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A First-in-human Clinical Evaluation of SN132D in Patients With Breast and Pancreatic Cancer (SPAGOPIX-01)

Primary Purpose

Breast Cancer, Pancreas Cancer

Status
Completed
Phase
Phase 1
Locations
Sweden
Study Type
Interventional
Intervention
SN132D
Sponsored by
Spago Nanomedical AB
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional diagnostic trial for Breast Cancer

Eligibility Criteria

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

Inclusion Criteria:

  1. Signed informed consent including willingness to undertake 3 MRI investigations (30 minute each) in one day
  2. Histological or cytological diagnosis of breast cancer > 5 mm (cT1c-cT4; cN0-cN3; Mx) or known or suspected pancreatic cancer with hepatic involvement with available or scheduled gadolinium enhanced MRI of the pancreas
  3. At least 3 weeks between core needle biopsy and planned pre-dose MRI. Fine needle aspiration is allowed at any time before MRI.
  4. Female and at least 18 years of age when signing the informed consent.
  5. Eastern Cooperative Oncology Group (ECOG) performance status 0 to 1 at screening
  6. Adequate renal and hepatic function: estimated glomerular filtration rate (eGFR) ≥ 50 mL/min/1.73 m2 (determined by the revised Lund-Malmö GFR estimating equation), bilirubin <1 x upper limit of normal (ULN; (in subjects with liver metastases <5 x ULN)), creatinine <1 x ULN, aspartate aminotransferase (ASAT) and alanine aminotransferase (ALAT) < 1 x ULN.

    Bilirubin ULN: 25 µmol/L, creatinine ULN: 90 µmol/L, ASAT ULN: 0.60 µkat/L and ALAT ULN: 0.75 µkat/L) at the screening visit.

  7. Females of child-bearing potential* must agree to the use of effective contraception** or practice abstinence during the study and for 30 days after the IMP administration.
  8. Adequate haematological function: haemoglobin ≥90 g/L, absolute neutrophil count (ANC) ≥1.3x109 /L and platelet count ≥ 100 x 109 /L.

    • A female of child-bearing potential is a sexually mature female who 1) has not undergone a hysterectomy or bilateral oophorectomy, or 2) has not been naturally postmenopausal for at least 24 consecutive months (i.e. had had menses at any time in the preceding 24 consecutive months).

      • Effective contraception is defined as contraceptive methods with a failure rate of < 1% to prevent pregnancy (combined [oestrogen and progestogen containing] hormonal contraception associated with inhibition of ovulation [oral, intravaginal, transdermal], progestogen-only hormonal contraception associated with inhibition of ovulation [oral, injectable, implantable], intrauterine device [IUD]or intrauterine hormone-releasing system [IUS]).

Exclusion Criteria:

  1. Female patients who are pregnant or who are currently breast feeding.
  2. Conditions contraindicating MRI including, but not limited to, body mass index (BMI) > 40 kg/m2 at screening claustrophobia, metallic implants or internal electrical devices (e.g., cochlear implant, nerve stimulator, gastric pacemaker, bladder stimulator, pacemaker, defibrillator, artificial valves in heart, aneurysm clips, etc.), and permanent makeup or tattoos which in the Investigator's opinion might jeopardise the patient's safety or interfere with the imaging measurements. The Investigator is encouraged to contact the MR clinic for advice on which implants, tattoos, etc may be unsuitable.
  3. Other malignancy than breast and pancreatic cancer within the past 5 years with the exception of in situ removal of basal cell carcinoma or resected benign colonic polyps.
  4. Moderate to severe hypertension as judged by the Investigator.
  5. History of significant cardiovascular disease such as myocardial infarction, congestive heart failure, stroke, serious cardiac arrhythmias. History of angina within 6 months prior to screening.
  6. Clinically diagnosed obstruction of bile duct as judged by investigator.
  7. Prolonged QTcF (>450 ms), cardiac arrhythmias or any clinically significant abnormalities in the resting electrocardiogram (ECG) at the time of screening, as judged by the Investigator.
  8. Abnormalities detected during examination at screening and admission, which in the opinion of the Investigator, may either put the patient at risk because of participation in the study or influence the results or the patient's ability to participate in the study.
  9. Active infection requiring systemic treatment within one week prior to agent administration.
  10. History of any clinically significant disease or disorder which, in the opinion of the Investigator, may either put the patient at risk because of participation in the study, or influence the results or the patient's ability to participate in the study.
  11. Seropositive for human immunodeficiency virus (HIV), Hepatitis B surface antigen (HBsAg), or Hepatitis C virus (HCV) antibodies.
  12. Any use of alcohol within 24 hours of admission to the clinic.
  13. Plasma donation within 1 month of screening or any blood donation or corresponding blood loss during 3 months prior to screening.
  14. Use of investigational agent within four weeks before Visit 1 or plans to initiate treatment with an investigational agent during the study.

Sites / Locations

  • Gothia Forum Clinical Trial Center
  • CTC Clinical Trial Consultants AB

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Single dose (i.v.) SN132D

Arm Description

Outcomes

Primary Outcome Measures

Number of treatment related adverse events (AEs)
Frequency, severity and seriousness of AEs including clinically significant changes in physical examinations, safety laboratory parameters, vital signs, electrocardiograms and injection site reactions will be assessed.

Secondary Outcome Measures

Preliminary efficacy (MRI enhancing effect)
Preliminary efficacy will be evaluated by assessing changes between pre-dose images and post-dose images acquired using T1-weighted imaging sequences, analysing contrast-to-noise in primary tumour vs reference tissue, signal-to-noise in primary tumour, contrast-to-noise in liver and pancreas vs reference tissue and signal-to-noise in liver and pancreas. Additionally, Changes between pre-dose T1 and post-dose T1 in liver and pancreas will be analysed. In pancreatic cancer patients, presence or absence of liver metastases and a number of lesions and diameter of smallest and largest lesion in liver will also be analysed.
Pharmacokinetics as measured by area under the plasma concentration-time curve from time 0 to the last measurable time point (AUC0-t) for manganese (Mn) (mM x min)
Samples for pharmacokinetic analysis will be collected at predose and at 10 min, 20 min, 60 min, 65 min, 75 min, 90 min, 105 min, 3 h and 9 h post start of dosing.
Pharmacokinetics as measured by area under the plasma concentration-time curve from time 0 extrapolated to infinite time (AUCinf) for Mn (mM x min)
Samples for pharmacokinetic analysis will be collected at predose and at 10 min, 20 min, 60 min, 65 min, 75 min, 90 min, 105 min, 3 h and 9 h post start of dosing.
Pharmacokinetics as measured by maximum plasma concentration (Cmax) for Mn (µg Mn/mL)
Samples for pharmacokinetic analysis will be collected at predose and at 10 min, 20 min, 60 min, 65 min, 75 min, 90 min, 105 min, 3 h and 9 h post start of dosing.
Pharmacokinetics as measured by time to Cmax (Tmax) for Mn (h)
Samples for pharmacokinetic analysis will be collected at predose and at 10 min, 20 min, 60 min, 65 min, 75 min, 90 min, 105 min, 3 h and 9 h post start of dosing.
Pharmacokinetics as measured by plasma elimination half-life (T½) for Mn (h)
Samples for pharmacokinetic analysis will be collected at predose and at 10 min, 20 min, 60 min, 65 min, 75 min, 90 min, 105 min, 3 h and 9 h post start of dosing.
Pharmacokinetics as measured by total body clearance (CL) for Mn (L/h)
Samples for pharmacokinetic analysis will be collected at predose and at 10 min, 20 min, 60 min, 65 min, 75 min, 90 min, 105 min, 3 h and 9 h post start of dosing.
Pharmacokinetics as measured by apparent volume of distribution at steady state (Vss) for Mn (L) the terminal phase half-life (T½) for manganese (Mn)
Samples for pharmacokinetic analysis will be collected at predose and at 10 min, 20 min, 60 min, 65 min, 75 min, 90 min, 105 min, 3 h and 9 h post start of dosing.

Full Information

First Posted
August 27, 2019
Last Updated
December 8, 2022
Sponsor
Spago Nanomedical AB
Collaborators
CTC Clinical Trial Consultants AB, Antaros Medical
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1. Study Identification

Unique Protocol Identification Number
NCT04080024
Brief Title
A First-in-human Clinical Evaluation of SN132D in Patients With Breast and Pancreatic Cancer
Acronym
SPAGOPIX-01
Official Title
A First-in-human Clinical Evaluation of the Novel Intravenous Contrast Agent SN132D in Patients With Breast and Pancreatic Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
December 2022
Overall Recruitment Status
Completed
Study Start Date
August 23, 2019 (Actual)
Primary Completion Date
November 30, 2022 (Actual)
Study Completion Date
November 30, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Spago Nanomedical AB
Collaborators
CTC Clinical Trial Consultants AB, Antaros Medical

4. Oversight

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

5. Study Description

Brief Summary
This phase I, first-in-human (FIH) study is open-label, non-randomised and non-placebo-controlled. The study is designed to evaluate the safety, tolerability and pharmacokinetics (PK) of a single intravenous dose of SN132D in approximately 24 patients with breast and pancreatic cancer. Magnetic resonance imaging (MRI) will be performed pre- and post-infusion of SN132D.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Breast Cancer, Pancreas Cancer

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Single dose (i.v.) SN132D
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
SN132D
Intervention Description
Novel manganese-based macromolecular MRI contrast agent
Primary Outcome Measure Information:
Title
Number of treatment related adverse events (AEs)
Description
Frequency, severity and seriousness of AEs including clinically significant changes in physical examinations, safety laboratory parameters, vital signs, electrocardiograms and injection site reactions will be assessed.
Time Frame
Baseline up to 2 weeks
Secondary Outcome Measure Information:
Title
Preliminary efficacy (MRI enhancing effect)
Description
Preliminary efficacy will be evaluated by assessing changes between pre-dose images and post-dose images acquired using T1-weighted imaging sequences, analysing contrast-to-noise in primary tumour vs reference tissue, signal-to-noise in primary tumour, contrast-to-noise in liver and pancreas vs reference tissue and signal-to-noise in liver and pancreas. Additionally, Changes between pre-dose T1 and post-dose T1 in liver and pancreas will be analysed. In pancreatic cancer patients, presence or absence of liver metastases and a number of lesions and diameter of smallest and largest lesion in liver will also be analysed.
Time Frame
Day 1
Title
Pharmacokinetics as measured by area under the plasma concentration-time curve from time 0 to the last measurable time point (AUC0-t) for manganese (Mn) (mM x min)
Description
Samples for pharmacokinetic analysis will be collected at predose and at 10 min, 20 min, 60 min, 65 min, 75 min, 90 min, 105 min, 3 h and 9 h post start of dosing.
Time Frame
Baseline up to Day 2
Title
Pharmacokinetics as measured by area under the plasma concentration-time curve from time 0 extrapolated to infinite time (AUCinf) for Mn (mM x min)
Description
Samples for pharmacokinetic analysis will be collected at predose and at 10 min, 20 min, 60 min, 65 min, 75 min, 90 min, 105 min, 3 h and 9 h post start of dosing.
Time Frame
Baseline up to Day 2
Title
Pharmacokinetics as measured by maximum plasma concentration (Cmax) for Mn (µg Mn/mL)
Description
Samples for pharmacokinetic analysis will be collected at predose and at 10 min, 20 min, 60 min, 65 min, 75 min, 90 min, 105 min, 3 h and 9 h post start of dosing.
Time Frame
Baseline up to Day 2
Title
Pharmacokinetics as measured by time to Cmax (Tmax) for Mn (h)
Description
Samples for pharmacokinetic analysis will be collected at predose and at 10 min, 20 min, 60 min, 65 min, 75 min, 90 min, 105 min, 3 h and 9 h post start of dosing.
Time Frame
Baseline up to Day 2
Title
Pharmacokinetics as measured by plasma elimination half-life (T½) for Mn (h)
Description
Samples for pharmacokinetic analysis will be collected at predose and at 10 min, 20 min, 60 min, 65 min, 75 min, 90 min, 105 min, 3 h and 9 h post start of dosing.
Time Frame
Baseline up to Day 2
Title
Pharmacokinetics as measured by total body clearance (CL) for Mn (L/h)
Description
Samples for pharmacokinetic analysis will be collected at predose and at 10 min, 20 min, 60 min, 65 min, 75 min, 90 min, 105 min, 3 h and 9 h post start of dosing.
Time Frame
Baseline up to Day 2
Title
Pharmacokinetics as measured by apparent volume of distribution at steady state (Vss) for Mn (L) the terminal phase half-life (T½) for manganese (Mn)
Description
Samples for pharmacokinetic analysis will be collected at predose and at 10 min, 20 min, 60 min, 65 min, 75 min, 90 min, 105 min, 3 h and 9 h post start of dosing.
Time Frame
Baseline up to Day 2
Other Pre-specified Outcome Measures:
Title
MRI enhancement of selected axillary (breast cancer patients) or regional and distant (e.g paraaortic lymph nodes, pancreatic cancer patients) lymph nodes
Description
MRI enhancement of selected lymph nodes will be assessed by changes in contrast-to-noise vs reference tissue and signal-to-noise in selected lymph nodes between pre-dose images and 2 post-dose occasions
Time Frame
Day 1
Title
Visualization of the pancreatic duct
Description
Visualization of the pancreatic duct will be assessed by a certified radiologist
Time Frame
Day 1

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Signed informed consent including willingness to undertake 3 MRI investigations (30 minute each) in one day Histological or cytological diagnosis of breast cancer > 5 mm (cT1c-cT4; cN0-cN3; Mx) or known or suspected pancreatic cancer with hepatic involvement with available or scheduled gadolinium enhanced MRI of the pancreas At least 3 weeks between core needle biopsy and planned pre-dose MRI. Fine needle aspiration is allowed at any time before MRI. Female and at least 18 years of age when signing the informed consent. Eastern Cooperative Oncology Group (ECOG) performance status 0 to 1 at screening Adequate renal and hepatic function: estimated glomerular filtration rate (eGFR) ≥ 50 mL/min/1.73 m2 (determined by the revised Lund-Malmö GFR estimating equation), bilirubin <1 x upper limit of normal (ULN; (in subjects with liver metastases <5 x ULN)), creatinine <1 x ULN, aspartate aminotransferase (ASAT) and alanine aminotransferase (ALAT) < 1 x ULN. Bilirubin ULN: 25 µmol/L, creatinine ULN: 90 µmol/L, ASAT ULN: 0.60 µkat/L and ALAT ULN: 0.75 µkat/L) at the screening visit. Females of child-bearing potential* must agree to the use of effective contraception** or practice abstinence during the study and for 30 days after the IMP administration. Adequate haematological function: haemoglobin ≥90 g/L, absolute neutrophil count (ANC) ≥1.3x109 /L and platelet count ≥ 100 x 109 /L. A female of child-bearing potential is a sexually mature female who 1) has not undergone a hysterectomy or bilateral oophorectomy, or 2) has not been naturally postmenopausal for at least 24 consecutive months (i.e. had had menses at any time in the preceding 24 consecutive months). Effective contraception is defined as contraceptive methods with a failure rate of < 1% to prevent pregnancy (combined [oestrogen and progestogen containing] hormonal contraception associated with inhibition of ovulation [oral, intravaginal, transdermal], progestogen-only hormonal contraception associated with inhibition of ovulation [oral, injectable, implantable], intrauterine device [IUD]or intrauterine hormone-releasing system [IUS]). Exclusion Criteria: Female patients who are pregnant or who are currently breast feeding. Conditions contraindicating MRI including, but not limited to, body mass index (BMI) > 40 kg/m2 at screening claustrophobia, metallic implants or internal electrical devices (e.g., cochlear implant, nerve stimulator, gastric pacemaker, bladder stimulator, pacemaker, defibrillator, artificial valves in heart, aneurysm clips, etc.), and permanent makeup or tattoos which in the Investigator's opinion might jeopardise the patient's safety or interfere with the imaging measurements. The Investigator is encouraged to contact the MR clinic for advice on which implants, tattoos, etc may be unsuitable. Other malignancy than breast and pancreatic cancer within the past 5 years with the exception of in situ removal of basal cell carcinoma or resected benign colonic polyps. Moderate to severe hypertension as judged by the Investigator. History of significant cardiovascular disease such as myocardial infarction, congestive heart failure, stroke, serious cardiac arrhythmias. History of angina within 6 months prior to screening. Clinically diagnosed obstruction of bile duct as judged by investigator. Prolonged QTcF (>450 ms), cardiac arrhythmias or any clinically significant abnormalities in the resting electrocardiogram (ECG) at the time of screening, as judged by the Investigator. Abnormalities detected during examination at screening and admission, which in the opinion of the Investigator, may either put the patient at risk because of participation in the study or influence the results or the patient's ability to participate in the study. Active infection requiring systemic treatment within one week prior to agent administration. History of any clinically significant disease or disorder which, in the opinion of the Investigator, may either put the patient at risk because of participation in the study, or influence the results or the patient's ability to participate in the study. Seropositive for human immunodeficiency virus (HIV), Hepatitis B surface antigen (HBsAg), or Hepatitis C virus (HCV) antibodies. Any use of alcohol within 24 hours of admission to the clinic. Plasma donation within 1 month of screening or any blood donation or corresponding blood loss during 3 months prior to screening. Use of investigational agent within four weeks before Visit 1 or plans to initiate treatment with an investigational agent during the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Folke Sjöberg, MD, Prof
Organizational Affiliation
CTC Clinical Trial Consultants AB
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Dan Curiac, MD, PhD
Organizational Affiliation
Gothia Forum Clinical Trial Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Gothia Forum Clinical Trial Center
City
Gothenburg
ZIP/Postal Code
SE-41345
Country
Sweden
Facility Name
CTC Clinical Trial Consultants AB
City
Uppsala
ZIP/Postal Code
SE-75185
Country
Sweden

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A First-in-human Clinical Evaluation of SN132D in Patients With Breast and Pancreatic Cancer

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