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Safety and Dose-Finding Study of TM-601 in Adults With Recurrent Malignant Glioma

Primary Purpose

Malignant Glioma, Glioblastoma Multiforme, GBM

Status
Unknown status
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
TM-601
Sponsored by
TransMolecular
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Malignant Glioma focused on measuring recurrent glioma, Phase I, Multi-Center, Open label, Brain Cancer, Brain tumor, GBM, Glioma, Glioblastoma multiforme

Eligibility Criteria

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

Inclusion Criteria:

Patients Must:

  1. Have histologically proven malignant glioma (anaplastic astrocytoma, anaplastic oligodendroglioma or glioblastoma multiforme) which is progressive or recurrent after external beam radiation therapy (to at least 50 Gy) ± chemotherapy. Patients with previous low grade glioma who progressed after radiotherapy ± chemotherapy and are biopsied and found to have a high grade glioma are eligible.
  2. Be ≥18 years of age.
  3. Have a baseline Karnofsky Performance status of ≥60%
  4. Have a Mini Mental State Exam score ≥ 19.
  5. Have a life expectancy, based on the Investigator's judgment, of >3 months.
  6. On screening ECG, have a QTc interval of <450 ms.
  7. If taking steroids, be on a dose that is stable for at least 5 days prior to the imaging dose.
  8. Have recovered from the toxicity of all previous therapy prior to enrollment. If the patient has undergone recent major surgery, an interval of at least 3 weeks must have elapsed between the surgery and the date of the imaging dose.
  9. Have adequate organ and marrow function as defined below:

    hemoglobin >9.0g/dL absolute neutrophil count >1,500 mm3 platelet count >100,000 mm3 prothrombin time <1.5 ULN partial thromboplastin time (PTT) <1.5 ULN total bilirubin < 2.0 mg/dL AST(SGOT)/ALT(SGPT) <5 x institutional ULN creatinine (serum) ≤2.0 mg/dL*

    *If serum creatinine is >2.0 then creatinine clearance must be ≥60 ml/min

  10. Have a negative serum and urine pregnancy test within 14 days of study drug administration, if female and of child bearing potential.
  11. Agree to use an effective form of contraception to avoid pregnancy, if fertile (applicable to both male and female patients).
  12. Agree to refrain from nursing, if female.
  13. Have signed and dated written informed consent.
  14. Be able to comply with treatment plan, study procedures and follow-up examinations.

Exclusion Criteria:

Patients may NOT:

  1. Have a serious concurrent infection or medical illness which would jeopardize the ability of the patient to receive the treatment outlined in this protocol with reasonable safety. (Examples of medical illnesses are [but not limited to] the following: uncontrolled hypertension, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situation that would limit compliance with study requirements.)
  2. Have a prior malignancy with less than 5-year disease free interval, except for adequately treated basal cell or squamous cell carcinoma of the skin, or in situ cancer of the cervix.
  3. Be pregnant or breast-feeding.
  4. Have received radiation treatments ≤ 3 months from time of first study drug administration.
  5. Have received any cytotoxic chemotherapy, whether conventional or investigational, ≤ 4 weeks prior to enrollment in this study (6 weeks for mitomycin-C or nitrosoureas).
  6. Have a history of allergic reactions attributed to compounds of similar chemical or biologic composition to 131I-TM-601 e.g. iodine or iodine-containing drugs.

Sites / Locations

  • University of Alabama
  • Cedars-Sinai Medical Center
  • Northwestern University
  • Washington University
  • Columbia University
  • Wake Forest University
  • University of Washington

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Arm Label

Cohort 1

Cohort 2

Cohort 3

Cohort 4

Cohort 5

Cohort 6

Arm Description

0.04 mg/kg TM-601 dose per administration

0.08 mg/kg TM-601 dose per administration

0.16 mg/kg TM-601 dose per administration

0.3 mg/kg TM-601 dose per administration

0.6 mg/kg TM-601 dose per administration

1.2 mg/kg TM-601 dose per administration

Outcomes

Primary Outcome Measures

To determine the safety profile/tolerability of TM-601 in this patient population, based on adverse event incidence, severity, duration, causality, seriousness and type as well as by physical examination, vital signs and clinical laboratory assessments.

Secondary Outcome Measures

A primary objective of this study is to evaluate the biologically active dose of TM-601 in this population of patients based on changes in perfusion MRI parameters.

Full Information

First Posted
December 27, 2007
Last Updated
July 16, 2009
Sponsor
TransMolecular
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1. Study Identification

Unique Protocol Identification Number
NCT00591058
Brief Title
Safety and Dose-Finding Study of TM-601 in Adults With Recurrent Malignant Glioma
Official Title
A Phase I Dose Escalation Study Evaluating the Safety and Biologically Active Dose of TM-601 Based on Perfusion MRI Imaging Criteria in Patients With Progressive and/or Recurrent Malignant Glioma
Study Type
Interventional

2. Study Status

Record Verification Date
July 2009
Overall Recruitment Status
Unknown status
Study Start Date
February 2008 (undefined)
Primary Completion Date
February 2010 (Anticipated)
Study Completion Date
February 2010 (Anticipated)

3. Sponsor/Collaborators

Name of the Sponsor
TransMolecular

4. Oversight

5. Study Description

Brief Summary
The purpose of this study is to evaluate the safety and biologically active dose of TM-601 in adult patients with recurrent malignant glioma.
Detailed Description
This Phase I study will evaluate the safety of TM-601 in patients with recurrent malignant glioma who have failed first-line, standard therapy. Study patients will be assigned to receive treatment in 1 of 6 treatment cohorts. Patients will be assigned to each dose level in groups of 3-6 (depending upon treatment response seen within each cohort), with escalation to the next highest dose dependent upon demonstrated tolerance in the previous dosing group. Patients will be administered an imaging dose of 131I-TM-601, intravenously, to demonstrate tumor-specific localization prior to study treatment with non-labeled TM-601. Eligible patients demonstrating tumor-specific imaging will be assigned to a treatment cohort and will received non-labeled TM-601 once a week for 3 weeks, followed by clinical follow-up visits and MR imaging. Data from this study will help determine the IV dose of TM-601 required to produce MR perfusion changes (as well as other biomarker changes) in patients with recurrent malignant glioma. It is not known whether participation in this trial will provide patients with benefit in terms of improved tumor control, although pre-clinical evidence and evidence from other clinical trials with 131I TM-601 suggest that TM-601 is an active agent in malignant glioma.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Malignant Glioma, Glioblastoma Multiforme, GBM, Astrocytoma, Oligodendroglioma
Keywords
recurrent glioma, Phase I, Multi-Center, Open label, Brain Cancer, Brain tumor, GBM, Glioma, Glioblastoma multiforme

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
36 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Cohort 1
Arm Type
Experimental
Arm Description
0.04 mg/kg TM-601 dose per administration
Arm Title
Cohort 2
Arm Type
Experimental
Arm Description
0.08 mg/kg TM-601 dose per administration
Arm Title
Cohort 3
Arm Type
Experimental
Arm Description
0.16 mg/kg TM-601 dose per administration
Arm Title
Cohort 4
Arm Type
Experimental
Arm Description
0.3 mg/kg TM-601 dose per administration
Arm Title
Cohort 5
Arm Type
Experimental
Arm Description
0.6 mg/kg TM-601 dose per administration
Arm Title
Cohort 6
Arm Type
Experimental
Arm Description
1.2 mg/kg TM-601 dose per administration
Intervention Type
Drug
Intervention Name(s)
TM-601
Other Intervention Name(s)
Chlorotoxin (Synthetic)
Intervention Description
TM-601, administered intravenously (IV), once/week for 3 weeks
Primary Outcome Measure Information:
Title
To determine the safety profile/tolerability of TM-601 in this patient population, based on adverse event incidence, severity, duration, causality, seriousness and type as well as by physical examination, vital signs and clinical laboratory assessments.
Time Frame
Throughout the treatment phase of the study for each study patient, and for 28 days following the final study dose.
Secondary Outcome Measure Information:
Title
A primary objective of this study is to evaluate the biologically active dose of TM-601 in this population of patients based on changes in perfusion MRI parameters.
Time Frame
At the completion of the dosing cycle for each patient, and at 28 days following the patient's final study treatment.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients Must: Have histologically proven malignant glioma (anaplastic astrocytoma, anaplastic oligodendroglioma or glioblastoma multiforme) which is progressive or recurrent after external beam radiation therapy (to at least 50 Gy) ± chemotherapy. Patients with previous low grade glioma who progressed after radiotherapy ± chemotherapy and are biopsied and found to have a high grade glioma are eligible. Be ≥18 years of age. Have a baseline Karnofsky Performance status of ≥60% Have a Mini Mental State Exam score ≥ 19. Have a life expectancy, based on the Investigator's judgment, of >3 months. On screening ECG, have a QTc interval of <450 ms. If taking steroids, be on a dose that is stable for at least 5 days prior to the imaging dose. Have recovered from the toxicity of all previous therapy prior to enrollment. If the patient has undergone recent major surgery, an interval of at least 3 weeks must have elapsed between the surgery and the date of the imaging dose. Have adequate organ and marrow function as defined below: hemoglobin >9.0g/dL absolute neutrophil count >1,500 mm3 platelet count >100,000 mm3 prothrombin time <1.5 ULN partial thromboplastin time (PTT) <1.5 ULN total bilirubin < 2.0 mg/dL AST(SGOT)/ALT(SGPT) <5 x institutional ULN creatinine (serum) ≤2.0 mg/dL* *If serum creatinine is >2.0 then creatinine clearance must be ≥60 ml/min Have a negative serum and urine pregnancy test within 14 days of study drug administration, if female and of child bearing potential. Agree to use an effective form of contraception to avoid pregnancy, if fertile (applicable to both male and female patients). Agree to refrain from nursing, if female. Have signed and dated written informed consent. Be able to comply with treatment plan, study procedures and follow-up examinations. Exclusion Criteria: Patients may NOT: Have a serious concurrent infection or medical illness which would jeopardize the ability of the patient to receive the treatment outlined in this protocol with reasonable safety. (Examples of medical illnesses are [but not limited to] the following: uncontrolled hypertension, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situation that would limit compliance with study requirements.) Have a prior malignancy with less than 5-year disease free interval, except for adequately treated basal cell or squamous cell carcinoma of the skin, or in situ cancer of the cervix. Be pregnant or breast-feeding. Have received radiation treatments ≤ 3 months from time of first study drug administration. Have received any cytotoxic chemotherapy, whether conventional or investigational, ≤ 4 weeks prior to enrollment in this study (6 weeks for mitomycin-C or nitrosoureas). Have a history of allergic reactions attributed to compounds of similar chemical or biologic composition to 131I-TM-601 e.g. iodine or iodine-containing drugs.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Burt Nabors, MD
Organizational Affiliation
University of Alabama at Birmingham
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Glenn Lesser, MD
Organizational Affiliation
Wake Forest University
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Steven Rosenfeld, MD, PhD
Organizational Affiliation
Columbia University
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Sean Grimm, MD
Organizational Affiliation
Northwestern University
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Maceij Mrugala, MD
Organizational Affiliation
University of Washington at Seattle
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Jeremy Rudnick, MD
Organizational Affiliation
Cedars-Sinai Medical Center
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Gerry Linette, MD
Organizational Affiliation
Washington University at St. Louis
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Alabama
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35294-3410
Country
United States
Facility Name
Cedars-Sinai Medical Center
City
Los Angeles
State/Province
California
ZIP/Postal Code
90048
Country
United States
Facility Name
Northwestern University
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
Washington University
City
St. Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
Columbia University
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Facility Name
Wake Forest University
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27157-1082
Country
United States
Facility Name
University of Washington
City
Seattle
State/Province
Washington
ZIP/Postal Code
98195-6470
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
17335414
Citation
Mamelak AN, Jacoby DB. Targeted delivery of antitumoral therapy to glioma and other malignancies with synthetic chlorotoxin (TM-601). Expert Opin Drug Deliv. 2007 Mar;4(2):175-86. doi: 10.1517/17425247.4.2.175.
Results Reference
background
PubMed Identifier
16877732
Citation
Mamelak AN, Rosenfeld S, Bucholz R, Raubitschek A, Nabors LB, Fiveash JB, Shen S, Khazaeli MB, Colcher D, Liu A, Osman M, Guthrie B, Schade-Bijur S, Hablitz DM, Alvarez VL, Gonda MA. Phase I single-dose study of intracavitary-administered iodine-131-TM-601 in adults with recurrent high-grade glioma. J Clin Oncol. 2006 Aug 1;24(22):3644-50. doi: 10.1200/JCO.2005.05.4569.
Results Reference
background
PubMed Identifier
15809479
Citation
Hockaday DC, Shen S, Fiveash J, Raubitschek A, Colcher D, Liu A, Alvarez V, Mamelak AN. Imaging glioma extent with 131I-TM-601. J Nucl Med. 2005 Apr;46(4):580-6.
Results Reference
background
PubMed Identifier
12112367
Citation
Lyons SA, O'Neal J, Sontheimer H. Chlorotoxin, a scorpion-derived peptide, specifically binds to gliomas and tumors of neuroectodermal origin. Glia. 2002 Aug;39(2):162-73. doi: 10.1002/glia.10083.
Results Reference
background

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Safety and Dose-Finding Study of TM-601 in Adults With Recurrent Malignant Glioma

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