EMD 521873 in Advanced Solid Tumors, MTD Finding
Primary Purpose
Non-Hodgkin Lymphoma
Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
EMD 521873
EMD 521873
EMD 521873
Sponsored by
About this trial
This is an interventional treatment trial for Non-Hodgkin Lymphoma focused on measuring Solid tumor, B-Cell Non-Hodgkin Lymphoma, Immunocytokine, interleukin-2, immunotherapy, Metastatic or Locally Advanced Solid Tumors or B-Cell Non-Hodgkin Lymphoma
Eligibility Criteria
Inclusion Criteria:
- Signed written informed consent
- Male or female, aged ≥ 18 years, inpatient for treatment phase of cycle 1 and 2, outpatient treatment possible for subsequent cycles
- Histologically or cytologically proven metastatic or locally advanced solid tumors (epithelial or mesenchymal cancers) or B-cell non-Hodgkin lymphoma for which no standard therapy exists or after failure of standard therapy
- Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1 at study entry and an estimated life expectancy of at least 3 months
- Adequate hematological function defined by WBC count ≥ 3 x 109/L with absolute neutrophil count (ANC) ≥ 1.5 x 109/L and lymphocyte count ≥ 0.5 x 109/L; platelet count ≥100 x 109/L; hemoglobin ≥9 g/dL ( If the laboratory values for hemoglobin are outside the required entry level at Screening, a patient may receive a transfusion of RBC. A stable hemoglobin level of ≥9 mg/dL for at least 7 days must be achieved prior to receiving the first dose of study medication.)
- Adequate hepatic function defined by a total bilirubin level ≤ 1.5 times the upper limit of normal (ULN) and aspartate-aminotransferase (AST) and alanine-aminotransferase (ALT) levels ≤ 2.5 x ULN or, for patients with documented metastatic disease to the liver, AST and ALT levels ≤ 5 x ULN
- No history of acute or chronic kidney disease and adequate renal function defined by an estimated creatinine clearance above 50 mL/min determined by 24-hour urine sampling or by the Cockcroft-Gault formula
- Effective contraception for both male and female subjects if the risk of conception exists
Exclusion Criteria:
- Prior IL-2 therapy within the last 6 months
- Requirement for concurrent anticancer treatment (chemotherapy, radiotherapy, immune therapy, cytokine therapy except erythropoietin) or for concurrent systemic therapy with steroids or other immunosuppressive agents. Short-term administration of steroids (i.e. for allergic reactions) is allowed.
- Radiotherapy, chemotherapy, surgery (excluding prior diagnostic biopsy) or any investigational drug in the 30 days before the start of treatment in this study
- Acquired immune defects such as human immunodeficiency virus (HIV)
- Systemic autoimmune disease (e.g. lupus erythematodes, rheumatoid arthritis, Addison's disease, autoimmune disease associated with lymphoma)
- Organ transplant recipients
- History of or active inflammatory bowel disease (e.g. Crohn's disease, ulcerative colitis)
- Chronic viral infections (e.g. hepatitis B virus [HBV], hepatitis C virus [HCV])
- Uncontrolled hypertension (systolic >180 mmHg, diastolic >100 mmHg)
- Known hypersensitivity reactions to any of the compounds of the study medication
- Confirmed or clinically suspected brain metastases
- Pregnancy (absence to be confirmed by beta-human chorionic gonadotropin [β-HCG] test) or lactation period
- Clinically significant (i.e. active) cardiovascular disease: Cerebral vascular accident /stroke (< 6 months prior to enrolment), myocardial infarction (< 6 months prior to enrolment), unstable angina, congestive heart failure or serious cardiac arrhythmia requiring medication.
- Pulmonary disease which, in the opinion of the investigator, might impair the patient's respiratory tolerance to moderate pulmonary fluid overload (e.g. interstitial lung disease, severe chronic obstructive pulmonary disease)
- All conditions which are associated with significant necroses of non tumor-bearing tissues like e.g. esophageal or gastroduodenal ulcers (< 6 months prior to enrolment), organ infarctions (< 6 months prior to enrolment) or active ischemic bowel disease
- Presence of medically significant third space fluid (pericardial effusion or ascites/ pleural infusion requiring repetitive paracentesis)
- Known alcohol or drug abuse
- Participation in another clinical trial within the past 30 days before start of study treatment
- All other significant diseases which, in the opinion of the investigator, might impair the patient's tolerance of study treatment.
- Dementia, altered mental status, or any psychiatric condition that would prohibit the understanding or rendering of informed consent
Sites / Locations
- Universitäts-Klinikum Mainz III.Medizinische Klinik
- Medizinische Klinik Universitätsklinikum Mannheim Medizinische Fakultät Mannheim
- Istituto Oncologico della Svizzera Italiana Ospedale Regionale Bellinzona e Valli (IOSI)
- University of Lausanne Hospitals (CHUV) and Hospitals of Riveria-Chablais
- Kantonsspital St. Gallen
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Experimental
Experimental
Experimental
Arm Label
Group 1
Group 2
Group 3
Arm Description
Dose escalation of EMD 521873 monotheraphy 3 doses per cycle
Low dose CPA + Dose escalation of EMD 521873 three doses per cycle
Dose escalation of EMD 521873 monotheraphy 1 dose per cycle
Outcomes
Primary Outcome Measures
Assess the safety and tolerability of EMD 521873
To determine whether the MTD is reached with EMD 521873 doses of up to 1.5 mg/kg given alone or in combination with fixed, low-dose CPA in patients with metastatic or locally advanced solid tumors or B-cell non-Hodgkin lymphoma
Secondary Outcome Measures
Characterize the PK profile of EMD 521873 alone or in combination with fixed lowdose CPA
Evaluate the immunogenicity of EMD 521873 alone or in combination with CPA measured by the induction of o Specific antibodies against the genetically modified IL-2 o Fc-IL2-specific antibodies o Anti-idiotype antibodies
Collect evidence of best overall response, changes in serum tumor marker levels and best clinical response after treatment with EMD 521873 alone or in combination with CPA
Evaluate survival
Evaluate biological responses to EMD 521873 alone or in combination with CPA as measured by o Absolute cell numbers and ratios of lymphocyte subsets in defined combinations o Change in serum level of sIL2R and neopterin
Full Information
NCT ID
NCT01032681
First Posted
December 11, 2009
Last Updated
July 30, 2014
Sponsor
Merck KGaA, Darmstadt, Germany
1. Study Identification
Unique Protocol Identification Number
NCT01032681
Brief Title
EMD 521873 in Advanced Solid Tumors, MTD Finding
Official Title
A Phase 1, Open-Label, Two-Group, Dose- Escalation Study to Investigate the Safety, Tolerability, Pharmacokinetics, Biological and Clinical Activity of EMD 521873 Alone and in Combination With Fixed Low Doses of Cyclophosphamide in Patients With Metastatic or Locally Advanced Solid Tumors or B-Cell Non-Hodgkin Lymphoma
Study Type
Interventional
2. Study Status
Record Verification Date
October 2012
Overall Recruitment Status
Completed
Study Start Date
December 2006 (undefined)
Primary Completion Date
February 2011 (Actual)
Study Completion Date
January 2012 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Merck KGaA, Darmstadt, Germany
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
Primary trial objective in this three arm trial is to assess the safety and tolerability of EMD 521873, and to determine whether the maximum tolerated dose (MTD) is reached with EMD 521873 doses of up to 1.5 mg/kg given alone or in combination with fixed, low-dose cyclophosphamide (CPA) in patients with metastatic or locally advanced solid tumors or B-cell non-Hodgkin lymphoma.
Secondary objectives are to evaluate pharmacokinetic, immunogenicity, overall and best clinical response, changes in tumor marker levels, survival and biological/immune responses to EMD 521873. A total of 78 patients are planned. Patients will remain on the dose throughout the trial. It is intended to administer 3 cycles (21 d each, or until progression or a xxx line therapy becomes necessary.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Non-Hodgkin Lymphoma
Keywords
Solid tumor, B-Cell Non-Hodgkin Lymphoma, Immunocytokine, interleukin-2, immunotherapy, Metastatic or Locally Advanced Solid Tumors or B-Cell Non-Hodgkin Lymphoma
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
66 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Group 1
Arm Type
Experimental
Arm Description
Dose escalation of EMD 521873 monotheraphy 3 doses per cycle
Arm Title
Group 2
Arm Type
Experimental
Arm Description
Low dose CPA + Dose escalation of EMD 521873 three doses per cycle
Arm Title
Group 3
Arm Type
Experimental
Arm Description
Dose escalation of EMD 521873 monotheraphy 1 dose per cycle
Intervention Type
Biological
Intervention Name(s)
EMD 521873
Intervention Description
Dose escalation steps:
Group 1: 0,075mg/kg - 0,15mg/kg - 0,225mg/kg - 0,3mg/kg - 0,45mg/kg - 0,6mg/kg - 0,9mg/kg (-1,8mg/kg - 2,1mg/kg - 2,5mg/kg - 3,0mg/kg)
Disease control and decision of continuation in patient who benefit from the treatment:
Every second cycle
Intervention Type
Biological
Intervention Name(s)
EMD 521873
Intervention Description
Dose escalation steps:
Group 2: CPA plus 0,6mg/kg - 0,9mg/kg
Disease control and decision of continuation in patient who benefit from the treatment:
Every second cycle
Intervention Type
Biological
Intervention Name(s)
EMD 521873
Intervention Description
Dose escalation steps:
Group 3: 0,9mg/kg - 1,2mg/kg - 1,5mg/kg (-1,8mg/kg - 2,1mg/kg - 2,5mg/kg - 3,0mg/kg)
Disease control and decision of continuation in patient who benefit from the treatment:
Every second cycle
Primary Outcome Measure Information:
Title
Assess the safety and tolerability of EMD 521873
Time Frame
First administration of any dose of EMD521873 until last administration plus 30 days.
Title
To determine whether the MTD is reached with EMD 521873 doses of up to 1.5 mg/kg given alone or in combination with fixed, low-dose CPA in patients with metastatic or locally advanced solid tumors or B-cell non-Hodgkin lymphoma
Time Frame
Incidence of DLTs occurring during the first cycle of administration of any dose of EMD 521873 given alone on 3 times per cycle (group 1) or with fixed low-dose CPA plus EMD 521873 (group 2) or of EMD 521873 given alone on once per cycle (group 3).
Secondary Outcome Measure Information:
Title
Characterize the PK profile of EMD 521873 alone or in combination with fixed lowdose CPA
Time Frame
Cycle 1-3 of EMD 521873 treatment
Title
Evaluate the immunogenicity of EMD 521873 alone or in combination with CPA measured by the induction of o Specific antibodies against the genetically modified IL-2 o Fc-IL2-specific antibodies o Anti-idiotype antibodies
Time Frame
Every EMD 521873 treatment cycle
Title
Collect evidence of best overall response, changes in serum tumor marker levels and best clinical response after treatment with EMD 521873 alone or in combination with CPA
Time Frame
Every second EMD 521873 treatment cycle
Title
Evaluate survival
Time Frame
Until 1 year after the last patient received his last dose of EMD 521873
Title
Evaluate biological responses to EMD 521873 alone or in combination with CPA as measured by o Absolute cell numbers and ratios of lymphocyte subsets in defined combinations o Change in serum level of sIL2R and neopterin
Time Frame
Cycle 1-3 of EMD 521873 treatment
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Signed written informed consent
Male or female, aged ≥ 18 years, inpatient for treatment phase of cycle 1 and 2, outpatient treatment possible for subsequent cycles
Histologically or cytologically proven metastatic or locally advanced solid tumors (epithelial or mesenchymal cancers) or B-cell non-Hodgkin lymphoma for which no standard therapy exists or after failure of standard therapy
Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1 at study entry and an estimated life expectancy of at least 3 months
Adequate hematological function defined by WBC count ≥ 3 x 109/L with absolute neutrophil count (ANC) ≥ 1.5 x 109/L and lymphocyte count ≥ 0.5 x 109/L; platelet count ≥100 x 109/L; hemoglobin ≥9 g/dL ( If the laboratory values for hemoglobin are outside the required entry level at Screening, a patient may receive a transfusion of RBC. A stable hemoglobin level of ≥9 mg/dL for at least 7 days must be achieved prior to receiving the first dose of study medication.)
Adequate hepatic function defined by a total bilirubin level ≤ 1.5 times the upper limit of normal (ULN) and aspartate-aminotransferase (AST) and alanine-aminotransferase (ALT) levels ≤ 2.5 x ULN or, for patients with documented metastatic disease to the liver, AST and ALT levels ≤ 5 x ULN
No history of acute or chronic kidney disease and adequate renal function defined by an estimated creatinine clearance above 50 mL/min determined by 24-hour urine sampling or by the Cockcroft-Gault formula
Effective contraception for both male and female subjects if the risk of conception exists
Exclusion Criteria:
Prior IL-2 therapy within the last 6 months
Requirement for concurrent anticancer treatment (chemotherapy, radiotherapy, immune therapy, cytokine therapy except erythropoietin) or for concurrent systemic therapy with steroids or other immunosuppressive agents. Short-term administration of steroids (i.e. for allergic reactions) is allowed.
Radiotherapy, chemotherapy, surgery (excluding prior diagnostic biopsy) or any investigational drug in the 30 days before the start of treatment in this study
Acquired immune defects such as human immunodeficiency virus (HIV)
Systemic autoimmune disease (e.g. lupus erythematodes, rheumatoid arthritis, Addison's disease, autoimmune disease associated with lymphoma)
Organ transplant recipients
History of or active inflammatory bowel disease (e.g. Crohn's disease, ulcerative colitis)
Chronic viral infections (e.g. hepatitis B virus [HBV], hepatitis C virus [HCV])
Uncontrolled hypertension (systolic >180 mmHg, diastolic >100 mmHg)
Known hypersensitivity reactions to any of the compounds of the study medication
Confirmed or clinically suspected brain metastases
Pregnancy (absence to be confirmed by beta-human chorionic gonadotropin [β-HCG] test) or lactation period
Clinically significant (i.e. active) cardiovascular disease: Cerebral vascular accident /stroke (< 6 months prior to enrolment), myocardial infarction (< 6 months prior to enrolment), unstable angina, congestive heart failure or serious cardiac arrhythmia requiring medication.
Pulmonary disease which, in the opinion of the investigator, might impair the patient's respiratory tolerance to moderate pulmonary fluid overload (e.g. interstitial lung disease, severe chronic obstructive pulmonary disease)
All conditions which are associated with significant necroses of non tumor-bearing tissues like e.g. esophageal or gastroduodenal ulcers (< 6 months prior to enrolment), organ infarctions (< 6 months prior to enrolment) or active ischemic bowel disease
Presence of medically significant third space fluid (pericardial effusion or ascites/ pleural infusion requiring repetitive paracentesis)
Known alcohol or drug abuse
Participation in another clinical trial within the past 30 days before start of study treatment
All other significant diseases which, in the opinion of the investigator, might impair the patient's tolerance of study treatment.
Dementia, altered mental status, or any psychiatric condition that would prohibit the understanding or rendering of informed consent
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jens-Peter Marschner, MD
Organizational Affiliation
Merck KGaA, Darmstadt, Germany
Official's Role
Study Director
Facility Information:
Facility Name
Universitäts-Klinikum Mainz III.Medizinische Klinik
City
Mainz
Country
Germany
Facility Name
Medizinische Klinik Universitätsklinikum Mannheim Medizinische Fakultät Mannheim
City
Mannheim
Country
Germany
Facility Name
Istituto Oncologico della Svizzera Italiana Ospedale Regionale Bellinzona e Valli (IOSI)
City
Bellinzona
Country
Switzerland
Facility Name
University of Lausanne Hospitals (CHUV) and Hospitals of Riveria-Chablais
City
Lausanne
Country
Switzerland
Facility Name
Kantonsspital St. Gallen
City
St.Gallen
Country
Switzerland
12. IPD Sharing Statement
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EMD 521873 in Advanced Solid Tumors, MTD Finding
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