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Ifetroban in Treating Patients With Malignant Solid Tumors at High Risk of Metastatic Recurrence

Primary Purpose

Malignant Solid Tumor

Status
Recruiting
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Ifetroban Sodium
Placebo
Sponsored by
Vanderbilt-Ingram Cancer Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Malignant Solid Tumor

Eligibility Criteria

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

Inclusion Criteria:

  • Signed and dated written informed consent.
  • Subjects ≥ 18 years of age
  • Eastern Cooperative Oncology Group (ECOG) performance status 0, 1 or 2
  • Current diagnosis of any stage I to III malignant solid tumor at high risk of metastatic recurrence (deemed by treating physician as patients with ≥ 50% chance of cancer metastatic recurrence within 5 years of diagnosis)
  • Patients must have completed all standard locoregional and systemic therapy for their cancer within 120 days of study enrollment.
  • Administration of an investigational agent prior to enrollment needs to be completed at least 30 days prior to enrollment
  • Patients must have recovered (≤ grade 1 toxicities or grade 2 toxicities well managed with optimal medical care) from effects of local (surgery, radiation) or systemic treatments.
  • Platelet count ≥ 100,000 per mL of blood
  • Hemoglobin ≥ 9/g/dL (may have been transfused)
  • Serum creatinine ≤ 1.5 x ULN or estimated creatinine clearance ≥ 50 mL/min as calculated using the Cockcroft-Gault (CG) equation
  • Total serum bilirubin ≤ 1.5 times upper limit of normal (ULN)
  • Aspartate aminotransferase (AST/SGOT) and alanine aminotransferase (ALT/SGPT) ≤ 2.5 × ULN
  • INR below upper limit of normal (ULN)
  • Female patients of childbearing potential and non-sterile males must agree to use at least two methods of acceptable contraception from 15 days prior to first trial treatment administration until at least 5 months after study participant's final dose of study drug

Note: Females of childbearing potential are defined as those who are not surgically sterile or post-menopausal (i.e. patient has not had a bilateral tubal ligation, a bilateral oophorectomy, or a complete hysterectomy; or has not been amenorrheic for 12 months without an alternative medical cause). Post-menopausal status in females under 55 years of age should be confirmed with a serum follicle-stimulating hormone (FSH) level within laboratory reference range for postmenopausal women. Non-sterile males are those who have not had a vasectomy with documentation of the absence of sperm in the ejaculate.

  • Patients unable to read/write in English are eligible to participate in the overall study but will not participate in the Patient-Reported Outcome questionnaires throughout the trial.
  • Re-enrollment of a subject that has discontinued the study as a pre-treatment screen failure (i.e. a consented patient who did not receive study drugs) is permitted. If reenrolled, the subject must be re-consented. Only the screening procedures performed outside of protocol-specified timing must be repeated.

Exclusion Criteria:

  • Evidence of biopsy-proven distant metastatic disease after completion of standard treatment
  • Current use of anti-platelet drugs (ASA, NSAIDs, clopidogrel, argatroban, etc.) or anticoagulants (warfarin, heparin products, etc.)
  • Active malignancy within 5 years prior to current diagnosis except for in situ disease or cancer with very high curability rate (i.e. testicular cancer, etc.)
  • Uncontrolled co-morbid serious systemic illnesses that in the opinion of the investigator could compromise therapeutic safety.
  • No concurrent anticancer therapy. Required washout from prior therapy:

    • Chemotherapy: 21 days
    • Major surgery: 14 days (provided wound healing is adequate)
    • Radiation: 7 days
    • Investigational/Biologic Therapy: 30 days
  • Current symptomatic congestive heart failure (New York Heart Association > class II), unstable cardiac arrhythmia requiring therapy (e.g. medication or pacemaker), unstable angina (e.g. new, worsening or persistent chest discomfort), or uncontrolled hypertension (systolic > 160 mmHg or diastolic > 100mmHg). Or any of the following occurring within 6 months (180 days) prior to first dose of study drugs: Myocardial infarction, coronary/peripheral artery bypass graft, cerebrovascular accident or transient ischemic attack. (Use of antihypertensive medication to control blood pressure is allowed.)
  • Ongoing peptic ulcer disease requiring treatment
  • History of gastrointestinal bleed
  • Severe gastro-esophageal reflux disease requiring treatment
  • History of bleeding diathesis
  • Pregnant or breastfeeding females.
  • Prisoners or subjects who are involuntarily incarcerated.
  • Known psychiatric condition, social circumstance, or other medical condition reasonably judged by the patient's study physician to unacceptably increase the risk of study participation; or to prohibit the understanding or rendering of informed consent or anticipated compliance with scheduled visits, treatment schedule, laboratory tests and other study requirements.

Sites / Locations

  • Vanderbilt-Ingram Cancer CenterRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Group 1 (ifetroban)

Group 2 (placebo)

Arm Description

ifetroban capsule (250mg) will be taken by mouth daily.

Placebo capsule (250mg) will be taken by mouth daily.

Outcomes

Primary Outcome Measures

Incidence of adverse events
Adherence to treatment (participants will be provided a pill diary to record when they take their medication. Study staff will collect the pill diary from participants at their clinic visits).
Summarized change of FACT-G score (scale = 0 to 4)

Secondary Outcome Measures

Percentage of patients within metastatic recurrence (within each cohort)
Event-free survival (within each cohort)

Full Information

First Posted
September 24, 2018
Last Updated
June 23, 2023
Sponsor
Vanderbilt-Ingram Cancer Center
Collaborators
Cumberland Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT03694249
Brief Title
Ifetroban in Treating Patients With Malignant Solid Tumors at High Risk of Metastatic Recurrence
Official Title
A Pilot Trial of Ifetroban, A Thromboxane A2 Receptor Antagonist, in Patients With Malignant Solid Tumors at High Risk of Metastatic Recurrence
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Recruiting
Study Start Date
December 12, 2018 (Actual)
Primary Completion Date
January 2024 (Anticipated)
Study Completion Date
January 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Vanderbilt-Ingram Cancer Center
Collaborators
Cumberland Pharmaceuticals

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
This pilot trial studies the side effects of ifetroban in treating patients with malignant solid tumors that are at high risk of coming back after treatment and spreading throughout the body. Platelets are a type of blood cells that help with clotting. Cancer cells stick to platelets and ride on them to get to different parts of the body. Drugs, such as ifetroban, may help these platelets become less "sticky," and reduce the chance of cancer cells spreading to other places in the body.
Detailed Description
PRIMARY OBJECTIVES: I. To assess the safety and feasibility of ifetroban sodium (ifetroban) administration in patients with malignant solid tumors at high risk of metastatic recurrence, after completion of all planned (neo)adjuvant locoregional and systemic therapies. SECONDARY OBJECTIVES: I. To assess rate of metastatic recurrence after completion of ifetroban in patients with malignant solid tumors. EXPLORATORY OBJECTIVES: I. To quantify pharmacodynamic markers of ifetroban effects. OUTLINE: Patients are randomized to 1 of 2 groups. GROUP 1 (IFETROBAN): Patients receive ifetroban sodium orally (PO) once daily (QD). Courses repeat every 28 days for 12 months in the absence of disease progression or unacceptable toxicity. GROUP 2 (PLACEBO): Patients receive a placebo PO QD. Courses repeat every 28 days for 12 months in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up at 30 days, then up to 12 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Malignant Solid Tumor

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
60 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Group 1 (ifetroban)
Arm Type
Experimental
Arm Description
ifetroban capsule (250mg) will be taken by mouth daily.
Arm Title
Group 2 (placebo)
Arm Type
Placebo Comparator
Arm Description
Placebo capsule (250mg) will be taken by mouth daily.
Intervention Type
Drug
Intervention Name(s)
Ifetroban Sodium
Intervention Description
Given by mouth
Intervention Type
Other
Intervention Name(s)
Placebo
Intervention Description
Given by mouth
Primary Outcome Measure Information:
Title
Incidence of adverse events
Time Frame
Up to 30 days after completing treatment
Title
Adherence to treatment (participants will be provided a pill diary to record when they take their medication. Study staff will collect the pill diary from participants at their clinic visits).
Time Frame
Up to 12 months
Title
Summarized change of FACT-G score (scale = 0 to 4)
Time Frame
Up to 12 months
Secondary Outcome Measure Information:
Title
Percentage of patients within metastatic recurrence (within each cohort)
Time Frame
At 12 months
Title
Event-free survival (within each cohort)
Time Frame
Up to 12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Signed and dated written informed consent. Subjects ≥ 18 years of age Eastern Cooperative Oncology Group (ECOG) performance status 0, 1 or 2 Current diagnosis of any stage I to III malignant solid tumor at high risk of metastatic recurrence (deemed by treating physician as patients with ≥ 50% chance of cancer metastatic recurrence within 5 years of diagnosis) Patients must have completed all standard locoregional and systemic therapy for their cancer within 120 days of study enrollment. Administration of an investigational agent prior to enrollment needs to be completed at least 30 days prior to enrollment Patients must have recovered (≤ grade 1 toxicities or grade 2 toxicities well managed with optimal medical care) from effects of local (surgery, radiation) or systemic treatments. Platelet count ≥ 100,000 per mL of blood Hemoglobin ≥ 9/g/dL (may have been transfused) Serum creatinine ≤ 1.5 x ULN or estimated creatinine clearance ≥ 50 mL/min as calculated using the Cockcroft-Gault (CG) equation Total serum bilirubin ≤ 1.5 times upper limit of normal (ULN) Aspartate aminotransferase (AST/SGOT) and alanine aminotransferase (ALT/SGPT) ≤ 2.5 × ULN INR below upper limit of normal (ULN) Female patients of childbearing potential and non-sterile males must agree to use at least two methods of acceptable contraception from 15 days prior to first trial treatment administration until at least 5 months after study participant's final dose of study drug Note: Females of childbearing potential are defined as those who are not surgically sterile or post-menopausal (i.e. patient has not had a bilateral tubal ligation, a bilateral oophorectomy, or a complete hysterectomy; or has not been amenorrheic for 12 months without an alternative medical cause). Post-menopausal status in females under 55 years of age should be confirmed with a serum follicle-stimulating hormone (FSH) level within laboratory reference range for postmenopausal women. Non-sterile males are those who have not had a vasectomy with documentation of the absence of sperm in the ejaculate. Patients unable to read/write in English are eligible to participate in the overall study but will not participate in the Patient-Reported Outcome questionnaires throughout the trial. Re-enrollment of a subject that has discontinued the study as a pre-treatment screen failure (i.e. a consented patient who did not receive study drugs) is permitted. If reenrolled, the subject must be re-consented. Only the screening procedures performed outside of protocol-specified timing must be repeated. Exclusion Criteria: Evidence of biopsy-proven distant metastatic disease after completion of standard treatment Current use of anti-platelet drugs (ASA, NSAIDs, clopidogrel, argatroban, etc.) or anticoagulants (warfarin, heparin products, etc.) Active malignancy within 5 years prior to current diagnosis except for in situ disease or cancer with very high curability rate (i.e. testicular cancer, etc.) Uncontrolled co-morbid serious systemic illnesses that in the opinion of the investigator could compromise therapeutic safety. No concurrent anticancer therapy. Required washout from prior therapy: Chemotherapy: 21 days Major surgery: 14 days (provided wound healing is adequate) Radiation: 7 days Investigational/Biologic Therapy: 30 days Current symptomatic congestive heart failure (New York Heart Association > class II), unstable cardiac arrhythmia requiring therapy (e.g. medication or pacemaker), unstable angina (e.g. new, worsening or persistent chest discomfort), or uncontrolled hypertension (systolic > 160 mmHg or diastolic > 100mmHg). Or any of the following occurring within 6 months (180 days) prior to first dose of study drugs: Myocardial infarction, coronary/peripheral artery bypass graft, cerebrovascular accident or transient ischemic attack. (Use of antihypertensive medication to control blood pressure is allowed.) Ongoing peptic ulcer disease requiring treatment History of gastrointestinal bleed Severe gastro-esophageal reflux disease requiring treatment History of bleeding diathesis Pregnant or breastfeeding females. Prisoners or subjects who are involuntarily incarcerated. Known psychiatric condition, social circumstance, or other medical condition reasonably judged by the patient's study physician to unacceptably increase the risk of study participation; or to prohibit the understanding or rendering of informed consent or anticipated compliance with scheduled visits, treatment schedule, laboratory tests and other study requirements.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Vanderbilt-Ingram Service for Timely Access
Phone
800-811-8480
Email
cip@vanderbilt.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Sonya Reid, MD
Organizational Affiliation
Vanderbilt-Ingram Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Vanderbilt-Ingram Cancer Center
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37232
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Vanderbilt-Ingram Service for Timely Access
Phone
800-811-8480
Email
cip@vanderbilt.edu
First Name & Middle Initial & Last Name & Degree
Sonya Reid, MD

12. IPD Sharing Statement

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Ifetroban in Treating Patients With Malignant Solid Tumors at High Risk of Metastatic Recurrence

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