ProAgio in Previously Treated Advanced Pancreatic Cancer and Other Solid Tumor Malignancies
Primary Purpose
Advanced Pancreatic Cancer, Solid Tumor Malignancies
Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
ProAgio Dose Levels (DL) 1,2,3
ProAgio Dose Levels (DL) 4,5,6
ProAgio Dose Levels 4a,5a,6a
Sponsored by
About this trial
This is an interventional treatment trial for Advanced Pancreatic Cancer
Eligibility Criteria
Inclusion Criteria:
- Histologically or cytologically confirmed diagnosis of a solid tumor malignancy for which no curative therapy exists as confirmed by the NCI Laboratory of Pathology.
- For expansion cohort: histologically or cytologically confirmed diagnosis of nonneuroendocrine pancreatic cancer. Participants with mixed acinar- neuroendocrine histology are permitted.
- Participants in the Biopsy Arm of the expansion cohort must have disease amenable to safe biopsy and willingness to undergo the procedure.
- Participants must have received at least one prior systemic treatment for advanced disease. Participants must be more than 14 days removed from most recent standard of care or experimental drug treatment for their tumor
- Participants in the dose escalation cohort must have evaluable disease, either by clinical exam, biochemical markers (including but not limited to CA 19-9 serum tumor marker for pancreatobiliary cancer participants, or other appropriate tumor marker in other tumor types), and/or radiographic studies.
- Participants in the expansion cohort must have measurable disease, per RECIST 1.1.
- Age >18 years. Because no dosing or adverse event data are currently available on the use of ProAgio in participants <18 years of age, children are excluded from this study.
- ECOG performance status <2 (Karnofsky >60%.
Participants must have adequate organ and marrow function as defined below:
- absolute neutrophil count >1,000 mcl
- hemoglobin >9 g/dl
- platelets >75,000/mcl
- AST(SGOT)/ALT(SGPT) < 2.5 x ULN. AST and ALT (up to 5x ULN is permitted for participants with liver metastases)
- Total bilirubin <1.5 X institutional ULN
- creatinine within normal institutional limits
OR
- creatinine clearance >60 mL/min/1.73 m2 for participants with creatinine levels above institutional normal
- Serum albumin > 2.5 mg/dl without intravenous supplementation
Participants must have:
- Resting systolic blood pressure < 145 and diastolic blood pressure < 90.
- Baseline QTcF interval of = 470 ms
- Baseline resting heart rate > 45 beats per minute and <100 beats per minute
- The effects of ProAgio on the developing human fetus are unknown. For this reason, women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry, for the duration of study participation and for the 3 months following the last dosing of study drug. Should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately.
- Ability of subject to understand and the willingness to sign a written informed consent document.
Exclusion Criteria:
- Diagnosis of primary malignant CNS tumor.
- Participants who are receiving any other investigational agents.
- Evidence of significant, uncontrolled concomitant diseases which could affect compliance with the protocol or interpretation of results, including but not limited to significant pulmonary disease other than that related to the primary cancer, uncontrolled diabetes mellitus, unstable angina, significant cardiovascular disease (such as New York Heart Association Class III or IV cardiac disease) and/or psychiatric illness/social situations within 12 weeks that would limit compliance with study requirements.
- Participants with known diagnosis of a chronic neurologic disorders (such as multiple sclerosis, Huntington's disease, Parkinson's disease, or uncontrolled epilepsy) which causes motor disturbance, visual disturbance or seizure and could confound assessment of neurologic toxicity caused by the study drug.
- Pregnant or nursing women are excluded from this study because ProAgio is an agent with the potential for teratogenic or abortifacient effects. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with ProAgio, breastfeeding should be discontinued if the mother is treated with ProAgio.
- Participants with leptomeningeal disease or with CNS metastases that are untreated, have required steroid treatment within the last 4 weeks, or anti-convulsant therapy in the last 14 days. For dose escalation cohort only: Participants with any known CNS metastases are excluded. Those with symptoms suggestive of possible CNS metastases (such as new headaches) must undergo brain MRI as part of screening.
- Participants who have undergone a recent minor surgical procedure (within <14 days) such as biliary stenting or major surgical procedure (within < 28 days) are excluded.
- Participants who have undergone recent (within <14 days) radiation therapy are excluded.
- Participants with uncontrolled bleeding episodes <28 days prior to enrollment are excluded.
- Participants with active or uncontrolled infections are excluded.
- Participants with HIV and detectable viral load are excluded. Patents on appropriate highly active anti-retroviral therapy with undetectable viral load are eligible.
- Participants with a history of Hepatitis B or C are excluded unless there is documented evidence of effective treatment and/or cure with undetectable viral load.
- Participants with recent (within < 28 days) thromboembolic disease including but not limited to acute coronary syndrome, stroke, or transient ischemic attack, recent deep vein thrombosis or pulmonary embolism are excluded.
- Participants with thromboembolic disease including but not limited to acute coronary syndrome, stroke, or transient ischemic attack, recent deep vein thrombosis or pulmonary embolism who have continued symptoms, or who are not on stable doses of appropriate antiplatelet / anticoagulant regimens are excluded.
Sites / Locations
- National Cancer InstituteRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Experimental
Experimental
Experimental
Arm Label
Dose Escalation
Biopsy Arm
Standard Arm
Arm Description
Participants will receive ProAgio in escalating doses.
Participants will receive ProAgio at the RP2D and undergo tumor biopsy.
Participants will receive ProAgio at the RP2D.
Outcomes
Primary Outcome Measures
Determine Recommended Phase 2 Dose (RP2D)
Following completion of the dose escalation cohort, all available data relating to the pharmacokinetics, pharmacodynamics, efficacy and safety of ProAgio will be reviewed by the study team including the Principle Investigator, clinical pharmacology collaborators and the sponsor. A single ideal dose will then be selected for further investigation in the dose escalation cohort. This ideal dose may or may not be the same as the MTD.
Secondary Outcome Measures
Safety and Tolerability of ProAgio
Toxicities will be tabulated and reported per dose level according to grade and type of toxicity experienced. This will take place during the dose escalation phase as well as during the expansion phase.
Evaluate the Maximum Plasma Concentration of ProAgio
ProAgio concentrations will be measured by a validated ELISA assay modified from the assay used in non-clinical studies. This PK data will be used to mathematically describe the kinetic disposition of ProAgio in humans following the current dosing schedule.
Evaluate the area under the curve of ProAgio
Statistical analysis of study data will calculate the area under the plasma concentration curve for each study subject that received ProAgio.
Evaluate the Serum half-life of ProAgio
ProAgio Serum half-life will be determined using standard statistical calculations. .
Evaluate the volume of distribution of ProAgio
If there are sufficient participant data available, a population PK analyses will be conducted to identify covariates that may be significantly associated with the inter-individual variability for a particular PK parameter (e.g. clearance of volume of distribution).The NCI CPP may also conduct dose-response and/or exposure-response analyses that will assess PK/PD relationships with relevant biomarkers, clinical response, and adverse event data.
Rate of study drug elimination in research participants
58 study participants will have study drug concentration levels analyzed with regard to drug elimination. Results will be expressed in units of inverse time, i.e. 1/hr or 1/day.
Objective Response Rate (ORR)
Make a preliminary assessment of anti-tumor activity by measuring objective response rate (ORR),
Disease control rate (DCR).
Make a preliminary assessment of anti-tumor activity by measuring disease control rate at 18 weeks (DCR).
Assess serum tumor marker CA19-9 or appropriate tumor specific marker.
Make a preliminary assessment of anti-tumor activity by measuring change in relevant serum tumor marker CA19-9 appropriate tumor specific marker.
Full Information
NCT ID
NCT05085548
First Posted
September 10, 2021
Last Updated
June 23, 2023
Sponsor
ProDa BioTech, LLC
Collaborators
National Cancer Institute (NCI)
1. Study Identification
Unique Protocol Identification Number
NCT05085548
Brief Title
ProAgio in Previously Treated Advanced Pancreatic Cancer and Other Solid Tumor Malignancies
Official Title
A Phase I Trial of ProAgio, an Anti- αvβ3 Integrin Cytotoxin, for Previously Treated Advanced Pancreatic Cancer and Other Solid Tumor Malignancies
Study Type
Interventional
2. Study Status
Record Verification Date
June 2023
Overall Recruitment Status
Recruiting
Study Start Date
October 29, 2021 (Actual)
Primary Completion Date
February 2024 (Anticipated)
Study Completion Date
May 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
ProDa BioTech, LLC
Collaborators
National Cancer Institute (NCI)
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
The study is a first-in-human, Phase I study to assess the safety of ProAgio in participants with advanced solid tumor malignancies including pancreatic cancer.
Detailed Description
Pancreatic cancer is the third leading cause of death from cancer in the United States. The median overall survival for patients with metastatic disease who are receiving the most effective combination of chemotherapy regimens remains less than 1 year.
ProAgio has been evaluated in nonclinical pharmacology, safety pharmacology, pharmacokinetic (PK), and toxicity studies. It has demonstrated efficacy at treating pancreatic cancer and prolonging survival in mice.
ProAgio is being developed for intravenous (IV) administration. All participants will receive ProAgio until disease progression, unacceptable toxicity, or withdrawal from study. Subjects in the dose escalation cohorts who will be administered ProAgio at doses ranging from 3.2 to 36.8 mg/kg.
Following the dose escalation phase, an expansion cohort of patients with advanced nonendocrine pancreatic adenocarcinoma will be administered ProAgio at the maximum tolerated dose (MTD) from the dose escalation phase. The expansion cohort will comprise 16 subjects, divided into two blocks (n=8 each) of patients who agree to have optional pre and post-treatment biopsies, and those who decline the optional biopsies.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Advanced Pancreatic Cancer, Solid Tumor Malignancies
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Sequential Assignment
Model Description
This study includes a dose escalation arm, followed by an expansion arm at the ideal dose for participants with non-neuroendocrine pancreatic cancer.
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
58 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Dose Escalation
Arm Type
Experimental
Arm Description
Participants will receive ProAgio in escalating doses.
Arm Title
Biopsy Arm
Arm Type
Experimental
Arm Description
Participants will receive ProAgio at the RP2D and undergo tumor biopsy.
Arm Title
Standard Arm
Arm Type
Experimental
Arm Description
Participants will receive ProAgio at the RP2D.
Intervention Type
Drug
Intervention Name(s)
ProAgio Dose Levels (DL) 1,2,3
Other Intervention Name(s)
ACT50
Intervention Description
ProAgio is administered to study participants by intravenous injections once every 14 days.
Intervention Type
Drug
Intervention Name(s)
ProAgio Dose Levels (DL) 4,5,6
Other Intervention Name(s)
ACT50
Intervention Description
ProAgio is administered to study participants by intravenous injections once every 7 days.
Intervention Type
Drug
Intervention Name(s)
ProAgio Dose Levels 4a,5a,6a
Other Intervention Name(s)
ACT50
Intervention Description
ProAgio is administered to study participants by intravenous injections once every 7 days with a drug holiday after every 5 administrations.
Primary Outcome Measure Information:
Title
Determine Recommended Phase 2 Dose (RP2D)
Description
Following completion of the dose escalation cohort, all available data relating to the pharmacokinetics, pharmacodynamics, efficacy and safety of ProAgio will be reviewed by the study team including the Principle Investigator, clinical pharmacology collaborators and the sponsor. A single ideal dose will then be selected for further investigation in the dose escalation cohort. This ideal dose may or may not be the same as the MTD.
Time Frame
3 Years
Secondary Outcome Measure Information:
Title
Safety and Tolerability of ProAgio
Description
Toxicities will be tabulated and reported per dose level according to grade and type of toxicity experienced. This will take place during the dose escalation phase as well as during the expansion phase.
Time Frame
3 Years
Title
Evaluate the Maximum Plasma Concentration of ProAgio
Description
ProAgio concentrations will be measured by a validated ELISA assay modified from the assay used in non-clinical studies. This PK data will be used to mathematically describe the kinetic disposition of ProAgio in humans following the current dosing schedule.
Time Frame
3 Years
Title
Evaluate the area under the curve of ProAgio
Description
Statistical analysis of study data will calculate the area under the plasma concentration curve for each study subject that received ProAgio.
Time Frame
3 Years
Title
Evaluate the Serum half-life of ProAgio
Description
ProAgio Serum half-life will be determined using standard statistical calculations. .
Time Frame
3 Years
Title
Evaluate the volume of distribution of ProAgio
Description
If there are sufficient participant data available, a population PK analyses will be conducted to identify covariates that may be significantly associated with the inter-individual variability for a particular PK parameter (e.g. clearance of volume of distribution).The NCI CPP may also conduct dose-response and/or exposure-response analyses that will assess PK/PD relationships with relevant biomarkers, clinical response, and adverse event data.
Time Frame
3 Years
Title
Rate of study drug elimination in research participants
Description
58 study participants will have study drug concentration levels analyzed with regard to drug elimination. Results will be expressed in units of inverse time, i.e. 1/hr or 1/day.
Time Frame
3 Years
Title
Objective Response Rate (ORR)
Description
Make a preliminary assessment of anti-tumor activity by measuring objective response rate (ORR),
Time Frame
3 Years
Title
Disease control rate (DCR).
Description
Make a preliminary assessment of anti-tumor activity by measuring disease control rate at 18 weeks (DCR).
Time Frame
At 18 Weeks
Title
Assess serum tumor marker CA19-9 or appropriate tumor specific marker.
Description
Make a preliminary assessment of anti-tumor activity by measuring change in relevant serum tumor marker CA19-9 appropriate tumor specific marker.
Time Frame
Day 1 of each treatment cycle and 30 days after the last dose of study therapy.
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Histologically or cytologically confirmed diagnosis of a solid tumor malignancy for which no curative therapy exists as confirmed by the NCI Laboratory of Pathology.
For expansion cohort: histologically or cytologically confirmed diagnosis of nonneuroendocrine pancreatic cancer. Participants with mixed acinar- neuroendocrine histology are permitted.
Participants in the Biopsy Arm of the expansion cohort must have disease amenable to safe biopsy and willingness to undergo the procedure.
Participants must have received at least one prior systemic treatment for advanced disease. Participants must be more than 14 days removed from most recent standard of care or experimental drug treatment for their tumor
Participants in the dose escalation cohort must have evaluable disease, either by clinical exam, biochemical markers (including but not limited to CA 19-9 serum tumor marker for pancreatobiliary cancer participants, or other appropriate tumor marker in other tumor types), and/or radiographic studies.
Participants in the expansion cohort must have measurable disease, per RECIST 1.1.
Age >18 years. Because no dosing or adverse event data are currently available on the use of ProAgio in participants <18 years of age, children are excluded from this study.
ECOG performance status <2 (Karnofsky >60%.
Participants must have adequate organ and marrow function as defined below:
absolute neutrophil count >1,000 mcl
hemoglobin >9 g/dl
platelets >75,000/mcl
AST(SGOT)/ALT(SGPT) < 2.5 x ULN. AST and ALT (up to 5x ULN is permitted for participants with liver metastases)
Total bilirubin <1.5 X institutional ULN
creatinine within normal institutional limits
OR
creatinine clearance >60 mL/min/1.73 m2 for participants with creatinine levels above institutional normal
Serum albumin > 2.5 mg/dl without intravenous supplementation
Participants must have:
Resting systolic blood pressure < 145 and diastolic blood pressure < 90.
Baseline QTcF interval of = 470 ms
Baseline resting heart rate > 45 beats per minute and <100 beats per minute
The effects of ProAgio on the developing human fetus are unknown. For this reason, women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry, for the duration of study participation and for the 3 months following the last dosing of study drug. Should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately.
Ability of subject to understand and the willingness to sign a written informed consent document.
Exclusion Criteria:
Diagnosis of primary malignant CNS tumor.
Participants who are receiving any other investigational agents.
Evidence of significant, uncontrolled concomitant diseases which could affect compliance with the protocol or interpretation of results, including but not limited to significant pulmonary disease other than that related to the primary cancer, uncontrolled diabetes mellitus, unstable angina, significant cardiovascular disease (such as New York Heart Association Class III or IV cardiac disease) and/or psychiatric illness/social situations within 12 weeks that would limit compliance with study requirements.
Participants with known diagnosis of a chronic neurologic disorders (such as multiple sclerosis, Huntington's disease, Parkinson's disease, or uncontrolled epilepsy) which causes motor disturbance, visual disturbance or seizure and could confound assessment of neurologic toxicity caused by the study drug.
Pregnant or nursing women are excluded from this study because ProAgio is an agent with the potential for teratogenic or abortifacient effects. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with ProAgio, breastfeeding should be discontinued if the mother is treated with ProAgio.
Participants with leptomeningeal disease or with CNS metastases that are untreated, have required steroid treatment within the last 4 weeks, or anti-convulsant therapy in the last 14 days. For dose escalation cohort only: Participants with any known CNS metastases are excluded. Those with symptoms suggestive of possible CNS metastases (such as new headaches) must undergo brain MRI as part of screening.
Participants who have undergone a recent minor surgical procedure (within <14 days) such as biliary stenting or major surgical procedure (within < 28 days) are excluded.
Participants who have undergone recent (within <14 days) radiation therapy are excluded.
Participants with uncontrolled bleeding episodes <28 days prior to enrollment are excluded.
Participants with active or uncontrolled infections are excluded.
Participants with HIV and detectable viral load are excluded. Patents on appropriate highly active anti-retroviral therapy with undetectable viral load are eligible.
Participants with a history of Hepatitis B or C are excluded unless there is documented evidence of effective treatment and/or cure with undetectable viral load.
Participants with recent (within < 28 days) thromboembolic disease including but not limited to acute coronary syndrome, stroke, or transient ischemic attack, recent deep vein thrombosis or pulmonary embolism are excluded.
Participants with thromboembolic disease including but not limited to acute coronary syndrome, stroke, or transient ischemic attack, recent deep vein thrombosis or pulmonary embolism who have continued symptoms, or who are not on stable doses of appropriate antiplatelet / anticoagulant regimens are excluded.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Damon R Michaels
Phone
615-614-1185
Email
damon.michaels@medelis.com
First Name & Middle Initial & Last Name or Official Title & Degree
Zhi-Ren Liu
Email
zliu8@gsu.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Christine Alewine, MD, PhD
Organizational Affiliation
National Cancer Institute (NCI)
Official's Role
Principal Investigator
Facility Information:
Facility Name
National Cancer Institute
City
Bethesda
State/Province
Maryland
ZIP/Postal Code
20892
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Eve Koehler, RN, MSN, MPH
Phone
240-858-3238
Email
eve.koehler@nih.gov
First Name & Middle Initial & Last Name & Degree
Christine Alewine, MD, PhD
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
ProAgio in Previously Treated Advanced Pancreatic Cancer and Other Solid Tumor Malignancies
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