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AMG-479 in Treating Patients With Advanced Solid Tumors or Non-Hodgkin Lymphoma

Primary Purpose

Lymphoma, Prostate Cancer, Sarcoma

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
ganitumab
laboratory biomarker analysis
pharmacological study
biopsy
Sponsored by
Amgen
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Lymphoma focused on measuring cutaneous B-cell non-Hodgkin lymphoma, angioimmunoblastic T-cell lymphoma, stage IV cutaneous T-cell non-Hodgkin lymphoma, adult nasal type extranodal NK/T-cell lymphoma, anaplastic large cell lymphoma, extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue, nodal marginal zone B-cell lymphoma, recurrent adult Burkitt lymphoma, recurrent adult diffuse large cell lymphoma, recurrent adult diffuse mixed cell lymphoma, recurrent adult diffuse small cleaved cell lymphoma, recurrent adult grade III lymphomatoid granulomatosis, recurrent adult immunoblastic large cell lymphoma, recurrent adult lymphoblastic lymphoma, recurrent cutaneous T-cell non-Hodgkin lymphoma, recurrent grade 1 follicular lymphoma, recurrent grade 2 follicular lymphoma, recurrent grade 3 follicular lymphoma, recurrent mantle cell lymphoma, recurrent marginal zone lymphoma, recurrent small lymphocytic lymphoma, small intestine lymphoma, splenic marginal zone lymphoma, unspecified adult solid tumor, protocol specific, recurrent Ewing sarcoma/peripheral primitive neuroectodermal tumor, adult desmoplastic small round cell tumor, recurrent adult soft tissue sarcoma, recurrent prostate cancer

Eligibility Criteria

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

DISEASE CHARACTERISTICS:

Inclusion criteria:

  • Histologically or cytologically confirmed advanced solid tumors or non-Hodgkin lymphoma that is refractory to standard treatment or for which no curative therapy is available
  • Tumor tissue that is accessible for biopsy by using minimally invasive procedures and must consent to undergo biopsies of the tumor (part 2)

    • Exception for patients with Ewing family tumors or desmoplastic small round cell tumors whose anatomic location would pose an increase in the risk of injury due to biopsy (i.e., bleeding or pneumothorax)
  • Willing to provide existing and/or future paraffin-embedded tumor samples

Exclusion criteria:

  • Primary CNS tumors or hematological malignancies, other than non-Hodgkin lymphoma
  • Primary hepatic tumors or at increased risk for hepatic tumors, including any of the following:

    • Hepatitis of any etiology
    • Alcohol abuse or dependency
    • Hepatic adenoma
    • Follicular nodular hyperplasia
    • Autoimmune conditions associated with biliary tract cancer
    • Alpha 1 antitrypsin deficiency
    • Hemochromatosis
    • History of vinyl chloride or thorotrast/thorium dioxide exposure
  • History of histiocytic (Kupffer cell) neoplasia
  • Presence of untreated or symptomatic CNS metastases or symptoms of brain metastases
  • Presence of ascites or pleural effusion requiring medical intervention

PATIENT CHARACTERISTICS:

Inclusion criteria:

  • ECOG performance status ≤ 2
  • Not pregnant or nursing
  • Fertile patients must use effective contraception
  • Able to provide fasting blood samples for triglyceride and glucose laboratory tests
  • Able to fast for 4-6 hours for fludeoxyglucose F18-PET/CT scan
  • Controlled type 1 or 2 diabetes (defined as hemoglobin A1c < 8.0% and fasting blood glucose level < 160 mg/dL) allowed for part 2 only

Exclusion criteria:

  • History of clinically significant hypoglycemia or hyperglycemia (in the opinion of the investigator)
  • Myocardial infarction within the past year
  • Unstable or uncontrolled disease/condition related to or impacting cardiac function, including any of the following:

    • Unstable angina
    • Congestive heart failure
    • NYHA class III or IV heart disease
    • Uncontrolled hypertension (diastolic BP > 90 mm Hg and systolic BP > 150 mm Hg)
    • Clinically significant cardiac arrhythmia
    • CTCAE version 3.0 ≥ grade 2
    • Clinically significant electrocardiogram abnormalities
  • History of arterial or venous (deep vein) thrombosis within the past year
  • History of bleeding diathesis
  • History of chronic hepatitis
  • History of HIV infection
  • Unable to tolerate intravenous administration
  • Known sensitivity to mammalian-derived products
  • ANC < 1,500/mm^3 (without filgrastim [G-CSF] support within the past 2 weeks)
  • Platelet count < 100,000/mm^3 (without transfusion within the past 2 weeks)
  • Hemoglobin < 9 g/dL (without transfusion within the past 4 weeks)
  • PT/PTT > 1.5 x upper limit of normal (ULN)
  • Serum creatinine > 1.5 x ULN
  • AST and ALT > 2.5 x ULN
  • Total bilirubin > 1.5 x ULN
  • Urinary protein excretion > 1,000 mg/day (≥ 2+ using dipstick analysis)
  • Any kind of disorder that compromises the ability of the patient to give written informed consent and/or comply with study procedures
  • Any comorbid medical condition, that in the sponsor's or investigator's opinion, may put the patients at significant risk
  • Known sensitivity to any of the products to be administered during dosing
  • Unresolved toxicities > grade 1 from prior anticancer therapy, excluding alopecia

PRIOR CONCURRENT THERAPY:

  • No prior antitumor treatment within the past 28 days

    • Palliative external-beam radiotherapy to a lesion not used for RECIST measurement is acceptable during study for symptom management if patient is stable or improving and not progressing
  • At least 30 days since prior and no concurrent enrollment in another clinical trial involving medication
  • No antibody therapy for the treatment of underlying malignancy within the past 8 weeks
  • No concurrent or prior anticoagulation therapy, except low-dose warfarin (< 2 mg/day) for prophylaxis against central venous catheter thrombosis
  • No concurrent insulin (except diabetic patients enrolled in dose expansion [part 2] of the study)
  • No other concurrent investigational procedures
  • No concurrent blood or blood-product transfusions
  • No concurrent herbal medications
  • No other concurrent anticancer therapy including chemotherapy or hormonal therapy

    • Gonadotropic releasing-hormone agonists or antagonists allowed for advanced prostate cancer
  • No major surgery within the past month and none planned for 28 days after completion of study treatment

Sites / Locations

  • Vanderbilt-Ingram Cancer Center

Outcomes

Primary Outcome Measures

Safety
Pharmacokinetic profile

Secondary Outcome Measures

Level of insulin-like growth factor receptor-1 (IGF-1R) on peripheral blood cells
Tumor response measured by modified RECIST
Tumor glucose metabolism as measured by fludeoxyglucose F 18-PET/CT scan
Anti-AMG-479 antibody formation
The incidence of dose-limiting toxicities and the severity of adverse events
Levels of cross-linked c-telopeptides of type 1 collagen and bone-specific alkaline phosphatase (may also include tartrate-resistant acid phosphatase 5b) in blood
Circulating levels of IGF-1R and IGF-BP3

Full Information

First Posted
November 21, 2007
Last Updated
July 17, 2013
Sponsor
Amgen
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00562380
Brief Title
AMG-479 in Treating Patients With Advanced Solid Tumors or Non-Hodgkin Lymphoma
Official Title
A Phase 1, Open-Label, Dose Finding Study Evaluating the Safety and Pharmacokinetics of AMG 479 in Subjects With Advanced Solid Tumors
Study Type
Interventional

2. Study Status

Record Verification Date
April 2010
Overall Recruitment Status
Completed
Study Start Date
October 2005 (undefined)
Primary Completion Date
April 2010 (Actual)
Study Completion Date
June 2010 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Amgen
Collaborators
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
RATIONALE: Monoclonal antibodies, such as AMG-479, can block cancer growth in different ways. Some block the ability of cancer cells to grow and spread. Others find cancer cells and help kill them or carry cancer-killing substances to them. PURPOSE: This phase I trial is studying the side effects and best dose of AMG-479 in treating patients with advanced solid tumors or non-Hodgkin lymphoma.
Detailed Description
OBJECTIVES: Primary To assess the safety and pharmacokinetics of anti-IGF-1R fully human monoclonal antibody AMG-479 (AMG-479) after multiple intravenous administrations in adult patients with histologically documented advanced solid tumors that are refractory to standard therapy or for which no curative therapy is available. Secondary To assess the tolerability and to determine the maximum tolerated dose of AMG-479. To assess tumor glucose metabolism using PET/CT scanning with the tracer fludeoxyglucose F 18. To measure insulin-like growth factor receptor (IGF-1R) levels on peripheral blood cells. To establish whether human anti-human antibodies to AMG-479 develop in patients with advanced solid tumors. To measure the tumor response by modified Response Evaluation Criteria in Solid Tumors. Tertiary To investigate bone turnover markers. To investigate potential biomarker development by biochemical analysis in blood cells and tumor cells. OUTLINE: This is a multicenter study. Part 1 (dose-escalation): Patients receive escalating doses of anti-IGF-1R fully human monoclonal antibody AMG-479 (AMG-479) IV over 1 hour on days 1, 15, and 29. Patients are evaluated in week 8, and those who demonstrate an objective tumor response or stable disease continue treatment beginning on day 57. Treatment with AMG-479 repeats every 2 weeks in the absence of disease progression or unacceptable toxicity. Part 2 (randomized dose-expansion): Patients are randomized to one of two dose regimens. Arm I: Patients receive AMG-479 IV over 1 hour at a lower dose on day 1. Arm II: Patients receive AMG-479 IV over 1 hour at a higher dose on day 1. Treatment repeats every 14 days in the absence of disease progression or unacceptable toxicity. Tumor tissue is obtained at baseline and after 4 weeks of study therapy for biomarker analysis. Blood is drawn periodically for biomarker analysis (insulin-like growth factor [IGF]-1, IGF-binding protein 3 [IGF-BP3], IGF-1 receptor [IGF-1R], cross-linked c-telopeptides of type 1 collagen [CTx], bone-specific alkaline phosphatase [BSAP], and tartrate-resistant acid phosphatase [TRAP5b]) and pharmacokinetic studies. After completion of study therapy, patients are followed for at least 4 weeks.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Lymphoma, Prostate Cancer, Sarcoma, Small Intestine Cancer, Unspecified Adult Solid Tumor, Protocol Specific
Keywords
cutaneous B-cell non-Hodgkin lymphoma, angioimmunoblastic T-cell lymphoma, stage IV cutaneous T-cell non-Hodgkin lymphoma, adult nasal type extranodal NK/T-cell lymphoma, anaplastic large cell lymphoma, extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue, nodal marginal zone B-cell lymphoma, recurrent adult Burkitt lymphoma, recurrent adult diffuse large cell lymphoma, recurrent adult diffuse mixed cell lymphoma, recurrent adult diffuse small cleaved cell lymphoma, recurrent adult grade III lymphomatoid granulomatosis, recurrent adult immunoblastic large cell lymphoma, recurrent adult lymphoblastic lymphoma, recurrent cutaneous T-cell non-Hodgkin lymphoma, recurrent grade 1 follicular lymphoma, recurrent grade 2 follicular lymphoma, recurrent grade 3 follicular lymphoma, recurrent mantle cell lymphoma, recurrent marginal zone lymphoma, recurrent small lymphocytic lymphoma, small intestine lymphoma, splenic marginal zone lymphoma, unspecified adult solid tumor, protocol specific, recurrent Ewing sarcoma/peripheral primitive neuroectodermal tumor, adult desmoplastic small round cell tumor, recurrent adult soft tissue sarcoma, recurrent prostate cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Masking
None (Open Label)
Allocation
Randomized
Enrollment
64 (Anticipated)

8. Arms, Groups, and Interventions

Intervention Type
Biological
Intervention Name(s)
ganitumab
Intervention Type
Other
Intervention Name(s)
laboratory biomarker analysis
Intervention Type
Other
Intervention Name(s)
pharmacological study
Intervention Type
Procedure
Intervention Name(s)
biopsy
Primary Outcome Measure Information:
Title
Safety
Title
Pharmacokinetic profile
Secondary Outcome Measure Information:
Title
Level of insulin-like growth factor receptor-1 (IGF-1R) on peripheral blood cells
Title
Tumor response measured by modified RECIST
Title
Tumor glucose metabolism as measured by fludeoxyglucose F 18-PET/CT scan
Title
Anti-AMG-479 antibody formation
Title
The incidence of dose-limiting toxicities and the severity of adverse events
Title
Levels of cross-linked c-telopeptides of type 1 collagen and bone-specific alkaline phosphatase (may also include tartrate-resistant acid phosphatase 5b) in blood
Title
Circulating levels of IGF-1R and IGF-BP3

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Inclusion criteria: Histologically or cytologically confirmed advanced solid tumors or non-Hodgkin lymphoma that is refractory to standard treatment or for which no curative therapy is available Tumor tissue that is accessible for biopsy by using minimally invasive procedures and must consent to undergo biopsies of the tumor (part 2) Exception for patients with Ewing family tumors or desmoplastic small round cell tumors whose anatomic location would pose an increase in the risk of injury due to biopsy (i.e., bleeding or pneumothorax) Willing to provide existing and/or future paraffin-embedded tumor samples Exclusion criteria: Primary CNS tumors or hematological malignancies, other than non-Hodgkin lymphoma Primary hepatic tumors or at increased risk for hepatic tumors, including any of the following: Hepatitis of any etiology Alcohol abuse or dependency Hepatic adenoma Follicular nodular hyperplasia Autoimmune conditions associated with biliary tract cancer Alpha 1 antitrypsin deficiency Hemochromatosis History of vinyl chloride or thorotrast/thorium dioxide exposure History of histiocytic (Kupffer cell) neoplasia Presence of untreated or symptomatic CNS metastases or symptoms of brain metastases Presence of ascites or pleural effusion requiring medical intervention PATIENT CHARACTERISTICS: Inclusion criteria: ECOG performance status ≤ 2 Not pregnant or nursing Fertile patients must use effective contraception Able to provide fasting blood samples for triglyceride and glucose laboratory tests Able to fast for 4-6 hours for fludeoxyglucose F18-PET/CT scan Controlled type 1 or 2 diabetes (defined as hemoglobin A1c < 8.0% and fasting blood glucose level < 160 mg/dL) allowed for part 2 only Exclusion criteria: History of clinically significant hypoglycemia or hyperglycemia (in the opinion of the investigator) Myocardial infarction within the past year Unstable or uncontrolled disease/condition related to or impacting cardiac function, including any of the following: Unstable angina Congestive heart failure NYHA class III or IV heart disease Uncontrolled hypertension (diastolic BP > 90 mm Hg and systolic BP > 150 mm Hg) Clinically significant cardiac arrhythmia CTCAE version 3.0 ≥ grade 2 Clinically significant electrocardiogram abnormalities History of arterial or venous (deep vein) thrombosis within the past year History of bleeding diathesis History of chronic hepatitis History of HIV infection Unable to tolerate intravenous administration Known sensitivity to mammalian-derived products ANC < 1,500/mm^3 (without filgrastim [G-CSF] support within the past 2 weeks) Platelet count < 100,000/mm^3 (without transfusion within the past 2 weeks) Hemoglobin < 9 g/dL (without transfusion within the past 4 weeks) PT/PTT > 1.5 x upper limit of normal (ULN) Serum creatinine > 1.5 x ULN AST and ALT > 2.5 x ULN Total bilirubin > 1.5 x ULN Urinary protein excretion > 1,000 mg/day (≥ 2+ using dipstick analysis) Any kind of disorder that compromises the ability of the patient to give written informed consent and/or comply with study procedures Any comorbid medical condition, that in the sponsor's or investigator's opinion, may put the patients at significant risk Known sensitivity to any of the products to be administered during dosing Unresolved toxicities > grade 1 from prior anticancer therapy, excluding alopecia PRIOR CONCURRENT THERAPY: No prior antitumor treatment within the past 28 days Palliative external-beam radiotherapy to a lesion not used for RECIST measurement is acceptable during study for symptom management if patient is stable or improving and not progressing At least 30 days since prior and no concurrent enrollment in another clinical trial involving medication No antibody therapy for the treatment of underlying malignancy within the past 8 weeks No concurrent or prior anticoagulation therapy, except low-dose warfarin (< 2 mg/day) for prophylaxis against central venous catheter thrombosis No concurrent insulin (except diabetic patients enrolled in dose expansion [part 2] of the study) No other concurrent investigational procedures No concurrent blood or blood-product transfusions No concurrent herbal medications No other concurrent anticancer therapy including chemotherapy or hormonal therapy Gonadotropic releasing-hormone agonists or antagonists allowed for advanced prostate cancer No major surgery within the past month and none planned for 28 days after completion of study treatment
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mace L. Rothenberg, MD, FACP
Organizational Affiliation
Vanderbilt-Ingram Cancer Center
Official's Role
Study Chair
Facility Information:
Facility Name
Vanderbilt-Ingram Cancer Center
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37232-6838
Country
United States

12. IPD Sharing Statement

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AMG-479 in Treating Patients With Advanced Solid Tumors or Non-Hodgkin Lymphoma

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