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131Iodine-Tenatumomab Treatment in Tenascin-C Positive Cancer Patients (Tenatumomab)

Primary Purpose

Breast Neoplasm, Head and Neck Neoplasm, Skin Neoplasm

Status
Terminated
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
131I-Tenatumomab
Sponsored by
sigma-tau i.f.r. S.p.A.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Breast Neoplasm

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • 1. Written informed consent.
  • 2. A patient who has (a) a histologically documented advanced tumor that has relapsed from, or is refractory to, standard treatment and for which no other standard treatment is available and (b) confirmed Tenascin-C expression obtained through a biopsy on at least one reachable tumor lesion.

These patients will have failed one or more prior therapeutic line and had assessable and measurable disease expression, but were not considered eligible for other standard approaches with curative intent, as assessed by the Investigator.

  • 3. Agreement to hemopoietic stem cell collection procedures (the procedure will be performed upon clinical evaluation of the Investigator and if deemed necessary in the interest of the patient).
  • 4. Male or female ≥18 years of age
  • 5. Eastern Cooperative Oncology Group (ECOG), or WHO performance status of ≤ 2 or Karnofsky > 60
  • 6. Life expectancy of at least 3 months.
  • 7. Negative pregnancy test for all women of child-bearing potential. Appropriate contraception (one highly effective method or a combination of acceptable methods) is to be used during the study period and until 90 days after the last follow-up visit (End of Study Visit)
  • 8. Hematological, thyroid, liver, cardiac and renal function test results ≤ grade 2 toxicity (according to US National Cancer Institute's "Common Terminology Criteria for Adverse Events v4.03 [CTCAE]"), e.g.:

Haematology:

  • Hematocrit ≥ 30%
  • Hemoglobin ≥ 9.0 g/dl
  • White blood cell count ≥ 3 x 109/L
  • Neutrophils > 1.5 x109/L
  • Platelets ≥ 100x 109/L

Thyroid:

- Free-Triiodothyronine and Free-Thyroxine ≤ 3 times upper limit of normal or >3 times lower limit of normal.

Liver:

  • Alanine transaminase, Aspartate transaminase, Alkaline Phosphatase ≤ 2.5 times institutional upper limit of normal (ULN) or ≤5 x ULN in presence of liver metastases.
  • Bilirubin ≤ 1.5 x ULN or ≤3 x ULN in presence of liver metastases.

Renal:

  • Urine protein: ≤30 mg/dl or dipstick: ≤3
  • eGFR≥60 ml/min/1.73 m2 (with Chronic kideny disease-Epidemiology collaboration formula)

Cardiac

• Resting Ejection Fraction (EF) ≥ 50%

Exclusion Criteria:

  • 1. Known hypersensitivity to Tenatumomab, Iodine or any excipient.
  • 2. Active infection at screening or history of severe infection within the previous 2 months, if considered clinically relevant by the Investigator.
  • 3. Positive test to Human Immunodeficiency Virus (HIV) and/or chronically active Hepatitis B or C.
  • 4. Patients with primary Central nervous system tumor or cerebral metastases.
  • 5. Administration of another investigational medicinal product within 45days before the screening period.
  • 6. Previous treatment with any radiopharmaceutical within a period corresponding to 8 half-lives of the radionuclide used prior to the administration of study drug.
  • 7. History of somatic or psychiatric disease/condition that may interfere with the objectives of the study.
  • 8. Major illness, trauma, or surgery within 2 weeks before the screening period, if considered clinically significant by the Investigator.
  • 9. Patient who underwent chemotherapy and/or radiation therapy and/or treatments with biologics (which are not to be of murine origin) within 4 weeks before the screening period.
  • 10. Women who are breast feeding, due to the potential risk of damage to the infant.
  • 11. Men unwilling to use appropriate contraceptive methods during the study and up to 90 days after the last follow-up visit (End of Study Visit).
  • 12. Bladder catheterization cannot be performed, or the patient is unwilling to be catheterized if necessary.
  • 13. Murine antibodies treated patients. It is at the discretion of the Investigator to exclude patients who have worsened considerably from screening to Day -1.

Sites / Locations

  • Institut Bergonnie
  • Centre Leon Berard
  • Icm Val D'Aurelle
  • Istituto Nazionale Dei Tumori Irccs - Fondazione "G. Pascale"
  • University of Study of Pisa
  • S. Maria Nuova Hospital - Irccs
  • Humanitas Clinical Institute

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

131I-Tenatumomab

Arm Description

Diagnostic: each patient will receive one single i.v. infusion of 370 MBq±10% 131I-Tenatumomab in 10 ml of saline (conveyed by 10 ±10%, 20 ±10%, 40 ±10% mg of Tenatumomab). It will be administered as a short infusion in approximately 30 minutes (333 ° µl / min). Therapeutic: each patient will receive one single i.v. infusion, escalating 131I-Tenatumomab dose starting at 2.5 GBq±10%,with escalation steps of 1 GBq, up to 5.5 GBq±10% in 10 ml of saline, (conveyed by 10 ±10% , 20 ±10%, 40 ±10% mg of Tenatumomab). It will be administered as a short infusion in approximately 30 minutes (333° µl / min)

Outcomes

Primary Outcome Measures

Dose Limiting Toxicity evaluated using NCI Common Toxicity Criteria (CTCAE 4.03)
no more details necessary

Secondary Outcome Measures

Adverse Events
no more details necessary

Full Information

First Posted
November 9, 2015
Last Updated
September 14, 2018
Sponsor
sigma-tau i.f.r. S.p.A.
Collaborators
Medpace, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT02602067
Brief Title
131Iodine-Tenatumomab Treatment in Tenascin-C Positive Cancer Patients
Acronym
Tenatumomab
Official Title
A Dose Escalation Study to Evaluate Safety, Tolerability Dosimetry, Pharmacokinetics and Preliminary Efficacy of 131I-Tenatumomab Treatment in Tenascin-C Positive Cancer Patients
Study Type
Interventional

2. Study Status

Record Verification Date
January 2018
Overall Recruitment Status
Terminated
Why Stopped
Uptake of drug into the tumour lesion was negligible
Study Start Date
November 2015 (undefined)
Primary Completion Date
April 30, 2017 (Actual)
Study Completion Date
April 30, 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
sigma-tau i.f.r. S.p.A.
Collaborators
Medpace, Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Tenatumomab is a Sigma-Tau developed new anti-Tenascin antibody. It is a murine monoclonal antibody directed towards Tenascin-C. By means of this antibody, Tenascin-C expression was studied on a commercial tissue array slides each carrying malignant breast, colorectal, lung, ovarian or B and T cell Non-Hodgkin Limphoma tissue sections. All these cancers type showed positivity to Tenascin-C between the 64% and 13.3%. Consequently, Sigma-tau is exploring the use of the 131I-labeled Tenatumomab for anti-cancer radioimmunotherapy.
Detailed Description
This will be an open-label dose escalation study. The study will be conducted in two steps: STEP A aims to identify the optimal amount of antibody to convey the specific radio-label activity of radionuclide. STEP B will be conducted with the amount of antibody chosen in STEP A, and an escalating radio-labeled therapeutic dose response curve will be performed (3.5 to 5.5 GBq) A maximum of 36 evaluable patients suffering from treatment-refractory Tenascin-C positive tumors. This dose escalation study will be evaluated using descriptive statistics: no sample size calculation was performed Primary objectives To identify the Maximum Tolerated Dose (MTD) and assess Safety and Tolerability of i.v. infused 131I-Tenatumomab. To identify the optimal amount of unlabeled Tenatumomab able to convey 131I- Tenatumomab with the highest Tumor/nonTumor ratio. To evaluate the whole body Dosimetry (safety dosimetry) and Tumor to normal tissue ratio (T/nT ratio, referred to AUC) of i.v.infused 131I-Tenatumomab. To evaluate intra-lesional distribution and retention of 131I-Tenatumomab and to record individual lesion dosimetry. To evaluate systemic biodistribution, pharmacokinetics, urinary excretion and dose linearity of 131I-Tenatumomab. Secondary objectives To evaluate proportional 131I-Tenatumomab tumor binding, as a function of the total load. To evaluate Pharmacokinetics of Tenatumomab (protein and protein related materials) in serum. To evaluate preliminary Efficacy of 131I-Tenatumomab based on disease response rate (Complete Response, Partial Response, Stable Disease) and patient's general clinical condition by ECOG performance status assessment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Breast Neoplasm, Head and Neck Neoplasm, Skin Neoplasm, Respiratory Tract Neoplasm, Urogenital Neoplasm, Digestive System Neoplasm, Pancreatic Neoplasm, Connective and Soft Tissue Neoplasm, Lymphoma, Non-Hodgkin

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Model Description
Tenatumomab infusion
Masking
None (Open Label)
Allocation
N/A
Enrollment
2 (Actual)

8. Arms, Groups, and Interventions

Arm Title
131I-Tenatumomab
Arm Type
Experimental
Arm Description
Diagnostic: each patient will receive one single i.v. infusion of 370 MBq±10% 131I-Tenatumomab in 10 ml of saline (conveyed by 10 ±10%, 20 ±10%, 40 ±10% mg of Tenatumomab). It will be administered as a short infusion in approximately 30 minutes (333 ° µl / min). Therapeutic: each patient will receive one single i.v. infusion, escalating 131I-Tenatumomab dose starting at 2.5 GBq±10%,with escalation steps of 1 GBq, up to 5.5 GBq±10% in 10 ml of saline, (conveyed by 10 ±10% , 20 ±10%, 40 ±10% mg of Tenatumomab). It will be administered as a short infusion in approximately 30 minutes (333° µl / min)
Intervention Type
Combination Product
Intervention Name(s)
131I-Tenatumomab
Other Intervention Name(s)
Tenatumomab/ST2146
Intervention Description
I131anti-Tenascin monoclonal antibody administered to be targeted on neoplasms expressing Tenascin-C
Primary Outcome Measure Information:
Title
Dose Limiting Toxicity evaluated using NCI Common Toxicity Criteria (CTCAE 4.03)
Description
no more details necessary
Time Frame
up to six weeks
Secondary Outcome Measure Information:
Title
Adverse Events
Description
no more details necessary
Time Frame
up to 1 year
Other Pre-specified Outcome Measures:
Title
Tumor response
Description
Tumor response according to Response Evaluation Criteria in Solid Tumors RECIST V 1.1 or PERCIST
Time Frame
1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: 1. Written informed consent. 2. A patient who has (a) a histologically documented advanced tumor that has relapsed from, or is refractory to, standard treatment and for which no other standard treatment is available and (b) confirmed Tenascin-C expression obtained through a biopsy on at least one reachable tumor lesion. These patients will have failed one or more prior therapeutic line and had assessable and measurable disease expression, but were not considered eligible for other standard approaches with curative intent, as assessed by the Investigator. 3. Agreement to hemopoietic stem cell collection procedures (the procedure will be performed upon clinical evaluation of the Investigator and if deemed necessary in the interest of the patient). 4. Male or female ≥18 years of age 5. Eastern Cooperative Oncology Group (ECOG), or WHO performance status of ≤ 2 or Karnofsky > 60 6. Life expectancy of at least 3 months. 7. Negative pregnancy test for all women of child-bearing potential. Appropriate contraception (one highly effective method or a combination of acceptable methods) is to be used during the study period and until 90 days after the last follow-up visit (End of Study Visit) 8. Hematological, thyroid, liver, cardiac and renal function test results ≤ grade 2 toxicity (according to US National Cancer Institute's "Common Terminology Criteria for Adverse Events v4.03 [CTCAE]"), e.g.: Haematology: Hematocrit ≥ 30% Hemoglobin ≥ 9.0 g/dl White blood cell count ≥ 3 x 109/L Neutrophils > 1.5 x109/L Platelets ≥ 100x 109/L Thyroid: - Free-Triiodothyronine and Free-Thyroxine ≤ 3 times upper limit of normal or >3 times lower limit of normal. Liver: Alanine transaminase, Aspartate transaminase, Alkaline Phosphatase ≤ 2.5 times institutional upper limit of normal (ULN) or ≤5 x ULN in presence of liver metastases. Bilirubin ≤ 1.5 x ULN or ≤3 x ULN in presence of liver metastases. Renal: Urine protein: ≤30 mg/dl or dipstick: ≤3 eGFR≥60 ml/min/1.73 m2 (with Chronic kideny disease-Epidemiology collaboration formula) Cardiac • Resting Ejection Fraction (EF) ≥ 50% Exclusion Criteria: 1. Known hypersensitivity to Tenatumomab, Iodine or any excipient. 2. Active infection at screening or history of severe infection within the previous 2 months, if considered clinically relevant by the Investigator. 3. Positive test to Human Immunodeficiency Virus (HIV) and/or chronically active Hepatitis B or C. 4. Patients with primary Central nervous system tumor or cerebral metastases. 5. Administration of another investigational medicinal product within 45days before the screening period. 6. Previous treatment with any radiopharmaceutical within a period corresponding to 8 half-lives of the radionuclide used prior to the administration of study drug. 7. History of somatic or psychiatric disease/condition that may interfere with the objectives of the study. 8. Major illness, trauma, or surgery within 2 weeks before the screening period, if considered clinically significant by the Investigator. 9. Patient who underwent chemotherapy and/or radiation therapy and/or treatments with biologics (which are not to be of murine origin) within 4 weeks before the screening period. 10. Women who are breast feeding, due to the potential risk of damage to the infant. 11. Men unwilling to use appropriate contraceptive methods during the study and up to 90 days after the last follow-up visit (End of Study Visit). 12. Bladder catheterization cannot be performed, or the patient is unwilling to be catheterized if necessary. 13. Murine antibodies treated patients. It is at the discretion of the Investigator to exclude patients who have worsened considerably from screening to Day -1.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
SECONDO LASTORIA, M.D.
Organizational Affiliation
ISTITUTO NAZIONALE DEI TUMORI IRCCS - FONDAZIONE "G. PASCALE" NAPLES - ITALY
Official's Role
Study Chair
Facility Information:
Facility Name
Institut Bergonnie
City
Bordeaux
ZIP/Postal Code
33076
Country
France
Facility Name
Centre Leon Berard
City
Lyon
ZIP/Postal Code
69373
Country
France
Facility Name
Icm Val D'Aurelle
City
Montpellier
ZIP/Postal Code
34298
Country
France
Facility Name
Istituto Nazionale Dei Tumori Irccs - Fondazione "G. Pascale"
City
Naples
ZIP/Postal Code
80131
Country
Italy
Facility Name
University of Study of Pisa
City
Pisa
ZIP/Postal Code
65126
Country
Italy
Facility Name
S. Maria Nuova Hospital - Irccs
City
Reggio Emilia
ZIP/Postal Code
42123
Country
Italy
Facility Name
Humanitas Clinical Institute
City
Rozzano Mi
ZIP/Postal Code
20089
Country
Italy

12. IPD Sharing Statement

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131Iodine-Tenatumomab Treatment in Tenascin-C Positive Cancer Patients

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