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Phase 1/2a Two-Arm Dose-Escalation Study of BAX69 in Subjects With Malignant Ascites of Ovarian Cancer

Primary Purpose

Refractory Ovarian Cancer With Recurrent Symptomatic Malignant Ascites

Status
Terminated
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
BAX69 Single-Route Arm
BAX69 Double-Route Arm
Sponsored by
Baxalta now part of Shire
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Refractory Ovarian Cancer With Recurrent Symptomatic Malignant Ascites

Eligibility Criteria

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

Inclusion Criteria:

  1. Provision of a signed informed consent
  2. Female participants of non-childbearing potential, ≥18 years of age
  3. Anticipated life expectancy >3 months at the time of screening
  4. Metastatic ovarian epithelial cancer that are platinum-resistant, and has no better option available in the investigator's opinion
  5. Recurrent symptomatic malignant ascites having required at least 2 paracenteses within a 45-day interval prior to baseline paracentesis
  6. Participants who have an indwelling draining IP catheter (to be drained only under medical supervision)
  7. Eastern Cooperative Oncology Group Performance Status (ECOG PS) of 0 to 2
  8. Adequate hematological function, defined as:

    • Platelet count ≥100,000/μL
    • Prothrombin time (PT) and activated partial thromboplastin time (aPTT) <1.5 times the upper limit of normal (ULN)
    • Absolute neutrophil count ≥1,000/μL
    • Hemoglobin ≥9 g/dL, without the need for transfusion in the 2 weeks prior to screening
  9. Adequate renal function, defined as serum creatinine ≤2.0 times ULN and creatinine clearance >50 mL/min or estimated glomerular filtration rate (eGFR) >50 mL/min/1.73 m^2
  10. Adequate liver function, defined as:

    • Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤2.5 times ULN for participants without liver metastases, or ≤5 times ULN in the presence of liver metastases
    • Bilirubin ≤2.0 times ULN, unless participant has known Gilbert's syndrome
  11. Adequate venous access
  12. Participant is willing and able to comply with the requirements of the protocol

Exclusion Criteria:

  1. Known central nervous system metastasis that is unstable within the last 2 months
  2. Prior malignancy within the past 3 years, with the exception of curatively treated basal or squamous cell carcinoma of the skin, ductal carcinoma in situ of breast, in situ cervical carcinoma, and superficial bladder cancer
  3. Residual AEs >Grade 2 from previous treatment
  4. Myocardial infarction within 6 months prior to C1D1 treatment, and/or prior diagnoses of congestive heart failure (New York Heart Association Class III or IV), unstable angina, unstable cardiac arrhythmia requiring medication; and/or the participant is at risk for polymorphic ventricular tachycardia (eg, hypokalemia, family history or long QT syndrome)
  5. Uncontrolled hypertension defined as systolic blood pressure ≥160 mmHg and/or diastolic blood pressure ≥100 mmHg confirmed upon repeated measures
  6. Left ventricular ejection fraction <50% as determined by echocardiogram (ECHO) performed at screening or within 30 days prior to C1D1
  7. QT/QTc interval >480 msec, before C1D1 treatment administration, as determined by screening electrocardiogram (ECG)
  8. Received anti-tumor therapy (chemotherapy, investigational product, radiotherapy, retinoid therapy, or hormonal therapy) within 2 weeks (less than 14 days) prior to C1D1 with no residual toxicity >Grade 1; antibody therapy, molecular targeted therapy within 5 half-lives prior to C1D1
  9. Major surgery within 4 weeks (less than 28 days) prior to C1D1
  10. Active joint inflammation or other immune disorder involving joints (osteoarthritis is not exclusionary)
  11. Active infection involving IV antibiotics within 2 weeks prior to C1D1
  12. Positive serology test for hepatitis B virus (HBV), hepatitis C virus (HCV), or active tuberculosis
  13. Positive serology test for human immunodeficiency virus (HIV) type 1 and 2, or known history of other immunodeficiency disease
  14. Participant has received a live vaccine within 2 weeks (less than 14 days) prior to C1D1
  15. Known hypersensitivity to any component of recombinant protein production by Chinese Hamster Ovary (CHO) cells
  16. Any disorder or disease, or clinically significant abnormality on laboratory or other clinical test(s) (eg, blood tests and ECG), that in medical judgment of the investigator may impede the participant's participation in the study, pose increased risk to the participant, and/or confound the results of the study
  17. Participant is a family member or employee of the investigator

Sites / Locations

  • University of Miami Miller School of Medicine
  • Georgia Regents University
  • Women's Health Specialists
  • Montefiore Medical Center
  • Stephenson Cancer Center at The University of Oklahoma
  • The University of Texas MD Anderson Cancer Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Single-Route Arm

Double-Route Arm

Arm Description

BAX69 administered weekly by intraperitoneal (IP) infusion only

BAX69 administered weekly by intravenous (IV) infusion + intraperitoneal (IP) infusion

Outcomes

Primary Outcome Measures

The Occurrence of Dose-limiting Toxicity (DLT)
DLT is defined as any drug related treatment-emergent adverse event that occurs during the 28-day period after the first dose of Imalumab and that meets any of these criteria: - Any ≥ grade 3 non-hematologic toxicity assessed by the investigator as related to study drug (except: single lab value out of normal range not necessarily translating or considered a feature of clinical diagnosis requiring an intervention per investigator's interpretation and resolves to ≤ Grade 2 with adequate measure in 7 days; Transient grade 3 elevations of hepatic transaminases in the absence of simultaneous increase in serum bilirubin; Alopecia) - Any toxicity resulted in dose delay for ≥14 days - Any grade 4 hematologic toxicity (except lymphopenia) - Grade 3 febrile neutropenia - Grade 3 thrombocytopenia associated with bleeding - Any life-threatening complication/abnormality not covered in the NCICTCAE v4.03
The Ratio of Puncture Free Survival (PuFS) Over Puncture-free Interval at Baseline
PuFS is defined as the time from the last dose of Imalumab to the first therapeutic paracentesis after that, or death, whichever occurs first. Puncture-free interval at baseline is calculated as the time between the last 2 therapeutic paracenteses immediately before the first dose of Imalubmab.

Secondary Outcome Measures

Ratio of Time to First Paracentesis Post-treatment Over Puncture-free Interval at Baseline
Time to first paracentesis post-treatment is calculated as the time between the last dose of Imalumab to subsequent first therapeutic paracentesis.
Change in Ascites Volume Per Unit Time With Treatment
The volume of ascites from the last dose of Imalumab to the first post-treatment paracentesis per unit time will be compared to the volume of the last pre-treatment paracentesis per unit time. At each paracentesis, the volume of fluid that can be removed safely (measured by ultrasound-guided paracentesis) to achieve close to dryness should be withdrawn, measured, and documented.
Changes in Ascites-related Symptoms
Ascites related symptoms: anorexia, nausea, early satiety, vomiting, abdominal pain, abdominal swelling, dyspnea, fatigue, swollen ankles, heartburn
Occurrence of Serious Adverse Events (SAEs) and/or Treatment-emergent Adverse Events (TEAEs), Regardless of Causality or Relationship to Study Drug
Occurrence of Binding and/or Neutralizing Anti-imalumab (BAX69) Antibodies Following Treatment With Imalumab (BAX69)
Imalumab (BAX69) Plasma Pharmacokinetic (PK) Parameter: Maximum Observed Concentration (Cmax)
Imalumab (BAX69) Plasma Pharmacokinetic (PK) Parameter: Minimum Observed Concentration (Cmin)
Imalumab (BAX69) Plasma Pharmacokinetic (PK) Parameter: Area Under the Concentration vs Time Curve (AUC)
Imalumab (BAX69) Plasma Pharmacokinetic (PK) Parameter: Half-life (t1/2)
Imalumab (BAX69) Plasma Pharmacokinetic (PK) Parameter: Apparent Systemic Clearance (CL)
Imalumab (BAX69) Plasma Pharmacokinetic (PK) Parameter: Volume of Distribution (V)
Quality of Life (QoL) Measure - European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) Questionnaire
QoL will be assessed using EORTC QLQ-C30.

Full Information

First Posted
August 24, 2015
Last Updated
December 22, 2020
Sponsor
Baxalta now part of Shire
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1. Study Identification

Unique Protocol Identification Number
NCT02540356
Brief Title
Phase 1/2a Two-Arm Dose-Escalation Study of BAX69 in Subjects With Malignant Ascites of Ovarian Cancer
Official Title
A Phase 1/2a, Open-Label, Parallel, Two-Arm Dose-Escalation Study to Assess the Safety, Tolerability, Efficacy, Pharmacokinetics, and Pharmacodynamics of BAX69 in Subjects With Refractory Ovarian Cancer With Malignant Ascites
Study Type
Interventional

2. Study Status

Record Verification Date
December 2020
Overall Recruitment Status
Terminated
Study Start Date
November 2, 2015 (Actual)
Primary Completion Date
May 26, 2016 (Actual)
Study Completion Date
May 26, 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Baxalta now part of Shire

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to evaluate the safety and tolerability of BAX69 monotherapy given either as intraperitoneal (IP) infusion (Single-Route Arm); or as IP infusion after intravenous (IV) infusion (IV+IP) (Double-Route Arm), and to determine the maximum tolerated dose (MTD) and recommended Phase 2 dose (RP2D) for each Arm separately, in subjects with refractory ovarian cancer and recurrent malignant ascites. In both Arms, the plasma pharmacokinetics (PK) of BAX69 will be characterized, and pharmacodynamics (PD) markers will be explored in plasma and ascites. Two expansion cohorts will further assess the tolerability of the RP2D and explore clinical signs of efficacy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Refractory Ovarian Cancer With Recurrent Symptomatic Malignant Ascites

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
2 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Single-Route Arm
Arm Type
Experimental
Arm Description
BAX69 administered weekly by intraperitoneal (IP) infusion only
Arm Title
Double-Route Arm
Arm Type
Experimental
Arm Description
BAX69 administered weekly by intravenous (IV) infusion + intraperitoneal (IP) infusion
Intervention Type
Biological
Intervention Name(s)
BAX69 Single-Route Arm
Other Intervention Name(s)
Macrophage Migration Inhibitory Factor Antibody (Anti-MIF), Imalumab
Intervention Description
Intraperitoneal (IP) only
Intervention Type
Biological
Intervention Name(s)
BAX69 Double-Route Arm
Other Intervention Name(s)
Imalumab, Macrophage Migration Inhibitory Factor Antibody (Anti-MIF)
Intervention Description
Intravenous (IV) infusion + intraperitoneal (IP) infusion
Primary Outcome Measure Information:
Title
The Occurrence of Dose-limiting Toxicity (DLT)
Description
DLT is defined as any drug related treatment-emergent adverse event that occurs during the 28-day period after the first dose of Imalumab and that meets any of these criteria: - Any ≥ grade 3 non-hematologic toxicity assessed by the investigator as related to study drug (except: single lab value out of normal range not necessarily translating or considered a feature of clinical diagnosis requiring an intervention per investigator's interpretation and resolves to ≤ Grade 2 with adequate measure in 7 days; Transient grade 3 elevations of hepatic transaminases in the absence of simultaneous increase in serum bilirubin; Alopecia) - Any toxicity resulted in dose delay for ≥14 days - Any grade 4 hematologic toxicity (except lymphopenia) - Grade 3 febrile neutropenia - Grade 3 thrombocytopenia associated with bleeding - Any life-threatening complication/abnormality not covered in the NCICTCAE v4.03
Time Frame
4 weeks
Title
The Ratio of Puncture Free Survival (PuFS) Over Puncture-free Interval at Baseline
Description
PuFS is defined as the time from the last dose of Imalumab to the first therapeutic paracentesis after that, or death, whichever occurs first. Puncture-free interval at baseline is calculated as the time between the last 2 therapeutic paracenteses immediately before the first dose of Imalubmab.
Time Frame
4 weeks
Secondary Outcome Measure Information:
Title
Ratio of Time to First Paracentesis Post-treatment Over Puncture-free Interval at Baseline
Description
Time to first paracentesis post-treatment is calculated as the time between the last dose of Imalumab to subsequent first therapeutic paracentesis.
Time Frame
4 weeks
Title
Change in Ascites Volume Per Unit Time With Treatment
Description
The volume of ascites from the last dose of Imalumab to the first post-treatment paracentesis per unit time will be compared to the volume of the last pre-treatment paracentesis per unit time. At each paracentesis, the volume of fluid that can be removed safely (measured by ultrasound-guided paracentesis) to achieve close to dryness should be withdrawn, measured, and documented.
Time Frame
Up to 4 weeks
Title
Changes in Ascites-related Symptoms
Description
Ascites related symptoms: anorexia, nausea, early satiety, vomiting, abdominal pain, abdominal swelling, dyspnea, fatigue, swollen ankles, heartburn
Time Frame
Baseline, weekly during the treatment period, and every 2 weeks during the safety follow-up period, up to approximately 6 months)
Title
Occurrence of Serious Adverse Events (SAEs) and/or Treatment-emergent Adverse Events (TEAEs), Regardless of Causality or Relationship to Study Drug
Time Frame
Throughout the study period of approximately 22 months
Title
Occurrence of Binding and/or Neutralizing Anti-imalumab (BAX69) Antibodies Following Treatment With Imalumab (BAX69)
Time Frame
Throughout the study period of approximately 22 months
Title
Imalumab (BAX69) Plasma Pharmacokinetic (PK) Parameter: Maximum Observed Concentration (Cmax)
Time Frame
Predose; and post-dose at 1.5, 4, 8, 24, and 72 hours
Title
Imalumab (BAX69) Plasma Pharmacokinetic (PK) Parameter: Minimum Observed Concentration (Cmin)
Time Frame
Predose; and post-dose at 1.5, 4, 8, 24, and 72 hours
Title
Imalumab (BAX69) Plasma Pharmacokinetic (PK) Parameter: Area Under the Concentration vs Time Curve (AUC)
Time Frame
Predose; and post-dose at 1.5, 4, 8, 24, and 72 hours
Title
Imalumab (BAX69) Plasma Pharmacokinetic (PK) Parameter: Half-life (t1/2)
Time Frame
Predose; and post-dose at 1.5, 4, 8, 24, and 72 hours
Title
Imalumab (BAX69) Plasma Pharmacokinetic (PK) Parameter: Apparent Systemic Clearance (CL)
Time Frame
Predose; and post-dose at 1.5, 4, 8, 24, and 72 hours
Title
Imalumab (BAX69) Plasma Pharmacokinetic (PK) Parameter: Volume of Distribution (V)
Time Frame
Predose; and post-dose at 1.5, 4, 8, 24, and 72 hours
Title
Quality of Life (QoL) Measure - European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) Questionnaire
Description
QoL will be assessed using EORTC QLQ-C30.
Time Frame
Weekly from the baseline visit to the last week of safety follow-up (8 weeks or longer, if additional treatment will be implemented)

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Provision of a signed informed consent Female participants of non-childbearing potential, ≥18 years of age Anticipated life expectancy >3 months at the time of screening Metastatic ovarian epithelial cancer that are platinum-resistant, and has no better option available in the investigator's opinion Recurrent symptomatic malignant ascites having required at least 2 paracenteses within a 45-day interval prior to baseline paracentesis Participants who have an indwelling draining IP catheter (to be drained only under medical supervision) Eastern Cooperative Oncology Group Performance Status (ECOG PS) of 0 to 2 Adequate hematological function, defined as: Platelet count ≥100,000/μL Prothrombin time (PT) and activated partial thromboplastin time (aPTT) <1.5 times the upper limit of normal (ULN) Absolute neutrophil count ≥1,000/μL Hemoglobin ≥9 g/dL, without the need for transfusion in the 2 weeks prior to screening Adequate renal function, defined as serum creatinine ≤2.0 times ULN and creatinine clearance >50 mL/min or estimated glomerular filtration rate (eGFR) >50 mL/min/1.73 m^2 Adequate liver function, defined as: Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤2.5 times ULN for participants without liver metastases, or ≤5 times ULN in the presence of liver metastases Bilirubin ≤2.0 times ULN, unless participant has known Gilbert's syndrome Adequate venous access Participant is willing and able to comply with the requirements of the protocol Exclusion Criteria: Known central nervous system metastasis that is unstable within the last 2 months Prior malignancy within the past 3 years, with the exception of curatively treated basal or squamous cell carcinoma of the skin, ductal carcinoma in situ of breast, in situ cervical carcinoma, and superficial bladder cancer Residual AEs >Grade 2 from previous treatment Myocardial infarction within 6 months prior to C1D1 treatment, and/or prior diagnoses of congestive heart failure (New York Heart Association Class III or IV), unstable angina, unstable cardiac arrhythmia requiring medication; and/or the participant is at risk for polymorphic ventricular tachycardia (eg, hypokalemia, family history or long QT syndrome) Uncontrolled hypertension defined as systolic blood pressure ≥160 mmHg and/or diastolic blood pressure ≥100 mmHg confirmed upon repeated measures Left ventricular ejection fraction <50% as determined by echocardiogram (ECHO) performed at screening or within 30 days prior to C1D1 QT/QTc interval >480 msec, before C1D1 treatment administration, as determined by screening electrocardiogram (ECG) Received anti-tumor therapy (chemotherapy, investigational product, radiotherapy, retinoid therapy, or hormonal therapy) within 2 weeks (less than 14 days) prior to C1D1 with no residual toxicity >Grade 1; antibody therapy, molecular targeted therapy within 5 half-lives prior to C1D1 Major surgery within 4 weeks (less than 28 days) prior to C1D1 Active joint inflammation or other immune disorder involving joints (osteoarthritis is not exclusionary) Active infection involving IV antibiotics within 2 weeks prior to C1D1 Positive serology test for hepatitis B virus (HBV), hepatitis C virus (HCV), or active tuberculosis Positive serology test for human immunodeficiency virus (HIV) type 1 and 2, or known history of other immunodeficiency disease Participant has received a live vaccine within 2 weeks (less than 14 days) prior to C1D1 Known hypersensitivity to any component of recombinant protein production by Chinese Hamster Ovary (CHO) cells Any disorder or disease, or clinically significant abnormality on laboratory or other clinical test(s) (eg, blood tests and ECG), that in medical judgment of the investigator may impede the participant's participation in the study, pose increased risk to the participant, and/or confound the results of the study Participant is a family member or employee of the investigator
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Study Director
Organizational Affiliation
Shire
Official's Role
Study Director
Facility Information:
Facility Name
University of Miami Miller School of Medicine
City
Miami
State/Province
Florida
ZIP/Postal Code
33136
Country
United States
Facility Name
Georgia Regents University
City
Augusta
State/Province
Georgia
ZIP/Postal Code
30912
Country
United States
Facility Name
Women's Health Specialists
City
Silver Spring
State/Province
Maryland
ZIP/Postal Code
20910
Country
United States
Facility Name
Montefiore Medical Center
City
Bronx
State/Province
New York
ZIP/Postal Code
10461
Country
United States
Facility Name
Stephenson Cancer Center at The University of Oklahoma
City
Oklahoma City
State/Province
Oklahoma
ZIP/Postal Code
73104
Country
United States
Facility Name
The University of Texas MD Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
De-identified individual participant data from this particular study will not be shared as there is a reasonable likelihood that individual patients could be re-identified (due to the low number of study participants).

Learn more about this trial

Phase 1/2a Two-Arm Dose-Escalation Study of BAX69 in Subjects With Malignant Ascites of Ovarian Cancer

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