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RX-3117 in Combination With Abraxane® in Subjects With Metastatic Pancreatic Cancer

Primary Purpose

Metastatic Pancreatic Cancer

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
RX-3117
Sponsored by
Rexahn Pharmaceuticals, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Metastatic Pancreatic Cancer focused on measuring pancreatic cancer, Abraxane, first line

Eligibility Criteria

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

Inclusion Criteria:

Disease Related

  1. Subject has confirmed histologic or cytologic evidence of metastatic pancreatic cancer and has no prior treatment for metastatic pancreatic cancer.
  2. Subject has measurable disease using Response Evaluation Criteria in Solid Tumors (RECIST) v 1.1.
  3. Subject has a life expectancy of at least 3 months.
  4. Subject has an Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1.

    Demographic

  5. Males or females ≥ 18 years of age
  6. Subject must be able to swallow capsules
  7. Subject must have adequate venous access for intravenous (IV) infusion

    Laboratory

  8. Subject has hemoglobin ≥ 9.0 g/dL at Screening
  9. Subject has absolute neutrophil count (ANC) ≥ 1.5 x 109/L at Screening
  10. Subject has platelet count ≥ 100 x 109/L at Screening
  11. Subject has serum creatinine ≤ 1.5 times the upper limit of normal (ULN) at Screening. Subjects with serum creatinine levels > 1.5 times the ULN must have a 24-hour urine creatinine clearance ≥ 60 mL/min
  12. Subject has serum bilirubin ≤ 1.5 times the ULN (except in subjects with Gilbert's Syndrome who must have serum bilirubin < 3.0 x ULN)
  13. Subject has aspartate aminotransferase (AST; SGOT) and alanine aminotransferase (ALT; SGPT) ≤ 2.5 times the ULN (OR, AST and ALT ≤ 5 times the ULN in the presence of known liver metastases)
  14. Subject has alkaline phosphatase ≤ 2.5 times the ULN (OR ≤ 5 times the ULN in the presence of known liver or bone metastases)
  15. Subject has normal coagulation parameters (prothrombin time [PT] and/or international normalized ratio [INR], and partial thromboplastin time [PTT] within normal limits [<1.2 x ULN])
  16. Subject has potassium concentration within normal range, or correctable with supplements.
  17. Oxygen saturation by pulse oximetry ≥ 92% at rest.
  18. For women of childbearing potential: Negative serum pregnancy test during screening and negative serum or urine pregnancy test at start of study therapy (Cycle1 Day 1).

    Reproductive

  19. For female subjects of childbearing potential, willingness to abstain from heterosexual intercourse or use a protocol-recommended method of contraception from the screening visit throughout the study treatment period and for 30 days following the last dose of study drug.
  20. Female subjects of non-childbearing potential defined as having amenorrhea for at least 24 consecutive months, a documented hysterectomy, or a documented bilateral oophorectomy)
  21. For fertile male subjects having intercourse with females of childbearing potential, willingness to abstain from heterosexual intercourse or use a protocol-recommended method of contraception from the start of study therapy throughout the study treatment period and for 30 days following the last dose of study drug and to refrain from sperm donation from the start of study treatment throughout the study treatment period and for 30 days following the last dose of study drug.

    Ethical

  22. In the judgment of the investigator, participation in the protocol offers an acceptable benefit-to-risk ratio when considering current disease status, medical condition, and the potential benefits and risks of alternative treatments for the subject's cancer.
  23. Before any study-specific procedure, the appropriate written informed consent must be obtained

Exclusion Criteria:

Disease Related

  1. Subject has primary brain tumors or clinical evidence of active brain metastasis
  2. Subject has undergone major surgery within 4 weeks of the start of study treatment. Laparoscopy and central venous catheter placement are not considered major surgery

    Medications

  3. Subject has a history of systemic corticosteroid use within 7 days before Day 1 of Cycle 1

    General

  4. Subject has an active infection requiring parenteral or oral antibiotics within 2 weeks before planned start of study therapy
  5. Subject has uncontrolled diabetes as assessed by the investigator
  6. Subject has a second malignancy other than curatively resected basal cell carcinoma of the skin, squamous cell carcinoma of the skin, in situ carcinoma of the cervix, or other cancers treated with curative intent and no known active disease within 3 years before planned start of study therapy
  7. Subject has an active infection of hepatitis B, hepatitis C or human immunodeficiency virus
  8. Female subjects who are pregnant, planning a pregnancy or breast feeding during the study
  9. Subject has a high cardiovascular risk, including, but not limited to, subjects with congestive heart failure (New York Heart Association [NYHA] Class III or IV), cardiac arrhythmia, unstable angina, coronary stenting or acute coronary syndromes within 6 months before planned start of study therapy or r myocardial infarction within one year before planned start of study therapy
  10. Criterion removed
  11. Subject has a history of prior allogeneic bone marrow progenitor cell or solid organ transplantation.
  12. Subject has known acute or chronic pancreatitis.
  13. Subject has persistent diarrhea, malabsorption, or known sub-acute bowel obstruction ≥ NCI CTCAE Grade 2, despite medical management.
  14. Subject has any disorder that may interfere with drug absorption, distribution, metabolism, or excretion (including gastrointestinal surgery and bariatric surgery)
  15. All acute toxic effects of any prior antitumor therapy resolved to Grade ≤ 1 before the start of study therapy (with the exception of alopecia [Grade 1 or 2 permitted], or neurotoxicity [Grade 1 or 2 permitted], or anemia [Grade 2 permitted])
  16. Subject has any other medical, psychiatric, or social condition, which in the opinion of the investigator, would preclude participation in the study, pose an undue medical hazard, interfere with the conduct of the study, or interfere with interpretation of the study results
  17. Subject has a history of interstitial lung disease, slowly progressive dyspnea and unproductive cough, sarcoidosis, silicosis, idiopathic pulmonary fibrosis, pulmonary hypersensitivity pneumonitis or multiple allergies. Any lung disease that may interfere with the detection or management of suspected drug-related pulmonary toxicity.
  18. Subject is currently enrolled in any other clinical protocol or investigational trial that involves administration of experimental therapy and/or therapeutic devices, or investigational drug.
  19. Subject has a history of hypersensitivity to RX-3117, gemcitabine, azacytidine cytosine arabinoside, paclitaxel, nab-paclitaxel, or their excipients.
  20. Subject is unwilling or unable to comply with study requirements or planned unavailability for follow-up assessments.

Sites / Locations

  • Rexahn Site
  • Rexahn Site
  • Rexahn Site
  • Rexahn Site
  • Rexahn Site
  • Rexahn Site
  • Rexahn Site
  • Rexahn Site
  • Rexahn Site
  • Rexahn Site

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

RX-3117 + Abraxane

Arm Description

RX-3117: oral, 500 - 700 mg/ day for 5 days on/ 2 days off for 3 weeks. 1 washout week/ cycle. Abraxane: 75 - 125 mg/m^2, infused once per week for 3 weeks. 1 washout week/ cycle.

Outcomes

Primary Outcome Measures

Number of participants with treatment-related adverse events as assessed by CTCAE v4.0 (Phase 1 and 2)
Type, frequency, severity, timing of onset, duration and relationship to study therapies of any adverse events (AEs)
Number of participants with Clinical laboratory abnormalities (Phase 1 and 2)
Type, frequency, severity, timing of onset, duration and relationship to study therapies of any clinical laboratory abnormalities
Number of participants with Vital sign abnormalities (Phase 1 and 2)
Type, frequency, severity, timing of onset, duration and relationship to study therapies of any vital signs including heart rate, respiration rate, and blood pressure
Number of participants with Electrocardiogram (ECG) abnormalities (Phase 1 and 2)
Type, frequency, severity, timing of onset, duration and relationship to study therapies of any electrocardiograms (ECGs)
Incidence of dose-limiting toxicities (DLTs) (Phase 1)
Number of participants with Progression Free Survival (PFS) and/or objective clinical response (Phase 2)

Secondary Outcome Measures

Area under the plasma concentration versus time curve (AUC) of RX-3117 and Abraxane® (Phase 1 and Phase 2)
Time to maximum observed concentration [Tmax] of RX-3117 and Abraxane® (Phase 1 and Phase 2)
Maximum observed concentration [Cmax] of RX-3117 and Abraxane® (Phase 1 and Phase 2)
Overall response rate [ORR] (Phase 1 and Phase 2)
Time to response [TTR] (Phase 1)
Duration of response [DOR] (Phase 1 and Phase 2)
Number of participants with Progression-free survival [PFS] (Phase 1)
Time to progression (Phase 2)

Full Information

First Posted
June 7, 2017
Last Updated
January 3, 2020
Sponsor
Rexahn Pharmaceuticals, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT03189914
Brief Title
RX-3117 in Combination With Abraxane® in Subjects With Metastatic Pancreatic Cancer
Official Title
A Phase 1/2 Open-Label, Safety, Pharmacokinetic, Pharmacodynamic and Efficacy Study of RX-3117 in Combination With Abraxane® in Subjects With Metastatic Pancreatic Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
January 2020
Overall Recruitment Status
Completed
Study Start Date
October 2, 2017 (Actual)
Primary Completion Date
October 1, 2019 (Actual)
Study Completion Date
November 21, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Rexahn Pharmaceuticals, Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This will be a Phase 1b/2a multicenter 2-stage study. Phase 1 will be conducted as a dose-finding, open-label study of oral RX-3117 administered in combination with Abraxane® to subjects with metastatic pancreatic cancer. After completion of the Phase 1 portion, a Phase 2a study will be conducted using a 2 stage, open-label design, of RX 3117 and Abraxane® in combination to treat subjects with metastatic pancreatic cancer as first line therapy.
Detailed Description
This will be a Phase 1b/2a multicenter 2-stage study. Phase 1 will be conducted as a dose-finding, open-label study of oral RX-3117 administered in combination with Abraxane® to subjects with metastatic pancreatic cancer. The recommended phase 2 dose (RP2D) and schedule of RX-3117, in combination with Abraxane®, will be determined based on the safety profile, dose modification, and pharmacokinetics (PK). Phase 1 will be conducted using a combination of the single agent maximum tolerated dose (MTD) for RX-3117 and the Abraxane dose as per the package insert for patients with pancreatic cancer in combination with gemcitabine. After completion of the Phase 1 portion, a Phase 2a study will be conducted using a 2 stage, open-label design, of RX 3117 and Abraxane® in combination to treat subjects with metastatic pancreatic cancer as first line therapy. Approximately 10 subjects will participate in the Stage 1 at the dose identified in Phase 1 (RP2D). Subjects will be treated for up to 8 cycles of combined therapy. An interim analysis will be conducted after 10 evaluable subjects have been treated at the RP2D, have completed a minimum of 4 cycles of therapy, or have discontinued therapy due to progressive disease before completing 4 cycles. If an adequate number of Responders are observed out of the initial 10 evaluable subjects, then 40 additional subjects will be enrolled to participate in Stage 2. Subjects will be treated for up to 8 cycles of combined therapy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metastatic Pancreatic Cancer
Keywords
pancreatic cancer, Abraxane, first line

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
46 (Actual)

8. Arms, Groups, and Interventions

Arm Title
RX-3117 + Abraxane
Arm Type
Experimental
Arm Description
RX-3117: oral, 500 - 700 mg/ day for 5 days on/ 2 days off for 3 weeks. 1 washout week/ cycle. Abraxane: 75 - 125 mg/m^2, infused once per week for 3 weeks. 1 washout week/ cycle.
Intervention Type
Drug
Intervention Name(s)
RX-3117
Other Intervention Name(s)
Abraxane
Intervention Description
RX-3117 will be administered orally in combination with Abraxane.
Primary Outcome Measure Information:
Title
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0 (Phase 1 and 2)
Description
Type, frequency, severity, timing of onset, duration and relationship to study therapies of any adverse events (AEs)
Time Frame
9 months
Title
Number of participants with Clinical laboratory abnormalities (Phase 1 and 2)
Description
Type, frequency, severity, timing of onset, duration and relationship to study therapies of any clinical laboratory abnormalities
Time Frame
9 months
Title
Number of participants with Vital sign abnormalities (Phase 1 and 2)
Description
Type, frequency, severity, timing of onset, duration and relationship to study therapies of any vital signs including heart rate, respiration rate, and blood pressure
Time Frame
9 months
Title
Number of participants with Electrocardiogram (ECG) abnormalities (Phase 1 and 2)
Description
Type, frequency, severity, timing of onset, duration and relationship to study therapies of any electrocardiograms (ECGs)
Time Frame
1 month
Title
Incidence of dose-limiting toxicities (DLTs) (Phase 1)
Time Frame
4 weeks
Title
Number of participants with Progression Free Survival (PFS) and/or objective clinical response (Phase 2)
Time Frame
9 months
Secondary Outcome Measure Information:
Title
Area under the plasma concentration versus time curve (AUC) of RX-3117 and Abraxane® (Phase 1 and Phase 2)
Time Frame
Cycle 1 Days 1 (pre-infusion, post-infusion, pre-dose RX-3117, and 0.5, 1, 2, 4, 6, and 24 hours after administration) and 15 (pre-infusion, post-infusion, pre-dose RX-3117, and 0.5, 1, 2, 4, and 6 hours after administration)
Title
Time to maximum observed concentration [Tmax] of RX-3117 and Abraxane® (Phase 1 and Phase 2)
Time Frame
Cycle 1 Days 1 (pre-infusion, post-infusion, pre-dose RX-3117, and 0.5, 1, 2, 4, 6, and 24 hours after administration) and 15 (pre-infusion, post-infusion, pre-dose RX-3117, and 0.5, 1, 2, 4, and 6 hours after administration)
Title
Maximum observed concentration [Cmax] of RX-3117 and Abraxane® (Phase 1 and Phase 2)
Time Frame
Cycle 1 Days 1 (pre-infusion, post-infusion, pre-dose RX-3117, and 0.5, 1, 2, 4, 6, and 24 hours after administration) and 15 (pre-infusion, post-infusion, pre-dose RX-3117, and 0.5, 1, 2, 4, and 6 hours after administration)
Title
Overall response rate [ORR] (Phase 1 and Phase 2)
Time Frame
Baseline, and at 8, 6, 24, and 32 weeks
Title
Time to response [TTR] (Phase 1)
Time Frame
Baseline, and at 8, 6, 24, and 32 weeks
Title
Duration of response [DOR] (Phase 1 and Phase 2)
Time Frame
Baseline, and at 8, 6, 24, and 32 weeks
Title
Number of participants with Progression-free survival [PFS] (Phase 1)
Time Frame
Baseline, and at 8, 6, 24, and 32 weeks
Title
Time to progression (Phase 2)
Time Frame
Baseline, and at 8, 6, 24, and 32 weeks
Other Pre-specified Outcome Measures:
Title
Exploratory measurement of protein biomarkers related to RX-3117 or pancreatic cancer (Phase 1 and 2)
Time Frame
Baseline, and at 8, 6, 24, and 32 weeks
Title
Tumor burden response (Phase 2)
Description
Changes in tumor burden response via tumor marker measurement
Time Frame
Baseline, and at 8, 6, 24, and 32 weeks
Title
Quality of Life (QOL) (Phase 1 and 2)
Description
Weekly patient reported quality of life measures using validated QOL questionnaires
Time Frame
9 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Disease Related Subject has confirmed histologic or cytologic evidence of metastatic pancreatic cancer and has no prior treatment for metastatic pancreatic cancer. Subject has measurable disease using Response Evaluation Criteria in Solid Tumors (RECIST) v 1.1. Subject has a life expectancy of at least 3 months. Subject has an Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1. Demographic Males or females ≥ 18 years of age Subject must be able to swallow capsules Subject must have adequate venous access for intravenous (IV) infusion Laboratory Subject has hemoglobin ≥ 9.0 g/dL at Screening Subject has absolute neutrophil count (ANC) ≥ 1.5 x 109/L at Screening Subject has platelet count ≥ 100 x 109/L at Screening Subject has serum creatinine ≤ 1.5 times the upper limit of normal (ULN) at Screening. Subjects with serum creatinine levels > 1.5 times the ULN must have a 24-hour urine creatinine clearance ≥ 60 mL/min Subject has serum bilirubin ≤ 1.5 times the ULN (except in subjects with Gilbert's Syndrome who must have serum bilirubin < 3.0 x ULN) Subject has aspartate aminotransferase (AST; SGOT) and alanine aminotransferase (ALT; SGPT) ≤ 2.5 times the ULN (OR, AST and ALT ≤ 5 times the ULN in the presence of known liver metastases) Subject has alkaline phosphatase ≤ 2.5 times the ULN (OR ≤ 5 times the ULN in the presence of known liver or bone metastases) Subject has normal coagulation parameters (prothrombin time [PT] and/or international normalized ratio [INR], and partial thromboplastin time [PTT] within normal limits [<1.2 x ULN]) Subject has potassium concentration within normal range, or correctable with supplements. Oxygen saturation by pulse oximetry ≥ 92% at rest. For women of childbearing potential: Negative serum pregnancy test during screening and negative serum or urine pregnancy test at start of study therapy (Cycle1 Day 1). Reproductive For female subjects of childbearing potential, willingness to abstain from heterosexual intercourse or use a protocol-recommended method of contraception from the screening visit throughout the study treatment period and for 30 days following the last dose of study drug. Female subjects of non-childbearing potential defined as having amenorrhea for at least 24 consecutive months, a documented hysterectomy, or a documented bilateral oophorectomy) For fertile male subjects having intercourse with females of childbearing potential, willingness to abstain from heterosexual intercourse or use a protocol-recommended method of contraception from the start of study therapy throughout the study treatment period and for 30 days following the last dose of study drug and to refrain from sperm donation from the start of study treatment throughout the study treatment period and for 30 days following the last dose of study drug. Ethical In the judgment of the investigator, participation in the protocol offers an acceptable benefit-to-risk ratio when considering current disease status, medical condition, and the potential benefits and risks of alternative treatments for the subject's cancer. Before any study-specific procedure, the appropriate written informed consent must be obtained Exclusion Criteria: Disease Related Subject has primary brain tumors or clinical evidence of active brain metastasis Subject has undergone major surgery within 4 weeks of the start of study treatment. Laparoscopy and central venous catheter placement are not considered major surgery Medications Subject has a history of systemic corticosteroid use within 7 days before Day 1 of Cycle 1 General Subject has an active infection requiring parenteral or oral antibiotics within 2 weeks before planned start of study therapy Subject has uncontrolled diabetes as assessed by the investigator Subject has a second malignancy other than curatively resected basal cell carcinoma of the skin, squamous cell carcinoma of the skin, in situ carcinoma of the cervix, or other cancers treated with curative intent and no known active disease within 3 years before planned start of study therapy Subject has an active infection of hepatitis B, hepatitis C or human immunodeficiency virus Female subjects who are pregnant, planning a pregnancy or breast feeding during the study Subject has a high cardiovascular risk, including, but not limited to, subjects with congestive heart failure (New York Heart Association [NYHA] Class III or IV), cardiac arrhythmia, unstable angina, coronary stenting or acute coronary syndromes within 6 months before planned start of study therapy or r myocardial infarction within one year before planned start of study therapy Criterion removed Subject has a history of prior allogeneic bone marrow progenitor cell or solid organ transplantation. Subject has known acute or chronic pancreatitis. Subject has persistent diarrhea, malabsorption, or known sub-acute bowel obstruction ≥ NCI CTCAE Grade 2, despite medical management. Subject has any disorder that may interfere with drug absorption, distribution, metabolism, or excretion (including gastrointestinal surgery and bariatric surgery) All acute toxic effects of any prior antitumor therapy resolved to Grade ≤ 1 before the start of study therapy (with the exception of alopecia [Grade 1 or 2 permitted], or neurotoxicity [Grade 1 or 2 permitted], or anemia [Grade 2 permitted]) Subject has any other medical, psychiatric, or social condition, which in the opinion of the investigator, would preclude participation in the study, pose an undue medical hazard, interfere with the conduct of the study, or interfere with interpretation of the study results Subject has a history of interstitial lung disease, slowly progressive dyspnea and unproductive cough, sarcoidosis, silicosis, idiopathic pulmonary fibrosis, pulmonary hypersensitivity pneumonitis or multiple allergies. Any lung disease that may interfere with the detection or management of suspected drug-related pulmonary toxicity. Subject is currently enrolled in any other clinical protocol or investigational trial that involves administration of experimental therapy and/or therapeutic devices, or investigational drug. Subject has a history of hypersensitivity to RX-3117, gemcitabine, azacytidine cytosine arabinoside, paclitaxel, nab-paclitaxel, or their excipients. Subject is unwilling or unable to comply with study requirements or planned unavailability for follow-up assessments.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ely Benaim, MD
Organizational Affiliation
Rexahn Pharmaceuticals, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Rexahn Site
City
Tucson
State/Province
Arizona
ZIP/Postal Code
85724
Country
United States
Facility Name
Rexahn Site
City
Weeki Wachee
State/Province
Florida
ZIP/Postal Code
34607
Country
United States
Facility Name
Rexahn Site
City
Joliet
State/Province
Illinois
ZIP/Postal Code
60435
Country
United States
Facility Name
Rexahn Site
City
Skokie
State/Province
Illinois
ZIP/Postal Code
60077
Country
United States
Facility Name
Rexahn Site
City
Lexington
State/Province
Kentucky
ZIP/Postal Code
40503
Country
United States
Facility Name
Rexahn Site
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Facility Name
Rexahn Site
City
New York
State/Province
New York
ZIP/Postal Code
10065
Country
United States
Facility Name
Rexahn Site
City
Spartanburg
State/Province
South Carolina
ZIP/Postal Code
29303
Country
United States
Facility Name
Rexahn Site
City
Spokane
State/Province
Washington
ZIP/Postal Code
99202
Country
United States
Facility Name
Rexahn Site
City
Milwaukee
State/Province
Wisconsin
ZIP/Postal Code
53226
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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RX-3117 in Combination With Abraxane® in Subjects With Metastatic Pancreatic Cancer

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