Ganetespib With Platinum, in Patients With Malignant Pleural Mesothelioma (MESO-02)
Primary Purpose
Lung Cancer - Malignant Pleural Mesothelioma
Status
Completed
Phase
Phase 1
Locations
United Kingdom
Study Type
Interventional
Intervention
Ganetespib
Sponsored by
About this trial
This is an interventional treatment trial for Lung Cancer - Malignant Pleural Mesothelioma
Eligibility Criteria
Inclusion Criteria:
- Histopathological confirmation of malignant pleural mesothelioma
- Measurable disease using meso-modified RECIST criteria (CT scan must be within 28 days of registration/randomisation)
- Performance status ECOG 0-1
- Age at least 18 years
Adequate haematological status:
- Haemoglobin 100g/L or greater
- Neutrophil count ≥2.0 x 10^9/L
- Platelets ≥100 x 10^9 /L
Adequate organ function:
- Bilirubin ≤1.5x ULN, ALP ≤2.5x ULN, ALT or AST ≤1.5x ULN
- Serum creatinine ≤1.5 x ULN or calculated creatinine clearance ≥ 60ml/min (C&G or EDTA)
- Chemotherapy naïve
- Negative serum pregnancy test for female patients of child bearing potential.
- Male subjects and women of child bearing potential must agree to use an acceptable method of birth control for the duration of the trial and for 6 months after the last trial treatment cycle has finished.
- Ability to understand and willing to sign the written informed consent to participate (including donation of diagnostic biopsy tissue for research)
- Ability to comply with the requirements of the protocol
Exclusion Criteria:
- Prior exposure to other investigational or commercial agents or therapies administered with the intent of treating the patient's malignancy. This includes crizotinib, other ALK-targeted agents, and any Hsp90 inhibitor (e.g. ganetespib). Prior valproic acid is acceptable but only if there has been at least 30 days wash-out period
- Evidence of CNS metastases that in the opinion of the investigator should receive local treatment prior to systemic cytotoxic chemotherapy
Uncontrolled intercurrent illness including but not limited to:
- Symptomatic neurological illness
- Active uncontrolled systemic infection considered opportunistic, life threatening or clinically significant at the time of treatment
- Significant pulmonary disease or hypoxia
- Psychiatric illness/social situations that would limit compliance with trial requirements
- Human immunodeficiency virus (HIV)-positive patients
- Known hepatitis B or C infection
- Uncontrolled diabetes mellitus
- Serum potassium, magnesium, and calcium levels no more than 10% outside the Sites normal reference ranges
Known serious cardiac illness including but not confined to:
- Clinically unstable cardiac disease, including unstable atrial fibrillation, symptomatic bradycardia, unstable congestive heart failure, active myocardial ischemia, or indwelling temporary pacemaker
- Ventricular tachycardia or a supraventricular tachycardia that requires treatment with a Class Ia anti-arrhythmic drug (e.g., quinidine, procainamide, disopyramide) or Class III anti-arrhythmic drug (e.g., sotalol, amiodarone, dofetilide). Use of other anti-arrhythmic drugs is permitted.
- Use of medications that have been linked to the occurrence of torsades de pointes
- Second- or third-degree atrioventricular (AV) block unless treated with a permanent pacemaker
- Complete left bundle branch block (LBBB)
- History of long QT Syndrome or a family member with this condition
- QTc >470ms (average of triplicate ECG recordings); a consistent method of QTc calculation must be used for each patient's QTc measurements. QTcF (Fridericia's formula) is preferred
- The patient has a history of prior malignant tumour, unless the patient has been without evidence of disease for at least three years, or the tumour was a non-melanoma skin tumour or in situ cervix carcinoma
- Pregnant women or those who are lactating
- Pre-planned surgery or procedures that would interfere with the conduct of the trial
- Patients who have had surgery (does not include pleurodesis or pleurectomy) within 28 days of randomisation should not be included
- Previous treatment of mesothelioma with systemic chemotherapy
- Receipt of extensive radiation therapy, systemic chemotherapy, or other anti-neoplastic therapy within 4 weeks before enrolment is not allowed. However, drain site radiotherapy is allowed
- Significant weight loss (≥10% body weight) within the 4 weeks prior to Cycle 1 Day 1.
- Patients who have had a yellow fever vaccination in the previous 30 days.
- Other medications, severe acute/chronic medical or psychiatric condition, or laboratory abnormality that may increase the risk associated with study participation or study drug administration, or may interfere with the interpretation of study results, and in the judgment of the investigator would make the subject inappropriate for entry into this study.
Sites / Locations
- UCL Cancer Trials Centre
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Experimental
Arm Label
Cisplatin/Pemetrexed
Carboplatin/Pemetrexed
Arm Description
Cisplatin 75mg/m2, Day 1 every 21 days Pemetrexed 500mg/m2, Day 1 every 21 days
Carboplatin AUC5, Day 1 every 21 days Pemetrexed 500mg/m2, Day 1 every 21 days
Outcomes
Primary Outcome Measures
Maximum Tolerated Dose of Ganetespib
Primary endpoint (phase I): Dose-limiting toxicities during Cycles 1 & 2; and number of cycles of pemetrexed-cisplatin given.
The Phase I trial will consist of three ganetespib dose cohorts, each with 3 or 6 patients:
Cohort 1: 100mg/m2 IV on day 1 and day 15 of each cycle
Cohort 2: 150mg/m2 IV on day 1 and day 15 of each cycle
Cohort 3: 200mg/m2 IV on day 1 and day 15 of each cycle
There will be additional patients to be treated with carboplatin (AUC5) instead of cisplatin. If treatment with carboplatin is confirmed to be safe and tolerable, the option of treating patients with either cisplatin or carboplatin during phase II will be taken. The evaluation will be done using an accelerated titrated phase I design.
Primary endpoint (phase II): Progression free survival
Secondary Outcome Measures
Progression Free Survival
Secondary endpoints (phase I):
To examine the number of cycles of pemetrexed/platinum chemotherapy administered.
To examine the objective tumour response according to meso-modified RECIST, and the overall response rate.
Secondary endpoints (phase II):
To examine the frequency of all Adverse Events graded by NCI-CTCAE version 4, in particular those with grade 3 or 4 events.
To examine the objective tumour response according to meso-modified RECIST, and the overall response rate.
To examine overall survival.
Full Information
NCT ID
NCT01590160
First Posted
April 30, 2012
Last Updated
November 8, 2019
Sponsor
University College, London
Collaborators
Cancer Research UK
1. Study Identification
Unique Protocol Identification Number
NCT01590160
Brief Title
Ganetespib With Platinum, in Patients With Malignant Pleural Mesothelioma
Acronym
MESO-02
Official Title
A Phase I/II Study of First Line Ganetespib With Platinum, in Patients With Malignant Pleural Mesothelioma
Study Type
Interventional
2. Study Status
Record Verification Date
November 2019
Overall Recruitment Status
Completed
Study Start Date
August 2013 (Actual)
Primary Completion Date
November 5, 2019 (Actual)
Study Completion Date
November 5, 2019 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University College, London
Collaborators
Cancer Research UK
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
Malignant pleural mesothelioma (MPM) is a rapidly lethal cancer arising from the parietal pleural mesothelium, and is associated with exposure to asbestos.
Once a rare disease, it is increasing in incidence in the UK and is presently more common than cervical cancer. MPM is characterized by local invasion of adjacent structures including the chest wall, mediastinum, diaphragm and pericardium resulting in progressive shortness of breath.
Median survival with best supportive care alone is approximately 6-9 months and most cases of mesothelioma present in the advanced setting. Therefore this trial will be looking at whether a new drug, Ganetespib has any improvement on survival for these types of patients.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Lung Cancer - Malignant Pleural Mesothelioma
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
27 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Cisplatin/Pemetrexed
Arm Type
Experimental
Arm Description
Cisplatin 75mg/m2, Day 1 every 21 days Pemetrexed 500mg/m2, Day 1 every 21 days
Arm Title
Carboplatin/Pemetrexed
Arm Type
Experimental
Arm Description
Carboplatin AUC5, Day 1 every 21 days Pemetrexed 500mg/m2, Day 1 every 21 days
Intervention Type
Drug
Intervention Name(s)
Ganetespib
Intervention Description
IV, Using dose from Phase I
Primary Outcome Measure Information:
Title
Maximum Tolerated Dose of Ganetespib
Description
Primary endpoint (phase I): Dose-limiting toxicities during Cycles 1 & 2; and number of cycles of pemetrexed-cisplatin given.
The Phase I trial will consist of three ganetespib dose cohorts, each with 3 or 6 patients:
Cohort 1: 100mg/m2 IV on day 1 and day 15 of each cycle
Cohort 2: 150mg/m2 IV on day 1 and day 15 of each cycle
Cohort 3: 200mg/m2 IV on day 1 and day 15 of each cycle
There will be additional patients to be treated with carboplatin (AUC5) instead of cisplatin. If treatment with carboplatin is confirmed to be safe and tolerable, the option of treating patients with either cisplatin or carboplatin during phase II will be taken. The evaluation will be done using an accelerated titrated phase I design.
Primary endpoint (phase II): Progression free survival
Time Frame
6 Months
Secondary Outcome Measure Information:
Title
Progression Free Survival
Description
Secondary endpoints (phase I):
To examine the number of cycles of pemetrexed/platinum chemotherapy administered.
To examine the objective tumour response according to meso-modified RECIST, and the overall response rate.
Secondary endpoints (phase II):
To examine the frequency of all Adverse Events graded by NCI-CTCAE version 4, in particular those with grade 3 or 4 events.
To examine the objective tumour response according to meso-modified RECIST, and the overall response rate.
To examine overall survival.
Time Frame
24 Months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Histopathological confirmation of malignant pleural mesothelioma
Measurable disease using meso-modified RECIST criteria (CT scan must be within 28 days of registration/randomisation)
Performance status ECOG 0-1
Age at least 18 years
Adequate haematological status:
Haemoglobin 100g/L or greater
Neutrophil count ≥2.0 x 10^9/L
Platelets ≥100 x 10^9 /L
Adequate organ function:
Bilirubin ≤1.5x ULN, ALP ≤2.5x ULN, ALT or AST ≤1.5x ULN
Serum creatinine ≤1.5 x ULN or calculated creatinine clearance ≥ 60ml/min (C&G or EDTA)
Chemotherapy naïve
Negative serum pregnancy test for female patients of child bearing potential.
Male subjects and women of child bearing potential must agree to use an acceptable method of birth control for the duration of the trial and for 6 months after the last trial treatment cycle has finished.
Ability to understand and willing to sign the written informed consent to participate (including donation of diagnostic biopsy tissue for research)
Ability to comply with the requirements of the protocol
Exclusion Criteria:
Prior exposure to other investigational or commercial agents or therapies administered with the intent of treating the patient's malignancy. This includes crizotinib, other ALK-targeted agents, and any Hsp90 inhibitor (e.g. ganetespib). Prior valproic acid is acceptable but only if there has been at least 30 days wash-out period
Evidence of CNS metastases that in the opinion of the investigator should receive local treatment prior to systemic cytotoxic chemotherapy
Uncontrolled intercurrent illness including but not limited to:
Symptomatic neurological illness
Active uncontrolled systemic infection considered opportunistic, life threatening or clinically significant at the time of treatment
Significant pulmonary disease or hypoxia
Psychiatric illness/social situations that would limit compliance with trial requirements
Human immunodeficiency virus (HIV)-positive patients
Known hepatitis B or C infection
Uncontrolled diabetes mellitus
Serum potassium, magnesium, and calcium levels no more than 10% outside the Sites normal reference ranges
Known serious cardiac illness including but not confined to:
Clinically unstable cardiac disease, including unstable atrial fibrillation, symptomatic bradycardia, unstable congestive heart failure, active myocardial ischemia, or indwelling temporary pacemaker
Ventricular tachycardia or a supraventricular tachycardia that requires treatment with a Class Ia anti-arrhythmic drug (e.g., quinidine, procainamide, disopyramide) or Class III anti-arrhythmic drug (e.g., sotalol, amiodarone, dofetilide). Use of other anti-arrhythmic drugs is permitted.
Use of medications that have been linked to the occurrence of torsades de pointes
Second- or third-degree atrioventricular (AV) block unless treated with a permanent pacemaker
Complete left bundle branch block (LBBB)
History of long QT Syndrome or a family member with this condition
QTc >470ms (average of triplicate ECG recordings); a consistent method of QTc calculation must be used for each patient's QTc measurements. QTcF (Fridericia's formula) is preferred
The patient has a history of prior malignant tumour, unless the patient has been without evidence of disease for at least three years, or the tumour was a non-melanoma skin tumour or in situ cervix carcinoma
Pregnant women or those who are lactating
Pre-planned surgery or procedures that would interfere with the conduct of the trial
Patients who have had surgery (does not include pleurodesis or pleurectomy) within 28 days of randomisation should not be included
Previous treatment of mesothelioma with systemic chemotherapy
Receipt of extensive radiation therapy, systemic chemotherapy, or other anti-neoplastic therapy within 4 weeks before enrolment is not allowed. However, drain site radiotherapy is allowed
Significant weight loss (≥10% body weight) within the 4 weeks prior to Cycle 1 Day 1.
Patients who have had a yellow fever vaccination in the previous 30 days.
Other medications, severe acute/chronic medical or psychiatric condition, or laboratory abnormality that may increase the risk associated with study participation or study drug administration, or may interfere with the interpretation of study results, and in the judgment of the investigator would make the subject inappropriate for entry into this study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Professor D Fennell, MBBS
Organizational Affiliation
University of Leicester & Leicester University Hospitals
Official's Role
Study Chair
Facility Information:
Facility Name
UCL Cancer Trials Centre
City
London
ZIP/Postal Code
W1T 4TJ
Country
United Kingdom
12. IPD Sharing Statement
Citations:
PubMed Identifier
32669375
Citation
Fennell DA, Danson S, Woll PJ, Forster M, Talbot D, Child J, Farrelly L, Sharkey A, Busacca S, Ngai Y, Hackshaw A, Wheeler GM. Ganetespib in Combination with Pemetrexed-Platinum Chemotherapy in Patients with Pleural Mesothelioma (MESO-02): A Phase Ib Trial. Clin Cancer Res. 2020 Sep 15;26(18):4748-4755. doi: 10.1158/1078-0432.CCR-20-1306. Epub 2020 Jul 15.
Results Reference
derived
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Ganetespib With Platinum, in Patients With Malignant Pleural Mesothelioma
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