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α-TEA in Advanced Cancer

Primary Purpose

Metastatic Carcinoma, Metastatic Sarcoma, Metastatic Lymphoma

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
2.4 mg/kg α-TEA
4.8 mg/kg α-TEA
8.0 mg/kg α-TEA
9.6 mg/kg α-TEA
12 mg/kg α-TEA
16.8 mg/kg α-TEA
19.2 mg/kg α-TEA
22.3 mg/kg α-TEA
26.8 mg/kg α-TEA
Sponsored by
Providence Health & Services
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Metastatic Carcinoma focused on measuring metastatic, refractory, progressive

Eligibility Criteria

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

Inclusion Criteria:

  • Patients with measurable or evaluable metastatic carcinoma, sarcoma or lymphoma who have malignancy refractory or progressed after therapy and for whom no other standard (non-experimental) therapy exists or who have declined available standard therapy, with potential to induce cure, remission or enhanced survival. Either histologic or cytologic diagnosis is acceptable of the primary cancer, or clinical evidence of metastasis.
  • Eastern Cooperative Oncology Group (ECOG) performance status 0, 1, or 2.
  • Age 18 years or above.
  • Laboratory values (performed within 28 days prior to enrollment) within protocol specified range.
  • Confirmed radiographic and/or serum marker showing cancer progression after at least one systemic therapy for metastatic disease.
  • Ability to give informed consent and comply with the protocol. Patients with a history of psychiatric illness must be judged able to understand the investigational nature of the study and the risks associated with the therapy.
  • No active bleeding.
  • No coagulopathy (INR <1.5, PT <16 seconds, PTT < 38 seconds) at baseline.
  • Anticipated lifespan greater than 12 weeks.
  • Ability to swallow capsules
  • Women of childbearing potential must have a negative pregnancy test and must avoid becoming pregnant while on α-TEA and for 4 weeks after the last dose of α-TEA. Men must avoid fathering a child while on α-TEA and for 4 weeks after the last dose of α-TEA.

Exclusion Criteria:

  • Active serious infection that could affect treatment.
  • Coagulopathy or need for anti-coagulation therapy.
  • Malabsorbtion state such as ulcerative colitis, previous surgical resection of > 20% of intestine or stomach.
  • History of or active atrial fibrilliationfibrillation or supraventricular tachycardia
  • Cardiac ejection fraction less than the lower limit of normal on echocardiography
  • Right atrial enlargement on echocardiography
  • Active cardiac ischemia. Patients with a history of ischemia ameliorated with stent placement or coronary artery bypass grafting and who have no evidence of ischemia by exercise or physiological stress testing are eligible.
  • History of or active congestive heart failure
  • Patients with tumor that has invaded vagal nerve, carotid bodies, mediastinal structures, pericardium or myocardium.
  • Abnormal thyroid function, or euthyroid, but are on medication for thyroid disorders
  • Need for chronic high dose maintenance oral steroids. Stable treatment with prednisone ≤ 10 mg daily (or a biologically-equivalent dose of another steroid) is allowed. Patients who require brief courses of steroids to manage allergic reaction to intravenous contrast used in radiographic studies are eligible. Patients requiring steroids for management of CNS metastatic disease are not eligible.
  • Surgery or severe trauma within 4 weeks of study entry (minimally invasive procedures acceptable).
  • Active brain metastatic disease. Patients with brain metastases who have been treated with surgery, gamma-knife radiosurgery or radiation and no radiographic progression for at least 4 weeks and off steroids are eligible.
  • Any medical or psychiatric condition that in the opinion of the PI would preclude compliance with study procedures.
  • Vitamin E supplements
  • QTc greater than 450 msec at baseline (calculated using Bazett's formula), sick-sinus syndrome or other active cardiac disease.

Sites / Locations

  • Providence Oncology & Hematology Care Clinic- Southeast
  • Providence Oncology & Hematoloty Care Clinic- Newberg
  • Providence Oncology & Hematology Care Clinic- Willamette Falls
  • Providence Oncology & Hematology Care Clinic- Eastside
  • Providence Oncology & Hematology Care Clinic- Westside

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm 7

Arm 8

Arm 9

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Arm Label

2.4 mg/kg α-TEA

4.8 mg/kg α-TEA

8.0 mg/kg α-TEA

9.6 mg/kg α-TEA

12 mg/kg α-TEA

16.8 mg/kg α-TEA

19.2 mg/kg α-TEA

22.3 mg/kg α-TEA

26.8 mg/kg α-TEA

Arm Description

Patients will receive oral α-TEA 2.4 mg/kg daily for the first 14 days of a 28 day cycle.

Patients will receive oral α-TEA 4.8 mg/kg daily for the first 14 days of a 28 day cycle.

Patients will receive oral α-TEA 8.0 mg/kg daily for the first 14 days of a 28 day cycle.

Patients will receive oral α-TEA 9.6 mg/kg daily for the first 14 days of a 28 day cycle.

Patients will receive oral α-TEA 12 mg/kg daily for the first 14 days of a 28 day cycle.

Patients will receive oral α-TEA 16.8 mg/kg daily for the first 14 days of a 28 day cycle.

Patients will receive oral α-TEA 19.2 mg/kg daily for the first 14 days of a 28 day cycle.

Patients will receive oral α-TEA 22.3 mg/kg daily for the first 14 days of a 28 day cycle.

Patients will receive oral α-TEA 26.8 mg/kg daily for the first 14 days of a 28 day cycle.

Outcomes

Primary Outcome Measures

Number of Participants with Adverse Events
Patients are seen in clinic 7 times over a 28-day period. Patients will have 6 physical exams and meet with a research nurse 5 times for evaluation of any potential drug-related toxicities. In addition, blood will be drawn 7 times for complete blood counts and metabolic panel to check for hematological toxicities. After 28 days, a review of all safety data will determine whether the dose will be increased for subsequent patients.

Secondary Outcome Measures

Number of Adverse Events Possibly Caused by α-TEA
Patients are seen in clinic 7 times over a 28-day period. Patients will have 6 physical exams and meet with a research nurse 5 times for evaluation of any potential drug-related toxicities. In addition, blood will be drawn 7 times for complete blood counts and metabolic panel to check for hematological toxicities. This information will be used to identify toxicities of α-TEA and characterize the safety profile.
Blood serum levels of α-TEA
Patients will have 11 blood draws over 28 days for evaluation of pharmacokinetics. High-performance liquid chromatography (HPLC) and mass spectrometry detection (MSD) will be used to determine serum drug levels of α-TEA using blood samples collected just before the first dose of α-TEA and 1, 4, 8, and 24 hours after the first dose. Additional samples will be drawn just before the α-TEA dose on Days 2, 5, 8, 15, 22, and 29.

Full Information

First Posted
July 13, 2014
Last Updated
August 16, 2018
Sponsor
Providence Health & Services
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1. Study Identification

Unique Protocol Identification Number
NCT02192346
Brief Title
α-TEA in Advanced Cancer
Official Title
Phase I Study of Alpha-tocopheryloxyacetic Acid (α-TEA) in Patients With Advanced Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
August 2018
Overall Recruitment Status
Completed
Study Start Date
August 4, 2014 (Actual)
Primary Completion Date
December 11, 2017 (Actual)
Study Completion Date
May 8, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Providence Health & Services

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The goal of this study is to find the highest dose of α-TEA that can be given to patients safely, to identify potential side effects of α-TEA, and to measure the amount of α-TEA in patients' blood. Additional goals of this study are to monitor the effect on tumors, to check for specific immune cells circulating in the blood, and to see if there are certain features of tumors that make it possible to predict the response to α-TEA.
Detailed Description
This is a dose-escalation study in which doses ranging from 2.4 mg/kg to 26.8 mg/kg of α-TEA will be tested. The main clinical objectives of this phase I two-stage dose-escalation trial will be to characterize α-TEA related toxicity, determine the maximum tolerated dose, and pharmacokinetics of α-TEA in humans. Tumor response and exploratory immunological monitoring will also be performed. Specifically, we will determine the frequency of circulating peripheral T cell subset populations including CD4+, CD8+ T cells and their activation status (central memory, effector cells) and regulatory T cells (CD4/CD25/Foxp3). Exploratory monitoring to assess tumor apoptosis and serum cytokine levels will also be performed to gain additional insight on the influence of α-TEA on the immune response and tumor. An assessment of the immunoscore in patients with tumor amenable to biopsy will also provide hypothesis-generating data on the influence of α-TEA on the tumor microenvironment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metastatic Carcinoma, Metastatic Sarcoma, Metastatic Lymphoma
Keywords
metastatic, refractory, progressive

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
2.4 mg/kg α-TEA
Arm Type
Experimental
Arm Description
Patients will receive oral α-TEA 2.4 mg/kg daily for the first 14 days of a 28 day cycle.
Arm Title
4.8 mg/kg α-TEA
Arm Type
Experimental
Arm Description
Patients will receive oral α-TEA 4.8 mg/kg daily for the first 14 days of a 28 day cycle.
Arm Title
8.0 mg/kg α-TEA
Arm Type
Experimental
Arm Description
Patients will receive oral α-TEA 8.0 mg/kg daily for the first 14 days of a 28 day cycle.
Arm Title
9.6 mg/kg α-TEA
Arm Type
Experimental
Arm Description
Patients will receive oral α-TEA 9.6 mg/kg daily for the first 14 days of a 28 day cycle.
Arm Title
12 mg/kg α-TEA
Arm Type
Experimental
Arm Description
Patients will receive oral α-TEA 12 mg/kg daily for the first 14 days of a 28 day cycle.
Arm Title
16.8 mg/kg α-TEA
Arm Type
Experimental
Arm Description
Patients will receive oral α-TEA 16.8 mg/kg daily for the first 14 days of a 28 day cycle.
Arm Title
19.2 mg/kg α-TEA
Arm Type
Experimental
Arm Description
Patients will receive oral α-TEA 19.2 mg/kg daily for the first 14 days of a 28 day cycle.
Arm Title
22.3 mg/kg α-TEA
Arm Type
Experimental
Arm Description
Patients will receive oral α-TEA 22.3 mg/kg daily for the first 14 days of a 28 day cycle.
Arm Title
26.8 mg/kg α-TEA
Arm Type
Experimental
Arm Description
Patients will receive oral α-TEA 26.8 mg/kg daily for the first 14 days of a 28 day cycle.
Intervention Type
Drug
Intervention Name(s)
2.4 mg/kg α-TEA
Intervention Description
Patients receive oral α-TEA 2.4 mg/kg daily for the first 14 days of a 28 day cycle.
Intervention Type
Drug
Intervention Name(s)
4.8 mg/kg α-TEA
Intervention Description
Patients will receive oral α-TEA 4.8 mg/kg daily for the first 14 days of a 28 day cycle.
Intervention Type
Drug
Intervention Name(s)
8.0 mg/kg α-TEA
Intervention Description
Patients will receive oral α-TEA 8.0 mg/kg daily for the first 14 days of a 28 day cycle.
Intervention Type
Drug
Intervention Name(s)
9.6 mg/kg α-TEA
Intervention Description
Patients will receive oral α-TEA 9.6 mg/kg daily for the first 14 days of a 28 day cycle.
Intervention Type
Drug
Intervention Name(s)
12 mg/kg α-TEA
Intervention Description
Patients will receive oral α-TEA 12 mg/kg daily for the first 14 days of a 28 day cycle.
Intervention Type
Drug
Intervention Name(s)
16.8 mg/kg α-TEA
Intervention Description
Patients will receive oral α-TEA 16.8 mg/kg daily for the first 14 days of a 28 day cycle.
Intervention Type
Drug
Intervention Name(s)
19.2 mg/kg α-TEA
Intervention Description
Patients will receive oral α-TEA 19.2 mg/kg daily for the first 14 days of a 28 day cycle.
Intervention Type
Drug
Intervention Name(s)
22.3 mg/kg α-TEA
Intervention Description
Patients will receive oral α-TEA 22.3 mg/kg daily for the first 14 days of a 28 day cycle.
Intervention Type
Drug
Intervention Name(s)
26.8 mg/kg α-TEA
Intervention Description
Patients will receive oral α-TEA 26.8 mg/kg daily for the first 14 days of a 28 day cycle.
Primary Outcome Measure Information:
Title
Number of Participants with Adverse Events
Description
Patients are seen in clinic 7 times over a 28-day period. Patients will have 6 physical exams and meet with a research nurse 5 times for evaluation of any potential drug-related toxicities. In addition, blood will be drawn 7 times for complete blood counts and metabolic panel to check for hematological toxicities. After 28 days, a review of all safety data will determine whether the dose will be increased for subsequent patients.
Time Frame
28 Days
Secondary Outcome Measure Information:
Title
Number of Adverse Events Possibly Caused by α-TEA
Description
Patients are seen in clinic 7 times over a 28-day period. Patients will have 6 physical exams and meet with a research nurse 5 times for evaluation of any potential drug-related toxicities. In addition, blood will be drawn 7 times for complete blood counts and metabolic panel to check for hematological toxicities. This information will be used to identify toxicities of α-TEA and characterize the safety profile.
Time Frame
28 days
Title
Blood serum levels of α-TEA
Description
Patients will have 11 blood draws over 28 days for evaluation of pharmacokinetics. High-performance liquid chromatography (HPLC) and mass spectrometry detection (MSD) will be used to determine serum drug levels of α-TEA using blood samples collected just before the first dose of α-TEA and 1, 4, 8, and 24 hours after the first dose. Additional samples will be drawn just before the α-TEA dose on Days 2, 5, 8, 15, 22, and 29.
Time Frame
28 days
Other Pre-specified Outcome Measures:
Title
Change in Tumor burden from baseline to 28 days
Description
Imaging exams (CT, MRI, PET, bone scan, or ultrasound) will be done before treatment and after 28 days to evaluate response to treatment. Imaging modality will be determined by the treating physician.
Time Frame
28 Days
Title
Change in Activity and Proliferation of Circulating T cell Sub-Populations
Description
Blood will be drawn at before treatment and on days 8 and 29 to identify the type and proportion of circulating T cell subsets.
Time Frame
28 days
Title
Change in the Number of Tumor-Infiltrating T cells from Baseline to 35 days
Description
Patients who agree to an optional biopsy and have a subcutaneous or lymph node metastatic site amenable to a simple biopsy procedure will be included in this analysis to evaluate the number of tumor-infiltrating T cells.
Time Frame
35 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients with measurable or evaluable metastatic carcinoma, sarcoma or lymphoma who have malignancy refractory or progressed after therapy and for whom no other standard (non-experimental) therapy exists or who have declined available standard therapy, with potential to induce cure, remission or enhanced survival. Either histologic or cytologic diagnosis is acceptable of the primary cancer, or clinical evidence of metastasis. Eastern Cooperative Oncology Group (ECOG) performance status 0, 1, or 2. Age 18 years or above. Laboratory values (performed within 28 days prior to enrollment) within protocol specified range. Confirmed radiographic and/or serum marker showing cancer progression after at least one systemic therapy for metastatic disease. Ability to give informed consent and comply with the protocol. Patients with a history of psychiatric illness must be judged able to understand the investigational nature of the study and the risks associated with the therapy. No active bleeding. No coagulopathy (INR <1.5, PT <16 seconds, PTT < 38 seconds) at baseline. Anticipated lifespan greater than 12 weeks. Ability to swallow capsules Women of childbearing potential must have a negative pregnancy test and must avoid becoming pregnant while on α-TEA and for 4 weeks after the last dose of α-TEA. Men must avoid fathering a child while on α-TEA and for 4 weeks after the last dose of α-TEA. Exclusion Criteria: Active serious infection that could affect treatment. Coagulopathy or need for anti-coagulation therapy. Malabsorbtion state such as ulcerative colitis, previous surgical resection of > 20% of intestine or stomach. History of or active atrial fibrilliationfibrillation or supraventricular tachycardia Cardiac ejection fraction less than the lower limit of normal on echocardiography Right atrial enlargement on echocardiography Active cardiac ischemia. Patients with a history of ischemia ameliorated with stent placement or coronary artery bypass grafting and who have no evidence of ischemia by exercise or physiological stress testing are eligible. History of or active congestive heart failure Patients with tumor that has invaded vagal nerve, carotid bodies, mediastinal structures, pericardium or myocardium. Abnormal thyroid function, or euthyroid, but are on medication for thyroid disorders Need for chronic high dose maintenance oral steroids. Stable treatment with prednisone ≤ 10 mg daily (or a biologically-equivalent dose of another steroid) is allowed. Patients who require brief courses of steroids to manage allergic reaction to intravenous contrast used in radiographic studies are eligible. Patients requiring steroids for management of CNS metastatic disease are not eligible. Surgery or severe trauma within 4 weeks of study entry (minimally invasive procedures acceptable). Active brain metastatic disease. Patients with brain metastases who have been treated with surgery, gamma-knife radiosurgery or radiation and no radiographic progression for at least 4 weeks and off steroids are eligible. Any medical or psychiatric condition that in the opinion of the PI would preclude compliance with study procedures. Vitamin E supplements QTc greater than 450 msec at baseline (calculated using Bazett's formula), sick-sinus syndrome or other active cardiac disease.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Brendan Curti, MD
Organizational Affiliation
Providence Cancer Center, Earle A. Chiles Reserach Institute at the Robert W. Franz Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Providence Oncology & Hematology Care Clinic- Southeast
City
Clackamas
State/Province
Oregon
ZIP/Postal Code
97015
Country
United States
Facility Name
Providence Oncology & Hematoloty Care Clinic- Newberg
City
Newberg
State/Province
Oregon
ZIP/Postal Code
97132
Country
United States
Facility Name
Providence Oncology & Hematology Care Clinic- Willamette Falls
City
Oregon City
State/Province
Oregon
ZIP/Postal Code
97045
Country
United States
Facility Name
Providence Oncology & Hematology Care Clinic- Eastside
City
Portland
State/Province
Oregon
ZIP/Postal Code
97213
Country
United States
Facility Name
Providence Oncology & Hematology Care Clinic- Westside
City
Portland
State/Province
Oregon
ZIP/Postal Code
97225
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Links:
URL
http://oregon.providence.org/our-services/p/providence-cancer-center/
Description
Providence Cancer Center

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α-TEA in Advanced Cancer

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