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Safety Study of Pritumumab in Brain Cancer

Primary Purpose

Malignant Primary Brain Tumors, Brain Metastases, Adult

Status
Unknown status
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Pritumumab
Sponsored by
Nascent Biotech
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Malignant Primary Brain Tumors

Eligibility Criteria

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

Inclusion Criteria Subjects must meet all of the inclusion criteria to participate in this study.

  1. Ability to understand and the willingness to provide informed consent.
  2. Diagnosis

    Histologically confirmed diagnosis of brain cancer:

    • glioblastoma (GBM),
    • anaplastic astrocytoma (AA),
    • anaplastic oligodendroglioma (AO),
    • anaplastic mixed oligoastrocytoma (AMO),
    • low grade gliomas,
    • brain metastases,
    • meningiomas, chordomas, medulloblastoma, craniopharyngiomas, pituitary tumors or
    • leptomeningeal metastases
  3. Prior Therapy Has failed prior standard therapy including maximal safe surgical resection, radiation therapy (when appropriate for the specific cancer type), or systemic therapy or is intolerant of, or has refused other available therapies, but is still in need of therapy. No patients may receive Pritumumab prior to any surgery for their cerebral tumor
  4. Progression/Recurrence Has progression of brain cancer and measurable disease by magnetic resonance imaging (MRI) or computed tomography (CT) scan.

    For leptomeningeal metastases, positive cytology is acceptable if imaging is not measurable.

  5. Age Age ≥ 18 years.
  6. Performance Status Karnofsky Performance Status ≥ 60% (see Appendix A). Subjects must have a life expectancy of equal to or greater than 8 weeks.
  7. Organ and Marrow Function Requirements

    Hematology:

    • Absolute Neutrophil Count (ANC) ≥ 1.5 x 109/L
    • Platelet count ≥ 100 x 109/L
    • Hemoglobin ≥ 9.0 g/dL
    • White blood cell (WBC) count ≥ 3.0 x 109/L

    Biochemistry:

    • AST/SGOT and ALT/SGPT ≤ 5 x institution's ULN
    • Total bilirubin ≤ 3 x institution's ULN
    • Serum creatinine ≤ 2 x institution's ULN or 24-hour creatinine clearance ≥ 50 mL/min
    • Alkaline phosphatase (ALP) ≤ 3 x ULN unless considered tumor related
    • Estimated GFR > 50 mL/min

    Coagulation:

    • INR ≤ 1.4
    • PT/aPTT ≤ 1.2 x institution's ULN
  8. Contraception All fertile females and any man with a partner of child-bearing potential agrees to use adequate contraception which will include two of the following: hormonal or barrier method of birth control, or abstinence prior to study entry, for the duration of study participation, and for 30 days following completion of therapy.
  9. Although Pritumumab shows notable immunohistologic reactivity against active endometrial tissues, fertile female patients will be included in this study.

Exclusion Criteria Subjects meeting any of the exclusion criteria at baseline will be excluded from study participation.

  1. Current or anticipated use of other investigational agents.
  2. Insufficient time for recovery from prior therapy:

    • less than 28 days from any prior cytotoxic investigational agent,
    • less than 14 days from any prior non-cytotoxic investigational agent,
    • less than 28 days from prior cytotoxic therapy (except 23 days from prior temozolomide at 5 day regimen and 14 days from prior temozolomide at daily regimen, 14 days from vincristine, 42 days from nitrosoureas, 21 days from procarbazine administration),
    • less than 7 days for non-cytotoxic agents, e.g., interferon, tamoxifen, thalidomide, cis-retinoic acid, targeted therapies (radiosensitizer does not count),
    • less than 7 days for immunotherapy agents, e.g., DCVax, Celldex, PD1, etc.
  3. Less than 3 weeks from surgery or insufficient recovery from surgical-related trauma or wound healing.
  4. History of allergic reactions attributed to compounds of similar chemical or biologic composition to Pritumumab plus any patently atopic patients who have a history of having experienced an episode of allergic anaphylaxis.
  5. Severe or uncontrolled medical disorder that would, in the investigator's opinion, impair ability to receive study treatment (i.e., uncontrolled diabetes, chronic renal disease, chronic pulmonary disease or active, uncontrolled infection).
  6. Known diagnosis of human immunodeficiency virus (HIV) infection.
  7. Impaired cardiac function including any of the following:

    • Congenital long QT syndrome or a known family history of long QT syndrome;
    • History or presence of clinically significant ventricular or atrial tachyarrhythmias
    • Clinically significant resting bradycardia (< 50 beats per minute)
    • Inability to monitor the QT interval by ECG
    • QTc > 450 msec on baseline ECG. If QTc > 450 and electrolytes are not within normal ranges, electrolytes should be corrected and then the patient re-screened for QTc
    • Myocardial infarction within 1 year of starting study drug
    • Other clinically significant heart disease (e.g., unstable angina, congestive heart failure, or uncontrolled hypertension)
  8. Any female patients who develop serious uterine hemorrhage during this study may need to be excluded from further treatment with Pritumumab.

Sites / Locations

  • Hoag Memorial Hospital PresbyterianRecruiting
  • Sharp Memorial HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Pritumumab

Arm Description

Dose Escalation phase (3+3 patients): Pritumumab administered sequentially as 1-hour IV infusion, on Day 1, 8, and 22 of each 28-day treatment cycle at: 1.6 mg/kg, 4.8 mg/kg, 8.0 mg/kg, 12.0 mg/kg, and 16.2 mg/kg, for a maximum of 6 cycles or progression or unacceptable toxicity. Expansion phase (6-12 patients): Pritumumab administered as 1-hour IV infusion, on Day 1, 8, and 22 of each 28-day treatment cycle at or below MTD for a maximum of 6 cycles or progression or unacceptable toxicity.

Outcomes

Primary Outcome Measures

Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability]
Number of participants with treatment-related adverse events as assessed by NCI-CTCAE v.5.0 during first 24 weeks of treatment

Secondary Outcome Measures

Intra-cranial Objective Response Rate
Intra-cranial objective response rate at 2 months as assessed by the Response Assessment in Neuro-oncology (RANO) criteria

Full Information

First Posted
April 29, 2020
Last Updated
April 7, 2022
Sponsor
Nascent Biotech
Collaborators
Hoag Memorial Hospital Presbyterian
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1. Study Identification

Unique Protocol Identification Number
NCT04396717
Brief Title
Safety Study of Pritumumab in Brain Cancer
Official Title
A Phase 1, Sequential Cohort, Open-Label, Dose-Escalation Study of the Safety and CNS Exposure of Pritumumab in Patients With Brain Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
August 2021
Overall Recruitment Status
Unknown status
Study Start Date
March 18, 2021 (Actual)
Primary Completion Date
January 30, 2023 (Anticipated)
Study Completion Date
June 30, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Nascent Biotech
Collaborators
Hoag Memorial Hospital Presbyterian

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
Pritumumab is a human IgG1 kappa antibody that binds to a malignant tumor associated antigen, ecto domain-vimentin (EDV) which is expressed in a variety of tumor cells. Pritumumab was shown to have relatively high reactivity with brain cancer cell lines, while no reactivity was demonstrated with normal neurons, astrocytes or fetal cerebral cells. Pritumumab has notable antibody-dependent cellular cytotoxicity (ADCC), brain tumor penetration and antitumor activity in nude mouse human xenograft models. Primary Objectives - To determine the safety and/or tolerability and the recommended Phase 2 dose (RP2D) of escalating, intravenously (IV) administered Pritumumab doses in patients with recurrent gliomas or with brain metastases. Secondary Objectives To determine pharmacokinetics and pharmacodynamics of Pritumumab To identify preliminary signals of anti-tumor response to Pritumumab To explore disease-related, patient-reported outcomes
Detailed Description
This is an open-label, Phase 1, outpatient, dose escalation study of Pritumumab in patients with brain cancer who have failed prior therapy and have no other available options. In the first part of the study, escalating doses of Pritumumab of 1.6, 4.8, 8.0, 12.0, and 16.2 mg/kg will be administered in a sequential, safety-driven manner to eligible patients according to standard 3+3 scheme, as an 1-hour IV infusion on Days 1, 8, 15, and 22 of each 28-day treatment cycle. The dose levels may be modified upon obtained results. Once the maximum tolerated dose (MTD) is determined, an expansion cohort including 6-12 patients in selected tumor type at a dose equal or below to MTD is planned to determine the recommended Phase 2 dose (RP2D). A total of 42 patients may be administered with Pritumumab in this study. Patients will be treated with Pritumumab for a maximum of 6 cycles or until cancer progression or unacceptable toxicity. Patients will be followed after treatment completion every four months or until death or lost to follow-up. Standard clinical, laboratory and functional assessments will be employed to monitor for safety, tolerability and tumor response, including blood sampling for clinical biochemistries, pharmacokinetics, CSF and tissue samples, at frequency specified by the protocol. Patient-reported outcomes will also be assessed.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Malignant Primary Brain Tumors, Brain Metastases, Adult

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Sequential Assignment
Model Description
Open label, non-randomized, 3+3 dose escalation to determine MTD, followed by exoansion to 6-12 patients to determine RP2D. Subjects will continue study treatment until progressive disease or unacceptable toxicity. Follow-up will occur until death or lost to follow-up.
Masking
None (Open Label)
Allocation
N/A
Enrollment
42 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Pritumumab
Arm Type
Experimental
Arm Description
Dose Escalation phase (3+3 patients): Pritumumab administered sequentially as 1-hour IV infusion, on Day 1, 8, and 22 of each 28-day treatment cycle at: 1.6 mg/kg, 4.8 mg/kg, 8.0 mg/kg, 12.0 mg/kg, and 16.2 mg/kg, for a maximum of 6 cycles or progression or unacceptable toxicity. Expansion phase (6-12 patients): Pritumumab administered as 1-hour IV infusion, on Day 1, 8, and 22 of each 28-day treatment cycle at or below MTD for a maximum of 6 cycles or progression or unacceptable toxicity.
Intervention Type
Biological
Intervention Name(s)
Pritumumab
Intervention Description
Pritumumab IgG1 human monoclonal antibody
Primary Outcome Measure Information:
Title
Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability]
Description
Number of participants with treatment-related adverse events as assessed by NCI-CTCAE v.5.0 during first 24 weeks of treatment
Time Frame
Up to 24 weeks
Secondary Outcome Measure Information:
Title
Intra-cranial Objective Response Rate
Description
Intra-cranial objective response rate at 2 months as assessed by the Response Assessment in Neuro-oncology (RANO) criteria
Time Frame
2 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Subjects must meet all of the inclusion criteria to participate in this study. Ability to understand and the willingness to provide informed consent. Diagnosis Histologically confirmed diagnosis of brain cancer: glioblastoma (GBM), anaplastic astrocytoma (AA), anaplastic oligodendroglioma (AO), anaplastic mixed oligoastrocytoma (AMO), low grade gliomas, brain metastases, meningiomas, chordomas, medulloblastoma, craniopharyngiomas, pituitary tumors or leptomeningeal metastases Prior Therapy Has failed prior standard therapy including maximal safe surgical resection, radiation therapy (when appropriate for the specific cancer type), or systemic therapy or is intolerant of, or has refused other available therapies, but is still in need of therapy. No patients may receive Pritumumab prior to any surgery for their cerebral tumor Progression/Recurrence Has progression of brain cancer and measurable disease by magnetic resonance imaging (MRI) or computed tomography (CT) scan. For leptomeningeal metastases, positive cytology is acceptable if imaging is not measurable. Age Age ≥ 18 years. Performance Status Karnofsky Performance Status ≥ 60% (see Appendix A). Subjects must have a life expectancy of equal to or greater than 8 weeks. Organ and Marrow Function Requirements Hematology: Absolute Neutrophil Count (ANC) ≥ 1.5 x 109/L Platelet count ≥ 100 x 109/L Hemoglobin ≥ 9.0 g/dL White blood cell (WBC) count ≥ 3.0 x 109/L Biochemistry: AST/SGOT and ALT/SGPT ≤ 5 x institution's ULN Total bilirubin ≤ 3 x institution's ULN Serum creatinine ≤ 2 x institution's ULN or 24-hour creatinine clearance ≥ 50 mL/min Alkaline phosphatase (ALP) ≤ 3 x ULN unless considered tumor related Estimated GFR > 50 mL/min Coagulation: INR ≤ 1.4 PT/aPTT ≤ 1.2 x institution's ULN Contraception All fertile females and any man with a partner of child-bearing potential agrees to use adequate contraception which will include two of the following: hormonal or barrier method of birth control, or abstinence prior to study entry, for the duration of study participation, and for 30 days following completion of therapy. Although Pritumumab shows notable immunohistologic reactivity against active endometrial tissues, fertile female patients will be included in this study. Exclusion Criteria Subjects meeting any of the exclusion criteria at baseline will be excluded from study participation. Current or anticipated use of other investigational agents. Insufficient time for recovery from prior therapy: less than 28 days from any prior cytotoxic investigational agent, less than 14 days from any prior non-cytotoxic investigational agent, less than 28 days from prior cytotoxic therapy (except 23 days from prior temozolomide at 5 day regimen and 14 days from prior temozolomide at daily regimen, 14 days from vincristine, 42 days from nitrosoureas, 21 days from procarbazine administration), less than 7 days for non-cytotoxic agents, e.g., interferon, tamoxifen, thalidomide, cis-retinoic acid, targeted therapies (radiosensitizer does not count), less than 7 days for immunotherapy agents, e.g., DCVax, Celldex, PD1, etc. Less than 3 weeks from surgery or insufficient recovery from surgical-related trauma or wound healing. History of allergic reactions attributed to compounds of similar chemical or biologic composition to Pritumumab plus any patently atopic patients who have a history of having experienced an episode of allergic anaphylaxis. Severe or uncontrolled medical disorder that would, in the investigator's opinion, impair ability to receive study treatment (i.e., uncontrolled diabetes, chronic renal disease, chronic pulmonary disease or active, uncontrolled infection). Known diagnosis of human immunodeficiency virus (HIV) infection. Impaired cardiac function including any of the following: Congenital long QT syndrome or a known family history of long QT syndrome; History or presence of clinically significant ventricular or atrial tachyarrhythmias Clinically significant resting bradycardia (< 50 beats per minute) Inability to monitor the QT interval by ECG QTc > 450 msec on baseline ECG. If QTc > 450 and electrolytes are not within normal ranges, electrolytes should be corrected and then the patient re-screened for QTc Myocardial infarction within 1 year of starting study drug Other clinically significant heart disease (e.g., unstable angina, congestive heart failure, or uncontrolled hypertension) Any female patients who develop serious uterine hemorrhage during this study may need to be excluded from further treatment with Pritumumab.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Laurie Hendricks, BSN, RN, OCN
Phone
949.764.5987
Email
laurie.hendricks@hoag.org
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jose A. Carrillo, MD
Organizational Affiliation
One Hoag Drive Newport Beach, CA 92663, United States
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hoag Memorial Hospital Presbyterian
City
Newport Beach
State/Province
California
ZIP/Postal Code
92663
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Laurie Hendricks, BSN, RN, OCN
Phone
949-764-5987
Email
laurie.hendricks@hoag.org
Facility Name
Sharp Memorial Hospital
City
San Diego
State/Province
California
ZIP/Postal Code
92123
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Amy King, BSN, RN, CCR
Phone
858-939-5052
Email
amy.king@sharp.com
First Name & Middle Initial & Last Name & Degree
Charles Redfern, MD

12. IPD Sharing Statement

Plan to Share IPD
No

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Safety Study of Pritumumab in Brain Cancer

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