search
Back to results

A Phase I/II Multicenter, Open-Label Study of Lu-177-αvβ3-IAC, for the Treatment of Angiogenic Breast Cancer Patients. (Heroine01)

Primary Purpose

Breast Cancer Stage IV

Status
Not yet recruiting
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
Lutetium-177-DOTAGA-PEG-IAC
Sponsored by
Advanced Imaging Projects, LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Breast Cancer Stage IV

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Angiogenic breast tumor by immunohistochemistry confirmation.
  2. Positive scan with PET/CT imaging with Ga-68 αvβ3-IAC PET/CT.
  3. Tumor progression resistant or refractory to at least one prior lines of standard chemotherapy which include trastuzumab and/or Ado-trastuzumab with or without chemotherapy agents.
  4. At least 18 years of age
  5. The patient is able and willing to provide informed consent and to comply with the requirements of this trial protocol.
  6. ECOG score ≤3
  7. Females of childbearing potential must have a negative serum pregnancy test or have had an intervention that renders pregnancy not possible
  8. Adequate organ function, defined as:

    1. Absolute neutrophil count (ANC) ≥ 1.5 x 109/mL.
    2. Hemoglobin (Hb) ≥10 g/dl (transfusion or use of EPO is permitted).
    3. Platelets > 100,000/mm3
    4. Creatinine ≤ 1.5 x upper limit of normal (ULN)
    5. AST or ALT ≤ 2.5 x ULN (or ≤5 x ULN in case of liver metastasis)
    6. Alkaline phosphatase ≤2.5 x ULN. Alkaline phosphatase may be more than 2.5 x ULN only in the case of bone metastases, and AST and ALT less than 1.5 x ULN.
    7. Total bilirubin ≤1.5 mg/dl (higher bilirubin levels are permitted if the patient has Gilbert's syndrome).
  9. Baseline LVEF ≥40% measured using echocardiogram or equilibrium isotopic ventriculography

Exclusion Criteria:

  1. Previously received external beam irradiation that includes more than 30% of bone marrow
  2. Previously received external beam irradiation to a field that one kidney.
  3. Previously received external beam irradiation to a field that includes the only known lesion.
  4. Any uncontrolled significant medical, psychiatric or surgical condition or laboratory finding that would pose a risk to subject safety or interfere with study participation or interpretation of individual subject results.
  5. Nephrectomy, renal transplant or concomitant nephrotoxic therapy putting the subject at high risk of renal toxicity during the study.
  6. eGFR ≤ 50.
  7. Bone metastases are the only known lesions.
  8. Patients with a body weight of 400 pounds or more or not able to enter the bore of the PET/CT scanner due to BMI, because of the compromise in image quality with CT, PET/CT and MRI that will result.
  9. Inability to lie still for the entire imaging time (e.g., cough, severe arthritis, etc.).
  10. Use of any other investigational therapeutic product within 30 days prior to dosing or known requirement for any other investigational agent prior to completion of all scheduled study assessments.
  11. Recognized concurrent active infection.
  12. Received any live (attenuated) vaccines within 30 days prior to Visit.
  13. Recent or chronic treatment with medium-to-high-dose intravenous corticosteroids (methylprednisolone 60 mg/day or hydrocortisone 300 mg/day) within 8 weeks prior to Visit or oral corticosteroids of more than 20 mg prednisone (or equivalent) within 30 days prior to Visit
  14. Any unresolved NCI-CTCAE Grade 2 or higher (except alopecia) from previous anti-tumour treatment and/or medical/surgical procedures/interventions.
  15. Additional inclusion criterion for measure human dosimetry

    1. Unable to comply with the requirements of the dosimetry imaging protocol
    2. Due to potential radiation safety issues, patients with urinary drainage or diversion (e.g., in-dwelling Foley™ catheter, ureteroileostomy, etc.) will not be enrolled.

Sites / Locations

  • Department of Veterans Affairs
  • All India Institute of Medical Sciences
  • Postgraduate Institute of Medical and Research

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Arm 1

Arm Description

Single Arm study Lu-177-DOTAGA-PEG-IAC (intracutaneous) Dosage and Dose Escalation Frequency: Cohort 1: 75 mCi x 3 (maximum cumulative administered activity, 225mCi) + 100 μgr IAC Cohort 2: 150 mCi x 3 (maximum cumulative administered activity, 450mCi) + 100 μgr IAC Cohort 3: 200 mCi x 3 (maximum cumulative administered activity, 600mCi) + 100 μgr IAC Three cycles each 8 weeks apart.

Outcomes

Primary Outcome Measures

Specific Aim 1
To determine the safety and tolerability of fractionated administrations of 2 cycles of Lu-177-DOTAGA-PEG-IAC administered with 4 weeks between cycles in patients with high-risk Angiogenic Breast Cancer who have progressed on, or do not tolerate, best standard-of-care treatment. Measurements used to assess the safety, tolerability and side-effects profile will include adverse events of any grade, grade 3 and 4 adverse events, withdrawals due to adverse events and dose reductions due to adverse events. National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE v.5.0) will be used to evaluate AE grade.
Specific Aim 2
To determine the pharmacokinetics (PK) of Lu-177-DOTAGA-PEG-IAC. The area under the Time vs. Concentration curve for Ga-68-αvβ3-IAC from injection to 72 h
Specific Aim 3
To determine the whole-body biodistribution of Lu-177-DOTAGA-PEG-IAC. Percent injected dose per gram of tissue (%ID)/gm of Lu-177-DOTAGA-PEG-IAC.
Specific Aim 4
To determine the radiation dosimetry of Lu-177-DOTAGA-PEG-IAC.Time points will be 0 and 120, 30 and 150, 60 and 180, or 90 and 210 min after injection.Time integrals of activity will be entered into the (Organ Level INternal Dose Assessment/ EXponential Modeling) OLINDA/EXM software.
Specific Aims 5
To determine optimum cumulative fractionated administered dose. Increase dose range if a DLT (Dose Limiting Toxicity) develops or they do not have a T/B ratio >1.

Secondary Outcome Measures

Specific Aim 1
To determine the Objective Response Rate (ORR) of fractionated administration of Lu-177-αvβ3-IAC.Percentage of subjects still alive. Percentage of subjects who achieved a best overall response of Complete Response [CR] or Partial Response [PR] according to RECIST 5.0 Criteria.

Full Information

First Posted
June 30, 2020
Last Updated
November 11, 2022
Sponsor
Advanced Imaging Projects, LLC
Collaborators
All India Institute of Medical Sciences, New Delhi, University of Witwatersrand, South Africa, Postgraduate Institute of Medical and Research, US Department of Veterans Affairs
search

1. Study Identification

Unique Protocol Identification Number
NCT04469127
Brief Title
A Phase I/II Multicenter, Open-Label Study of Lu-177-αvβ3-IAC, for the Treatment of Angiogenic Breast Cancer Patients.
Acronym
Heroine01
Official Title
This Study is a Phase I/II Clinical Evaluation of a New Investigational Agent, Lutetium-177-PEG-αvβ3-IAC (HurlutinTM Lu-177) to Treat Patients With Unresectable Angiogenic Breast Cancer.
Study Type
Interventional

2. Study Status

Record Verification Date
November 2022
Overall Recruitment Status
Not yet recruiting
Study Start Date
January 30, 2023 (Anticipated)
Primary Completion Date
August 30, 2024 (Anticipated)
Study Completion Date
August 30, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Advanced Imaging Projects, LLC
Collaborators
All India Institute of Medical Sciences, New Delhi, University of Witwatersrand, South Africa, Postgraduate Institute of Medical and Research, US Department of Veterans Affairs

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
This study is a Phase I/II clinical evaluation of a new investigational agent, Lutetium-177-DOTAGA-PEG-IAC (HurlutinTM Lu-177) to treat patients with unresectable angiogenic breast cancer who have previously been treated with at least one prior line of therapy.
Detailed Description
This is a prospective, Phase I/II multi-center, interventional open-label study in a total of up to 100 subjects with angiogenic breast cancer. Phase I is to assess the safety and adequacy of a dose of HurlutinTM Lu-177 for up to two cycles, at 6-8-week intervals. It will include a dose expansion cohort of up to 20 patients. Phase II is to demonstrate the safety, dose adequacy, anti-tumor activity and efficacy of tumor targeted therapy using Lutetium-177-DOTAGA-PEG-IAC , as a second- or third-line treatment to extend survival and improve the quality of life of patients with angiogenic breast cancer.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
100 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Arm 1
Arm Type
Experimental
Arm Description
Single Arm study Lu-177-DOTAGA-PEG-IAC (intracutaneous) Dosage and Dose Escalation Frequency: Cohort 1: 75 mCi x 3 (maximum cumulative administered activity, 225mCi) + 100 μgr IAC Cohort 2: 150 mCi x 3 (maximum cumulative administered activity, 450mCi) + 100 μgr IAC Cohort 3: 200 mCi x 3 (maximum cumulative administered activity, 600mCi) + 100 μgr IAC Three cycles each 8 weeks apart.
Intervention Type
Drug
Intervention Name(s)
Lutetium-177-DOTAGA-PEG-IAC
Intervention Description
Study participants be administered therapeutic doses of Lutetium-177-PEG-DOTAGA-PEG-IAC up to three treatments spaced 6-8 weeks apart and a CT scan immediately after. A Ga-68-PEG-αvβ3-IAC PET/CT scan will be performed four weeks before and four weeks after the initial dose of the Lutetium-177-DOTAGA-PEG-IAC.
Primary Outcome Measure Information:
Title
Specific Aim 1
Description
To determine the safety and tolerability of fractionated administrations of 2 cycles of Lu-177-DOTAGA-PEG-IAC administered with 4 weeks between cycles in patients with high-risk Angiogenic Breast Cancer who have progressed on, or do not tolerate, best standard-of-care treatment. Measurements used to assess the safety, tolerability and side-effects profile will include adverse events of any grade, grade 3 and 4 adverse events, withdrawals due to adverse events and dose reductions due to adverse events. National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE v.5.0) will be used to evaluate AE grade.
Time Frame
6 months
Title
Specific Aim 2
Description
To determine the pharmacokinetics (PK) of Lu-177-DOTAGA-PEG-IAC. The area under the Time vs. Concentration curve for Ga-68-αvβ3-IAC from injection to 72 h
Time Frame
6 months
Title
Specific Aim 3
Description
To determine the whole-body biodistribution of Lu-177-DOTAGA-PEG-IAC. Percent injected dose per gram of tissue (%ID)/gm of Lu-177-DOTAGA-PEG-IAC.
Time Frame
6 months
Title
Specific Aim 4
Description
To determine the radiation dosimetry of Lu-177-DOTAGA-PEG-IAC.Time points will be 0 and 120, 30 and 150, 60 and 180, or 90 and 210 min after injection.Time integrals of activity will be entered into the (Organ Level INternal Dose Assessment/ EXponential Modeling) OLINDA/EXM software.
Time Frame
6 months
Title
Specific Aims 5
Description
To determine optimum cumulative fractionated administered dose. Increase dose range if a DLT (Dose Limiting Toxicity) develops or they do not have a T/B ratio >1.
Time Frame
6 months
Secondary Outcome Measure Information:
Title
Specific Aim 1
Description
To determine the Objective Response Rate (ORR) of fractionated administration of Lu-177-αvβ3-IAC.Percentage of subjects still alive. Percentage of subjects who achieved a best overall response of Complete Response [CR] or Partial Response [PR] according to RECIST 5.0 Criteria.
Time Frame
6-12 Months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Angiogenic breast tumor by immunohistochemistry confirmation. Positive scan with PET/CT imaging with Ga-68 αvβ3-IAC PET/CT. Tumor progression resistant or refractory to at least one prior lines of standard chemotherapy which include trastuzumab and/or Ado-trastuzumab with or without chemotherapy agents. At least 18 years of age The patient is able and willing to provide informed consent and to comply with the requirements of this trial protocol. ECOG score ≤3 Females of childbearing potential must have a negative serum pregnancy test or have had an intervention that renders pregnancy not possible Adequate organ function, defined as: Absolute neutrophil count (ANC) ≥ 1.5 x 109/mL. Hemoglobin (Hb) ≥10 g/dl (transfusion or use of EPO is permitted). Platelets > 100,000/mm3 Creatinine ≤ 1.5 x upper limit of normal (ULN) AST or ALT ≤ 2.5 x ULN (or ≤5 x ULN in case of liver metastasis) Alkaline phosphatase ≤2.5 x ULN. Alkaline phosphatase may be more than 2.5 x ULN only in the case of bone metastases, and AST and ALT less than 1.5 x ULN. Total bilirubin ≤1.5 mg/dl (higher bilirubin levels are permitted if the patient has Gilbert's syndrome). Baseline LVEF ≥40% measured using echocardiogram or equilibrium isotopic ventriculography Exclusion Criteria: Previously received external beam irradiation that includes more than 30% of bone marrow Previously received external beam irradiation to a field that one kidney. Previously received external beam irradiation to a field that includes the only known lesion. Any uncontrolled significant medical, psychiatric or surgical condition or laboratory finding that would pose a risk to subject safety or interfere with study participation or interpretation of individual subject results. Nephrectomy, renal transplant or concomitant nephrotoxic therapy putting the subject at high risk of renal toxicity during the study. eGFR ≤ 50. Bone metastases are the only known lesions. Patients with a body weight of 400 pounds or more or not able to enter the bore of the PET/CT scanner due to BMI, because of the compromise in image quality with CT, PET/CT and MRI that will result. Inability to lie still for the entire imaging time (e.g., cough, severe arthritis, etc.). Use of any other investigational therapeutic product within 30 days prior to dosing or known requirement for any other investigational agent prior to completion of all scheduled study assessments. Recognized concurrent active infection. Received any live (attenuated) vaccines within 30 days prior to Visit. Recent or chronic treatment with medium-to-high-dose intravenous corticosteroids (methylprednisolone 60 mg/day or hydrocortisone 300 mg/day) within 8 weeks prior to Visit or oral corticosteroids of more than 20 mg prednisone (or equivalent) within 30 days prior to Visit Any unresolved NCI-CTCAE Grade 2 or higher (except alopecia) from previous anti-tumour treatment and/or medical/surgical procedures/interventions. Additional inclusion criterion for measure human dosimetry Unable to comply with the requirements of the dosimetry imaging protocol Due to potential radiation safety issues, patients with urinary drainage or diversion (e.g., in-dwelling Foley™ catheter, ureteroileostomy, etc.) will not be enrolled.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Stanley Satz, Ph.D.
Phone
561-561 286-6842
Email
ssatz@advancedimagingprojects.com
First Name & Middle Initial & Last Name or Official Title & Degree
Rose Satz
Phone
5617578666
Email
rsatz@advancedimagingprojects.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Stanley Satz, Ph.D.
Organizational Affiliation
Advanced Imaging Projects
Official's Role
Study Director
Facility Information:
Facility Name
Department of Veterans Affairs
City
Iowa City
State/Province
Iowa
ZIP/Postal Code
52242
Country
United States
Facility Contact:
First Name & Middle Initial & Last Name & Degree
David L Bushnell, M.D.
Phone
319-384-7306
Email
david-bushnell@uiowa.edu
Facility Name
All India Institute of Medical Sciences
City
New Delhi
State/Province
Dehli
ZIP/Postal Code
110029
Country
India
Facility Contact:
First Name & Middle Initial & Last Name & Degree
C.S. Bal, M.D./Ph.D.
Email
drcsbal@gmail.com
Facility Name
Postgraduate Institute of Medical and Research
City
Chandigarh
ZIP/Postal Code
160 012
Country
India
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Br Mittal, M.D./Ph.D.
Phone
+911722756722
Email
brmittal@yahoo.com

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
IPD is to be shared with researchers
IPD Sharing Time Frame
1 Yr.
IPD Sharing Access Criteria
Contact Sponsor
Citations:
PubMed Identifier
25945808
Citation
Baum RP, Kulkarni HR, Muller D, Satz S, Danthi N, Kim YS, Brechbiel MW. First-In-Human Study Demonstrating Tumor-Angiogenesis by PET/CT Imaging with (68)Ga-NODAGA-THERANOST, a High-Affinity Peptidomimetic for alphavbeta3 Integrin Receptor Targeting. Cancer Biother Radiopharm. 2015 May;30(4):152-9. doi: 10.1089/cbr.2014.1747.
Results Reference
result
PubMed Identifier
22853992
Citation
Kim YS, Nwe K, Milenic DE, Brechbiel MW, Satz S, Baidoo KE. Synthesis and characterization of alphavbeta(3)-targeting peptidomimetic chelate conjugates for PET and SPECT imaging. Bioorg Med Chem Lett. 2012 Sep 1;22(17):5517-22. doi: 10.1016/j.bmcl.2012.07.024. Epub 2012 Jul 14.
Results Reference
result

Learn more about this trial

A Phase I/II Multicenter, Open-Label Study of Lu-177-αvβ3-IAC, for the Treatment of Angiogenic Breast Cancer Patients.

We'll reach out to this number within 24 hrs