COAST Therapy in Advanced Solid Tumors and Prostate Cancer (COAST)
Primary Purpose
Prostate Cancer Recurrent, Solid Tumor, Adult
Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Hydroxychloroquine, Metformin, Sirolimus
Hydroxychloroquine, Metformin, Sirolimus, Dasatanib
Hydroxychloroquine, Metformin, Sirolimus, Nelfinavir
Hydroxychloroquine, Metformin, Sirolimus, Nelfinavir, Dasatinib
Hydroxychloroquine, Metformin, Sirolimus, Nelfinavir
Hydroxychloroquine, Metformin, Sirolimus, Nelfinavir, Dasatinib
Sponsored by
About this trial
This is an interventional treatment trial for Prostate Cancer Recurrent
Eligibility Criteria
Inclusion Criteria:
- Patient must have advanced solid tumor cancer of any type (Phase I) or advanced prostate cancer (Phase II).
- Tissue diagnosis documented by pathology report, or clinic note attesting to same.
- Measurable / evaluable tumor by RECIST, quantitative blood biomarker, or radionuclide imaging
- Voluntary, signed and dated, Institutional Review Board (IRB) approved consent form in accordance with regulatory and institutional guidelines.
- Documented progression of disease during treatment with one or more standard systemic regimens. Single or multiple regimens of chemotherapy, hormone suppression therapy, radiation therapy, surgery, immunotherapy, or adoptive cell therapy are allowed.
- 18 years of age or older.
- ECOG performance status of 0-2.
- Bilirubin ≤ 1.5 times upper limit of normal (ULN) and AST / ALT ≤ 3 times ULN. Subjects with Gilbert's syndrome may be included if the total bilirubin is < 3 times ULN and the direct bilirubin is within normal limits.
- Serum creatinine ≤ 1.5 times ULN.
- Absolute neutrophil count (ANC) ≥ 1,000 cells / mm3
- Platelet count ≥ 75,000 cells / mm3
- Hemoglobin ≥ 9 g/ dL.
- Fasting glucose ≤ 160 mg/dL or non-fasting glucose ≤ 200 mg/dL.
- Urinalysis with no clinically significant abnormalities.
- Adequately controlled blood pressure as determined by the treating investigator.
- Subjects with the potential to produce children must agree to effective contraceptive method use during study participation.
- Patients requiring narcotic analgesics must be on stable doses for at least 2 weeks prior to study entry.
- Patients being considered for a dose level containing nelfinavir mesylate must discontinue any statin use within 48 hours of beginning study treatment.
Exclusion Criteria:
- New York Heart Association Class III or IV, cardiac disease, myocardial infarction within the past 6 months, unstable arrhythmia, or history of ischemia on ECG.
- Underlying psychiatric disorder requiring hospitalization within the last two years.
- Clinically significant neurological disorder (Parkinson's disease, dementia, multiple sclerosis), as determined by the enrolling investigator.
- Active, uncontrolled bacterial, viral, or fungal infection, requiring systemic therapy.
- Treatment with local or systemic radiation therapy, surgery, or investigational therapy within 28 days prior to registration.
- Unwillingness or inability to comply with procedures required in this protocol.
- Serious nonmalignant disease that could compromise protocol objectives in the opinion of the Investigator.
- Patients who are receiving, coumadin, apixaban, argatroban or rivaroxaban.
- Patients who are currently participating in any other clinical trial of an investigational product.
- Any other mental incapacitation or psychiatric illness that would preclude study participation, as determined by the enrolling investigator.
- Prisoners or patients who are compulsorily detained (involuntarily incarcerated) for treatment of either a psychiatric or physical (e.g., infectious disease) illness must not be enrolled into this study.
Sites / Locations
- Medical University of South CarolinaRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Arm 6
Arm Type
Experimental
Experimental
Experimental
Experimental
Experimental
Experimental
Arm Label
Dose level 1
Dose level 2a
Dose level 2b
Dose level 3a
Dose level 3b
Dose level 4
Arm Description
Outcomes
Primary Outcome Measures
Maximum Tolerated Dose (MTD) - Phase I
Maximum dose achievable without dose limiting toxicities (DLT's)
Measure of proportion of patients with disease control - Phase II
Stable disease by RECIST or PCWG3 criteria after 16 weeks of treatment on study.
Secondary Outcome Measures
Change in Quality of Life (QOL) score
To document the change in QOL (via disease-specific FACT questionnaire, composite score) in patients treated with COAST) after two and four cycles of treatment
Full Information
NCT ID
NCT05036226
First Posted
August 30, 2021
Last Updated
April 17, 2023
Sponsor
Medical University of South Carolina
1. Study Identification
Unique Protocol Identification Number
NCT05036226
Brief Title
COAST Therapy in Advanced Solid Tumors and Prostate Cancer
Acronym
COAST
Official Title
Combination of Autophagy Selective Therapeutics (COAST) in Advanced Solid Tumors or Relapsed Prostate Cancer, A Phase I/II Trial
Study Type
Interventional
2. Study Status
Record Verification Date
April 2023
Overall Recruitment Status
Recruiting
Study Start Date
March 3, 2022 (Actual)
Primary Completion Date
October 15, 2024 (Anticipated)
Study Completion Date
October 15, 2025 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Medical University of South Carolina
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The purpose of this Phase I/II study is to determine the safety and effectiveness of up to 5 study drugs used together for the treatment of solid tumor cancers. The drugs are hydroxychloroquine, nelfinavir, metformin, dasatinib and sirolimus.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Prostate Cancer Recurrent, Solid Tumor, Adult
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
76 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Dose level 1
Arm Type
Experimental
Arm Title
Dose level 2a
Arm Type
Experimental
Arm Title
Dose level 2b
Arm Type
Experimental
Arm Title
Dose level 3a
Arm Type
Experimental
Arm Title
Dose level 3b
Arm Type
Experimental
Arm Title
Dose level 4
Arm Type
Experimental
Intervention Type
Combination Product
Intervention Name(s)
Hydroxychloroquine, Metformin, Sirolimus
Intervention Description
Hydroxychloroquine 600mg twice daily Metformin 500mg daily for 7 days, then increase to 1000mg daily Sirolimus 0.5mg daily
Intervention Type
Combination Product
Intervention Name(s)
Hydroxychloroquine, Metformin, Sirolimus, Dasatanib
Intervention Description
Hydroxychloroquine 600mg twice daily Metformin 500mg daily for 7 days, then increase to 1000mg daily Sirolimus 0.5mg daily Dasatinib 20mg daily
Intervention Type
Combination Product
Intervention Name(s)
Hydroxychloroquine, Metformin, Sirolimus, Nelfinavir
Intervention Description
Hydroxychloroquine 600mg twice daily Metformin 500mg daily for 7 days, then increase to 1000mg daily Sirolimus 0.5mg daily Nelfinavir 1250mg twice daily
Intervention Type
Combination Product
Intervention Name(s)
Hydroxychloroquine, Metformin, Sirolimus, Nelfinavir, Dasatinib
Intervention Description
Hydroxychloroquine 600mg twice daily Metformin 500mg daily for 7 days, then increase to 1000mg daily Sirolimus 0.5mg daily Nelfinavir 1250mg twice daily Dasatanib 20mg daily
Intervention Type
Combination Product
Intervention Name(s)
Hydroxychloroquine, Metformin, Sirolimus, Nelfinavir
Intervention Description
Hydroxychloroquine 600mg twice daily Metformin 500mg daily for 7 days, then increase to 1000mg daily Sirolimus 0.5mg daily Nelfinavir 2500mg twice daily
Intervention Type
Combination Product
Intervention Name(s)
Hydroxychloroquine, Metformin, Sirolimus, Nelfinavir, Dasatinib
Intervention Description
Hydroxychloroquine 600mg twice daily Metformin 500mg daily for 7 days, then increase to 1000mg daily Sirolimus 0.5mg daily Nelfinavir 2500mg twice daily Dasatanib 20mg daily
Primary Outcome Measure Information:
Title
Maximum Tolerated Dose (MTD) - Phase I
Description
Maximum dose achievable without dose limiting toxicities (DLT's)
Time Frame
Minimum of 3 months after start of treatment on each dose level
Title
Measure of proportion of patients with disease control - Phase II
Description
Stable disease by RECIST or PCWG3 criteria after 16 weeks of treatment on study.
Time Frame
Minimum of 16 weeks after start of treatment, per patient
Secondary Outcome Measure Information:
Title
Change in Quality of Life (QOL) score
Description
To document the change in QOL (via disease-specific FACT questionnaire, composite score) in patients treated with COAST) after two and four cycles of treatment
Time Frame
Minimum of 16 weeks of treatment on study
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patient must have advanced solid tumor cancer of any type (Phase I) or advanced prostate cancer (Phase II).
Tissue diagnosis documented by pathology report, or clinic note attesting to same.
Measurable / evaluable tumor by RECIST, quantitative blood biomarker, or radionuclide imaging
Voluntary, signed and dated, Institutional Review Board (IRB) approved consent form in accordance with regulatory and institutional guidelines.
Documented progression of disease during treatment with one or more standard systemic regimens. Single or multiple regimens of chemotherapy, hormone suppression therapy, radiation therapy, surgery, immunotherapy, or adoptive cell therapy are allowed.
18 years of age or older.
ECOG performance status of 0-2.
Bilirubin ≤ 1.5 times upper limit of normal (ULN) and AST / ALT ≤ 3 times ULN. Subjects with Gilbert's syndrome may be included if the total bilirubin is < 3 times ULN and the direct bilirubin is within normal limits.
Serum creatinine ≤ 1.5 times ULN.
Absolute neutrophil count (ANC) ≥ 1,000 cells / mm3
Platelet count ≥ 75,000 cells / mm3
Hemoglobin ≥ 9 g/ dL.
Fasting glucose ≤ 160 mg/dL or non-fasting glucose ≤ 200 mg/dL.
Urinalysis with no clinically significant abnormalities.
Adequately controlled blood pressure as determined by the treating investigator.
Subjects with the potential to produce children must agree to effective contraceptive method use during study participation.
Patients requiring narcotic analgesics must be on stable doses for at least 2 weeks prior to study entry.
Patients being considered for a dose level containing nelfinavir mesylate must discontinue any statin use within 48 hours of beginning study treatment.
Exclusion Criteria:
New York Heart Association Class III or IV, cardiac disease, myocardial infarction within the past 6 months, unstable arrhythmia, or history of ischemia on ECG.
Underlying psychiatric disorder requiring hospitalization within the last two years.
Clinically significant neurological disorder (Parkinson's disease, dementia, multiple sclerosis), as determined by the enrolling investigator.
Active, uncontrolled bacterial, viral, or fungal infection, requiring systemic therapy.
Treatment with local or systemic radiation therapy, surgery, or investigational therapy within 28 days prior to registration.
Unwillingness or inability to comply with procedures required in this protocol.
Serious nonmalignant disease that could compromise protocol objectives in the opinion of the Investigator.
Patients who are receiving, coumadin, apixaban, argatroban or rivaroxaban.
Patients who are currently participating in any other clinical trial of an investigational product.
Any other mental incapacitation or psychiatric illness that would preclude study participation, as determined by the enrolling investigator.
Prisoners or patients who are compulsorily detained (involuntarily incarcerated) for treatment of either a psychiatric or physical (e.g., infectious disease) illness must not be enrolled into this study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Alan Brisendine
Phone
843-792-9007
Email
brisend@musc.edu
First Name & Middle Initial & Last Name or Official Title & Degree
Jasmin Brooks
Email
brooksjm@musc.edu
Facility Information:
Facility Name
Medical University of South Carolina
City
Charleston
State/Province
South Carolina
ZIP/Postal Code
29425
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Alan Brisendine
Phone
843-792-9007
Email
brisend@musc.edu
First Name & Middle Initial & Last Name & Degree
Jasmin Brooks
Email
brooksjm@musc.edu
First Name & Middle Initial & Last Name & Degree
Michael B Lilly, MD
First Name & Middle Initial & Last Name & Degree
Joe Delaney, MD
12. IPD Sharing Statement
Learn more about this trial
COAST Therapy in Advanced Solid Tumors and Prostate Cancer
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