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Safety and Efficacy of IV Nerofe™ Followed by Doxorubicin, In Metastatic Ovarian Cancer and Triple Negative Breast Cancer

Primary Purpose

Metastatic Ovarian Cancer, Triple Negative Breast Cancer

Status
Withdrawn
Phase
Phase 1
Locations
Israel
Study Type
Interventional
Intervention
Nerofe is a first in class derivative of a human hormon-peptide(TCApF), with Cancer suppressive properties.
Sponsored by
Immune System Key Ltd
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Metastatic Ovarian Cancer

Eligibility Criteria

18 Years - 90 Years (Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  1. Females over18 years of age.
  2. Pathologically confirmed locally advanced and/or metastatic solid tumor, for which, in the judgment of the Principal Investigator, no standard curative therapy exists.
  3. Subjects must have 1 of the following solid tumor types: Ovarian cancer (up to 12 patients), or by Triple-negative breast cancer (up to 12 patients).
  4. Disease that is evaluable, or measurable on imaging by Response Evaluation Criteria in Solid Tumors (RECIST v1.1 Appendix A), and where applicable is characterized by informative tumor marker(s).
  5. Eastern Cooperative Oncology Group (ECOG) Performance Status of ≤ 2(Section 6.1.1.6) .
  6. Acceptable clinical laboratory values at screening, as indicated by:

    Absolute neutrophil count ≥ 1,500/mm3; Platelets ≥ 75,000/mm3; Total bilirubin ≤ 5 mg/dL. ASpartate aminoTransferase (SGOT) ≤ 2.5 × the Upper Limit of Normal; ALalanine aminoTransferase (SGPT) ≤ 2.5 × the Upper Limit of Normal; Serum creatinine ≤ 1.5 mg/dL or a measured creatinine clearance higher than 60 mL/min; and Negative serum Beta human chorionic gonadotropin test in women of childbearing potential (defined as women ≤ 50 years of age or history of amenorrhea for ≤ 12 months prior to study entry).

  7. Patients with hepatic metastasis are eligible to enroll, provided that the following criteria are met at Screening:

    Total bilirubin ≤ 5 * mg/dL; ASpartate aminoTransferase and ALalanine aminoTransferase are each ≤ 5 × the Upper Limit of Normal;

  8. Willing and able to provide written Informed Consent and comply with the requirements of the study.
  9. Tumor tissue, taken from either an archival sample or a fresh biopsy, must be available for staining for T1/ST2 receptor, and must be ST2 positive.
  10. Subject has not been previously treated with Doxorubicin or total accumulated dose has never exceeded 240 mg/m2.

Exclusion Criteria:

  1. Any chemotherapy, immunomodulatory drug therapy, anti-neoplastic hormonal therapy (unless dose has been stable for 1 month prior to Baseline and remains stable during the trial), immunosuppressive therapy, corticosteroids > 20 mg/day prednisone or equivalent (unless administered to prevent contrast material reactions during radiographic procedures), or growth factor treatment (eg, erythropoietin) within 14 days prior to initiation of study drug.
  2. Presence of an acute toxicity of prior chemotherapy, with the exception of alopecia or peripheral neuropathy, that has not resolved to ≤ Grade 1, as determined by NCI CTCAE v 4.0 (http://evs.nci.nih.gov/ftp1/CTCAE/About.html).
  3. Receipt of >3 prior regimens of cytotoxic chemotherapy, including any use in the neo-adjuvant, adjuvant, and/or metastatic settings ,Unless more than 1 year elapsed since the Neo-adjuvant treatment was completed
  4. Receipt of Blood Transfusion during 2 weeks prior to Baseline
  5. Life expectancy <12 weeks.
  6. Major surgery or radiation therapy within 28 days prior to initiation of study drug,
  7. Known human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome-related illness.
  8. Patients with history of brain metastasis
  9. Known active hepatitis B or C or other active liver disease (other than malignancy).
  10. Severe liver dysfunction (Child-Pugh Class B or C) and
  11. Patients with a history of esophageal bleeding have varices that have been sclerosed or banded and no bleeding episodes have occurred during the prior 6 months.
  12. Active infection requiring systemic therapy.
  13. Insulin-requiring diabetes mellitus will not be included if, according to the investigator, not stable, during the last 6 months.
  14. History of any of the following within 12 months prior to initiation of study drug:

    Uncontrolled congestive heart failure (New York Heart Association Classification 3 or 4), unstable angina, myocardial infarction, cerebrovascular accident, coronary/peripheral artery bypass graft surgery, transient ischemic attack, or pulmonary embolism (within the last 6 months). Left Ventricular Ejection Fraction <50% .

  15. Uncontrolled arterial hypertension, or anti-hypertensive drugs whose type or dose has been changed within 1 months prior to screening or whose dose is anticipated to change within cycle 1.
  16. Risk of syncope, in the judgment of the Principal Investigator, according to the patient's history of syncope.
  17. History of ongoing cardiac dysrhythmias requiring drug treatment
  18. Malignancies can be a reason for exclusion only if active during the last year or requiring any anti-tumor treatment. Skin non-melanomatous tumors and thyroid carcinomas - can be included. as well as, Previously treated malignancy within the past 2 years that the Principal Investigator deems to be at low risk for recurrence during the course of this trial.
  19. Use of any investigational agents within a minimum of 4 weeks or 5 half-lives of initiation of study drug.
  20. Pregnant or lactating female.
  21. Women of childbearing potential, unless they agree to use dual contraceptive methods which, in the opinion of the Principal Investigator, are effective and adequate for that patient's circumstances while on study drug and for 3 months afterward.
  22. Any severe, acute, or chronic medical or psychiatric condition, or laboratory abnormality that may increase the risk associated with study participation or study drug administration, may interfere with the informed consent process and/or with compliance with the requirements of the study, or may interfere with the interpretation of study results and, in the investigator's opinion, would make the patient inappropriate for entry into this study.
  23. Any known multiple allergy, or acute allergic reaction within the subject's medical History or General Practitioner's records.

Sites / Locations

  • Oncologic Institue, Kaplan

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Single arm Nerofe followed by Doxorubicin

Arm Description

IV treatment of Nerofe 96 mg\m2 followed by IV Doxorubicin 10mg\m2 Once weekly

Outcomes

Primary Outcome Measures

The primary safety endpoint will be the Adverse Events (AE) reported during the combined treatment of Nerofe and low Dose doxorubicin , using the CTCAE score.
The Adverse Events (AE) reported during the combined treatment of Nerofe and low Dose doxorubicin, using the CTCAE score.
Assessing Change in tumor size from Baseline to End of study
Assessing Change in tumor size from Baseline to End of study under combined treatment of Nerofe and Low dose Doxorubicin in Ovarian cancer or triple negative breast cancer. Subject population will be evaluated using Response Evaluation Criteria in Solid Tumors, from Baseline, and every 2 cycles( 8 weeks), and last one- at the end of the study.
Assessing Change in Blood markers from Baseline to End of study
Assessing Change in tumor size from Baseline to End of study, under combined treatment of Nerofe and Low dose Doxorubicin, in Ovarian cancer or triple negative breast cancer. Subject population will be evaluated from Baseline, and every cycle( 28 days each cycle) until the end of the study.

Secondary Outcome Measures

Pharmacokinetic Profile
Pharmacokinetic Profile, including area under the curve.
Pharmacokinetic Profile
Pharmacokinetic Profile, including maximum plasma concentration
Pharmacokinetic Profile
Pharmacokinetic Profile, including trough plasma concentration.
Pharmacokinetic Profile
Pharmacokinetic Profile, including time to maximum plasma concentration.
Pharmacokinetic Profile
Pharmacokinetic Profile, including plasma half-life.
Pharmacodynamics profile
PharmacoDynamics profile, including changes in plasma levels of circulating cytokines
Pharmacodynamics profile
PharmacoDynamics profile, including changes in plasma levels of soluble T1/ST2 receptor
Pharmacodynamics profile
PharmacoDynamics profile, including changes in Peripheral blood mononuclear cells' T1/ST2 receptor expression
Pharmacodynamics profile
Immunogenicity of Nerofe, through the analysis of Plasma levels of circulating anti-Nerofe antibodies.

Full Information

First Posted
June 20, 2018
Last Updated
October 18, 2021
Sponsor
Immune System Key Ltd
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1. Study Identification

Unique Protocol Identification Number
NCT03634150
Brief Title
Safety and Efficacy of IV Nerofe™ Followed by Doxorubicin, In Metastatic Ovarian Cancer and Triple Negative Breast Cancer
Official Title
A Phase 1b, Open-Label, Dose-Confirmation Study Evaluating the Safety, and Clinical Effects of Intravenously Administered Nerofe™ in Combination With Doxorubicin, In Subjects With Metastatic Ovarian Cancer and Triple Negative Breast Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
October 2021
Overall Recruitment Status
Withdrawn
Why Stopped
Patients were screened but not enrolled
Study Start Date
September 6, 2018 (Actual)
Primary Completion Date
April 21, 2020 (Actual)
Study Completion Date
April 21, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Immune System Key Ltd

4. Oversight

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

5. Study Description

Brief Summary
This is a Phase 1b, open-label, non-randomized, Dose Confirmation study. Subjects will be treated, once a week, with IV doses of Nerofe and low dose (20 mg/m2) Doxorubicin (6-8 hours from one another) in consecutive, 28-day cycles.
Detailed Description
Subjects will be evaluated regularly for safety. Subjects will return for a follow-up visit 30-33 days after the last dosing of study drug. Subjects who tolerate the drug and who do not experience progressive disease, intolerable toxicity, or meet any of the other withdrawal criteria - may continue to receive Nerofe & Doxorubicin for up to 5 cycles, at the discretion of the Principal Investigator. Throughout the trial, oversight will be provided by the Clinical Safety Committee (CSC).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metastatic Ovarian Cancer, Triple Negative Breast Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Model Description
Experimental: IV Nerofe 96 mg\m2 followed by IV Doxorubicin 10mg\m2, once weekly
Masking
None (Open Label)
Allocation
N/A
Enrollment
0 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Single arm Nerofe followed by Doxorubicin
Arm Type
Experimental
Arm Description
IV treatment of Nerofe 96 mg\m2 followed by IV Doxorubicin 10mg\m2 Once weekly
Intervention Type
Biological
Intervention Name(s)
Nerofe is a first in class derivative of a human hormon-peptide(TCApF), with Cancer suppressive properties.
Other Intervention Name(s)
Doxorubicin or Adriamycin is a registered chemotherapy, which belongs to the Anthracyclines. It slows or stops the growth of cancer cells.
Intervention Description
Once weekly treatment, with IV doses of Nerofe (96mg\m2) and low dose (20 mg/m2) Doxorubicin 5 or 24 hours from one another) .
Primary Outcome Measure Information:
Title
The primary safety endpoint will be the Adverse Events (AE) reported during the combined treatment of Nerofe and low Dose doxorubicin , using the CTCAE score.
Description
The Adverse Events (AE) reported during the combined treatment of Nerofe and low Dose doxorubicin, using the CTCAE score.
Time Frame
Safety data will be collected weekly during the subjects visits(Weeks 1-20), throughout the study and up to 1 year.
Title
Assessing Change in tumor size from Baseline to End of study
Description
Assessing Change in tumor size from Baseline to End of study under combined treatment of Nerofe and Low dose Doxorubicin in Ovarian cancer or triple negative breast cancer. Subject population will be evaluated using Response Evaluation Criteria in Solid Tumors, from Baseline, and every 2 cycles( 8 weeks), and last one- at the end of the study.
Time Frame
Imaging would be performed at Baseline and at the end of every 2 cycles(8 weeks), through the study completion, which is estimated to be after 6 months.
Title
Assessing Change in Blood markers from Baseline to End of study
Description
Assessing Change in tumor size from Baseline to End of study, under combined treatment of Nerofe and Low dose Doxorubicin, in Ovarian cancer or triple negative breast cancer. Subject population will be evaluated from Baseline, and every cycle( 28 days each cycle) until the end of the study.
Time Frame
Blood Markers would be measured at Baseline, and at the end of every cycle(28 Days in each cycle), through the study completion, which is estimated to be after 6 months.
Secondary Outcome Measure Information:
Title
Pharmacokinetic Profile
Description
Pharmacokinetic Profile, including area under the curve.
Time Frame
Pharmacokinetic sampling is planned once at Baseline. In Cycle 1(28 Days in each cycle), and Cycle 2 Day 1 visits: pre-dose and following the end of Nerofe infusion: 15 minutes, 1 hour, 2 hours, 4 hours, 6 hours, 8 hours, and 24 hours
Title
Pharmacokinetic Profile
Description
Pharmacokinetic Profile, including maximum plasma concentration
Time Frame
Pharmacokinetic sampling is planned once at Baseline. In Cycle 1(28 Days in each cycle), and Cycle 2 Day 1 visits: pre-dose and following the end of Nerofe infusion: 15 min ,1 hour, 2 hours, 4 hours, 6 hours, 8 hours, and 24 hours.
Title
Pharmacokinetic Profile
Description
Pharmacokinetic Profile, including trough plasma concentration.
Time Frame
Pharmacokinetic sampling is planned once at Baseline. In Cycle 1(28 Days in each cycle), and Cycle 2 Day 1 visits: pre-dose and following the end of Nerofe infusion: 15 min, 1 hour, 2 hours, 4 hours, 6 hours, 8 hours, and 24 hours.
Title
Pharmacokinetic Profile
Description
Pharmacokinetic Profile, including time to maximum plasma concentration.
Time Frame
Pharmacokinetic sampling is planned once at Baseline. In Cycle 1(28 Days in each cycle), and Cycle 2 Day 1 visits: pre-dose and following the end of Nerofe infusion: 15 min, 1 hour, 2 hours, 4 hours, 6 hours, 8 hours, and 24 hours.
Title
Pharmacokinetic Profile
Description
Pharmacokinetic Profile, including plasma half-life.
Time Frame
Pharmacokinetic sampling is planned once at Baseline. In Cycle 1(28 Days in each cycle), and Cycle 2 Day 1 visits: pre-dose and following the end of Nerofe infusion: 15 min, 1 hour, 2 hours, 4 hours, 6 hours, 8 hours, and 24 hours.
Title
Pharmacodynamics profile
Description
PharmacoDynamics profile, including changes in plasma levels of circulating cytokines
Time Frame
PharmacoDynamics sampling is planned at Baseline, at Day 1, 15, visits of every cycle (28 Days in each cycle), through the study completion which is estimated to be after 6 months..
Title
Pharmacodynamics profile
Description
PharmacoDynamics profile, including changes in plasma levels of soluble T1/ST2 receptor
Time Frame
PharmacoDynamics sampling is planned at Baseline, at Day 1, 15, visits of every cycle (28 Days in each cycle), through the study completion which is estimated to be after 6 months.
Title
Pharmacodynamics profile
Description
PharmacoDynamics profile, including changes in Peripheral blood mononuclear cells' T1/ST2 receptor expression
Time Frame
PharmacoDynamics sampling is planned at Baseline, at Day 1, 15, visits of every cycle (28 Days in each cycle), through the study completion which is estimated to be after 6 months.
Title
Pharmacodynamics profile
Description
Immunogenicity of Nerofe, through the analysis of Plasma levels of circulating anti-Nerofe antibodies.
Time Frame
PharmacoDynamics sampling is planned at Baseline, at Day 1, 15, visits of every cycle(28 Days in each cycle), through the study completion which is estimated to be after 6 months.

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
90 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Females over18 years of age. Pathologically confirmed locally advanced and/or metastatic solid tumor, for which, in the judgment of the Principal Investigator, no standard curative therapy exists. Subjects must have 1 of the following solid tumor types: Ovarian cancer (up to 12 patients), or by Triple-negative breast cancer (up to 12 patients). Disease that is evaluable, or measurable on imaging by Response Evaluation Criteria in Solid Tumors (RECIST v1.1 Appendix A), and where applicable is characterized by informative tumor marker(s). Eastern Cooperative Oncology Group (ECOG) Performance Status of ≤ 2(Section 6.1.1.6) . Acceptable clinical laboratory values at screening, as indicated by: Absolute neutrophil count ≥ 1,500/mm3; Platelets ≥ 75,000/mm3; Total bilirubin ≤ 5 mg/dL. ASpartate aminoTransferase (SGOT) ≤ 2.5 × the Upper Limit of Normal; ALalanine aminoTransferase (SGPT) ≤ 2.5 × the Upper Limit of Normal; Serum creatinine ≤ 1.5 mg/dL or a measured creatinine clearance higher than 60 mL/min; and Negative serum Beta human chorionic gonadotropin test in women of childbearing potential (defined as women ≤ 50 years of age or history of amenorrhea for ≤ 12 months prior to study entry). Patients with hepatic metastasis are eligible to enroll, provided that the following criteria are met at Screening: Total bilirubin ≤ 5 * mg/dL; ASpartate aminoTransferase and ALalanine aminoTransferase are each ≤ 5 × the Upper Limit of Normal; Willing and able to provide written Informed Consent and comply with the requirements of the study. Tumor tissue, taken from either an archival sample or a fresh biopsy, must be available for staining for T1/ST2 receptor, and must be ST2 positive. Subject has not been previously treated with Doxorubicin or total accumulated dose has never exceeded 240 mg/m2. Exclusion Criteria: Any chemotherapy, immunomodulatory drug therapy, anti-neoplastic hormonal therapy (unless dose has been stable for 1 month prior to Baseline and remains stable during the trial), immunosuppressive therapy, corticosteroids > 20 mg/day prednisone or equivalent (unless administered to prevent contrast material reactions during radiographic procedures), or growth factor treatment (eg, erythropoietin) within 14 days prior to initiation of study drug. Presence of an acute toxicity of prior chemotherapy, with the exception of alopecia or peripheral neuropathy, that has not resolved to ≤ Grade 1, as determined by NCI CTCAE v 4.0 (http://evs.nci.nih.gov/ftp1/CTCAE/About.html). Receipt of >3 prior regimens of cytotoxic chemotherapy, including any use in the neo-adjuvant, adjuvant, and/or metastatic settings ,Unless more than 1 year elapsed since the Neo-adjuvant treatment was completed Receipt of Blood Transfusion during 2 weeks prior to Baseline Life expectancy <12 weeks. Major surgery or radiation therapy within 28 days prior to initiation of study drug, Known human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome-related illness. Patients with history of brain metastasis Known active hepatitis B or C or other active liver disease (other than malignancy). Severe liver dysfunction (Child-Pugh Class B or C) and Patients with a history of esophageal bleeding have varices that have been sclerosed or banded and no bleeding episodes have occurred during the prior 6 months. Active infection requiring systemic therapy. Insulin-requiring diabetes mellitus will not be included if, according to the investigator, not stable, during the last 6 months. History of any of the following within 12 months prior to initiation of study drug: Uncontrolled congestive heart failure (New York Heart Association Classification 3 or 4), unstable angina, myocardial infarction, cerebrovascular accident, coronary/peripheral artery bypass graft surgery, transient ischemic attack, or pulmonary embolism (within the last 6 months). Left Ventricular Ejection Fraction <50% . Uncontrolled arterial hypertension, or anti-hypertensive drugs whose type or dose has been changed within 1 months prior to screening or whose dose is anticipated to change within cycle 1. Risk of syncope, in the judgment of the Principal Investigator, according to the patient's history of syncope. History of ongoing cardiac dysrhythmias requiring drug treatment Malignancies can be a reason for exclusion only if active during the last year or requiring any anti-tumor treatment. Skin non-melanomatous tumors and thyroid carcinomas - can be included. as well as, Previously treated malignancy within the past 2 years that the Principal Investigator deems to be at low risk for recurrence during the course of this trial. Use of any investigational agents within a minimum of 4 weeks or 5 half-lives of initiation of study drug. Pregnant or lactating female. Women of childbearing potential, unless they agree to use dual contraceptive methods which, in the opinion of the Principal Investigator, are effective and adequate for that patient's circumstances while on study drug and for 3 months afterward. Any severe, acute, or chronic medical or psychiatric condition, or laboratory abnormality that may increase the risk associated with study participation or study drug administration, may interfere with the informed consent process and/or with compliance with the requirements of the study, or may interfere with the interpretation of study results and, in the investigator's opinion, would make the patient inappropriate for entry into this study. Any known multiple allergy, or acute allergic reaction within the subject's medical History or General Practitioner's records.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Yoram Devary, phd
Organizational Affiliation
Immune System Key Ltd
Official's Role
Study Director
Facility Information:
Facility Name
Oncologic Institue, Kaplan
City
Reẖovot
ZIP/Postal Code
7661041
Country
Israel

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
29423221
Citation
Stemmer SM, Benjaminov O, Silverman MH, Sandler U, Purim O, Sender N, Meir C, Oren-Apoteker P, Ohana J, Devary Y. A phase I clinical trial of dTCApFs, a derivative of a novel human hormone peptide, for the treatment of advanced/metastatic solid tumors. Mol Clin Oncol. 2018 Jan;8(1):22-29. doi: 10.3892/mco.2017.1505. Epub 2017 Nov 15.
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Safety and Efficacy of IV Nerofe™ Followed by Doxorubicin, In Metastatic Ovarian Cancer and Triple Negative Breast Cancer

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