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Dose Escalating Study of Foxy-5 in Breast-, Colon- or Prostate Cancer Patients

Primary Purpose

Metastatic Breast Cancer, Metastatic Colon Cancer, Metastatic Prostate Cancer

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
Foxy-5
Sponsored by
WntResearch AB
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Metastatic Breast Cancer

Eligibility Criteria

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

Inclusion Criteria:

  • Males and females of at least 18 years of age

    • Histologically/cytologically documented diagnosis of metastatic breast, colon or prostate cancer, refractory to standard therapy or for which no curative therapy exists
    • Must have an evaluable tumour appropriate for biopsy as determined by the Investigator.
    • Loss of or reduced Wnt-5a protein expression in primary or metastatic tumour cells, characterised by IHC analysis
    • Eastern Cooperative Oncology Group (ECOG) performance status of <= 1
    • Life expectancy of at least 3 months
    • Unresectable disease, i.e. the metastases cannot be surgically removed with a curative intent

      • 4 weeks must have elapsed since the patient has received any other IMP
      • 4 weeks must have elapsed since the patient has received any anti cancer treatment; including radiotherapy (except for single dose of palliative radiotherapy), cytotoxic chemotherapy, biologic agents or targeted therapy
      • 2 weeks must have elapsed since any prior surgery or therapy with bone marrow stimulating factors
    • Adequate haematological functions as defined by:
    • Absolute neutrophil count >= 1.5 10E9/L
    • Platelets >= 100 10E9/L
    • Hemoglobin >= 5.6 mmol/L
    • Adequate hepatic function as defined by:
    • Total bilirubin <= 1.5 x the upper limit of normal (ULN)
    • Aspartate aminotransferase (AST) <= 2.5 x ULN*
    • Alanine aminotransferase (ALT) <= 2.5 x ULN*

      • For patients with liver metastasis adequate hepatic function is defined by AST <= 5 x ULN and ALT <= 5 ULN.
    • Adequate renal function as defined by Serum creatinine <= 1,5 x ULN
    • Patients in active anti-coagulating treatment must be evaluated according to local standards on the discretion of the Investigator..
    • Provision of written informed consent
    • Willingness and ability to comply with scheduled visits, treatment plans, laboratory tests and other study procedures
    • Sexually active males and females of child-producing potential, must use adequate contraception (intrauterine devices, hormonal contraceptives (contraceptive pills, implants, transdermal patches, hormonal vaginal devices or injections with prolonged release) or diaphragm always with spermicidal jelly and a male condom) for the study duration and at least six months afterwards

Exclusion Criteria:

  • Active uncontrolled bleeding or bleeding diathesis (e.g., active peptic ulcer disease)

    • Any active infection requiring antibiotic treatment
    • Known infection with human immunodeficiency virus (HIV) or hepatitis virus
    • Active heart disease including myocardial infarction or congestive heart failure within the previous 6 months, symptomatic coronary artery disease, or symptomatic arrhythmias currently requiring medication
    • Known or suspected active central nervous system (CNS) metastasis. (Patients stable 8 weeks after completion of treatment for CNS metastasis are eligible)
    • Impending or symptomatic spinal cord compression or carcinomatous meningitis
    • Requiring immediate palliative surgery and/or radiotherapy(except for a single dose of palliative radiotherapy)
    • Pre-existing neuropathy, i.e., Grade >2 neuromotor or neurosensory toxicity
    • Participation in other clinical studies within 4 weeks of first dose of study treatment
    • Previous exposure to Foxy-5
    • History of severe allergic or hypersensitive reactions to excipients
    • Pregnant or breastfeeding women
    • Active and/or within the last 5 years histologically confirmed diagnosis of malignant melanoma, gastric cancer, pancreatic cancer, lung cancer or nasopharyngeal cancer
    • Severe or uncontrolled chronic or uncontrolled systemic disease (e. g. severe respiratory or cardiovascular disease)
    • Other medications or conditions that in the Investigator's opinion would contraindicate study participation of safety reasons or interfere with the interpretation of study results

Sites / Locations

  • Clinical Research Department, Oncology, Rigshospitalet
  • Onkologisk Afdeling R, Herlev Hospital
  • Odense University Hospital
  • NCCC, Freeman Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Foxy-5

Arm Description

Slow infusion of lyophilised and reconstituted Foxy-5 three times weekly for three weeks. There will be a maximum of 8 dose cohorts. Cohorts 1-4 will be conducted in the United Kingdom and Denmark whereas cohorts 5-8 will only be conducted in Denmark. As doses in cohort 1 and 2 have been investigated in the previous phase I study, cohorts 1+2 and 3 can be run in parallel with dose escalation approved by the DSMB at all times. DK+UK: Cohort 1: 0.8 mg/kg DK+UK: Cohort 2: 1.3 mg/kg DK+UK: Cohort 3: 1.8 mg/kg DK+UK: Cohort 4: 2.3 mg/kg DK only: Cohort 5: 3.0 mg/kg DK only: Cohort 6: 4.0 mg/kg DK only: Cohort 7: 5.3 mg/kg DK only: Cohort 8: 7.0 mg/kg

Outcomes

Primary Outcome Measures

Presence of Dose Limiting Toxicities (DLTs).
The number of adverse events along with the results of vital sign measurements, physical examinations, and clinical laboratory tests will be used to determine the safety and tolerability profile of Foxy-5

Secondary Outcome Measures

Genome wide mRNA gene expression in tumour biopsies and blood (buffy coat)
Determination of the biological response dose (BRD) based on the alterations in the exploratory biomarkers during treatment with Foxy-5
Wnt-5a protein expression and hematoxylin-eosin (HE) staining of tumour biopsies
Determination of the biological response dose (BRD) based on the alterations in the exploratory biomarkers during treatment with Foxy-5
Numbers of circulating tumour cells (CTCs) in blood
Determination of the biological response dose (BRD) based on the alterations in the exploratory biomarkers during treatment with Foxy-5
Maximum tolerated dose (MTD)
Determined as the dose preceding the dose at which two or more patients have experienced DLTs. Assessment of adverse events and laboratory abnormalities
Area under the plasma concentration curve (AUC) of Foxy-5
The concentration of Foxy-5 in human biological samples will be measured with liquid chromatography with tandem mass spectrometry detection (LC-MS/MS)
Bioavailability (F) of Foxy-5
The concentration of Foxy-5 in human biological samples will be measured with liquid chromatography with tandem mass spectrometry detection (LC-MS/MS)
Half life (T½) of Foxy-5
The concentration of Foxy-5 in human biological samples will be measured with liquid chromatography with tandem mass spectrometry detection (LC-MS/MS)
Absorption rate Constant (tmax) of Foxy-5
The concentration of Foxy-5 in human biological samples will be measured with liquid chromatography with tandem mass spectrometry detection (LC-MS/MS)
Volume of distribution (V) of Foxy-5
The concentration of Foxy-5 in human biological samples will be measured with liquid chromatography with tandem mass spectrometry detection (LC-MS/MS)
Clearance (C) of Foxy-5
The concentration of Foxy-5 in human biological samples will be measured with liquid chromatography with tandem mass spectrometry detection (LC-MS/MS)
Extraction Ratio (E) of Foxy-5
The concentration of Foxy-5 in human biological samples will be measured with liquid chromatography with tandem mass spectrometry detection (LC-MS/MS)
Hepatic and Renal Clearance of Foxy-5
The concentration of Foxy-5 in human biological samples will be measured with liquid chromatography with tandem mass spectrometry detection (LC-MS/MS)

Full Information

First Posted
January 6, 2016
Last Updated
December 26, 2018
Sponsor
WntResearch AB
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1. Study Identification

Unique Protocol Identification Number
NCT02655952
Brief Title
Dose Escalating Study of Foxy-5 in Breast-, Colon- or Prostate Cancer Patients
Official Title
Phase Ib Dose Escalating Study to Evaluate the Safety, Tolerability and Pharmacodynamic Response of Foxy-5 in Patients With Metastatic Breast-, Colon- or Prostate Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
February 2018
Overall Recruitment Status
Completed
Study Start Date
April 2016 (Actual)
Primary Completion Date
October 2017 (Actual)
Study Completion Date
October 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
WntResearch AB

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The Wnt proteins belong to a family of proteins that have been demonstrated to play a role in the formation and dissemination of tumours. The present project focuses on the critical role of the Wnt-5a protein in the pathobiological processes that lead to metastatic cancer disease. WntResearch has identified a formylated 6 amino acid peptide fragment, named Foxy-5, which mimick the effects of Wnt-5a to impair migration of epithelial cancer cells and thereby acting anti-metastatic. The aim of the first clinical phase I study was to establish the recommended dose for a clinical phase II study and enable further development of Foxy-5 as a first in class anti-metastatic cancer drug. The study did not see any DLTs and therefore failed to reach maximum tolerated dose (MTD); no recommended phase II dose (RP2D) could therefore be established based on toxicity. The aim of this study is to continue to establish the safety profile of Foxy-5 in higher doses, and determine the RP2D for later stage development based on any observed DLT's/MTD and further analysis of the pharmacodynamic profile of Foxy-5 to determine the biological response dose (BRD).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metastatic Breast Cancer, Metastatic Colon Cancer, Metastatic Prostate Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
17 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Foxy-5
Arm Type
Experimental
Arm Description
Slow infusion of lyophilised and reconstituted Foxy-5 three times weekly for three weeks. There will be a maximum of 8 dose cohorts. Cohorts 1-4 will be conducted in the United Kingdom and Denmark whereas cohorts 5-8 will only be conducted in Denmark. As doses in cohort 1 and 2 have been investigated in the previous phase I study, cohorts 1+2 and 3 can be run in parallel with dose escalation approved by the DSMB at all times. DK+UK: Cohort 1: 0.8 mg/kg DK+UK: Cohort 2: 1.3 mg/kg DK+UK: Cohort 3: 1.8 mg/kg DK+UK: Cohort 4: 2.3 mg/kg DK only: Cohort 5: 3.0 mg/kg DK only: Cohort 6: 4.0 mg/kg DK only: Cohort 7: 5.3 mg/kg DK only: Cohort 8: 7.0 mg/kg
Intervention Type
Drug
Intervention Name(s)
Foxy-5
Primary Outcome Measure Information:
Title
Presence of Dose Limiting Toxicities (DLTs).
Description
The number of adverse events along with the results of vital sign measurements, physical examinations, and clinical laboratory tests will be used to determine the safety and tolerability profile of Foxy-5
Time Frame
6 month
Secondary Outcome Measure Information:
Title
Genome wide mRNA gene expression in tumour biopsies and blood (buffy coat)
Description
Determination of the biological response dose (BRD) based on the alterations in the exploratory biomarkers during treatment with Foxy-5
Time Frame
Tumour biopsies obtained prior to day 1 and on day 12 and 19
Title
Wnt-5a protein expression and hematoxylin-eosin (HE) staining of tumour biopsies
Description
Determination of the biological response dose (BRD) based on the alterations in the exploratory biomarkers during treatment with Foxy-5
Time Frame
Tumour biopsies obtained prior to day 1 and on day 12 and 19
Title
Numbers of circulating tumour cells (CTCs) in blood
Description
Determination of the biological response dose (BRD) based on the alterations in the exploratory biomarkers during treatment with Foxy-5
Time Frame
Blood sample obtained prior to day 1 and on day 12 and 19
Title
Maximum tolerated dose (MTD)
Description
Determined as the dose preceding the dose at which two or more patients have experienced DLTs. Assessment of adverse events and laboratory abnormalities
Time Frame
6 month
Title
Area under the plasma concentration curve (AUC) of Foxy-5
Description
The concentration of Foxy-5 in human biological samples will be measured with liquid chromatography with tandem mass spectrometry detection (LC-MS/MS)
Time Frame
immediately prior to treatment, at 0, 5, 15, 30, minutes 1, 3, 6, 8, 24, 48, 72 and 96 hours after infusion.
Title
Bioavailability (F) of Foxy-5
Description
The concentration of Foxy-5 in human biological samples will be measured with liquid chromatography with tandem mass spectrometry detection (LC-MS/MS)
Time Frame
immediately prior to treatment, at 0, 5, 15, 30, minutes 1, 3, 6, 8, 24, 48, 72 and 96 hours after infusion.
Title
Half life (T½) of Foxy-5
Description
The concentration of Foxy-5 in human biological samples will be measured with liquid chromatography with tandem mass spectrometry detection (LC-MS/MS)
Time Frame
immediately prior to treatment, at 0, 5, 15, 30, minutes 1, 3, 6, 8, 24, 48, 72 and 96 hours after infusion.
Title
Absorption rate Constant (tmax) of Foxy-5
Description
The concentration of Foxy-5 in human biological samples will be measured with liquid chromatography with tandem mass spectrometry detection (LC-MS/MS)
Time Frame
immediately prior to treatment, at 0, 5, 15, 30, minutes 1, 3, 6, 8, 24, 48, 72 and 96 hours after infusion.
Title
Volume of distribution (V) of Foxy-5
Description
The concentration of Foxy-5 in human biological samples will be measured with liquid chromatography with tandem mass spectrometry detection (LC-MS/MS)
Time Frame
immediately prior to treatment, at 0, 5, 15, 30, minutes 1, 3, 6, 8, 24, 48, 72 and 96 hours after infusion.
Title
Clearance (C) of Foxy-5
Description
The concentration of Foxy-5 in human biological samples will be measured with liquid chromatography with tandem mass spectrometry detection (LC-MS/MS)
Time Frame
immediately prior to treatment, at 0, 5, 15, 30, minutes 1, 3, 6, 8, 24, 48, 72 and 96 hours after infusion.
Title
Extraction Ratio (E) of Foxy-5
Description
The concentration of Foxy-5 in human biological samples will be measured with liquid chromatography with tandem mass spectrometry detection (LC-MS/MS)
Time Frame
immediately prior to treatment, at 0, 5, 15, 30, minutes 1, 3, 6, 8, 24, 48, 72 and 96 hours after infusion.
Title
Hepatic and Renal Clearance of Foxy-5
Description
The concentration of Foxy-5 in human biological samples will be measured with liquid chromatography with tandem mass spectrometry detection (LC-MS/MS)
Time Frame
immediately prior to treatment, at 0, 5, 15, 30, minutes 1, 3, 6, 8, 24, 48, 72 and 96 hours after infusion.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Males and females of at least 18 years of age Histologically/cytologically documented diagnosis of metastatic breast, colon or prostate cancer, refractory to standard therapy or for which no curative therapy exists Must have an evaluable tumour appropriate for biopsy as determined by the Investigator. Loss of or reduced Wnt-5a protein expression in primary or metastatic tumour cells, characterised by IHC analysis Eastern Cooperative Oncology Group (ECOG) performance status of <= 1 Life expectancy of at least 3 months Unresectable disease, i.e. the metastases cannot be surgically removed with a curative intent 4 weeks must have elapsed since the patient has received any other IMP 4 weeks must have elapsed since the patient has received any anti cancer treatment; including radiotherapy (except for single dose of palliative radiotherapy), cytotoxic chemotherapy, biologic agents or targeted therapy 2 weeks must have elapsed since any prior surgery or therapy with bone marrow stimulating factors Adequate haematological functions as defined by: Absolute neutrophil count >= 1.5 10E9/L Platelets >= 100 10E9/L Hemoglobin >= 5.6 mmol/L Adequate hepatic function as defined by: Total bilirubin <= 1.5 x the upper limit of normal (ULN) Aspartate aminotransferase (AST) <= 2.5 x ULN* Alanine aminotransferase (ALT) <= 2.5 x ULN* For patients with liver metastasis adequate hepatic function is defined by AST <= 5 x ULN and ALT <= 5 ULN. Adequate renal function as defined by Serum creatinine <= 1,5 x ULN Patients in active anti-coagulating treatment must be evaluated according to local standards on the discretion of the Investigator.. Provision of written informed consent Willingness and ability to comply with scheduled visits, treatment plans, laboratory tests and other study procedures Sexually active males and females of child-producing potential, must use adequate contraception (intrauterine devices, hormonal contraceptives (contraceptive pills, implants, transdermal patches, hormonal vaginal devices or injections with prolonged release) or diaphragm always with spermicidal jelly and a male condom) for the study duration and at least six months afterwards Exclusion Criteria: Active uncontrolled bleeding or bleeding diathesis (e.g., active peptic ulcer disease) Any active infection requiring antibiotic treatment Known infection with human immunodeficiency virus (HIV) or hepatitis virus Active heart disease including myocardial infarction or congestive heart failure within the previous 6 months, symptomatic coronary artery disease, or symptomatic arrhythmias currently requiring medication Known or suspected active central nervous system (CNS) metastasis. (Patients stable 8 weeks after completion of treatment for CNS metastasis are eligible) Impending or symptomatic spinal cord compression or carcinomatous meningitis Requiring immediate palliative surgery and/or radiotherapy(except for a single dose of palliative radiotherapy) Pre-existing neuropathy, i.e., Grade >2 neuromotor or neurosensory toxicity Participation in other clinical studies within 4 weeks of first dose of study treatment Previous exposure to Foxy-5 History of severe allergic or hypersensitive reactions to excipients Pregnant or breastfeeding women Active and/or within the last 5 years histologically confirmed diagnosis of malignant melanoma, gastric cancer, pancreatic cancer, lung cancer or nasopharyngeal cancer Severe or uncontrolled chronic or uncontrolled systemic disease (e. g. severe respiratory or cardiovascular disease) Other medications or conditions that in the Investigator's opinion would contraindicate study participation of safety reasons or interfere with the interpretation of study results
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Tine Mølvadgaard, M.Sc.Pharm
Organizational Affiliation
Smerud Medical Research Denmark
Official's Role
Study Director
Facility Information:
Facility Name
Clinical Research Department, Oncology, Rigshospitalet
City
Copenhagen
ZIP/Postal Code
2100
Country
Denmark
Facility Name
Onkologisk Afdeling R, Herlev Hospital
City
Herlev
ZIP/Postal Code
2730
Country
Denmark
Facility Name
Odense University Hospital
City
Odense
Country
Denmark
Facility Name
NCCC, Freeman Hospital
City
Newcastle
State/Province
Newcastle Upon Tyne
ZIP/Postal Code
NE7 7DN
Country
United Kingdom

12. IPD Sharing Statement

Learn more about this trial

Dose Escalating Study of Foxy-5 in Breast-, Colon- or Prostate Cancer Patients

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