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L-DOS47 Plus Doxorubicin in Advanced Pancreatic Cancer

Primary Purpose

Pancreas Cancer

Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
L-DOS47
Doxorubicin
Sponsored by
Helix BioPharma Corporation
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pancreas Cancer focused on measuring pancreatic cancer, immunoconjugate, tumor microenvironment alkalinization

Eligibility Criteria

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

Inclusion Criteria:

  1. Male or female aged ≥ 18 years old
  2. One or more metastatic tumors measurable on computed tomography (CT) scan per RECIST version 1.1 and screening FDG-PET scan with maximum standardized uptake value (SUV max) ≥ 5.5 for at least one lesion consistent with pancreatic cancer.
  3. Karnofsky performance status ≥ 70%
  4. Life expectancy of at least 3 months
  5. Able to understand the information provided to them and to give written institutional review board (IRB)-approved informed consent prior to any study activities being conducted
  6. A negative pregnancy test (if of child bearing potential)
  7. Acceptable liver function:

    1. Bilirubin ≤ 1.5 times upper limit of normal
    2. Aspartate aminotransferase (AST), alanine aminotransferase (ALT) and Alkaline phosphatase (ALP) ≤ 2.5 times upper limit of normal (ULN; if liver metastases are present, then ≤ 5 x ULN is allowed)
  8. Acceptable renal function as defined by creatinine ≤1.5x institutional upper limits of normal, or calculated creatinine clearance ≥ 60 mL/min/1.73 m2 for patients with creatinine levels above institutional normal
  9. Acceptable hematologic status:

    1. Granulocyte ≥ 1500 cells/mm3
    2. Platelet count ≥ 100,000 (plt/mm3)
    3. Hemoglobin ≥ 9g/dL
  10. Urinalysis:

    a) No clinically significant abnormalities

  11. Acceptable coagulation status

    1. Prothrombin time within 1.5x of normal limits
    2. Partial thromboplastin time (PTT) within 1.5x of normal limits
  12. For men and women of child-bearing potential, the use of effective contraceptive methods during the study
  13. Normal ejection fraction on ECHO or MUGA

Exclusion Criteria:

  1. New York Heart Association Class III or IV, cardiac disease, myocardial infarction within the past 6 months, unstable arrhythmia, or evidence of ischemia on ECG
  2. Abnormal ejection fraction on ECHO or MUGA
  3. Active, uncontrolled bacterial, viral, or fungal infections requiring systematic therapy
  4. Pregnant or nursing women. NOTE: Women of childbearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; or abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant while participating in this study, she should inform her treating physician immediately.
  5. Treatment with radiation therapy, surgery, chemotherapy, or investigational therapy within 3 weeks prior to study entry
  6. Major surgery within 4 weeks prior to study entry
  7. Unwillingness or inability to comply with procedures required in this protocol
  8. Known infection with HIV, hepatitis B, or hepatitis C
  9. Serious nonmalignant disease (eg hydro nephrosis, liver failure, or other conditions) that could compromise protocol objectives in the opinion of the investigator and/or the sponsor
  10. Patients who are currently receiving any other investigational agent
  11. Patients with any evidence of uncontrolled brain metastases or carcinomatosis meningitis.
  12. Patients with marked screening prolongation of QT/QTc interval (e.g. repeated demonstration of a QTc interval > 480 milliseconds (CTCAE grade 1) using Fredericia's QT correction formula.

Sites / Locations

  • Scottsdale Healthcare Hospitals DBA HonorHealthRecruiting
  • Atlantic Health System, Morristown Medical CenterRecruiting
  • Froedtert Hospital and the Medical College of WisconsinRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

L-DOS47 + doxorubicin

Arm Description

Patients will be recruited into escalating dosing cohorts of 3, 6 and 9 µg/kg of L-DOS47, with a minimum of 3 and a maximum of 6 patients per cohort. A fixed dose of intravenous doxorubicin [20 mg/m2/week] will be administered in combination with L-DOS47 across all cohorts.

Outcomes

Primary Outcome Measures

Number of complete plus partial responders as per RECIST version 1.1
Assess number of complete plus partial responders according to RECIST version 1.1 as a measure of preliminary anti-tumor activity of L-DOS47 in combination with doxorubicin
Adverse events (as per CTCAE v. 5.0)
Assess frequency of treatment emergent adverse events as per Common Terminology Criteria for Adverse Events (CTCAE) v. 5 as a measure of safety and tolerability of L-DOS47 in combination with doxorubicin

Secondary Outcome Measures

Change in tumor pH
Change from screening tumor pH as measured by SUV on fluorodeoxyglucose-positron emission tomography scan (FDG-PET) scan
Carbohydrate antigen (CA) 19-9 biomarker level
Change from screening in CA19-9 biomarker levels
Proportion of patients expressing anti-L-DOS47 antibodies
Assess number of patients expressing anti-L-DOS47 antibodies levels as a measure of

Full Information

First Posted
September 16, 2019
Last Updated
October 2, 2023
Sponsor
Helix BioPharma Corporation
Collaborators
Theradex
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1. Study Identification

Unique Protocol Identification Number
NCT04203641
Brief Title
L-DOS47 Plus Doxorubicin in Advanced Pancreatic Cancer
Official Title
A Phase Ib/II Study of the Microenvironment Modifier L-DOS47 Plus Doxorubicin for the Treatment of Patients With Previously Treated Advanced Pancreatic Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
December 11, 2019 (Actual)
Primary Completion Date
August 31, 2024 (Anticipated)
Study Completion Date
August 31, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Helix BioPharma Corporation
Collaborators
Theradex

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 study will evaluate the safety and tolerability of escalating doses of L-DOS47 in combination with doxorubicin, as well as preliminary anti-tumor activity in patients with previously treated advanced pancreatic cancer.
Detailed Description
The Phase Ib part of the study will apply a standard 3 + 3 algorithm for dose escalation to determine the appropriate L-DOS47 maximum tolerated dose to use in combination with doxorubicin for the Phase II part of the study. Patients will be recruited into 3 cohorts where each cohort will receive increasing weekly dose levels of L-DOS47 in combination with a fixed dose of 20 mg/m2 of doxorubicin weekly. The decision for escalation to the next dose level will be made after all patients in a cohort have completed 4 weeks of combination treatment and the safety data have been reviewed by the Safety Review Committee. If a patient in any cohort experiences a dose limiting toxicity, an additional 3 patients will be enrolled, for a maximum of up to 18 patients in this initial dose escalation part of the study. The Phase II part of the study will focus on evaluating preliminary anti-tumor activity, as well as continuing to evaluate safety and tolerability of L-DOS47 in combination with doxorubicin. A further 11 additional patients will be enrolled in this phase of the study, which is designed to ensure patient safety and to detect whether there is a level of anti-tumor activity that would be worth pursuing in a larger clinical trial. Patients will be initiated on the L-DOS47 dose determined in Phase I, in combination with 20 mg/m2 doxorubicin, with tumor marker carbohydrate antigen 19-9 (CA19-9) measurements at each treatment cycle, and radiological assessments every two treatment cycles. Tumor response will be assessed according to the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 criteria. Safety will be assessed by reported adverse events (AEs), serious adverse events (SAEs), physical exams, vital signs, Karnofsky Performance Status, electrocardiogram (ECG), echocardiogram (ECHO)/multigated acquisition scan (MUGA), clinical laboratory evaluations (hematology, chemistry, coagulation and urinalysis), and anti-L-DOS47 antibody levels.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pancreas Cancer
Keywords
pancreatic cancer, immunoconjugate, tumor microenvironment alkalinization

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Sequential Assignment
Model Description
This is an open-label, single arm study that includes an initial three cohort dose escalation phase with 3, 6 and 9 µg/kg of L-DOS47 in combination with doxorubicin.
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
L-DOS47 + doxorubicin
Arm Type
Experimental
Arm Description
Patients will be recruited into escalating dosing cohorts of 3, 6 and 9 µg/kg of L-DOS47, with a minimum of 3 and a maximum of 6 patients per cohort. A fixed dose of intravenous doxorubicin [20 mg/m2/week] will be administered in combination with L-DOS47 across all cohorts.
Intervention Type
Biological
Intervention Name(s)
L-DOS47
Intervention Description
A treatment cycle will be 28 days, with patients receiving L-DOS47 on Days 1, 8, 15, and 22.
Intervention Type
Drug
Intervention Name(s)
Doxorubicin
Intervention Description
A treatment cycle will be 28 days, with patients receiving doxorubicin on Days 2, 9, 16 and 23
Primary Outcome Measure Information:
Title
Number of complete plus partial responders as per RECIST version 1.1
Description
Assess number of complete plus partial responders according to RECIST version 1.1 as a measure of preliminary anti-tumor activity of L-DOS47 in combination with doxorubicin
Time Frame
24 weeks
Title
Adverse events (as per CTCAE v. 5.0)
Description
Assess frequency of treatment emergent adverse events as per Common Terminology Criteria for Adverse Events (CTCAE) v. 5 as a measure of safety and tolerability of L-DOS47 in combination with doxorubicin
Time Frame
24 weeks
Secondary Outcome Measure Information:
Title
Change in tumor pH
Description
Change from screening tumor pH as measured by SUV on fluorodeoxyglucose-positron emission tomography scan (FDG-PET) scan
Time Frame
From screening to end of Cycle 2, where each treatment cycle is 28 days.
Title
Carbohydrate antigen (CA) 19-9 biomarker level
Description
Change from screening in CA19-9 biomarker levels
Time Frame
Up to 24 weeks
Title
Proportion of patients expressing anti-L-DOS47 antibodies
Description
Assess number of patients expressing anti-L-DOS47 antibodies levels as a measure of
Time Frame
Up to 24 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female aged ≥ 18 years old One or more metastatic tumors measurable on computed tomography (CT) scan per RECIST version 1.1 and screening FDG-PET scan with maximum standardized uptake value (SUV max) ≥ 5.5 for at least one lesion consistent with pancreatic cancer. Karnofsky performance status ≥ 70% Life expectancy of at least 3 months Able to understand the information provided to them and to give written institutional review board (IRB)-approved informed consent prior to any study activities being conducted A negative pregnancy test (if of child bearing potential) Acceptable liver function: Bilirubin ≤ 1.5 times upper limit of normal Aspartate aminotransferase (AST), alanine aminotransferase (ALT) and Alkaline phosphatase (ALP) ≤ 2.5 times upper limit of normal (ULN; if liver metastases are present, then ≤ 5 x ULN is allowed) Acceptable renal function as defined by creatinine ≤1.5x institutional upper limits of normal, or calculated creatinine clearance ≥ 60 mL/min/1.73 m2 for patients with creatinine levels above institutional normal Acceptable hematologic status: Granulocyte ≥ 1500 cells/mm3 Platelet count ≥ 100,000 (plt/mm3) Hemoglobin ≥ 9g/dL Urinalysis: a) No clinically significant abnormalities Acceptable coagulation status Prothrombin time within 1.5x of normal limits Partial thromboplastin time (PTT) within 1.5x of normal limits For men and women of child-bearing potential, the use of effective contraceptive methods during the study Normal ejection fraction on ECHO or MUGA Exclusion Criteria: New York Heart Association Class III or IV, cardiac disease, myocardial infarction within the past 6 months, unstable arrhythmia, or evidence of ischemia on ECG Abnormal ejection fraction on ECHO or MUGA Active, uncontrolled bacterial, viral, or fungal infections requiring systematic therapy Pregnant or nursing women. NOTE: Women of childbearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; or abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant while participating in this study, she should inform her treating physician immediately. Treatment with radiation therapy, surgery, chemotherapy, or investigational therapy within 3 weeks prior to study entry Major surgery within 4 weeks prior to study entry Unwillingness or inability to comply with procedures required in this protocol Known infection with HIV, hepatitis B, or hepatitis C Serious nonmalignant disease (eg hydro nephrosis, liver failure, or other conditions) that could compromise protocol objectives in the opinion of the investigator and/or the sponsor Patients who are currently receiving any other investigational agent Patients with any evidence of uncontrolled brain metastases or carcinomatosis meningitis. Patients with marked screening prolongation of QT/QTc interval (e.g. repeated demonstration of a QTc interval > 480 milliseconds (CTCAE grade 1) using Fredericia's QT correction formula.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Brenda Lee, M.Sc.
Phone
416 642 1807
Email
blee@helixbiopharma.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Erkut Borazanci, MD
Organizational Affiliation
Scottsdale Healthcare Hospitals DBA HonorHealth
Official's Role
Principal Investigator
Facility Information:
Facility Name
Scottsdale Healthcare Hospitals DBA HonorHealth
City
Scottsdale
State/Province
Arizona
ZIP/Postal Code
85260
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Erkut Borazanci, MD
First Name & Middle Initial & Last Name & Degree
Joyce Schaffer, RN
Phone
480-323-1364
Email
clinicaltrials@honorhealth.com
Facility Name
Atlantic Health System, Morristown Medical Center
City
Morristown
State/Province
New Jersey
ZIP/Postal Code
07962
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Nancy Ginder, BSN, OCN
Phone
973-971-6608
Email
nancy.ginder@atlantichealth.org
Facility Name
Froedtert Hospital and the Medical College of Wisconsin
City
Milwaukee
State/Province
Wisconsin
ZIP/Postal Code
53226
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
General Cancer Center Information
Phone
866-680-0505
Ext
8900
Email
cccto@mcw.edu
Phone
414-805-8900

12. IPD Sharing Statement

Learn more about this trial

L-DOS47 Plus Doxorubicin in Advanced Pancreatic Cancer

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