Safety and Efficacy Study of 90Y-hPAM4 at Different Doses
Primary Purpose
Pancreatic Cancer
Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
90Y-hPAM4
Sponsored by
About this trial
This is an interventional treatment trial for Pancreatic Cancer focused on measuring pancreatic cancer, cancer of the pancreas, pancreas cancer
Eligibility Criteria
Inclusion Criteria:
- Male or female patients, >18 years of age, who are able to understand and give written informed consent.
- Histologically or cytologically confirmed, Stage III or IV pancreatic adenocarcinoma.
- Patients with Stage III (locally advanced) disease must have documented progression after failing primary therapy
- Patients with Stage IV (metastatic) disease must not have received more than one chemotherapy regimen.
- Measurable disease by CT, with at least on lesion >1.5 cm in one dimension.
- Karnofsky performance status > 70 % (Appendix A).
- Expected survival > three months.
- At least 4 weeks beyond chemotherapy, radiotherapy, major surgery, other experimental treatments, and recovered from all acute toxicities.
- At least 2 weeks beyond corticosteroids, except low doses (i.e., 20 mg/day of prednisone or equivalent) to treat nausea or other illness such as rheumatoid arthritis
- Adequate hematology without ongoing transfusional support (hemoglobin > 10 g/dL, ANC > 1,500 per mm3, platelets > 150,000 per mm3)
- Adequate renal and hepatic function (creatinine and bilirubin ≤ 1.5 X IULN, AST and ALT ≤ 2.0 X IULN)
- Otherwise, all toxicity at study entry <Grade 1 by NCI CTC v3.0.
Exclusion Criteria:
- Women who are pregnant or lactating.
- Women of childbearing potential and fertile men unwilling to use effective contraception during study until conclusion of 12-week post-treatment evaluation period.
- Known metastatic disease to the central nervous system.
- Presence of bulky disease (defined as any single mass >10 cm in its greatest dimension)
- Patients with >Grade 2 anorexia, nausea or vomiting, and/or signs of intestinal obstruction.
- Prior treatment with nitrosureas, actinomycin-D, radioimmunotherapy or other antibody-based therapies (murine, chimeric, humanized or human) Prior radiation dose >3,000 cGy to the liver, >2,000 cGy to lungs and kidneys or prior external beam irradiation to a field that includes more than 30% of the red marrow.
- Patients with non-melanoma skin cancer or carcinoma in situ of the cervix are not excluded, but patients with other prior malignancies must have had at least a 5- year disease free interval.
- Patients known to be HIV positive, hepatitis B positive, or hepatitis C positive.
- Known history of active coronary artery disease, unstable angina, myocardial infarction, or congestive heart failure present within 6 months or cardiac arrhythmia requiring anti-arrhythmia therapy.
- Known history of active COPD, or other moderate-to-severe respiratory illness present within 6 months.
- Known autoimmune disease or presence of autoimmune phenomena (except rheumatoid arthritis requiring only low dose maintenance corticosteroids).
- Infection requiring intravenous antibiotic use within 1 week.
- Other concurrent medical or psychiatric conditions that, in the Investigator's opinion, may be likely to confound study interpretation
Sites / Locations
- Goshen Cancer Center
- Nebraska Medical Center
- University of Medicine and Dentistry
- Fox Chase Cancer Center
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Multi Dose levels
Arm Description
different doses of 90YhPAM4 will be given only once.
Outcomes
Primary Outcome Measures
safety MTD
Secondary Outcome Measures
targeting, biodistribution, organ dosimetry
pharmacokinetics (PK), antigenicity,
efficacy
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT00597129
Brief Title
Safety and Efficacy Study of 90Y-hPAM4 at Different Doses
Official Title
A Phase I, Dose-Escalating Study to Investigate the Safety, Tolerability, Pharmacokinetics and Dosimetry of a Single Dose of 90YHumanized PAM4 IgG in Patients With Locally Advanced/Metastatic Pancreatic Cancer
Study Type
Interventional
2. Study Status
Record Verification Date
January 2008
Overall Recruitment Status
Completed
Study Start Date
August 2004 (undefined)
Primary Completion Date
October 2007 (Actual)
Study Completion Date
October 2007 (Actual)
3. Sponsor/Collaborators
Name of the Sponsor
Gilead Sciences
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
Safety study to determine highest dose of 90Y-hPAM4 can be safety administered
Detailed Description
radiolabeled anti-MUC1 humanized antibody) administered intravenously as a single dose to patients with locally advanced and/or metastatic pancreatic cancer. The primary objective is to determine the dose-limiting toxicity (DLT) and maximum tolerated dose (MTD) of 90Y-hPAM4 in this population. Secondary objectives include the assessment of tumor targeting, biodistribution, organ dosimetry and pharmacokinetics (PK) of 90Y-hPAM4 as determined by pre-therapy administration of 111In-hPAM4, the assessment of the antigenicity of 90Y-hPAM4, as determined by development of human anti-humanized antibodies (HAHA), and to obtain preliminary information on the efficacy of single dose 90Y-hPAM4 in this patient population.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pancreatic Cancer
Keywords
pancreatic cancer, cancer of the pancreas, pancreas cancer
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
21 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Multi Dose levels
Arm Type
Experimental
Arm Description
different doses of 90YhPAM4 will be given only once.
Intervention Type
Biological
Intervention Name(s)
90Y-hPAM4
Other Intervention Name(s)
111-IN-hPAM4, MUC-1 antibody
Intervention Description
Single dose of 90Y-hPAM4 will be given and all patients will be followed for 12 weeks.
Primary Outcome Measure Information:
Title
safety MTD
Time Frame
over the first 12 weeks, then over 2 years
Secondary Outcome Measure Information:
Title
targeting, biodistribution, organ dosimetry
Time Frame
first 2 weeks
Title
pharmacokinetics (PK), antigenicity,
Time Frame
first 12 weeks
Title
efficacy
Time Frame
over first 12 weeks, then over 2 years
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Male or female patients, >18 years of age, who are able to understand and give written informed consent.
Histologically or cytologically confirmed, Stage III or IV pancreatic adenocarcinoma.
Patients with Stage III (locally advanced) disease must have documented progression after failing primary therapy
Patients with Stage IV (metastatic) disease must not have received more than one chemotherapy regimen.
Measurable disease by CT, with at least on lesion >1.5 cm in one dimension.
Karnofsky performance status > 70 % (Appendix A).
Expected survival > three months.
At least 4 weeks beyond chemotherapy, radiotherapy, major surgery, other experimental treatments, and recovered from all acute toxicities.
At least 2 weeks beyond corticosteroids, except low doses (i.e., 20 mg/day of prednisone or equivalent) to treat nausea or other illness such as rheumatoid arthritis
Adequate hematology without ongoing transfusional support (hemoglobin > 10 g/dL, ANC > 1,500 per mm3, platelets > 150,000 per mm3)
Adequate renal and hepatic function (creatinine and bilirubin ≤ 1.5 X IULN, AST and ALT ≤ 2.0 X IULN)
Otherwise, all toxicity at study entry <Grade 1 by NCI CTC v3.0.
Exclusion Criteria:
Women who are pregnant or lactating.
Women of childbearing potential and fertile men unwilling to use effective contraception during study until conclusion of 12-week post-treatment evaluation period.
Known metastatic disease to the central nervous system.
Presence of bulky disease (defined as any single mass >10 cm in its greatest dimension)
Patients with >Grade 2 anorexia, nausea or vomiting, and/or signs of intestinal obstruction.
Prior treatment with nitrosureas, actinomycin-D, radioimmunotherapy or other antibody-based therapies (murine, chimeric, humanized or human) Prior radiation dose >3,000 cGy to the liver, >2,000 cGy to lungs and kidneys or prior external beam irradiation to a field that includes more than 30% of the red marrow.
Patients with non-melanoma skin cancer or carcinoma in situ of the cervix are not excluded, but patients with other prior malignancies must have had at least a 5- year disease free interval.
Patients known to be HIV positive, hepatitis B positive, or hepatitis C positive.
Known history of active coronary artery disease, unstable angina, myocardial infarction, or congestive heart failure present within 6 months or cardiac arrhythmia requiring anti-arrhythmia therapy.
Known history of active COPD, or other moderate-to-severe respiratory illness present within 6 months.
Known autoimmune disease or presence of autoimmune phenomena (except rheumatoid arthritis requiring only low dose maintenance corticosteroids).
Infection requiring intravenous antibiotic use within 1 week.
Other concurrent medical or psychiatric conditions that, in the Investigator's opinion, may be likely to confound study interpretation
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
William Wegener, MD, PhD
Organizational Affiliation
Gilead Sciences
Official's Role
Study Chair
Facility Information:
Facility Name
Goshen Cancer Center
City
Goshen
State/Province
Indiana
ZIP/Postal Code
46526
Country
United States
Facility Name
Nebraska Medical Center
City
Omaha
State/Province
Nebraska
ZIP/Postal Code
68198
Country
United States
Facility Name
University of Medicine and Dentistry
City
Newark
State/Province
New Jersey
ZIP/Postal Code
07101
Country
United States
Facility Name
Fox Chase Cancer Center
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19111
Country
United States
12. IPD Sharing Statement
Citations:
PubMed Identifier
18094420
Citation
Gold DV, Karanjawala Z, Modrak DE, Goldenberg DM, Hruban RH. PAM4-reactive MUC1 is a biomarker for early pancreatic adenocarcinoma. Clin Cancer Res. 2007 Dec 15;13(24):7380-7. doi: 10.1158/1078-0432.CCR-07-1488.
Results Reference
background
PubMed Identifier
16505092
Citation
Modrak DE, Gold DV, Goldenberg DM. Sphingolipid targets in cancer therapy. Mol Cancer Ther. 2006 Feb;5(2):200-8. doi: 10.1158/1535-7163.MCT-05-0420.
Results Reference
background
PubMed Identifier
16344318
Citation
Gold DV, Modrak DE, Ying Z, Cardillo TM, Sharkey RM, Goldenberg DM. New MUC1 serum immunoassay differentiates pancreatic cancer from pancreatitis. J Clin Oncol. 2006 Jan 10;24(2):252-8. doi: 10.1200/JCO.2005.02.8282. Epub 2005 Dec 12.
Results Reference
background
PubMed Identifier
15870874
Citation
Modrak DE, Karacay H, Cardillo TM, Newsome G, Goldenberg DM, Gold DV. Identification of a Mu-9 (anti-colon-specific antigen-p)-reactive peptide having homology to CA125 (MUC16). Int J Oncol. 2005 Jun;26(6):1591-6.
Results Reference
background
PubMed Identifier
15548711
Citation
Modrak DE, Cardillo TM, Newsome GA, Goldenberg DM, Gold DV. Synergistic interaction between sphingomyelin and gemcitabine potentiates ceramide-mediated apoptosis in pancreatic cancer. Cancer Res. 2004 Nov 15;64(22):8405-10. doi: 10.1158/0008-5472.CAN-04-2988.
Results Reference
background
PubMed Identifier
14991585
Citation
Gold DV, Modrak DE, Schutsky K, Cardillo TM. Combined 90Yttrium-DOTA-labeled PAM4 antibody radioimmunotherapy and gemcitabine radiosensitization for the treatment of a human pancreatic cancer xenograft. Int J Cancer. 2004 Apr 20;109(4):618-26. doi: 10.1002/ijc.20004.
Results Reference
background
PubMed Identifier
14506191
Citation
Gold DV, Schutsky K, Modrak D, Cardillo TM. Low-dose radioimmunotherapy ((90)Y-PAM4) combined with gemcitabine for the treatment of experimental pancreatic cancer. Clin Cancer Res. 2003 Sep 1;9(10 Pt 2):3929S-37S.
Results Reference
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PubMed Identifier
12743424
Citation
Modrak DE, Gold DV, Goldenberg DM, Blumenthal RD. Colonic tumor CEA, CSAp and MUC-1 expression following radioimmunotherapy or chemotherapy. Tumour Biol. 2003 Jan-Feb;24(1):32-9. doi: 10.1159/000070658.
Results Reference
background
PubMed Identifier
12565994
Citation
Reddy PK, Gold DV, Cardillo TM, Goldenberg DM, Li H, Burton JD. Interferon-gamma upregulates MUC1 expression in haematopoietic and epithelial cancer cell lines, an effect associated with MUC1 mRNA induction. Eur J Cancer. 2003 Feb;39(3):397-404. doi: 10.1016/s0959-8049(02)00700-1.
Results Reference
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PubMed Identifier
11774294
Citation
Cardillo TM, Blumenthal R, Ying Z, Gold DV. Combined gemcitabine and radioimmunotherapy for the treatment of pancreatic cancer. Int J Cancer. 2002 Jan 20;97(3):386-92. doi: 10.1002/ijc.1613.
Results Reference
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PubMed Identifier
11595713
Citation
Cardillo TM, Ying Z, Gold DV. Therapeutic advantage of (90)yttrium- versus (131)iodine-labeled PAM4 antibody in experimental pancreatic cancer. Clin Cancer Res. 2001 Oct;7(10):3186-92.
Results Reference
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PubMed Identifier
11418312
Citation
Gold DV, Cardillo T, Goldenberg DM, Sharkey RM. Localization of pancreatic cancer with radiolabeled monoclonal antibody PAM4. Crit Rev Oncol Hematol. 2001 Jul-Aug;39(1-2):147-54. doi: 10.1016/s1040-8428(01)00114-7.
Results Reference
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PubMed Identifier
9178823
Citation
Gold DV, Cardillo T, Vardi Y, Blumenthal R. Radioimmunotherapy of experimental pancreatic cancer with 131I-labeled monoclonal antibody PAM4. Int J Cancer. 1997 May 16;71(4):660-7. doi: 10.1002/(sici)1097-0215(19970516)71:43.0.co;2-e.
Results Reference
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PubMed Identifier
7493369
Citation
Mariani G, Molea N, Bacciardi D, Boggi U, Fornaciari G, Campani D, Salvadori PA, Giulianotti PC, Mosca F, Gold DV, et al. Initial tumor targeting, biodistribution, and pharmacokinetic evaluation of the monoclonal antibody PAM4 in patients with pancreatic cancer. Cancer Res. 1995 Dec 1;55(23 Suppl):5911s-5915s.
Results Reference
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PubMed Identifier
7493339
Citation
Alisauskus R, Wong GY, Gold DV. Initial studies of monoclonal antibody PAM4 targeting to xenografted orthotopic pancreatic cancer. Cancer Res. 1995 Dec 1;55(23 Suppl):5743s-5748s.
Results Reference
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PubMed Identifier
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Citation
Gold DV, Alisauskas R, Sharkey RM. Targeting of xenografted pancreatic cancer with a new monoclonal antibody, PAM4. Cancer Res. 1995 Mar 1;55(5):1105-10.
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Safety and Efficacy Study of 90Y-hPAM4 at Different Doses
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