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Phase 1/2 Study of USL311 +/- Lomustine in Advanced Solid Tumors or Relapsed/Recurrent Glioblastoma Multiforme (GBM)

Primary Purpose

Solid Tumors (Phase 1), Relapsed/Recurrent GBM (Phase 2)

Status
Terminated
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
USL311
USL311
USL311
Lomustine
Sponsored by
Proximagen, LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Solid Tumors (Phase 1) focused on measuring Phase 1, Phase 2, Glioblastoma Multiforme, Glioblastoma, GBM, Brain Tumor, Brain Cancer, Tumor, Solid Tumor, Tumour, Lomustine, CCNU, CXCR4, Phase 1 Clinical Trial, Phase 2 Clinical Trial

Eligibility Criteria

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

Inclusion Criteria:

All Subjects:

  1. Provide signed and dated informed consent prior to study-specific screening procedures
  2. ≥ 18 years old
  3. Karnofsky performance status (KPS) ≥ 70
  4. Must have adequate bone marrow and renal/hepatic function within protocol specified limits
  5. Disease-free period of > 2 years from any other previous malignancies, excluding curatively treated basal cell carcinoma, squamous cell carcinoma of the skin, or carcinoma in situ of the cervix. Subjects with prostate cancer Stage 1 that do not require treatment may also be included
  6. Women and men must use protocol approved methods of contraception
  7. Must be able and willing to comply with the study visit schedule and study procedures
  8. Must be able to take oral medications
  9. Must have available archived tumor tissue and willing and able to provide consent for study access to such tissue
  10. For subjects with a history of seizures, must be adequately controlled on a stable regimen of anti-epileptic drugs

    For Phase 1 Subjects Only:

  11. Histologically or cytologically documented diagnosis of solid tumor for which no standard therapy is recognized or have failed or intolerant to the standard-of-care treatment
  12. Inoperable metastatic or locally advanced, unresectable disease
  13. Subjects may have either evaluable or measurable disease
  14. Subjects with treated (surgically excised or irradiated) and stable brain metastases are eligible as long as the subject has adequately recovered from treatment and the treatment was ≥ 28 days prior to initiation of study drug(s) and baseline brain computed tomography (CT) with contrast or magnetic resonance imaging (MRI) ≤ 14 days of initiation of study drug is negative for new brain metastases

    For Phase 2 Subjects Only:

  15. Histologically confirmed diagnosis of GBM
  16. Subjects must have documented recurrence after first-line treatment
  17. Prior first-line treatment must have included radiation and temozolomide
  18. Subject is suitable for re-resection, per Investigator discretion, as a component of their clinical care
  19. No more than one prior resection (Note: biopsy does not count as prior resection)

Exclusion Criteria:

All Subjects

  1. Subjects who have had recent systemic anticancer therapies, interventional device treatment and/or radiotherapy either within 14 days prior to first dose of study drug(s) or have not recovered (to grade ≤ 1) from all clinically significant toxicities related to prior therapies
  2. Subjects who have had any major surgery (not including re-resection surgery required in Phase 2) within 28 days prior to first dose of study drug(s), or minor surgery within 14 days prior to first day of study drug(s)
  3. Subjects taking any strong cytochrome P450 3A4 inducers within 14 days prior to the first dose of study drug(s)
  4. Subjects taking any strong cytochrome P450 3A4 inhibitors within 14 days prior to the first dose of study drug(s)
  5. Subjects taking any agents with moderate to high risk to prolong QT corrected (QTc) interval or to cause Torsades de Pointes within 14 days prior to the first dose of study drug(s)
  6. Subjects who have been treated with an investigational agent or investigational interventional device within 21 days prior to the first dose of study drug(s)
  7. Subject is growth factor dependent or transfusion dependent, or has received growth factor support or transfusion support within 14 days prior to the first dose of study drug(s)
  8. History of significant cardiac disease
  9. Status epilepticus within 1 year prior to the first dose of study drug(s)
  10. Pregnant or breastfeeding
  11. Any other significant co-morbid conditions that in the opinion of the Investigator would impair study participation or cooperation

    For Phase 1 Subjects Only:

  12. Lymphoma as primary cancer

    For Phase 2 Subjects Only:

  13. Unable or unwilling to consent to the provision of resected tissue after surgery
  14. Prior treatment with plerixafor or another CXCR4 inhibitor
  15. Prior treatment with bevacizumab
  16. Prior treatment with lomustine and/or carmustine

    For All Cohorts Receiving Oral USL311:

  17. Any active medical condition or previous major abdominal surgery or procedure that might, in the investigator's opinion, have a significant effect on USL311 absorption

Sites / Locations

  • Washington University
  • University of Oklahoma Stephenson Cancer Center
  • University of Texas/MD Anderson Cancer Center
  • South Texas Accelerated Research Therapeutics (START)
  • UT Health San Antonio Cancer Center
  • South Texas Accelerated Research Therapeutics (START) - FJD

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Arm Label

Dose-Escalation USL311, Solid Tumor, Part 1a

Dose-Escalation USL311, Solid Tumor, Part 1b

Dose-Escalation USL311 with Lomustine, Solid Tumor, Part 2

Dose-Expansion, USL311, GBM, Part 3

Dose-Expansion, USL311 with Lomustine, GBM, Part 4

Arm Description

USL311, intravenous, once per week, starting at 60 mg/m˄2

USL311, oral, daily, starting at 40 mg

USL311, oral, daily, starting at dose as determined in Part 1b, in combination with lomustine 90 mg/m˄2, oral, once every 6 weeks

USL311, oral, daily, starting at dose determined in Part 1b

USL311, oral, daily, in combination with lomustine, oral, once every 6 weeks, at dose(s) as determined in part 2

Outcomes

Primary Outcome Measures

Phase 1: Maximum Tolerated Dose (MTD)
The MTD was defined as the highest safe dose (mg/m^2) administered where safe is defined by having at least a 50% probability that the dose limiting toxicity (DLT) rate is less than 33%, as determined by a modified continuous reassessment model.
Phase 1: Maximum Tolerated Dose (MTD)
The MTD was defined as the highest safe dose (mg) administered where safe is defined by having at least a 50% probability that the dose limiting toxicity (DLT) rate is less than 33%, as determined by a modified continuous reassessment model.

Secondary Outcome Measures

Percentage Progression Free Survival (PFS) at 6 Months (PFS-6m)
Percentage of subjects who were without progression at 6 months as assessed radiographically with response to treatment determined by Response Evaluation Criteria in Solid Tumors (RECIST) or Response Assessment in Neuro-Oncology (RANO) criteria.
Overall Survival (OS)
Percentage of subjects alive five years after start of treatment.
Median Progression Free Survival (PFS)
Time after initiation of treatment before disease progression
Objective Response Rate (ORR%)
Percentage of patients whose disease decreased (Partial response) and/or disappears (Complete response) after initiation of treatment
Peak Concentration (Cmax)
Peak USL311 concentration (Cmax) in plasma
Time to Peak Concentration (Tmax)
Time to peak concentration of USL311 in plasma
Area Under the Concentration Versus Time Curve (AUC)
Area under the curve versus time from time 0 to infinity for USL311 concentration in plasma

Full Information

First Posted
April 19, 2016
Last Updated
July 1, 2021
Sponsor
Proximagen, LLC
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1. Study Identification

Unique Protocol Identification Number
NCT02765165
Brief Title
Phase 1/2 Study of USL311 +/- Lomustine in Advanced Solid Tumors or Relapsed/Recurrent Glioblastoma Multiforme (GBM)
Official Title
A Phase 1/2 Dose-escalation of USL311 as Single Agent and in Combination With Lomustine (CCNU) in Subjects With Advanced Solid Tumors, With Subsequent Single Agent and Combination Phase 2 Cohorts for Subjects With Relapsed/Recurrent Glioblastoma Multiforme (GBM)
Study Type
Interventional

2. Study Status

Record Verification Date
July 2021
Overall Recruitment Status
Terminated
Why Stopped
Business reasons not related to safety
Study Start Date
April 2016 (Actual)
Primary Completion Date
July 1, 2020 (Actual)
Study Completion Date
July 1, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Proximagen, LLC

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a multicenter, open-label, Phase 1/2, dose-escalation and dose expansion study of a CXCR4 inhibitor, USL311, alone and in combination with lomustine in subjects with advanced solid tumors (Phase 1) and subjects with relapsed/recurrent GBM (Phase 2). The study is designed to explore the safety, tolerability, pharmacokinetics, and preliminary efficacy of USL311 alone and in combination with lomustine.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Solid Tumors (Phase 1), Relapsed/Recurrent GBM (Phase 2)
Keywords
Phase 1, Phase 2, Glioblastoma Multiforme, Glioblastoma, GBM, Brain Tumor, Brain Cancer, Tumor, Solid Tumor, Tumour, Lomustine, CCNU, CXCR4, Phase 1 Clinical Trial, Phase 2 Clinical Trial

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Dose-Escalation USL311, Solid Tumor, Part 1a
Arm Type
Experimental
Arm Description
USL311, intravenous, once per week, starting at 60 mg/m˄2
Arm Title
Dose-Escalation USL311, Solid Tumor, Part 1b
Arm Type
Experimental
Arm Description
USL311, oral, daily, starting at 40 mg
Arm Title
Dose-Escalation USL311 with Lomustine, Solid Tumor, Part 2
Arm Type
Experimental
Arm Description
USL311, oral, daily, starting at dose as determined in Part 1b, in combination with lomustine 90 mg/m˄2, oral, once every 6 weeks
Arm Title
Dose-Expansion, USL311, GBM, Part 3
Arm Type
Experimental
Arm Description
USL311, oral, daily, starting at dose determined in Part 1b
Arm Title
Dose-Expansion, USL311 with Lomustine, GBM, Part 4
Arm Type
Experimental
Arm Description
USL311, oral, daily, in combination with lomustine, oral, once every 6 weeks, at dose(s) as determined in part 2
Intervention Type
Drug
Intervention Name(s)
USL311
Intervention Description
Administered once weekly in a 21-day cycle
Intervention Type
Drug
Intervention Name(s)
USL311
Intervention Description
Administered once daily in a 21-day cycle
Intervention Type
Drug
Intervention Name(s)
USL311
Intervention Description
Administered once daily in a 42-day cycle
Intervention Type
Drug
Intervention Name(s)
Lomustine
Intervention Description
Administered once every 6 weeks in a 42-day cycle
Primary Outcome Measure Information:
Title
Phase 1: Maximum Tolerated Dose (MTD)
Description
The MTD was defined as the highest safe dose (mg/m^2) administered where safe is defined by having at least a 50% probability that the dose limiting toxicity (DLT) rate is less than 33%, as determined by a modified continuous reassessment model.
Time Frame
Assessed weekly during treatment period. Median duration of exposure was 5.14 (range 2.1-17.3) weeks.
Title
Phase 1: Maximum Tolerated Dose (MTD)
Description
The MTD was defined as the highest safe dose (mg) administered where safe is defined by having at least a 50% probability that the dose limiting toxicity (DLT) rate is less than 33%, as determined by a modified continuous reassessment model.
Time Frame
Assessed weekly during treatment period. Median duration of exposure was 6.00 (range 0.3-30.0) weeks.
Secondary Outcome Measure Information:
Title
Percentage Progression Free Survival (PFS) at 6 Months (PFS-6m)
Description
Percentage of subjects who were without progression at 6 months as assessed radiographically with response to treatment determined by Response Evaluation Criteria in Solid Tumors (RECIST) or Response Assessment in Neuro-Oncology (RANO) criteria.
Time Frame
Once every 6 weeks during treatment
Title
Overall Survival (OS)
Description
Percentage of subjects alive five years after start of treatment.
Time Frame
Weekly during treatment or every 12 weeks during follow-up
Title
Median Progression Free Survival (PFS)
Description
Time after initiation of treatment before disease progression
Time Frame
Every 6 weeks during treatment
Title
Objective Response Rate (ORR%)
Description
Percentage of patients whose disease decreased (Partial response) and/or disappears (Complete response) after initiation of treatment
Time Frame
Every 6 weeks
Title
Peak Concentration (Cmax)
Description
Peak USL311 concentration (Cmax) in plasma
Time Frame
Day 1
Title
Time to Peak Concentration (Tmax)
Description
Time to peak concentration of USL311 in plasma
Time Frame
Day 1
Title
Area Under the Concentration Versus Time Curve (AUC)
Description
Area under the curve versus time from time 0 to infinity for USL311 concentration in plasma
Time Frame
Day 1

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: All Subjects: Provide signed and dated informed consent prior to study-specific screening procedures ≥ 18 years old Karnofsky performance status (KPS) ≥ 70 Must have adequate bone marrow and renal/hepatic function within protocol specified limits Disease-free period of > 2 years from any other previous malignancies, excluding curatively treated basal cell carcinoma, squamous cell carcinoma of the skin, or carcinoma in situ of the cervix. Subjects with prostate cancer Stage 1 that do not require treatment may also be included Women and men must use protocol approved methods of contraception Must be able and willing to comply with the study visit schedule and study procedures Must be able to take oral medications Must have available archived tumor tissue and willing and able to provide consent for study access to such tissue For subjects with a history of seizures, must be adequately controlled on a stable regimen of anti-epileptic drugs For Phase 1 Subjects Only: Histologically or cytologically documented diagnosis of solid tumor for which no standard therapy is recognized or have failed or intolerant to the standard-of-care treatment Inoperable metastatic or locally advanced, unresectable disease Subjects may have either evaluable or measurable disease Subjects with treated (surgically excised or irradiated) and stable brain metastases are eligible as long as the subject has adequately recovered from treatment and the treatment was ≥ 28 days prior to initiation of study drug(s) and baseline brain computed tomography (CT) with contrast or magnetic resonance imaging (MRI) ≤ 14 days of initiation of study drug is negative for new brain metastases For Phase 2 Subjects Only: Histologically confirmed diagnosis of GBM Subjects must have documented recurrence after first-line treatment Prior first-line treatment must have included radiation and temozolomide Subject is suitable for re-resection, per Investigator discretion, as a component of their clinical care No more than one prior resection (Note: biopsy does not count as prior resection) Exclusion Criteria: All Subjects Subjects who have had recent systemic anticancer therapies, interventional device treatment and/or radiotherapy either within 14 days prior to first dose of study drug(s) or have not recovered (to grade ≤ 1) from all clinically significant toxicities related to prior therapies Subjects who have had any major surgery (not including re-resection surgery required in Phase 2) within 28 days prior to first dose of study drug(s), or minor surgery within 14 days prior to first day of study drug(s) Subjects taking any strong cytochrome P450 3A4 inducers within 14 days prior to the first dose of study drug(s) Subjects taking any strong cytochrome P450 3A4 inhibitors within 14 days prior to the first dose of study drug(s) Subjects taking any agents with moderate to high risk to prolong QT corrected (QTc) interval or to cause Torsades de Pointes within 14 days prior to the first dose of study drug(s) Subjects who have been treated with an investigational agent or investigational interventional device within 21 days prior to the first dose of study drug(s) Subject is growth factor dependent or transfusion dependent, or has received growth factor support or transfusion support within 14 days prior to the first dose of study drug(s) History of significant cardiac disease Status epilepticus within 1 year prior to the first dose of study drug(s) Pregnant or breastfeeding Any other significant co-morbid conditions that in the opinion of the Investigator would impair study participation or cooperation For Phase 1 Subjects Only: Lymphoma as primary cancer For Phase 2 Subjects Only: Unable or unwilling to consent to the provision of resected tissue after surgery Prior treatment with plerixafor or another CXCR4 inhibitor Prior treatment with bevacizumab Prior treatment with lomustine and/or carmustine For All Cohorts Receiving Oral USL311: Any active medical condition or previous major abdominal surgery or procedure that might, in the investigator's opinion, have a significant effect on USL311 absorption
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Tze-Chiang Meng, MD
Organizational Affiliation
Proximagen, LLC
Official's Role
Study Director
Facility Information:
Facility Name
Washington University
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
University of Oklahoma Stephenson Cancer Center
City
Oklahoma City
State/Province
Oklahoma
ZIP/Postal Code
73104
Country
United States
Facility Name
University of Texas/MD Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
South Texas Accelerated Research Therapeutics (START)
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States
Facility Name
UT Health San Antonio Cancer Center
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States
Facility Name
South Texas Accelerated Research Therapeutics (START) - FJD
City
Madrid
Country
Spain

12. IPD Sharing Statement

Learn more about this trial

Phase 1/2 Study of USL311 +/- Lomustine in Advanced Solid Tumors or Relapsed/Recurrent Glioblastoma Multiforme (GBM)

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