
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21201
Country
United States
Facility Name
Johns Hopkins Sidney Kimmel Comprehensive Cancer Center
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21231
Country
United States
Facility Name
Weinberg Cancer Institute
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21237
Country
United States
Facility Name
University of Michigan Medical Center, Clinical Trials Office
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48109
Country
United States
Facility Name
Karmanos Cancer Institute
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48201
Country
United States
Facility Name
Minnesota Oncology Hematology , P.A.
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55404
Country
United States
Facility Name
Oncology Hematology West PC, dba Nebraska Cancer Specialists
City
Omaha
State/Province
Nebraska
ZIP/Postal Code
68130
Country
United States
Facility Name
Roswell Park Cancer Institute
City
Buffalo
State/Province
New York
ZIP/Postal Code
14263
Country
United States
Facility Name
Memorial Sloan-Kettering Cancer Center
City
New York
State/Province
New York
ZIP/Postal Code
10065
Country
United States
Facility Name
Oncology Hematology Care, Inc.
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45242
Country
United States
Facility Name
Case Western Reserve University
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44106
Country
United States
Facility Name
Providence Cancer Center Oncology and Hematology Care Eastside
City
Portland
State/Province
Oregon
ZIP/Postal Code
97213
Country
United States
Facility Name
UPMC Cancer Pavilion
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15232
Country
United States
Facility Name
Greenville Health System, Clinical Research Unit, Institute for Translational Oncology Research
City
Greenville
State/Province
South Carolina
ZIP/Postal Code
29605
Country
United States
Facility Name
Tennessee Oncology, PLLC
City
Chattanooga
State/Province
Tennessee
ZIP/Postal Code
37404
Country
United States
Facility Name
The Sarah Cannon Research Institute
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37203
Country
United States
Facility Name
Texas Oncology-South Austin
City
Austin
State/Province
Texas
ZIP/Postal Code
78745
Country
United States
Facility Name
Texas Oncology-Bedford
City
Bedford
State/Province
Texas
ZIP/Postal Code
76022
Country
United States
Facility Name
Texas Oncology, P.A.
City
Dallas
State/Province
Texas
ZIP/Postal Code
75246
Country
United States
Facility Name
The University of Texas MD A nderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
Cancer Care Network of South Texas
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78217
Country
United States
Facility Name
Oncology and Hematology Associates of Southwest Virginia Inc.
City
Blacksburg
State/Province
Virginia
ZIP/Postal Code
24060
Country
United States
Facility Name
Virginia Cancer Specialists
City
Fairfax
State/Province
Virginia
ZIP/Postal Code
22031
Country
United States
Facility Name
Swedish Cancer Institute
City
Seattle
State/Province
Washington
ZIP/Postal Code
98104
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
Undecided
Learn more about this trial
A Phase 1b/2 Study of OMP-59R5 (Tarextumab) in Combination With Etoposide and Platinum Therapy
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