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First-in-Human Safety, Tolerability and Antitumour Activity Study of MTL-CEBPA in Patients With Advanced Liver Cancer (OUTREACH)

Primary Purpose

Hepatocellular Carcinoma, Liver Cancer

Status
Unknown status
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
MTL-CEBPA
Sorafenib 200mg
Sponsored by
Mina Alpha Limited
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hepatocellular Carcinoma focused on measuring Oligonucleotide, RNA, saRNA, Sorafenib, Myeloid

Eligibility Criteria

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

Inclusion Criteria:

  • Histologically confirmed advanced HCC with cirrhosis resulting from hepatitis B, hepatitis C, alcohol-related liver disease or any other aetiology OR Histologically confirmed advanced HCC resulting from NASH with or without cirrhosis
  • Patient is considered unsuitable for liver tumour resection and/or is refractory to radiotherapy and other loco-regional therapies
  • At least one measurable lesion with target lesion size ≥ 1.0 cm as measured by MRI or CT
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0-1
  • Child-Pugh class A or B (up to B7)
  • Eligible to undergo pre and post treatment mandated biopsies
  • Acceptable laboratory parameters, as demonstrated by:

    • Platelets ≥ 70 x 10^9/L
    • Serum albumin > 26 g/L
    • ALT and AST ≤ 5 x ULN
    • Bilirubin ≤ 50 µmol /L
    • WBC ≥ 2.0 x 10^9/L, Absolute neutrophil count ≥ 1.5 x 109/L
    • Haemoglobin ≥ 9.0 g/dL
    • Prothrombin time (PT) <20 seconds
  • Acceptable renal function as demonstrated by:

    • Serum creatinine ≤ 1.5 x ULN
    • Calculated creatinine clearance ≥ 60 mL/min

Exclusion Criteria:

  • Patients who have been treated with TACE or chemotherapy within the last 28 days
  • Prior investigational drugs within the last 30 days
  • Grade > 1 prior treatment-related toxicities (excluding alopecia) at the time of screening
  • Patients with clinically significant cancer ascites
  • Any episode of bleeding from oesophageal varices or other uncontrolled bleeding within the last 3 months prior to study treatment initiation
  • Patients with history of haemorrhage or gastrointestinal perforation
  • Patients administered with serum albumin within the last 7 days prior to the first study drug administration
  • Known infection with human immunodeficiency virus (HIV)
  • Patients with central nervous system (CNS), bone or peritoneal metastasis
  • Patients presenting with marked baseline prolongation of QT/QTc interval defined as repeated demonstration of a QTc interval ≥450 ms (males) and ≥460 ms (females) using Fridericia's correction formula
  • Signs and symptoms of heart failure characterised as greater than the New York Heart Association (NYHA) Class I or other clinically significant cardiac abnormalities (including history of myocardial infarction) including stable abnormalities.
  • Major surgery within the last 30 days prior to study treatment initiation
  • Patients with history of organ transplantation or cardiac surgery
  • Patients with sepsis, ineffective biliary drainage with or without cholangitis, obstructive jaundice or encephalopathy at screening visit or within the last two weeks prior to study treatment initiation, whichever earlier
  • Evidence of spontaneous bacterial peritonitis or renal failure or allergic reactions to the agent or excipient at screening visit or within the last two weeks prior to study treatment initiation, whichever earlier
  • Known hypersensitivity to the active sorafenib or to any of the excipients
  • Occurrence of a grade 3 or higher sorafenib or lenvatinib related toxicity during any sorafenib / lenvatinib treatment received prior to study enrolment, according to toxicity criteria (NCI CTCAE v 5.0)
  • Pregnant or lactating women

Sites / Locations

  • National University Hospital
  • National Taiwan University Hospital
  • University Hospitals Birmingham NHS Foundation Trust
  • Cambridge University Hospitals NHS Trust
  • The Beatson West of Scotland Cancer Centre
  • Clatterbridge Cancer Centre NHS Foundation Trust
  • Guy's and St. Thomas' NHS Foundation Trust
  • Imperial College Healthcare NHS Trust
  • The Royal Free London NHS Foundation Trust
  • University College London Hospitals NHS Foundation Trust
  • Newcastle upon Tyne Hospitals NHS Foundation Trust

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

MTL-CEBPA Monotherapy

MTL-CEBPA & Sorafenib (combination)

MTL-CEBPA & Sorafenib (sequential)

Arm Description

MTL-CEBPA administered weekly, twice weekly or thrice weekly over 3 weeks followed by 1 week of rest defining a 28-day cycle.

MTL-CEBPA is administered weekly or twice weekly in combination with sorafenib over 3 weeks followed by 1 week of rest defining a 28-day cycle.

MTL-CEBPA is administered weekly or twice weekly for 2 cycles (28-day cycle) followed by 2 cycles of sorafenib

Outcomes

Primary Outcome Measures

Part 1- Incidence of Grade 3 or 4 drug related adverse events
Frequency of adverse events graded according to NCI CTCAE v5.0
Part 2 - Change in tumour size from baseline using RECIST 1.1 and mRECIST in patients treated with MTL-CEBPA in combination with sorafenib
Increase or decrease in tumour measurement using Response Evaluation Criteria in Solid Tumours (RECIST) reports

Secondary Outcome Measures

Part 2 - Safety and tolerability of co-administering MTL-CEBPA with sorafenib assessed using frequency of adverse events graded according to toxicity criteria (NCI CTCAE v 5.0) and categorised by body system
Frequency of treatment-related adverse events graded according to NCI CTCAE v5.0

Full Information

First Posted
March 11, 2016
Last Updated
April 4, 2022
Sponsor
Mina Alpha Limited
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1. Study Identification

Unique Protocol Identification Number
NCT02716012
Brief Title
First-in-Human Safety, Tolerability and Antitumour Activity Study of MTL-CEBPA in Patients With Advanced Liver Cancer
Acronym
OUTREACH
Official Title
A First-in-Human, Multi-centre, Open-label, Phase 1a/b Clinical Study With RNA Oligonucleotide Drug MTL-CEBPA to Investigate Its Safety, Tolerability, and Antitumour Activity in Patients With Advanced Liver Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
September 2021
Overall Recruitment Status
Unknown status
Study Start Date
March 1, 2016 (Actual)
Primary Completion Date
November 1, 2022 (Anticipated)
Study Completion Date
January 1, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Mina Alpha Limited

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
MNA-3521-011 study is a multi-centre, open-label, first-in-human, phase 1a/b clinical study dose/dose frequency escalation followed by a cohort expansion part. MTL-CEBPA is administered as monotherapy or in combination with sorafenib to patients with advanced hepatocellular carcinoma and cirrhosis of the liver. All participants will be considered unsuitable for liver tumour resection and/or is refractory to radiotherapy and other loco-regional therapies. MTL-CEBPA consists of a double stranded RNA formulated into a SMARTICLES® liposomal nanoparticle and is designed to activate the CEBPA gene.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hepatocellular Carcinoma, Liver Cancer
Keywords
Oligonucleotide, RNA, saRNA, Sorafenib, Myeloid

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
MTL-CEBPA Monotherapy
Arm Type
Experimental
Arm Description
MTL-CEBPA administered weekly, twice weekly or thrice weekly over 3 weeks followed by 1 week of rest defining a 28-day cycle.
Arm Title
MTL-CEBPA & Sorafenib (combination)
Arm Type
Experimental
Arm Description
MTL-CEBPA is administered weekly or twice weekly in combination with sorafenib over 3 weeks followed by 1 week of rest defining a 28-day cycle.
Arm Title
MTL-CEBPA & Sorafenib (sequential)
Arm Type
Experimental
Arm Description
MTL-CEBPA is administered weekly or twice weekly for 2 cycles (28-day cycle) followed by 2 cycles of sorafenib
Intervention Type
Drug
Intervention Name(s)
MTL-CEBPA
Intervention Description
Intravenous administration
Intervention Type
Drug
Intervention Name(s)
Sorafenib 200mg
Intervention Description
Sorafenib tablets
Primary Outcome Measure Information:
Title
Part 1- Incidence of Grade 3 or 4 drug related adverse events
Description
Frequency of adverse events graded according to NCI CTCAE v5.0
Time Frame
During cycle 1 (28 days) of treatment assessed over 15 months
Title
Part 2 - Change in tumour size from baseline using RECIST 1.1 and mRECIST in patients treated with MTL-CEBPA in combination with sorafenib
Description
Increase or decrease in tumour measurement using Response Evaluation Criteria in Solid Tumours (RECIST) reports
Time Frame
Eight weekly intervals until death assessed for 100 weeks
Secondary Outcome Measure Information:
Title
Part 2 - Safety and tolerability of co-administering MTL-CEBPA with sorafenib assessed using frequency of adverse events graded according to toxicity criteria (NCI CTCAE v 5.0) and categorised by body system
Description
Frequency of treatment-related adverse events graded according to NCI CTCAE v5.0
Time Frame
At the end of every cycle (28 days) of treatment assessed over 15 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
16 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically confirmed advanced HCC with cirrhosis resulting from hepatitis B, hepatitis C, alcohol-related liver disease or any other aetiology OR Histologically confirmed advanced HCC resulting from NASH with or without cirrhosis Patient is considered unsuitable for liver tumour resection and/or is refractory to radiotherapy and other loco-regional therapies At least one measurable lesion with target lesion size ≥ 1.0 cm as measured by MRI or CT Eastern Cooperative Oncology Group (ECOG) performance status of 0-1 Child-Pugh class A or B (up to B7) Eligible to undergo pre and post treatment mandated biopsies Acceptable laboratory parameters, as demonstrated by: Platelets ≥ 70 x 10^9/L Serum albumin > 26 g/L ALT and AST ≤ 5 x ULN Bilirubin ≤ 50 µmol /L WBC ≥ 2.0 x 10^9/L, Absolute neutrophil count ≥ 1.5 x 109/L Haemoglobin ≥ 9.0 g/dL Prothrombin time (PT) <20 seconds Acceptable renal function as demonstrated by: Serum creatinine ≤ 1.5 x ULN Calculated creatinine clearance ≥ 60 mL/min Exclusion Criteria: Patients who have been treated with TACE or chemotherapy within the last 28 days Prior investigational drugs within the last 30 days Grade > 1 prior treatment-related toxicities (excluding alopecia) at the time of screening Patients with clinically significant cancer ascites Any episode of bleeding from oesophageal varices or other uncontrolled bleeding within the last 3 months prior to study treatment initiation Patients with history of haemorrhage or gastrointestinal perforation Patients administered with serum albumin within the last 7 days prior to the first study drug administration Known infection with human immunodeficiency virus (HIV) Patients with central nervous system (CNS), bone or peritoneal metastasis Patients presenting with marked baseline prolongation of QT/QTc interval defined as repeated demonstration of a QTc interval ≥450 ms (males) and ≥460 ms (females) using Fridericia's correction formula Signs and symptoms of heart failure characterised as greater than the New York Heart Association (NYHA) Class I or other clinically significant cardiac abnormalities (including history of myocardial infarction) including stable abnormalities. Major surgery within the last 30 days prior to study treatment initiation Patients with history of organ transplantation or cardiac surgery Patients with sepsis, ineffective biliary drainage with or without cholangitis, obstructive jaundice or encephalopathy at screening visit or within the last two weeks prior to study treatment initiation, whichever earlier Evidence of spontaneous bacterial peritonitis or renal failure or allergic reactions to the agent or excipient at screening visit or within the last two weeks prior to study treatment initiation, whichever earlier Known hypersensitivity to the active sorafenib or to any of the excipients Occurrence of a grade 3 or higher sorafenib or lenvatinib related toxicity during any sorafenib / lenvatinib treatment received prior to study enrolment, according to toxicity criteria (NCI CTCAE v 5.0) Pregnant or lactating women
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Dr Debashis Sarker, MBChB, MRCP
Organizational Affiliation
Guy's and St Thomas' NHS Foundation Trust and King's College London
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Professor Nagy Habib, FRCS
Organizational Affiliation
Mina Alpha Limited
Official's Role
Study Director
Facility Information:
Facility Name
National University Hospital
City
Singapore
Country
Singapore
Facility Name
National Taiwan University Hospital
City
Taipei
Country
Taiwan
Facility Name
University Hospitals Birmingham NHS Foundation Trust
City
Birmingham
Country
United Kingdom
Facility Name
Cambridge University Hospitals NHS Trust
City
Cambridge
Country
United Kingdom
Facility Name
The Beatson West of Scotland Cancer Centre
City
Glasgow
Country
United Kingdom
Facility Name
Clatterbridge Cancer Centre NHS Foundation Trust
City
Liverpool
Country
United Kingdom
Facility Name
Guy's and St. Thomas' NHS Foundation Trust
City
London
Country
United Kingdom
Facility Name
Imperial College Healthcare NHS Trust
City
London
Country
United Kingdom
Facility Name
The Royal Free London NHS Foundation Trust
City
London
Country
United Kingdom
Facility Name
University College London Hospitals NHS Foundation Trust
City
London
Country
United Kingdom
Facility Name
Newcastle upon Tyne Hospitals NHS Foundation Trust
City
Newcastle
Country
United Kingdom

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
32357963
Citation
Sarker D, Plummer R, Meyer T, Sodergren MH, Basu B, Chee CE, Huang KW, Palmer DH, Ma YT, Evans TRJ, Spalding DRC, Pai M, Sharma R, Pinato DJ, Spicer J, Hunter S, Kwatra V, Nicholls JP, Collin D, Nutbrown R, Glenny H, Fairbairn S, Reebye V, Voutila J, Dorman S, Andrikakou P, Lloyd P, Felstead S, Vasara J, Habib R, Wood C, Saetrom P, Huber HE, Blakey DC, Rossi JJ, Habib N. MTL-CEBPA, a Small Activating RNA Therapeutic Upregulating C/EBP-alpha, in Patients with Advanced Liver Cancer: A First-in-Human, Multicenter, Open-Label, Phase I Trial. Clin Cancer Res. 2020 Aug 1;26(15):3936-3946. doi: 10.1158/1078-0432.CCR-20-0414. Epub 2020 May 1.
Results Reference
derived
Links:
URL
http://minatx.com
Description
Company Webpage

Learn more about this trial

First-in-Human Safety, Tolerability and Antitumour Activity Study of MTL-CEBPA in Patients With Advanced Liver Cancer

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