Single Agent ONC201 in Recurrent or Metastatic Endometrial Cancer
Primary Purpose
Endometrial Cancer
Status
Suspended
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
ONC201
Sponsored by
About this trial
This is an interventional treatment trial for Endometrial Cancer
Eligibility Criteria
Inclusion Criteria:
- Patients must have histologically confirmed metastatic or recurrent endometrial cancer. Eligible histologies include but are not limited to endometrioid, serous, clear cell, carcinosarcoma, adenosquamous, and mixed histologies.
- Patients must have measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension in accordance with RECIST criteria v. 1.1
- Must have radiographic disease progression after 1 line of systemic cytotoxic therapy for metastatic disease or with progression within 12 months of completing adjuvant chemotherapy
- Available archived tissue biopsies will be provided for correlative studies
- Age > 18 years.
- Eastern Cooperative Oncology group (ECOG) performance status of 0, 1, or 2
Patients must have adequate bone marrow, hepatic and renal function as defined below:
- Leukocytes > 3,000/micro-liter (mcl)
- Absolute neutrophil count > 1,500/mcL
- Platelets > 100,000/mcL
- Total bilirubin ≤1.5 upper limit of normal (ULN)
- Aspartate aminotransferase/ Alanine aminotransferase (AST/ALT) < 2 ULN
- Creatinine ≤1.5 ULN OR
- Creatinine clearance > 60 Ml/min/1.73 m2 for patients with creatinine levels above ULN calculated using Calvert formula
- Prior chemotherapy, hormonal and radiation therapy administered in the adjuvant setting will be allowed.
- Life expectancy at least 3 months
- Ability to understand and willingness to sign a written informed consent and HIPAA consent document
- Patients must be surgically sterile or be postmenopausal, or must agree to use effective contraception during the period of the trial and for at least 90 days after completion of treatment.
Exclusion Criteria:
- No prior treatment with ONC201
- Patients who have had chemotherapy or radiotherapy within 4 weeks prior to entering the study or those who have not recovered from adverse events due to agents administered more than 4 weeks earlier
- The subjects who have not recovered to baseline or CTCAE ≤ Grade 1 from related toxicity to all prior therapies will be excluded. Patients with Non-serious adverse events such as alopecia, fatigue, weakness, loss of appetite and nausea that are non-significant will not be excluded.
- Any other prior malignancy from which the patient has been disease free for less than 3 years, with the exception of adequately treated and cured basal or squamous cell skin cancer, superficial bladder cancer, carcinoma in situ of any site.
- The subject is unable to swallow capsules
- Patients receiving any other investigational agents
- Patients with symptomatic brain metastases are excluded. Patients with asymptomatic and treated central nervous system (CNS) metastases may participate in this trial. The patient must have completed any prior treatment for CNS metastases > 28 days prior to study entry including radiotherapy or surgery. Steroids for the treatment of brain metastasis are not permitted, and patients must be stable off steroid treatment for 4 weeks prior to enrollment
- Uncontrolled inter-current illness including, but not limited to ongoing or active infection. Any of the following in the previous 6 months: myocardial infarction, severe/unstable angina, coronary/peripheral artery bypass graft, cerebrovascular accident, transient ischemic attack or symptomatic pulmonary embolism.
- Active inflammatory gastrointestinal disease, chronic diarrhea (unless related to underlying malignancy or prior related treatment) or history of abdominal fistula, gastrointestinal perforation, peptic ulcer disease, or intra-abdominal abscess within 6 months prior to study enrollment. Gastroesophageal reflux disease under treatment with proton pump inhibitors is allowed.
- Known Human Immunodeficiency Virus (HIV)-positive patients on combination antiretroviral therapy
- Known history of Hepatitis B Virus (HBV) or Hepatitis C Virus (HCV) infection.
- Other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or study drug administration, or may interfere with the interpretation of study results, or in the judgment of the investigator would make the patient inappropriate for entry into the study.
- Pregnant or breast feeding. Refer to section 4.4 for further details.
Sites / Locations
- Fox Chase Cancer Center
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
ONC201 treatment Arm
Arm Description
Outcomes
Primary Outcome Measures
Progression free survival (PFS) rate at 12 weeks
PFS will be calculated from the day of starting the treatment until 12 weeks
Objective Response rate (ORR) as determined by Response Criteria In Solid Tumors (RECIST)1.1 criteria
ORR will be calculated from the day of starting the treatment until disease progression
Secondary Outcome Measures
Safety profile of ONC201 will be determined by adverse events according to Common terminology criteria for Adverse Events (CTCAE) 4.03
Safety profile of ONC201 will be determined by type, frequency, severity and timing and relationship of Adverse Events and lab abnormalities to ONC201
Duration of response
Duration or response will be determined from the time when a partial or complete response is seen until disease progression
Duration of stable disease
Duration of stable disease will be calculated from the time of first treatment until disease progression
Median progression free survival
Progression free survival will be calculated from the time of the start of the treatment until disease progression
Full Information
NCT ID
NCT03099499
First Posted
March 23, 2017
Last Updated
September 6, 2022
Sponsor
Fox Chase Cancer Center
Collaborators
Oncoceutics, Inc.
1. Study Identification
Unique Protocol Identification Number
NCT03099499
Brief Title
Single Agent ONC201 in Recurrent or Metastatic Endometrial Cancer
Official Title
A Phase 2 Study of Single Agent ONC201 in Recurrent or Metastatic Endometrial Cancer
Study Type
Interventional
2. Study Status
Record Verification Date
September 2022
Overall Recruitment Status
Suspended
Why Stopped
Slow accrual
Study Start Date
June 8, 2017 (Actual)
Primary Completion Date
September 9, 2020 (Actual)
Study Completion Date
September 2023 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Fox Chase Cancer Center
Collaborators
Oncoceutics, Inc.
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
ONC201 is a small molecule which selectively targets the G protein-coupled receptor DRD2. Downstream of target engagement, ONC201 activates the integrated stress response (ISR) in tumor cell leading to inactivation of Akt and extracellular signal-regulated kinase (ERK) signaling as well as induction of the TRAIL pathway. ONC201 also inhibits dopamine receptor 2 (DRD2), resulting in anti-tumor responses in preclinical models. Single agent ONC201 has been examined in open-label Phase I studies in patients with advanced, treatment refractory solid malignancies. Due to its differential anti-proliferative and pro-apoptotic response in tumor cells, treatment was overall well tolerated, and the recommended phase II dose of ONC201 was set at 625mg every three weeks. An additional dose-escalation phase I study (NCT02609230) is further evaluating weekly versus three week dosing in patients with advanced solid tumors and multiple myeloma. Preliminary data from these phase I studies suggests a possible clinical benefit in patients with advanced, chemo-refractory endometrial cancers, with at least one mixed response noted in a patient with clear cell histology.
Hypothesis: Single agent ONC201 will demonstrate clinical benefit in women with recurrent or metastatic endometrial cancers, especially in those women with alterations in the Phosphoinositide 3 kinase (PI3K)/Akt/mammalian target of Rapamycin (mTOR) pathway.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Endometrial Cancer
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
36 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
ONC201 treatment Arm
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
ONC201
Intervention Description
ONC201 will be administered at a dose of 625 mg by mouth weekly until disease progression, unacceptable toxicity, or if the patient discontinues for any other reason. Radiologic tumor assessment would be performed at baseline, Cycle 3 Day 1, Cycle 5 Day 1, and at the end of every 3 cycles beyond cycle 5. All patients including those removed from the study due to unacceptable toxicity, will undergo radiologic tumor assessment at the time of discontinuation (End of treatment).
Primary Outcome Measure Information:
Title
Progression free survival (PFS) rate at 12 weeks
Description
PFS will be calculated from the day of starting the treatment until 12 weeks
Time Frame
12 weeks
Title
Objective Response rate (ORR) as determined by Response Criteria In Solid Tumors (RECIST)1.1 criteria
Description
ORR will be calculated from the day of starting the treatment until disease progression
Time Frame
1-2 years
Secondary Outcome Measure Information:
Title
Safety profile of ONC201 will be determined by adverse events according to Common terminology criteria for Adverse Events (CTCAE) 4.03
Description
Safety profile of ONC201 will be determined by type, frequency, severity and timing and relationship of Adverse Events and lab abnormalities to ONC201
Time Frame
1-2 years
Title
Duration of response
Description
Duration or response will be determined from the time when a partial or complete response is seen until disease progression
Time Frame
1-2 years
Title
Duration of stable disease
Description
Duration of stable disease will be calculated from the time of first treatment until disease progression
Time Frame
1-2 years
Title
Median progression free survival
Description
Progression free survival will be calculated from the time of the start of the treatment until disease progression
Time Frame
1-2 years
10. Eligibility
Sex
Female
Gender Based
Yes
Gender Eligibility Description
Endometrial cancer happens only in females
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patients must have histologically confirmed metastatic or recurrent endometrial cancer. Eligible histologies include but are not limited to endometrioid, serous, clear cell, carcinosarcoma, adenosquamous, and mixed histologies.
Patients must have measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension in accordance with RECIST criteria v. 1.1
Must have radiographic disease progression after 1 line of systemic cytotoxic therapy for metastatic disease or with progression within 12 months of completing adjuvant chemotherapy
Available archived tissue biopsies will be provided for correlative studies
Age > 18 years.
Eastern Cooperative Oncology group (ECOG) performance status of 0, 1, or 2
Patients must have adequate bone marrow, hepatic and renal function as defined below:
Leukocytes > 3,000/micro-liter (mcl)
Absolute neutrophil count > 1,500/mcL
Platelets > 100,000/mcL
Total bilirubin ≤1.5 upper limit of normal (ULN)
Aspartate aminotransferase/ Alanine aminotransferase (AST/ALT) < 2 ULN
Creatinine ≤1.5 ULN OR
Creatinine clearance > 60 Ml/min/1.73 m2 for patients with creatinine levels above ULN calculated using Calvert formula
Prior chemotherapy, hormonal and radiation therapy administered in the adjuvant setting will be allowed.
Life expectancy at least 3 months
Ability to understand and willingness to sign a written informed consent and HIPAA consent document
Patients must be surgically sterile or be postmenopausal, or must agree to use effective contraception during the period of the trial and for at least 90 days after completion of treatment.
Exclusion Criteria:
No prior treatment with ONC201
Patients who have had chemotherapy or radiotherapy within 4 weeks prior to entering the study or those who have not recovered from adverse events due to agents administered more than 4 weeks earlier
The subjects who have not recovered to baseline or CTCAE ≤ Grade 1 from related toxicity to all prior therapies will be excluded. Patients with Non-serious adverse events such as alopecia, fatigue, weakness, loss of appetite and nausea that are non-significant will not be excluded.
Any other prior malignancy from which the patient has been disease free for less than 3 years, with the exception of adequately treated and cured basal or squamous cell skin cancer, superficial bladder cancer, carcinoma in situ of any site.
The subject is unable to swallow capsules
Patients receiving any other investigational agents
Patients with symptomatic brain metastases are excluded. Patients with asymptomatic and treated central nervous system (CNS) metastases may participate in this trial. The patient must have completed any prior treatment for CNS metastases > 28 days prior to study entry including radiotherapy or surgery. Steroids for the treatment of brain metastasis are not permitted, and patients must be stable off steroid treatment for 4 weeks prior to enrollment
Uncontrolled inter-current illness including, but not limited to ongoing or active infection. Any of the following in the previous 6 months: myocardial infarction, severe/unstable angina, coronary/peripheral artery bypass graft, cerebrovascular accident, transient ischemic attack or symptomatic pulmonary embolism.
Active inflammatory gastrointestinal disease, chronic diarrhea (unless related to underlying malignancy or prior related treatment) or history of abdominal fistula, gastrointestinal perforation, peptic ulcer disease, or intra-abdominal abscess within 6 months prior to study enrollment. Gastroesophageal reflux disease under treatment with proton pump inhibitors is allowed.
Known Human Immunodeficiency Virus (HIV)-positive patients on combination antiretroviral therapy
Known history of Hepatitis B Virus (HBV) or Hepatitis C Virus (HCV) infection.
Other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or study drug administration, or may interfere with the interpretation of study results, or in the judgment of the investigator would make the patient inappropriate for entry into the study.
Pregnant or breast feeding. Refer to section 4.4 for further details.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gina Mantia-Smaldone, MD
Organizational Affiliation
Fox Chase Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Fox Chase Cancer Center
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19111
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
No
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Single Agent ONC201 in Recurrent or Metastatic Endometrial Cancer
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