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Phase II Study of PX-12 in Patients With Advanced Pancreatic Cancer

Primary Purpose

Pancreatic Neoplasms

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
PX-12
Sponsored by
Cascadian Therapeutics Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pancreatic Neoplasms focused on measuring Pancreas, Cancer, Carcinoma

Eligibility Criteria

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

Inclusion Criteria:

  • Histologically- or cytologically-confirmed diagnosis of advanced carcinoma of the pancreas (stage IV disease only).
  • Patients whose tumor has progressed on gemcitabine or on a gemcitabine-containing combination. Patients must have received no more than two prior regimens for metastatic disease. Use of gemcitabine as a radiation sensitizer in combination with radiotherapy for localized disease will not be considered a prior gemcitabine-containing regimen if gemcitabine was received for ≤ 1 month following completion of radiotherapy. In addition, the use of 5-fluorouracil as a radiation sensitizer for localized disease will be allowed and not counted as a prior regimen if the 5-FU was continued for ≤ 1month following completion of radiotherapy.
  • Karnofsky Performance Status of ≥ 70%.
  • Patients must have discontinued previous anti-cancer therapy or other investigational agent at least three weeks or within 5 half lives of the drug (whichever is shorter) prior to entry into the study (six weeks for mitomycin C or nitrosureas) provided that all toxicities from prior treatment have resolved to a Grade 1 or less.
  • Patients must have discontinued radiation therapy at least two weeks prior to entry into the study and have recovered from all radiation-related toxicities.
  • Adequate organ function including the following:
  • ANC ≥ 1500 cells/microL; platelets > 100,000/microL; hemoglobin ≥ 9 g/dL (may be transfused to this level).
  • Bilirubin ≤ 2.0 mg/dL; aspartate transaminase (AST/SGOT) and alanine transaminase (ALT/SGPT) ≤ 3.0 times institutional upper limit of normal (ULN) OR < 5 times institutional ULN if the subject has documented liver metastases.
  • Creatinine ≤2.0 mg/dL.
  • CA19-9 level >2 times ULN.
  • Disease that is measurable by CT scan per RECIST criteria (Appendix IV).
  • PET/CT or PET scan with SUV of ≥ 5.0 in at least one lesion on an 18F FDG scan.

Exclusion Criteria:

  • Active infection requiring antibiotics at study entry.
  • Any serious concomitant systemic disorder that in the opinion of the investigator would place the patient at excessive or unacceptable risk of toxicity.
  • Patients with active (requiring continuous medical therapy) pulmonary disease (COPD, asthma) or evidence of interstitial pneumonitis or pulmonary fibrosis on baseline chest X-ray or PET/CT scan.
  • Significant central nervous system or psychiatric disorder(s) that preclude the ability of the patient to provide informed consent.
  • Known or suspected brain metastases that have not received adequate therapy. Patients must be stable without requirement for steroids or seizure medications.
  • Major surgery within 4 weeks of study entry.
  • Chemotherapy/investigational drugs within 3 weeks or within 5 half lives of the drug (whichever is shorter) of study entry, provided that all toxicities from prior treatment have resolved to a Grade 1 or less.
  • Inability to tolerate prophylactic (1 mg/day) coumadin.

Sites / Locations

  • TGen Clinical Research Services at Scottsdale Healthcare
  • Arizona Cancer Center, University of Arizona
  • The University of Texas M.D. Anderson Cancer Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

High dose

Low dose

Arm Description

128 mg/m2

54 mg/m2

Outcomes

Primary Outcome Measures

Progression free survival and overall survival (percentage of patients alive at 6 months)
Determine if there is a difference in effect on circulating Trx-1 protein levels between two dose levels of PX-12

Secondary Outcome Measures

Determine which of two dose levels of PX-12 causes the greatest effect on three surrogate markers of clinical activity
Determine effects of two different dose levels on overall clinical response
Further evaluate safety profile of PX-12
Assess the effects of metabolic excretion of PX-12

Full Information

First Posted
December 29, 2006
Last Updated
May 14, 2018
Sponsor
Cascadian Therapeutics Inc.
Collaborators
National Cancer Institute (NCI), Translational Genomics Research Institute
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1. Study Identification

Unique Protocol Identification Number
NCT00417287
Brief Title
Phase II Study of PX-12 in Patients With Advanced Pancreatic Cancer
Official Title
A Randomized Phase II Open-Label Study of Two Different Dose Levels of PX-12 in Patients With Advanced Carcinoma of the Pancreas Whose Tumors Have Progressed on Gemcitabine or on a Gemcitabine-Containing Combination
Study Type
Interventional

2. Study Status

Record Verification Date
April 2015
Overall Recruitment Status
Terminated
Why Stopped
Investigator decision
Study Start Date
December 2006 (undefined)
Primary Completion Date
April 2009 (Actual)
Study Completion Date
April 2009 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Cascadian Therapeutics Inc.
Collaborators
National Cancer Institute (NCI), Translational Genomics Research Institute

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study is being conducted to evaluate the clinical efficacy, biologic activity (inhibition of PX-12 target thioredoxin-1) and effects of an expired metabolite of PX-12 in patients with advanced pancreatic cancer.
Detailed Description
In a Phase I trial, PX-12 demonstrated anti-tumor activity and pharmacodynamic activity across a wide dose range. At higher doses, one side effect of the agent was a garlic-like odor of an expired metabolite. This study is being conducted to evaluate the clinical efficacy, biologic activity (inhibition of PX-12 target thioredoxin-1) and effects of the expired metabolite at two dose levels of PX-12. This study will determine if the efficacy and biologic activity achieved at either of the two dose levels is sufficient to proceed to further studies without pushing to the maximally tolerated dose.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pancreatic Neoplasms
Keywords
Pancreas, Cancer, Carcinoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
17 (Actual)

8. Arms, Groups, and Interventions

Arm Title
High dose
Arm Type
Active Comparator
Arm Description
128 mg/m2
Arm Title
Low dose
Arm Type
Active Comparator
Arm Description
54 mg/m2
Intervention Type
Drug
Intervention Name(s)
PX-12
Other Intervention Name(s)
Thioredoxin Inhibitor
Intervention Description
3 hour intravenous infusion as a dose of either 54 mg/m2 or 128 mg/m2 daily for 5 days every three weeks.
Primary Outcome Measure Information:
Title
Progression free survival and overall survival (percentage of patients alive at 6 months)
Time Frame
6 months
Title
Determine if there is a difference in effect on circulating Trx-1 protein levels between two dose levels of PX-12
Time Frame
21 days
Secondary Outcome Measure Information:
Title
Determine which of two dose levels of PX-12 causes the greatest effect on three surrogate markers of clinical activity
Time Frame
42 days
Title
Determine effects of two different dose levels on overall clinical response
Time Frame
42 days
Title
Further evaluate safety profile of PX-12
Time Frame
21 days
Title
Assess the effects of metabolic excretion of PX-12
Time Frame
3 hours

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically- or cytologically-confirmed diagnosis of advanced carcinoma of the pancreas (stage IV disease only). Patients whose tumor has progressed on gemcitabine or on a gemcitabine-containing combination. Patients must have received no more than two prior regimens for metastatic disease. Use of gemcitabine as a radiation sensitizer in combination with radiotherapy for localized disease will not be considered a prior gemcitabine-containing regimen if gemcitabine was received for ≤ 1 month following completion of radiotherapy. In addition, the use of 5-fluorouracil as a radiation sensitizer for localized disease will be allowed and not counted as a prior regimen if the 5-FU was continued for ≤ 1month following completion of radiotherapy. Karnofsky Performance Status of ≥ 70%. Patients must have discontinued previous anti-cancer therapy or other investigational agent at least three weeks or within 5 half lives of the drug (whichever is shorter) prior to entry into the study (six weeks for mitomycin C or nitrosureas) provided that all toxicities from prior treatment have resolved to a Grade 1 or less. Patients must have discontinued radiation therapy at least two weeks prior to entry into the study and have recovered from all radiation-related toxicities. Adequate organ function including the following: ANC ≥ 1500 cells/microL; platelets > 100,000/microL; hemoglobin ≥ 9 g/dL (may be transfused to this level). Bilirubin ≤ 2.0 mg/dL; aspartate transaminase (AST/SGOT) and alanine transaminase (ALT/SGPT) ≤ 3.0 times institutional upper limit of normal (ULN) OR < 5 times institutional ULN if the subject has documented liver metastases. Creatinine ≤2.0 mg/dL. CA19-9 level >2 times ULN. Disease that is measurable by CT scan per RECIST criteria (Appendix IV). PET/CT or PET scan with SUV of ≥ 5.0 in at least one lesion on an 18F FDG scan. Exclusion Criteria: Active infection requiring antibiotics at study entry. Any serious concomitant systemic disorder that in the opinion of the investigator would place the patient at excessive or unacceptable risk of toxicity. Patients with active (requiring continuous medical therapy) pulmonary disease (COPD, asthma) or evidence of interstitial pneumonitis or pulmonary fibrosis on baseline chest X-ray or PET/CT scan. Significant central nervous system or psychiatric disorder(s) that preclude the ability of the patient to provide informed consent. Known or suspected brain metastases that have not received adequate therapy. Patients must be stable without requirement for steroids or seizure medications. Major surgery within 4 weeks of study entry. Chemotherapy/investigational drugs within 3 weeks or within 5 half lives of the drug (whichever is shorter) of study entry, provided that all toxicities from prior treatment have resolved to a Grade 1 or less. Inability to tolerate prophylactic (1 mg/day) coumadin.
Facility Information:
Facility Name
TGen Clinical Research Services at Scottsdale Healthcare
City
Scottsdale
State/Province
Arizona
ZIP/Postal Code
85258
Country
United States
Facility Name
Arizona Cancer Center, University of Arizona
City
Tucson
State/Province
Arizona
ZIP/Postal Code
85724
Country
United States
Facility Name
The University of Texas M.D. Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States

12. IPD Sharing Statement

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Phase II Study of PX-12 in Patients With Advanced Pancreatic Cancer

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