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A Study of L-DOS47 in Combination With Vinorelbine/Cisplatin in Lung Adenocarcinoma

Primary Purpose

Lung Adenocarcinoma

Status
Terminated
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
L-DOS47
Cisplatin
Vinorelbine
Sponsored by
Helix BioPharma Corporation
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Lung Adenocarcinoma focused on measuring lung adenocarcinoma, immunoconjugate, tumor microenvironment alkalinization

Eligibility Criteria

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

Inclusion Criteria:

  1. Male or female aged ≥ 18 years old
  2. Histologically confirmed lung adenocarcinoma, classified as:

    • Chemotherapy-naive patients with metastatic lung adenocarcinoma for whom vinorelbine/cisplatin would be appropriate therapy;
    • metastatic recurrent lung adenocarcinoma following prior surgery, radiation and/or adjuvant chemotherapy at least 6 months ago, for whom vinorelbine/cisplatin would be appropriate therapy;
    • Staging assessed according to Tumor Node Metastases (TNM), 8th edition and based on computed tomography (CT) scan;
    • Grade 1 - 4 adenocarcinoma
  3. No prior adjuvant chemotherapy within 6 months of the first treatment day if there is recurrent disease
  4. At least a single measurable lesion in accordance with the RECIST v1.1 criteria
  5. Eastern Cooperative Oncology Group (ECOG) performance status: 0-1
  6. A life expectancy of ≥ 3 months
  7. Adequate organ function as determined by the following criteria:

    • Absolute neutrophil count (ANC) ≥ 1.5 × 10^9/L
    • Platelet count ≥ 100 × 10^9/L
    • Haemoglobin (HGB) ≥ 9 g/dL
    • Creatinine clearance ≥ 60 mL/min calculated using the Cockcroft-Gault Formula and serum creatinine ≤ 1.5 × the upper limit of normal (ULN)
    • Serum aspartate aminotransferase (AST) and serum alanine aminotransferase (ALT) ≤ 3 × ULN or < 5 × ULN if liver abnormalities are due to underlying malignancy
    • Total bilirubin ≤ 1.5 × ULN Note: Blood transfusions administered for the sole purpose of meeting the study inclusion criteria between the time informed consent is signed and first dose of L-DOS47 is administered are not allowed.
  8. Able to understand the information provided to them and to give written informed consent before any study activities are conducted
  9. Willing and able to comply with scheduled visits, treatment plans, laboratory tests and other study procedures
  10. Not pregnant and do not plan to become pregnant during the study. Females of childbearing potential must provide a negative pregnancy test within the Screening period (Day 21 to 0) and agree to use adequate non-hormonal contraception (which includes but is not limited to double barrier or sexual abstinence) during the study and for a period of 90 days following the last dose of study treatment. Male patients and their female partners of child-bearing potential must agree to each use an approved form of contraception during the study and for a period of 90 days following the last dose of study treatment.

Exclusion Criteria:

  1. Pregnant or nursing mother
  2. Prior history of other malignancies with the exception of non melanoma skin cancer
  3. Patients with a known positive Epidermal Growth Factor Receptor (EGFR) mutation or whose tumour harbour an anaplastic lymphoma kinase (ALK) translocation
  4. Active central nervous system metastasis and/or leptomeningeal disease (known or suspected); Patients with asymptomatic brain metastases are eligible if they had local therapy more than 1 month before enrolment
  5. Evidence of active infection
  6. Received treatment in another clinical study within the 30 days before commencing study drug and have not recovered from side effects of a study drug, except for alopecia
  7. A serious uncontrolled medical condition
  8. Known positive human immunodeficiency virus (HIV), known hepatitis B surface antigen, or hepatitis C positive
  9. Sustained QT interval corrected for heart rate (QTc) with Fridericia's correction > 450 msec at Screening, or a history of additional risk factors for Torsades de pointes (e.g., heart failure, hypokalaemia, family history of long QT syndrome)
  10. Pre-existing peripheral neuropathy Grade ≥ 1 CTCAE
  11. Dementia or significantly altered mental status that would prohibit the understanding or rendering of informed consent or compliance with the requirements of the protocol
  12. Receiving chemotherapy during the 30 days before study treatment start; are receiving radiotherapy, targeted therapy, hormonal therapy, immunotherapy, major surgery or other study drugs during the 4 weeks before study treatment start, or have not recovered from all treatment related toxicities to Grade ≤ 1, except for alopecia. (Radiotherapy is allowed for the symptomatic treatment of bone metastases.)
  13. Taking systemic steroids (other than inhalers or topical steroids) or other medication to suppress the immune system
  14. Participating (or planning to participate) in any other clinical trial during this study

Sites / Locations

  • Europejskie Centrum Zdrowia Otwock
  • Dnipropetrovsk City Multi-field Clinical Hospital #4
  • Sumy Regional Clinical Oncological Centre
  • Vinnytsya Regional Clinical Oncological Centre

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

L-DOS47 in combination with cisplatin + vinorelbine

Cisplatin + vinorelbine alone

Arm Description

L-DOS47 (6/9/12 µg/kg) is administered by iv on Day 1 and 8 of each 21-day treatment cycle, in combination with iv administration of standard cisplatin (80 mg/m2) on Day 2 + vinorelbine (30 mg/m2) on Day 2 and 9.

Administration by iv of standard Cisplatin (80 mg/m2) on Day 1 + vinorelbine (30 mg/m2) on Day 1 and 8 of each 21-day treatment cycle.

Outcomes

Primary Outcome Measures

Time to disease progression
Time from first day of study drug administration to documentation of disease progression (including death due to progression)

Secondary Outcome Measures

Objective response rate as measured using RECIST v. 1.1
Proportion of patients with a best overall response of complete response and partial response
Overall survival
Time to death as defined as time from first day of study drug administration to death to to any cause
Safety and tolerability of L-DOS47 in combination with vinorelbine/cisplatin: Frequency of treatment emergence adverse events in patients
Frequency of treatment emergent adverse events in patients

Full Information

First Posted
March 18, 2019
Last Updated
August 9, 2022
Sponsor
Helix BioPharma Corporation
Collaborators
KCR S.A.
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1. Study Identification

Unique Protocol Identification Number
NCT03891173
Brief Title
A Study of L-DOS47 in Combination With Vinorelbine/Cisplatin in Lung Adenocarcinoma
Official Title
A Phase II, Open-Label, Randomized Study Immunoconjugate L-DOS47 in Combination With Vinorelbine/Cisplatin Versus Vinorelbine/Cisplatin Alone in Patients With Lung Adenocarcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
August 2022
Overall Recruitment Status
Terminated
Why Stopped
Study was halted at this time due to other budgetary priorities. Completion of reporting has been delayed first due to covid restrictions and more recently due to war in Ukraine.
Study Start Date
February 19, 2019 (Actual)
Primary Completion Date
May 22, 2020 (Actual)
Study Completion Date
May 22, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Helix BioPharma Corporation
Collaborators
KCR S.A.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study will determine the highest dose of L-DOS47 that can be given in combination with vinorelbine/cisplatin, evaluate safety and tolerability of L-DOS47 when given in combination with vinorelbine/cisplatin, and assess how effective this combination is in treating patients with lung adenocarcinoma compared to patients who are given vinorelbine/cisplatin alone.
Detailed Description
The study is divided into two parts. In part I, the maximum tolerated dose of L-DOS47, when given in combination with vinorelbine/cisplatin, will be determined. Cohorts of 3 patients will be recruited into three dosing cohorts (6, 9 and 12 µg/kg). All patients at a given dose level must complete the first treatment cycle (3 week period) before escalation in subsequent patients can proceed. The decision for escalation to the next dose level will be made after the safety data have been reviewed by the Trial Steering Committee (TSC). If a patient in any cohort experiences a dose limiting toxicity, an additional 3 patients will be enrolled, for a maximum of up to 18 patients in this initial dose escalation part of the study. In part II, after the maximum tolerated dose of L-DOS47 in combination with vinorelbine/cisplatin has been determined, a further 118 patients will be randomized (1:1) to receive L-DOS47 in combination with vinorelbine/cisplatin, or vinorelbine/cisplatin alone. Efficacy will be assessed by time to progression (time from first day of study drug administration to documented disease progression), response rate (proportion of patients with a best overall response of complete response and partial response using the Response Evaluation Criteria in Solid Tumours [RECIST] version 1.1 criteria), and overall survival (time from first day of study drug administration to death due to any cause). Monitoring will include radiological evaluations every second cycle. Safety and tolerability of L-DOS47 in combination will also continue to be evaluated. For all patients, treatment will continue either until the patient experiences disease progression, unacceptable toxicity, the patient withdraws consent or has completed four treatment cycles.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Lung Adenocarcinoma
Keywords
lung adenocarcinoma, immunoconjugate, tumor microenvironment alkalinization

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
Part I includes a brief initial dose escalation phase, followed by Part II, which includes a randomized treatment phase.
Masking
None (Open Label)
Allocation
Randomized
Enrollment
9 (Actual)

8. Arms, Groups, and Interventions

Arm Title
L-DOS47 in combination with cisplatin + vinorelbine
Arm Type
Experimental
Arm Description
L-DOS47 (6/9/12 µg/kg) is administered by iv on Day 1 and 8 of each 21-day treatment cycle, in combination with iv administration of standard cisplatin (80 mg/m2) on Day 2 + vinorelbine (30 mg/m2) on Day 2 and 9.
Arm Title
Cisplatin + vinorelbine alone
Arm Type
Active Comparator
Arm Description
Administration by iv of standard Cisplatin (80 mg/m2) on Day 1 + vinorelbine (30 mg/m2) on Day 1 and 8 of each 21-day treatment cycle.
Intervention Type
Drug
Intervention Name(s)
L-DOS47
Intervention Description
L-DOS47 lyophilized powder reconstituted and diluted for iv injection
Intervention Type
Drug
Intervention Name(s)
Cisplatin
Intervention Description
Cisplatin concentrate for solution for iv infusion
Intervention Type
Drug
Intervention Name(s)
Vinorelbine
Other Intervention Name(s)
vinorelbine tartrate
Intervention Description
Vinorelbine concentrate for solution for iv infusion
Primary Outcome Measure Information:
Title
Time to disease progression
Description
Time from first day of study drug administration to documentation of disease progression (including death due to progression)
Time Frame
Up to 12 weeks
Secondary Outcome Measure Information:
Title
Objective response rate as measured using RECIST v. 1.1
Description
Proportion of patients with a best overall response of complete response and partial response
Time Frame
Up to 12 weeks
Title
Overall survival
Description
Time to death as defined as time from first day of study drug administration to death to to any cause
Time Frame
Up to 12 weeks
Title
Safety and tolerability of L-DOS47 in combination with vinorelbine/cisplatin: Frequency of treatment emergence adverse events in patients
Description
Frequency of treatment emergent adverse events in patients
Time Frame
Up to 12 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female aged ≥ 18 years old Histologically confirmed lung adenocarcinoma, classified as: Chemotherapy-naive patients with metastatic lung adenocarcinoma for whom vinorelbine/cisplatin would be appropriate therapy; metastatic recurrent lung adenocarcinoma following prior surgery, radiation and/or adjuvant chemotherapy at least 6 months ago, for whom vinorelbine/cisplatin would be appropriate therapy; Staging assessed according to Tumor Node Metastases (TNM), 8th edition and based on computed tomography (CT) scan; Grade 1 - 4 adenocarcinoma No prior adjuvant chemotherapy within 6 months of the first treatment day if there is recurrent disease At least a single measurable lesion in accordance with the RECIST v1.1 criteria Eastern Cooperative Oncology Group (ECOG) performance status: 0-1 A life expectancy of ≥ 3 months Adequate organ function as determined by the following criteria: Absolute neutrophil count (ANC) ≥ 1.5 × 10^9/L Platelet count ≥ 100 × 10^9/L Haemoglobin (HGB) ≥ 9 g/dL Creatinine clearance ≥ 60 mL/min calculated using the Cockcroft-Gault Formula and serum creatinine ≤ 1.5 × the upper limit of normal (ULN) Serum aspartate aminotransferase (AST) and serum alanine aminotransferase (ALT) ≤ 3 × ULN or < 5 × ULN if liver abnormalities are due to underlying malignancy Total bilirubin ≤ 1.5 × ULN Note: Blood transfusions administered for the sole purpose of meeting the study inclusion criteria between the time informed consent is signed and first dose of L-DOS47 is administered are not allowed. Able to understand the information provided to them and to give written informed consent before any study activities are conducted Willing and able to comply with scheduled visits, treatment plans, laboratory tests and other study procedures Not pregnant and do not plan to become pregnant during the study. Females of childbearing potential must provide a negative pregnancy test within the Screening period (Day 21 to 0) and agree to use adequate non-hormonal contraception (which includes but is not limited to double barrier or sexual abstinence) during the study and for a period of 90 days following the last dose of study treatment. Male patients and their female partners of child-bearing potential must agree to each use an approved form of contraception during the study and for a period of 90 days following the last dose of study treatment. Exclusion Criteria: Pregnant or nursing mother Prior history of other malignancies with the exception of non melanoma skin cancer Patients with a known positive Epidermal Growth Factor Receptor (EGFR) mutation or whose tumour harbour an anaplastic lymphoma kinase (ALK) translocation Active central nervous system metastasis and/or leptomeningeal disease (known or suspected); Patients with asymptomatic brain metastases are eligible if they had local therapy more than 1 month before enrolment Evidence of active infection Received treatment in another clinical study within the 30 days before commencing study drug and have not recovered from side effects of a study drug, except for alopecia A serious uncontrolled medical condition Known positive human immunodeficiency virus (HIV), known hepatitis B surface antigen, or hepatitis C positive Sustained QT interval corrected for heart rate (QTc) with Fridericia's correction > 450 msec at Screening, or a history of additional risk factors for Torsades de pointes (e.g., heart failure, hypokalaemia, family history of long QT syndrome) Pre-existing peripheral neuropathy Grade ≥ 1 CTCAE Dementia or significantly altered mental status that would prohibit the understanding or rendering of informed consent or compliance with the requirements of the protocol Receiving chemotherapy during the 30 days before study treatment start; are receiving radiotherapy, targeted therapy, hormonal therapy, immunotherapy, major surgery or other study drugs during the 4 weeks before study treatment start, or have not recovered from all treatment related toxicities to Grade ≤ 1, except for alopecia. (Radiotherapy is allowed for the symptomatic treatment of bone metastases.) Taking systemic steroids (other than inhalers or topical steroids) or other medication to suppress the immune system Participating (or planning to participate) in any other clinical trial during this study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Cezary Szczylik, MD, Ph.D.
Organizational Affiliation
Europejskie Centrum Zdrowia Otwock
Official's Role
Principal Investigator
Facility Information:
Facility Name
Europejskie Centrum Zdrowia Otwock
City
Otwock
ZIP/Postal Code
05-400
Country
Poland
Facility Name
Dnipropetrovsk City Multi-field Clinical Hospital #4
City
Dnipro
ZIP/Postal Code
49102
Country
Ukraine
Facility Name
Sumy Regional Clinical Oncological Centre
City
Sumy
ZIP/Postal Code
40005
Country
Ukraine
Facility Name
Vinnytsya Regional Clinical Oncological Centre
City
Vinnytsia
ZIP/Postal Code
21029
Country
Ukraine

12. IPD Sharing Statement

Plan to Share IPD
No

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A Study of L-DOS47 in Combination With Vinorelbine/Cisplatin in Lung Adenocarcinoma

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