The First-in-human Phase I Trial of PU-H71 in Patients With Advanced Malignancies
Primary Purpose
Metastatic Solid Tumor, Lymphoma, Myeloproliferative Neoplasms (MPN)
Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
PU-H71
Sponsored by
About this trial
This is an interventional treatment trial for Metastatic Solid Tumor focused on measuring PU-H71, Solid Tumor, Lymphoma, 11-041, incurable, locally advanced or metastatic solid tumor malignancy or lymphoma
Eligibility Criteria
Inclusion Criteria:
- The safety-expansion phase will be open to accrual only for patients with MPN.
- ≥ 18 years of age
- For patients with solid malignancies and lymphoma, radiographically detectable (Either FDG-PET, CT scan/ MRI or Bone Scan) or measurable disease will be required. Measurable disease is defined as at least one measurable lesion ≥ 10 mm on CT scan (15 mm for nodal lesions).
- Prior therapy for advanced malignancy with no current curative option
- Neutrophil count ≥ 1,000/μL, platelet count ≥ 50,000/μL, and hemoglobin ≥ 8 g/dL (Platelet count must be assessed at least 7 days after a prior transfusion, if any)
- Serum bilirubin ≤ 1.5 mg/dL;
- AST and ALT≤ 1.5 × ULN
- Serum creatinine ≤ 1.5 mg/dL or creatinine clearance of ≥ 50 mL/min based on a 24-hour urine collection
- Patients receiving hydroxyurea may continue receiving it for up to 14 days after the start of protocol treatment if WBC >30 x10^9/L.
- Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2
- Patients with HIV/AIDS are allowed on study if they have an undetectable viral load, CD4 > 300 and on stable Highly Active Antiretroviral Therapy (HAART) regimen for 1 month.
- Patients who have been treated for at least two weeks with stable doses of corticosteroids to address conditions unrelated to their malignancy will be allowed to continue this treatment during enrollment on the current trial.
- Patients currently being treated with a gonadotropin-releasing hormone agonist (GnRH agonist), bicalutamide or with bisphosphonates may continue treatment while on clinical trial PU-H71 as long as the treatment has been initiated before the study start. GnRH agonist must have been well tolerated for at least three months.
- Optional participation in the microdose imaging trial, IRB#10-139.
- Signed written informed consent and HIPAA consent.
- PATIENTS WITH MPN must be:
- On ruxolitinib for at least three months and on a stable dose for at least 1 month prior to enrollment and taking at least 5 mg twice daily of ruxolitinib
- Tolerating ruxolitinib but with persistent manifestations of disease (i.e. persistent splenomegaly, abnormal blood counts, persistent constitutional symptoms residual fibrosis in bone marrow (2+ or greater), or measurable allele burden as evidenced of clonal JAK2 or MPL mutation).
- Ruxilitinib treatment requirements will be waived for patients who have failed this treatment in the past or for whom this treatment is otherwise contraindicated
EXCLUSION CRITERIA
- Ejection fraction < 50%, as determined by echocardiogram or MUGA scan
- Symptomatic brain or CNS metastases. Previously treated and stable CNS disease is allowed.
- Any of the following for the treatment of cancer within 2 weeks of first study treatment: chemotherapy, immunotherapy, experimental therapy or biologic therapy.
- Any major surgical procedure or radiation within 4 weeks of first study treatment
- Active liver disease, including viral or other hepatitis, or cirrhosis
- Pregnancy or lactation
- Active hepatitis or other active infections
- Any other significant medical condition not under control, including any acute coronary syndrome within the past 6 months.
- Patients with a permanent pacemaker
- Patients with a QTcF or QTcB > 480 ms in the baseline EKG
- Systemic corticosteroids (e.g. prednisone ≥ 12.5 mg/day or dexamethasone ≥ 2 mg/day) for the purpose of palliating tumor-related symptoms will not be allowed within 1 week of starting treatment on trial.
Sites / Locations
- Memorial Sloan-Kettering Cancer Center
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
PU-H71
Arm Description
This Phase 1 trial will be an open-label, dose-escalation study of single-agent PU-H71 in patients with advanced solid malignancies and lymphoma.
Outcomes
Primary Outcome Measures
To assess the safety of PU-H71 in patients with advanced malignancies.
Toxicity will be graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE), Version 4.0. All patients enrolled who receive study drug will be eligible for these analyses.
To assess the tolerability of PU-H71 in patients with advanced malignancies.
Toxicity will be graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE), Version 4.0.
To assess the pharmacokinetics of PU-H71 in patients with advanced malignancies.
Blood will be drawn at the multiple time points for radioactive pharmacokinetic and metabolite analyses of 124I-PUH71
To determine the maximum tolerated dose (MTD) based on toxicity analysis.
Toxicity will be monitored using NCI- Common Terminology Criteria for Adverse Events version (4.0).Patients receiving at least 3 out of 4 planned doses of study drug developing a drug-related toxicity will be eligible for these analyses.
Secondary Outcome Measures
To assess anti-tumor activity as defined by response rate
complete response (CR), partial response (PR), stable disease (SD), duration of response, and progression free survival (PFS). Patients with measurable disease will be eligible for these analyses.
To evaluate 124I-PU-H71 as a non-invasive means to determine tumor pharmacokinetics and intra-tumoral concentration
In a selected group of patients with advanced malignancies. All patients who undergo planned imaging will be eligible for this analysis.
Full Information
NCT ID
NCT01393509
First Posted
July 9, 2011
Last Updated
March 24, 2023
Sponsor
Memorial Sloan Kettering Cancer Center
1. Study Identification
Unique Protocol Identification Number
NCT01393509
Brief Title
The First-in-human Phase I Trial of PU-H71 in Patients With Advanced Malignancies
Official Title
The First-in-human Phase I Trial of PU-H71 in Patients With Advanced Malignancies
Study Type
Interventional
2. Study Status
Record Verification Date
March 2023
Overall Recruitment Status
Completed
Study Start Date
July 6, 2011 (Actual)
Primary Completion Date
March 23, 2023 (Actual)
Study Completion Date
March 23, 2023 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Memorial Sloan Kettering Cancer Center
4. Oversight
5. Study Description
Brief Summary
NOTE: This study is now recruiting only patients with Myeloproliferative Neoplasms (MPN). Dose escalation has been completed.
The purpose of this study is to test a new drug, called PU-H71 for the first time in humans, to find out what effects, good or bad, this new drug has on the patient and the cancer at different dose levels. PU-H71 blocks a protein called Heat Shock Protein-90 (Hsp90). Hsp90 is found in both normal and cancer cells, but may be more important in cancer cells. Attacking Hsp90 can stop the function of certain proteins that are needed for cancer cells to survive. The diseases that are part of this study may be especially sensitive to attacking Hsp90, and the investigators have seen signs of disease control in patients with MPN. This study is currently enrolling a cohort expansion for patients with myeloproliferative neoplasms (MPN).
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metastatic Solid Tumor, Lymphoma, Myeloproliferative Neoplasms (MPN)
Keywords
PU-H71, Solid Tumor, Lymphoma, 11-041, incurable, locally advanced or metastatic solid tumor malignancy or lymphoma
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
47 (Actual)
8. Arms, Groups, and Interventions
Arm Title
PU-H71
Arm Type
Experimental
Arm Description
This Phase 1 trial will be an open-label, dose-escalation study of single-agent PU-H71 in patients with advanced solid malignancies and lymphoma.
Intervention Type
Drug
Intervention Name(s)
PU-H71
Intervention Description
PU-H71 will be administered as an intravenous infusion over 1 hour two times a week on a 2 week on and 1 week off (Q21 day) schedule with a starting dose of 10 mg/m2. A Cycle on study will be defined as 21 days. The same schedule of administration will be used for all patients in this Phase I trial, and a MCRM (modified continual reassessment method)design will be employed. The MPN expansion may explore different dosing schedules.
Primary Outcome Measure Information:
Title
To assess the safety of PU-H71 in patients with advanced malignancies.
Description
Toxicity will be graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE), Version 4.0. All patients enrolled who receive study drug will be eligible for these analyses.
Time Frame
2 years
Title
To assess the tolerability of PU-H71 in patients with advanced malignancies.
Description
Toxicity will be graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE), Version 4.0.
Time Frame
2 years
Title
To assess the pharmacokinetics of PU-H71 in patients with advanced malignancies.
Description
Blood will be drawn at the multiple time points for radioactive pharmacokinetic and metabolite analyses of 124I-PUH71
Time Frame
The investigators anticipate these time points to be: 5 min (+mins), 3-4, 18-24 and 44-48 hours post-injection.
Title
To determine the maximum tolerated dose (MTD) based on toxicity analysis.
Description
Toxicity will be monitored using NCI- Common Terminology Criteria for Adverse Events version (4.0).Patients receiving at least 3 out of 4 planned doses of study drug developing a drug-related toxicity will be eligible for these analyses.
Time Frame
2 years
Secondary Outcome Measure Information:
Title
To assess anti-tumor activity as defined by response rate
Description
complete response (CR), partial response (PR), stable disease (SD), duration of response, and progression free survival (PFS). Patients with measurable disease will be eligible for these analyses.
Time Frame
2 years
Title
To evaluate 124I-PU-H71 as a non-invasive means to determine tumor pharmacokinetics and intra-tumoral concentration
Description
In a selected group of patients with advanced malignancies. All patients who undergo planned imaging will be eligible for this analysis.
Time Frame
2 years
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
The safety-expansion phase will be open to accrual only for patients with MPN.
≥ 18 years of age
For patients with solid malignancies and lymphoma, radiographically detectable (Either FDG-PET, CT scan/ MRI or Bone Scan) or measurable disease will be required. Measurable disease is defined as at least one measurable lesion ≥ 10 mm on CT scan (15 mm for nodal lesions).
Prior therapy for advanced malignancy with no current curative option
Neutrophil count ≥ 1,000/μL, platelet count ≥ 50,000/μL, and hemoglobin ≥ 8 g/dL (Platelet count must be assessed at least 7 days after a prior transfusion, if any)
Serum bilirubin ≤ 1.5 mg/dL;
AST and ALT≤ 1.5 × ULN
Serum creatinine ≤ 1.5 mg/dL or creatinine clearance of ≥ 50 mL/min based on a 24-hour urine collection
Patients receiving hydroxyurea may continue receiving it for up to 14 days after the start of protocol treatment if WBC >30 x10^9/L.
Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2
Patients with HIV/AIDS are allowed on study if they have an undetectable viral load, CD4 > 300 and on stable Highly Active Antiretroviral Therapy (HAART) regimen for 1 month.
Patients who have been treated for at least two weeks with stable doses of corticosteroids to address conditions unrelated to their malignancy will be allowed to continue this treatment during enrollment on the current trial.
Patients currently being treated with a gonadotropin-releasing hormone agonist (GnRH agonist), bicalutamide or with bisphosphonates may continue treatment while on clinical trial PU-H71 as long as the treatment has been initiated before the study start. GnRH agonist must have been well tolerated for at least three months.
Optional participation in the microdose imaging trial, IRB#10-139.
Signed written informed consent and HIPAA consent.
PATIENTS WITH MPN must be:
On ruxolitinib for at least three months and on a stable dose for at least 1 month prior to enrollment and taking at least 5 mg twice daily of ruxolitinib
Tolerating ruxolitinib but with persistent manifestations of disease (i.e. persistent splenomegaly, abnormal blood counts, persistent constitutional symptoms residual fibrosis in bone marrow (2+ or greater), or measurable allele burden as evidenced of clonal JAK2 or MPL mutation).
Ruxilitinib treatment requirements will be waived for patients who have failed this treatment in the past or for whom this treatment is otherwise contraindicated
EXCLUSION CRITERIA
Ejection fraction < 50%, as determined by echocardiogram or MUGA scan
Symptomatic brain or CNS metastases. Previously treated and stable CNS disease is allowed.
Any of the following for the treatment of cancer within 2 weeks of first study treatment: chemotherapy, immunotherapy, experimental therapy or biologic therapy.
Any major surgical procedure or radiation within 4 weeks of first study treatment
Active liver disease, including viral or other hepatitis, or cirrhosis
Pregnancy or lactation
Active hepatitis or other active infections
Any other significant medical condition not under control, including any acute coronary syndrome within the past 6 months.
Patients with a permanent pacemaker
Patients with a QTcF or QTcB > 480 ms in the baseline EKG
Systemic corticosteroids (e.g. prednisone ≥ 12.5 mg/day or dexamethasone ≥ 2 mg/day) for the purpose of palliating tumor-related symptoms will not be allowed within 1 week of starting treatment on trial.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Komal Jhaveri, MD
Organizational Affiliation
Memorial Sloan Kettering Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Memorial Sloan-Kettering Cancer Center
City
New York
State/Province
New York
ZIP/Postal Code
10065
Country
United States
12. IPD Sharing Statement
Links:
URL
http://www.mskcc.org/mskcc/html/44.cfm
Description
Memorial Sloan Kettering Cancer Center
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The First-in-human Phase I Trial of PU-H71 in Patients With Advanced Malignancies
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