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A Phase I Study With Lymfactin® in the Treatment of Patients With Secondary Lymphedema

Primary Purpose

Secondary Lymphedema

Status
Terminated
Phase
Phase 1
Locations
Finland
Study Type
Interventional
Intervention
Lymfactin® [1 x 10E10 vp]
Lymfactin® [1 x 10E11 vp]
Sponsored by
Herantis Pharma Plc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Secondary Lymphedema focused on measuring Lymphedema, Breast cancer

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion criteria:

  1. Female patients with secondary lymphedema associated with the treatment of breast cancer.
  2. Patient who understands and voluntarily signs informed consent prior to any screening procedure.
  3. 18 - 70 years of age.
  4. BMI between 18 and 32 inclusive.
  5. Female patients with secondary lymphedema in the arm associated with breast cancer who:

    1. Have undergone sentinel lymph node biopsies and/or lymph node resection in the axilla on the affected side of their breast cancer with initial N1 staging and lymph node metastasis in ≤ three lymph nodes.
    2. Require garment use as a compression treatment for the lymphedema in the affected arm.
    3. Have the volume of the affected arm at least 10% greater than the unaffected arm following 7 days after removal of the compression garments.
    4. Have the presence of pitting edema in the affected arm without compression garments.
  6. No evidence of recurrent or active breast cancer at least 2 years and no more than 5 years after breast cancer surgery and/or the end of chemotherapy and/or radiotherapy (excluding endocrine and/or aromatase inhibitor treatment). PET CT scan of the chest and the abdomen within 45 days of treatment with Lymfactin® without signs of active breast cancer or any other malignancy.
  7. Patient with the following laboratory values:

    1. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2.5 times the institutional upper limit of normal (ULN)
    2. Bilirubin ≤ 1.5 mg/dL
    3. PT and PTT ≤ 1.5 times the ULN
    4. Serum creatinine ≤ 2 mg/dL
    5. Absolute neutrophil count (ANC) ≥ 1,500 cells/mm³
    6. Platelet count ≥ 100,000/mm³
    7. Hemoglobin ≥ 10 g/dL
  8. Willingness to comply with scheduled visits, laboratory assessments, and other study-related procedures due to the regulatory requirements related to gene based therapies.
  9. Non-smoker or willing to stop smoking or using nicotine-containing products for at least 4 weeks prior to entry to study.
  10. Negative urine pregnancy test (only patients with childbearing potential) at screening and use of adequate contraceptive measures from screening until 6 months after the study treatment administration:

    1. A patient with childbearing potential should be using a reliable contraception method: intrauterine device (hormonal or non-hormonal); oral combination pill or hormonal contraception patch; or two of the following: intra-vaginal hormonal ring, oral contraceptive containing progestin only, spermicidal foam, condom, sterilization of male sexual partner (surgical vasectomy).
    2. A patient with no current heterosexual relationship may be included according to the judgement of the Investigator.
    3. If the patient is surgically sterile or whose menopause occurred 2 years previously at the minimum, no contraception is required nor pregnancy test.

Exclusion criteria:

  1. A patient who had an N2/N3 or a T4 stage breast cancer or an inflammatory breast cancer at the time of the original diagnosis.
  2. A patient with evidence (clinical, laboratory, or imaging) or history of a neoplasm other than breast cancer (except basal cell carcinoma or cervical in situ carcinoma).
  3. A patient known to be pregnant, lactating or having a positive or indeterminate pregnancy test.
  4. Treatment with COX-2 inhibitors should be interrupted from one week prior until 2 weeks post surgery and treatment with Lymfactin®.
  5. Previous treatment with, or participation in, trial of a gene therapy product.
  6. Current participation or participation in the preceding two months, in any clinical study apart from a noninterventional study.
  7. Current treatment with immunosuppressive drugs.
  8. Current or history of drug, including nicotinecontaining products, or alcohol abuse.
  9. Known human immunodeficiency virus- or acquired immunodeficiency syndrome-related illness.
  10. Allergy to any ingredients of the Lymfactin® solution for injection (glycerol, N-2-hydroxyethylpiperazine-N´-2-ethanesulfonic acid (HEPES), sodium hydroxide).
  11. Other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or study drug administration, that would affect the patient's ability to follow study-related procedures, or that may interfere with the interpretation of study results and, in the Investigator's opinion, would make the patient inappropriate for entry into this study.
  12. Doubtful availability, in the opinion of the Investigator, to complete the study.

Sites / Locations

  • Toeoeloe Hospital, Department of Plastic Surgery
  • Tampere University Hospital, Department of Plastic Surgery
  • Turku University Hospital, Department of Plastic Surgery

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

Lymfactin® [1 x 10E10 vp]

Lymfactin® [1 x 10E11 vp]

Arm Description

Lymfactin® [1 x 10E10 vp] will be administered as a single dose via perinodal injection in a volume of 2 mL.

Lymfactin® [1 x 10E11 vp] will be administered as a single dose via perinodal injection in a volume of 2 mL.

Outcomes

Primary Outcome Measures

Safety as measured by number of patients with treatment related adverse events and serious adverse events as assessed by CTCAE v4.0
Adverse events and serious adverse events assessed by CTCAE v4.0 to evaluate the safety profile after administration of Lymfactin
CT scan of chest and abdomen
Changes in the CT scan of chest and abdomen in order to detect malignancies
Biodistribution of Lymfactin in blood
Changes in Lymfactin genome copy number in blood
Formation of anti-Lymfactin antibodies
Changes in the anti-Lymfactin antibody titer in blood

Secondary Outcome Measures

Measurement of the volume of the arms
Changes in the volume of the affected arm and comparison to the unaffected arm
Measurement of the lymphatic flow of the affected arm by quantitative lymphoscintigraphy (99Tc-nanocolloid clearance rate with calculation of transport index)
Assessment of the changes in the lymphatic flow
Questionnaire according to the Lymphedema Quality of Life Inventory (LQOLI)
Assessment of changes in the quality of life using Lymphedema Quality of Life Inventory (LQOLI) in which patients assess how their lymphedema is affecting the activities of daily living. LQOLI consists of three dimensions: Physical, psychosocial and practical, which are reported separately as the mean score of each dimension. Each dimension of the LQOLI is scored from 0 to 3, where score 0 means "no impact", 1 means "a little bit impact", 2 means "somewhat impact", and 3 means "significant impact" on the quality of life of the patient, the smaller score thus being the better.

Full Information

First Posted
November 10, 2016
Last Updated
April 20, 2023
Sponsor
Herantis Pharma Plc.
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1. Study Identification

Unique Protocol Identification Number
NCT02994771
Brief Title
A Phase I Study With Lymfactin® in the Treatment of Patients With Secondary Lymphedema
Official Title
A Phase I Open-Label Study to Assess the Safety, Tolerability and Preliminary Efficacy of Lymfactin® (AdAptVEGF-C Adenoviral Vector) in Combination With a Surgical Lymph Node Transfer for the Treatment of Patients With Secondary Lymphedema
Study Type
Interventional

2. Study Status

Record Verification Date
April 2023
Overall Recruitment Status
Terminated
Why Stopped
Lack of efficacy
Study Start Date
June 2016 (Actual)
Primary Completion Date
February 3, 2019 (Actual)
Study Completion Date
April 5, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Herantis Pharma Plc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Indicated for the Treatment of Secondary Lymphedema Associated with the Treatment of Breast Cancer. Primary objective is to evaluate the safety and tolerability of a single dose of Lymfactin® in patients with secondary lymphedema associated with the treatment of breast cancer.
Detailed Description
This is an open label, multi-center, uncontrolled first in human trial that uses a standard 3 + 3 dose escalation scheme. Lymfactin® will be administered as a single dose by ex vivo perinodal injection into the fat pad of a flap of tissue containing lymph nodes from the abdominal wall. This flap of tissue will then be surgically implanted into the axillary region of the affected arm. This treatment with Lymfactin® may be performed in conjunction with or without breast reconstruction surgery. Up to two dose cohorts are planned to be included. Each dose of Lymfactin® will be administered as a single dose via perinodal injection in a volume of 2 mL: Cohort 1: Lymfactin® [1 x 10E10 vp] Cohort 2: Lymfactin® [1 x 10E11 vp] Should the dose escalation go up to Cohort 2 with initiation of a subsequent Extension Cohort a total of 15 - 21 patients may be treated in this study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Secondary Lymphedema
Keywords
Lymphedema, Breast cancer

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Lymfactin® [1 x 10E10 vp]
Arm Type
Active Comparator
Arm Description
Lymfactin® [1 x 10E10 vp] will be administered as a single dose via perinodal injection in a volume of 2 mL.
Arm Title
Lymfactin® [1 x 10E11 vp]
Arm Type
Active Comparator
Arm Description
Lymfactin® [1 x 10E11 vp] will be administered as a single dose via perinodal injection in a volume of 2 mL.
Intervention Type
Drug
Intervention Name(s)
Lymfactin® [1 x 10E10 vp]
Other Intervention Name(s)
LX-1101, AdAptVEGF-C Adenoviral Vector
Intervention Description
Lymfactin® [1 x 10E10 vp] will be administered as a single dose via perinodal injection in a volume of 2 mL.
Intervention Type
Drug
Intervention Name(s)
Lymfactin® [1 x 10E11 vp]
Other Intervention Name(s)
LX-1101, AdAptVEGF-C Adenoviral Vector
Intervention Description
Lymfactin® [1 x 10E11 vp] will be administered as a single dose via perinodal injection in a volume of 2 mL.
Primary Outcome Measure Information:
Title
Safety as measured by number of patients with treatment related adverse events and serious adverse events as assessed by CTCAE v4.0
Description
Adverse events and serious adverse events assessed by CTCAE v4.0 to evaluate the safety profile after administration of Lymfactin
Time Frame
baseline to 1 year, yearly up to 5 years
Title
CT scan of chest and abdomen
Description
Changes in the CT scan of chest and abdomen in order to detect malignancies
Time Frame
baseline, yearly up to 5 years
Title
Biodistribution of Lymfactin in blood
Description
Changes in Lymfactin genome copy number in blood
Time Frame
90 days
Title
Formation of anti-Lymfactin antibodies
Description
Changes in the anti-Lymfactin antibody titer in blood
Time Frame
6 months
Secondary Outcome Measure Information:
Title
Measurement of the volume of the arms
Description
Changes in the volume of the affected arm and comparison to the unaffected arm
Time Frame
baseline, 6, 12, 24 and 36 months
Title
Measurement of the lymphatic flow of the affected arm by quantitative lymphoscintigraphy (99Tc-nanocolloid clearance rate with calculation of transport index)
Description
Assessment of the changes in the lymphatic flow
Time Frame
baseline, 12, 24 and 36 months
Title
Questionnaire according to the Lymphedema Quality of Life Inventory (LQOLI)
Description
Assessment of changes in the quality of life using Lymphedema Quality of Life Inventory (LQOLI) in which patients assess how their lymphedema is affecting the activities of daily living. LQOLI consists of three dimensions: Physical, psychosocial and practical, which are reported separately as the mean score of each dimension. Each dimension of the LQOLI is scored from 0 to 3, where score 0 means "no impact", 1 means "a little bit impact", 2 means "somewhat impact", and 3 means "significant impact" on the quality of life of the patient, the smaller score thus being the better.
Time Frame
baseline, 6, 12, 24 and 36 months

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria: Female patients with secondary lymphedema associated with the treatment of breast cancer. Patient who understands and voluntarily signs informed consent prior to any screening procedure. 18 - 70 years of age. BMI between 18 and 32 inclusive. Female patients with secondary lymphedema in the arm associated with breast cancer who: Have undergone sentinel lymph node biopsies and/or lymph node resection in the axilla on the affected side of their breast cancer with initial N1 staging and lymph node metastasis in ≤ three lymph nodes. Require garment use as a compression treatment for the lymphedema in the affected arm. Have the volume of the affected arm at least 10% greater than the unaffected arm following 7 days after removal of the compression garments. Have the presence of pitting edema in the affected arm without compression garments. No evidence of recurrent or active breast cancer at least 2 years and no more than 5 years after breast cancer surgery and/or the end of chemotherapy and/or radiotherapy (excluding endocrine and/or aromatase inhibitor treatment). PET CT scan of the chest and the abdomen within 45 days of treatment with Lymfactin® without signs of active breast cancer or any other malignancy. Patient with the following laboratory values: Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2.5 times the institutional upper limit of normal (ULN) Bilirubin ≤ 1.5 mg/dL PT and PTT ≤ 1.5 times the ULN Serum creatinine ≤ 2 mg/dL Absolute neutrophil count (ANC) ≥ 1,500 cells/mm³ Platelet count ≥ 100,000/mm³ Hemoglobin ≥ 10 g/dL Willingness to comply with scheduled visits, laboratory assessments, and other study-related procedures due to the regulatory requirements related to gene based therapies. Non-smoker or willing to stop smoking or using nicotine-containing products for at least 4 weeks prior to entry to study. Negative urine pregnancy test (only patients with childbearing potential) at screening and use of adequate contraceptive measures from screening until 6 months after the study treatment administration: A patient with childbearing potential should be using a reliable contraception method: intrauterine device (hormonal or non-hormonal); oral combination pill or hormonal contraception patch; or two of the following: intra-vaginal hormonal ring, oral contraceptive containing progestin only, spermicidal foam, condom, sterilization of male sexual partner (surgical vasectomy). A patient with no current heterosexual relationship may be included according to the judgement of the Investigator. If the patient is surgically sterile or whose menopause occurred 2 years previously at the minimum, no contraception is required nor pregnancy test. Exclusion criteria: A patient who had an N2/N3 or a T4 stage breast cancer or an inflammatory breast cancer at the time of the original diagnosis. A patient with evidence (clinical, laboratory, or imaging) or history of a neoplasm other than breast cancer (except basal cell carcinoma or cervical in situ carcinoma). A patient known to be pregnant, lactating or having a positive or indeterminate pregnancy test. Treatment with COX-2 inhibitors should be interrupted from one week prior until 2 weeks post surgery and treatment with Lymfactin®. Previous treatment with, or participation in, trial of a gene therapy product. Current participation or participation in the preceding two months, in any clinical study apart from a noninterventional study. Current treatment with immunosuppressive drugs. Current or history of drug, including nicotinecontaining products, or alcohol abuse. Known human immunodeficiency virus- or acquired immunodeficiency syndrome-related illness. Allergy to any ingredients of the Lymfactin® solution for injection (glycerol, N-2-hydroxyethylpiperazine-N´-2-ethanesulfonic acid (HEPES), sodium hydroxide). Other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or study drug administration, that would affect the patient's ability to follow study-related procedures, or that may interfere with the interpretation of study results and, in the Investigator's opinion, would make the patient inappropriate for entry into this study. Doubtful availability, in the opinion of the Investigator, to complete the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Anne Saarikko, MD, PhD
Organizational Affiliation
HUCH
Official's Role
Principal Investigator
Facility Information:
Facility Name
Toeoeloe Hospital, Department of Plastic Surgery
City
Helsinki
Country
Finland
Facility Name
Tampere University Hospital, Department of Plastic Surgery
City
Tampere
Country
Finland
Facility Name
Turku University Hospital, Department of Plastic Surgery
City
Turku
Country
Finland

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Phase I Study With Lymfactin® in the Treatment of Patients With Secondary Lymphedema

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