A Ph 2 Study of Fosbretabulin in Subjects w Pancreatic or Gastrointestinal Neuroendocrine Tumors w Elevated Biomarkers (GI-NETorPNET)
Primary Purpose
Neuroendocrine Tumors
Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
fosbretabulin tromethamine
Sponsored by
About this trial
This is an interventional treatment trial for Neuroendocrine Tumors focused on measuring PNET, GI-NET, neuroendocrine, carcinoid
Eligibility Criteria
Inclusion Criteria:
- Ability to read, understand and provide written consent to participate in the study
- Age ≥ 18 years
- Biopsy-proven well-differentiated, low-to-intermediate-grade PNET or GI-NET with elevated (> ULN) biomarkers (serotonin, 5-hydroxyindoleacetic acid (5-HIAA), chromogranin A (CgA), neurokinin A, and neuron-specific enolase (NSE))
- Life expectancy > 12 weeks
- Must have received or may still be receiving one or more therapies including octreotide or serotonin synthesis inhibitor (SSI) or other somatostatin analogues
- Confirmed progressive disease within 18 months of enrollment on study
- Recovered from prior radiation therapy or surgery
- Eastern Cooperative Oncology Group (ECOG) performance score 0-2
- Absolute neutrophil count (ANC) ≥ 1,500/µL (without growth factors)
- Platelet count ≥ 100,000/µL
Adequate renal function as evidenced by serum creatinine
≤ 2.0 mg/dL (177 µmol/L)
- Adequate hepatic function: serum total bilirubin ≤ 2X greater than the upper limit of normal (ULN) (≤ 3X ULN in subjects with liver metastases), aspartate aminotransferase) AST) / alanine aminotransferase (AST) ≤ 2X the ULN for the local reference lab (≤ 5X the ULN for subjects with liver metastases)
- Disease that can be assessed (evaluable) with imaging (CT, MRI, PET, radionuclide imaging or other imaging modality)
- Women of childbearing potential as well as fertile men and their partners must use an effective method of birth control
Exclusion Criteria:
- Inadequately controlled hypertension defined as BP > 150/100 mm Hg despite medication
- Prior history of hypertensive crisis or hypertensive encephalopathy
- Recent history (within 6 months of start of screening) of unstable angina pectoris pattern, myocardial infarction (including non-Q wave MI), or NYHA (New York Heart Association) Class III and IV Congestive Heart Failure (CHF)
- Subjects who have clinical evidence of carcinoid-induced heart disease
- History of prior cerebrovascular accident (CVA), including transient ischemic attach (TIA)
- Known central nervous system (CNS) disease except for treated brain metastasis
- History of torsade de pointes, ventricular tachycardia or fibrillation, pathologic sinus bradycardia (<60 bpm), heart block (excluding 1st degree block, being PR interval prolongation only), congenital long QT syndrome or new ST segment elevation or depression or new Q wave on ECG
- Corrected QT interval (QTc) > 480 msec
- Ongoing treatment with any drugs known to prolong the QTc interval, including anti-arrhythmic medications (stable regimen of antidepressants of the selective serotonin reuptake inhibitor (SSRI) class is allowed))
- Evidence of bleeding diathesis or significant coagulopathy (in the absence of therapeutic anticoagulation)
- Significant vascular disease or recent peripheral arterial thrombosis
- Known intolerance of or hypersensitivity to fosbretabulin
- History of solid organ transplant or bone marrow transplant
- Any other intercurrent medical condition, including mental illness or substance abuse, deemed by the Investigator to be likely to interfere with a subject's ability to sign informed consent, cooperate and participate in the study, or interfere with the interpretation of the results
- High grade or poorly differentiated NET
- NET tumor other than PNET or GI-NET
- No elevated biomarker (>ULN) that can be followed
- Received regional hepatic infusion therapy within 6 months of enrollment (RFA allowed >6 months prior to enrollment)
Sites / Locations
- Stanford University School of Medicine
- Markey Cancer Center, Clinical Research Office
- Montefiore
- Duke University Medical Center
- Froedtert Hospital, Medicial College of Wisconsin
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
fosbretabulin tromethamine
Arm Description
Fosbretabulin 90 mg/vial; 60 mg/m2, IV infusion over 10 minutes; 1x/wk; three 3-week cycles
Outcomes
Primary Outcome Measures
Number of Participants With Improved, Stable, or Worsened Change In Chromogranin A (CgA) Biomarker Levels From Baseline
The mean change from baseline in chromogranin A (CgA) biomarker level is considered improved if a 25% reduction occurs and worsened if the mean change from baseline is increased by 25%.
Number of Participants With Improved, Stable, or Worsened Change In 5-hydroxyindoleacetic Acid (5-HIAA) Biomarker Levels From Baseline
The mean change from baseline in 5-hydroxyindoleacetic acid (5-HIAA) biomarker level is considered improved if a 25% reduction occurs and worsened if the mean change from baseline is increased by 25%.
Number of Participants With Improved, Stable, or Worsened Change In Serotonin Biomarker Levels From Baseline
The mean change from baseline in serotonin biomarker level is considered improved if a 25% reduction occurs and worsened if the mean change from baseline is increased by 25%.
Secondary Outcome Measures
Number of Participants With Partial Response (PR), Progressive Disease (PD), or Stable Disease (SD) Based on RECIST 1.1
The objective response rate (complete response, partial response, progressive disease, or stable disease) was determined by the investigator assessment of the participant's CT or MRI using Response Evaluation Criteria in Solid Tumors Criteria (RECIST 1.1) for target lesions. Partial Response (PR) is when there is at least 30% decrease in sum of the longest diameter of the target lesions. Progressive Disease (PD) is when there is at least 20% increase in the sum of the longest diameter of the target lesions, as well as an absolute increase of at least 5 mm (including appearance of new lesions). Stable Disease (SD) is when there neither a PR nor PD is noted.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02132468
Brief Title
A Ph 2 Study of Fosbretabulin in Subjects w Pancreatic or Gastrointestinal Neuroendocrine Tumors w Elevated Biomarkers
Acronym
GI-NETorPNET
Official Title
A Ph 2 Study to Investigate the Safety and Activity of Fosbretabulin Tromethamine (CA4P) in the Treatment of Well-Differentiated, Low-to-Intermediate-Grade Unresectable, Recurrent or Metastatic PNET or GI-NET Neuroendocrine Tumors/Carcinoid With Elevated Biomarkers
Study Type
Interventional
2. Study Status
Record Verification Date
October 2017
Overall Recruitment Status
Completed
Study Start Date
September 2014 (undefined)
Primary Completion Date
June 2016 (Actual)
Study Completion Date
August 2016 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Mateon Therapeutics
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
This study will investigate the safety, symptoms and biomarker response of subjects with biopsy-proven well-differentiated, low-to-intermediate-grade, unresectable, or metastatic pancreatic neuroendocrine tumors (PNETs) or or Gastrointestinal Neuroendocrine tumors (GI-NETs) with elevated biochemical markers who have relapsed during or after receiving prior standard of care therapies, including octreotide, chemotherapy or targeted therapy.
Detailed Description
Subjects enrolled in this PNET/GI-NET study (OX4218s) will receive weekly dosing with fosbretabulin for up to 3 cycles or approximately 9 weeks.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Neuroendocrine Tumors
Keywords
PNET, GI-NET, neuroendocrine, carcinoid
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
18 (Actual)
8. Arms, Groups, and Interventions
Arm Title
fosbretabulin tromethamine
Arm Type
Experimental
Arm Description
Fosbretabulin 90 mg/vial; 60 mg/m2, IV infusion over 10 minutes; 1x/wk; three 3-week cycles
Intervention Type
Drug
Intervention Name(s)
fosbretabulin tromethamine
Other Intervention Name(s)
fosbretabulin, combretastatin A4-phosphate, CA4P
Intervention Description
60 mg/m2, IV on Day 1, 8 and 15 of a 3-week cycle; 3 cycles or until progression or unacceptable toxicity
Primary Outcome Measure Information:
Title
Number of Participants With Improved, Stable, or Worsened Change In Chromogranin A (CgA) Biomarker Levels From Baseline
Description
The mean change from baseline in chromogranin A (CgA) biomarker level is considered improved if a 25% reduction occurs and worsened if the mean change from baseline is increased by 25%.
Time Frame
Baseline and 4 months
Title
Number of Participants With Improved, Stable, or Worsened Change In 5-hydroxyindoleacetic Acid (5-HIAA) Biomarker Levels From Baseline
Description
The mean change from baseline in 5-hydroxyindoleacetic acid (5-HIAA) biomarker level is considered improved if a 25% reduction occurs and worsened if the mean change from baseline is increased by 25%.
Time Frame
Baseline and 4 months
Title
Number of Participants With Improved, Stable, or Worsened Change In Serotonin Biomarker Levels From Baseline
Description
The mean change from baseline in serotonin biomarker level is considered improved if a 25% reduction occurs and worsened if the mean change from baseline is increased by 25%.
Time Frame
Baseline and 4 months
Secondary Outcome Measure Information:
Title
Number of Participants With Partial Response (PR), Progressive Disease (PD), or Stable Disease (SD) Based on RECIST 1.1
Description
The objective response rate (complete response, partial response, progressive disease, or stable disease) was determined by the investigator assessment of the participant's CT or MRI using Response Evaluation Criteria in Solid Tumors Criteria (RECIST 1.1) for target lesions. Partial Response (PR) is when there is at least 30% decrease in sum of the longest diameter of the target lesions. Progressive Disease (PD) is when there is at least 20% increase in the sum of the longest diameter of the target lesions, as well as an absolute increase of at least 5 mm (including appearance of new lesions). Stable Disease (SD) is when there neither a PR nor PD is noted.
Time Frame
Baseline and 4 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Ability to read, understand and provide written consent to participate in the study
Age ≥ 18 years
Biopsy-proven well-differentiated, low-to-intermediate-grade PNET or GI-NET with elevated (> ULN) biomarkers (serotonin, 5-hydroxyindoleacetic acid (5-HIAA), chromogranin A (CgA), neurokinin A, and neuron-specific enolase (NSE))
Life expectancy > 12 weeks
Must have received or may still be receiving one or more therapies including octreotide or serotonin synthesis inhibitor (SSI) or other somatostatin analogues
Confirmed progressive disease within 18 months of enrollment on study
Recovered from prior radiation therapy or surgery
Eastern Cooperative Oncology Group (ECOG) performance score 0-2
Absolute neutrophil count (ANC) ≥ 1,500/µL (without growth factors)
Platelet count ≥ 100,000/µL
Adequate renal function as evidenced by serum creatinine
≤ 2.0 mg/dL (177 µmol/L)
Adequate hepatic function: serum total bilirubin ≤ 2X greater than the upper limit of normal (ULN) (≤ 3X ULN in subjects with liver metastases), aspartate aminotransferase) AST) / alanine aminotransferase (AST) ≤ 2X the ULN for the local reference lab (≤ 5X the ULN for subjects with liver metastases)
Disease that can be assessed (evaluable) with imaging (CT, MRI, PET, radionuclide imaging or other imaging modality)
Women of childbearing potential as well as fertile men and their partners must use an effective method of birth control
Exclusion Criteria:
Inadequately controlled hypertension defined as BP > 150/100 mm Hg despite medication
Prior history of hypertensive crisis or hypertensive encephalopathy
Recent history (within 6 months of start of screening) of unstable angina pectoris pattern, myocardial infarction (including non-Q wave MI), or NYHA (New York Heart Association) Class III and IV Congestive Heart Failure (CHF)
Subjects who have clinical evidence of carcinoid-induced heart disease
History of prior cerebrovascular accident (CVA), including transient ischemic attach (TIA)
Known central nervous system (CNS) disease except for treated brain metastasis
History of torsade de pointes, ventricular tachycardia or fibrillation, pathologic sinus bradycardia (<60 bpm), heart block (excluding 1st degree block, being PR interval prolongation only), congenital long QT syndrome or new ST segment elevation or depression or new Q wave on ECG
Corrected QT interval (QTc) > 480 msec
Ongoing treatment with any drugs known to prolong the QTc interval, including anti-arrhythmic medications (stable regimen of antidepressants of the selective serotonin reuptake inhibitor (SSRI) class is allowed))
Evidence of bleeding diathesis or significant coagulopathy (in the absence of therapeutic anticoagulation)
Significant vascular disease or recent peripheral arterial thrombosis
Known intolerance of or hypersensitivity to fosbretabulin
History of solid organ transplant or bone marrow transplant
Any other intercurrent medical condition, including mental illness or substance abuse, deemed by the Investigator to be likely to interfere with a subject's ability to sign informed consent, cooperate and participate in the study, or interfere with the interpretation of the results
High grade or poorly differentiated NET
NET tumor other than PNET or GI-NET
No elevated biomarker (>ULN) that can be followed
Received regional hepatic infusion therapy within 6 months of enrollment (RFA allowed >6 months prior to enrollment)
Facility Information:
Facility Name
Stanford University School of Medicine
City
Stanford
State/Province
California
ZIP/Postal Code
94305
Country
United States
Facility Name
Markey Cancer Center, Clinical Research Office
City
Lexington
State/Province
Kentucky
ZIP/Postal Code
40356
Country
United States
Facility Name
Montefiore
City
Bronx
State/Province
New York
ZIP/Postal Code
10467
Country
United States
Facility Name
Duke University Medical Center
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27710
Country
United States
Facility Name
Froedtert Hospital, Medicial College of Wisconsin
City
Milwaukee
State/Province
Wisconsin
ZIP/Postal Code
53226
Country
United States
12. IPD Sharing Statement
Learn more about this trial
A Ph 2 Study of Fosbretabulin in Subjects w Pancreatic or Gastrointestinal Neuroendocrine Tumors w Elevated Biomarkers
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