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A Pharmacokinetic, Pharmacodynamic, Safety and Tolerability Study of CERC-006 in Adults With Complex Lymphatic Malformations

Primary Purpose

Lymphatic Malformation

Status
Withdrawn
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
CERC-006
Sponsored by
Avalo Therapeutics, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Lymphatic Malformation focused on measuring Lymphatic Malformation, Complex Lymphatic Malformations, CERC-006

Eligibility Criteria

18 Years - 31 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

Participants must fulfill the following requirements to be eligible for the study:

  1. Participant is 18 to 31 years of age (inclusive) at the time of consent.
  2. Participant has a verified diagnosis of a complex lymphatic malformation. Other moderate to severe vascular anomalies with associated lymphatic involvement will be considered, with approval by the study medical monitor.
  3. Participant's complex lymphatic malformation is considered, in the opinion of the investigator, to be moderate to severe.
  4. Participant has adequate liver function defined as:

    • Total bilirubin (sum of conjugated and unconjugated) ≤1.5 × upper limit of normal (ULN)
    • Aspartate transaminase/Alanine aminotransferase (AST/ALT) <5 × ULN
    • Serum albumin > 2 g/dL
  5. Participant has fasting low-density lipoprotein (LDL) of <160 mg/dL.
  6. Participant has adequate bone marrow function defined as:

    • Peripheral absolute neutrophil count (ANC) > 1000/µL
    • Hemoglobin > 8.0 g/dL
    • Platelet count ≥ 50,000/µL
  7. Participant has adequate renal function defined as:

    • Serum creatinine ≤ 1.5 mg/dL or calculated creatinine clearance of > 50 mL/min according to the Cockcroft-Gault equation

  8. Participant has agreed to and met the washout period as follows:

    • At least 14 days prior to initiation of CERC-006 if receiving sirolimus (also known as rapamycin), mitogen-activated protein kinase (MEK) inhibitors, phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA) inhibitors, interferon alfa 2b, vascular endothelial growth factor receptor 3 (VEGFR-3) inhibitors, and/or other systemic agents targeting lymphatic malformation
    • At least 7 days prior to initiation of CERC-006 if receiving topical agents targeting lymphatic malformation
  9. Participant has a Karnofsky performance status of ≥50%.

Exclusion Criteria:

The presence of any of the following criteria excludes a participant from the study:

  1. Participant has a concurrent severe or uncontrolled medical disorder, which could compromise participation in the study.
  2. Participant has significant impairment of gastrointestinal function or gastrointestinal disease that may significantly alter the absorption of CERC-006.
  3. Participant has taken any medication that is a strong cytochrome P450 3A4 (CYP3A4) enzyme inducer or inhibitor within 2 weeks prior to first dose of study drug, or in the opinion of the Investigator, subject may require such medication during the study
  4. Participant is receiving chronic treatment with systemic steroids or another immunosuppressive agent, or in the opinion of the Investigator, subject may require such medication during the study
  5. Participant has undergone myelosuppressive chemotherapy within 2 weeks, or radiation within 4 weeks prior to first dose of study drug.
  6. Participant has a known history of uncontrolled hypertension, cardiovascular disease, advanced arteriosclerosis, structural cardiac abnormality, cardiomyopathy, serious heart rhythm abnormalities, coronary artery disease, cardiac conduction problems, heart failure, exercise-related cardiac events including syncope and pre-syncope, or a known family history of sudden cardiac death or ventricular arrhythmia.
  7. Participant has received treatment with a medication that has the potential to prolong the QT interval within 1 week prior to the first dose of study drug, or in the opinion of the Investigator, subject may require such medication during the study.

Sites / Locations

  • Children's Hospital Colorado
  • Children's Healthcare of Atlanta
  • Cincinnati Children's Hospital Medical Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Cohort 1: CERC-006 (0.5 mg)

Cohort 2: CERC-006 (1 mg)

Arm Description

Approximately 5 participants will receive CERC-006 at a dose of 0.5 mg twice daily for 28 days.

Following a safety review, if there are no clinically important safety findings in Cohort 1, a second cohort of approximately 5 participants will be enrolled to receive CERC-006 at a dose of 1 mg twice daily for 28 days.

Outcomes

Primary Outcome Measures

Safety and Tolerability of CERC-006 in Adults (Aged 18-31 Years) with Active, Moderate to Severe Complex Lymphatic Malformations
Safety and tolerability will be assessed by incidence of adverse events (AEs). Clinically significant changes from baseline in vital signs, ocular exams, cardiology tests including echocardiogram (ECHO) and electrocardiogram (ECG), and clinical laboratory results will be recorded as AEs.

Secondary Outcome Measures

Serum Concentrations of CERC-006
Change from Baseline in Levels of mTOR Related Pathway Biomarkers
Change from baseline to end of treatment in radiologic assessment, if clinically indicated and/or clinical signs/symptoms of disease
Radiologic disease assessment will be done if clinically indicated, at the discretion of the investigator.
Change from Baseline in 36-Item Short Form Health Survey (SF-36) Score
SF-36 score will measure eight scales: physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotional, and mental health. Scores on each scale will be directly transformed into a 0-100 scale, where a lower score indicates more disability.
Change from Baseline in Karnofsky Performance Status Score
Karnofsky Performance Status score will be measured on a scale from 0 percent (%) to 100%, where a lower percentage score indicates a worse disease state.
Change from Baseline in Pain Scale Assessment
Pain scale assessment will be done using a 100 mm Visual Analog Scale (VAS) from no pain (0 mm) to extreme pain (100 mm).

Full Information

First Posted
July 20, 2021
Last Updated
March 7, 2022
Sponsor
Avalo Therapeutics, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT04994002
Brief Title
A Pharmacokinetic, Pharmacodynamic, Safety and Tolerability Study of CERC-006 in Adults With Complex Lymphatic Malformations
Official Title
A Phase 1b, Open-Label, Pharmacokinetic, Pharmacodynamic, Safety and Tolerability Study of CERC-006 in Adults (Aged 18-31 Years) With Complex Lymphatic Malformations
Study Type
Interventional

2. Study Status

Record Verification Date
March 2022
Overall Recruitment Status
Withdrawn
Why Stopped
Sponsor Decision
Study Start Date
September 3, 2021 (Actual)
Primary Completion Date
June 2022 (Anticipated)
Study Completion Date
June 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Avalo Therapeutics, Inc.

4. Oversight

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

5. Study Description

Brief Summary
The primary objective of this study is to evaluate the safety and tolerability of CERC-006 in adults (aged 18-31 years) with active, moderate to severe complex lymphatic malformations.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Lymphatic Malformation
Keywords
Lymphatic Malformation, Complex Lymphatic Malformations, CERC-006

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
0 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Cohort 1: CERC-006 (0.5 mg)
Arm Type
Experimental
Arm Description
Approximately 5 participants will receive CERC-006 at a dose of 0.5 mg twice daily for 28 days.
Arm Title
Cohort 2: CERC-006 (1 mg)
Arm Type
Experimental
Arm Description
Following a safety review, if there are no clinically important safety findings in Cohort 1, a second cohort of approximately 5 participants will be enrolled to receive CERC-006 at a dose of 1 mg twice daily for 28 days.
Intervention Type
Drug
Intervention Name(s)
CERC-006
Intervention Description
Oral solution
Primary Outcome Measure Information:
Title
Safety and Tolerability of CERC-006 in Adults (Aged 18-31 Years) with Active, Moderate to Severe Complex Lymphatic Malformations
Description
Safety and tolerability will be assessed by incidence of adverse events (AEs). Clinically significant changes from baseline in vital signs, ocular exams, cardiology tests including echocardiogram (ECHO) and electrocardiogram (ECG), and clinical laboratory results will be recorded as AEs.
Time Frame
Up to approximately 6 weeks
Secondary Outcome Measure Information:
Title
Serum Concentrations of CERC-006
Time Frame
Baseline (Day 1) up to 3 days after last dose of study drug (up to approximately 4 weeks)
Title
Change from Baseline in Levels of mTOR Related Pathway Biomarkers
Time Frame
Baseline (Day 1) up to 3 days after last dose of study drug (up to approximately 4 weeks)
Title
Change from baseline to end of treatment in radiologic assessment, if clinically indicated and/or clinical signs/symptoms of disease
Description
Radiologic disease assessment will be done if clinically indicated, at the discretion of the investigator.
Time Frame
Baseline (Screening) up to 3 days after last dose of study drug (up to approximately 8 weeks)
Title
Change from Baseline in 36-Item Short Form Health Survey (SF-36) Score
Description
SF-36 score will measure eight scales: physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotional, and mental health. Scores on each scale will be directly transformed into a 0-100 scale, where a lower score indicates more disability.
Time Frame
Baseline (Day 1) up to 3 days after last dose of study drug (up to approximately 4 weeks)
Title
Change from Baseline in Karnofsky Performance Status Score
Description
Karnofsky Performance Status score will be measured on a scale from 0 percent (%) to 100%, where a lower percentage score indicates a worse disease state.
Time Frame
Baseline (Day 1) up to 3 days after last dose of study drug (up to approximately 4 weeks)
Title
Change from Baseline in Pain Scale Assessment
Description
Pain scale assessment will be done using a 100 mm Visual Analog Scale (VAS) from no pain (0 mm) to extreme pain (100 mm).
Time Frame
Baseline (Day 1) up to 3 days after last dose of study drug (up to approximately 4 weeks)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
31 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Participants must fulfill the following requirements to be eligible for the study: Participant is 18 to 31 years of age (inclusive) at the time of consent. Participant has a verified diagnosis of a complex lymphatic malformation. Other moderate to severe vascular anomalies with associated lymphatic involvement will be considered, with approval by the study medical monitor. Participant's complex lymphatic malformation is considered, in the opinion of the investigator, to be moderate to severe. Participant has adequate liver function defined as: Total bilirubin (sum of conjugated and unconjugated) ≤1.5 × upper limit of normal (ULN) Aspartate transaminase/Alanine aminotransferase (AST/ALT) <5 × ULN Serum albumin > 2 g/dL Participant has fasting low-density lipoprotein (LDL) of <160 mg/dL. Participant has adequate bone marrow function defined as: Peripheral absolute neutrophil count (ANC) > 1000/µL Hemoglobin > 8.0 g/dL Platelet count ≥ 50,000/µL Participant has adequate renal function defined as: • Serum creatinine ≤ 1.5 mg/dL or calculated creatinine clearance of > 50 mL/min according to the Cockcroft-Gault equation Participant has agreed to and met the washout period as follows: At least 14 days prior to initiation of CERC-006 if receiving sirolimus (also known as rapamycin), mitogen-activated protein kinase (MEK) inhibitors, phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA) inhibitors, interferon alfa 2b, vascular endothelial growth factor receptor 3 (VEGFR-3) inhibitors, and/or other systemic agents targeting lymphatic malformation At least 7 days prior to initiation of CERC-006 if receiving topical agents targeting lymphatic malformation Participant has a Karnofsky performance status of ≥50%. Exclusion Criteria: The presence of any of the following criteria excludes a participant from the study: Participant has a concurrent severe or uncontrolled medical disorder, which could compromise participation in the study. Participant has significant impairment of gastrointestinal function or gastrointestinal disease that may significantly alter the absorption of CERC-006. Participant has taken any medication that is a strong cytochrome P450 3A4 (CYP3A4) enzyme inducer or inhibitor within 2 weeks prior to first dose of study drug, or in the opinion of the Investigator, subject may require such medication during the study Participant is receiving chronic treatment with systemic steroids or another immunosuppressive agent, or in the opinion of the Investigator, subject may require such medication during the study Participant has undergone myelosuppressive chemotherapy within 2 weeks, or radiation within 4 weeks prior to first dose of study drug. Participant has a known history of uncontrolled hypertension, cardiovascular disease, advanced arteriosclerosis, structural cardiac abnormality, cardiomyopathy, serious heart rhythm abnormalities, coronary artery disease, cardiac conduction problems, heart failure, exercise-related cardiac events including syncope and pre-syncope, or a known family history of sudden cardiac death or ventricular arrhythmia. Participant has received treatment with a medication that has the potential to prolong the QT interval within 1 week prior to the first dose of study drug, or in the opinion of the Investigator, subject may require such medication during the study.
Facility Information:
Facility Name
Children's Hospital Colorado
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Facility Name
Children's Healthcare of Atlanta
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30322
Country
United States
Facility Name
Cincinnati Children's Hospital Medical Center
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45229
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Pharmacokinetic, Pharmacodynamic, Safety and Tolerability Study of CERC-006 in Adults With Complex Lymphatic Malformations

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