TK216 in Patients With Relapsed or Refractory Ewing Sarcoma
Primary Purpose
Sarcoma, Ewing
Status
Terminated
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
TK216
Sponsored by
About this trial
This is an interventional treatment trial for Sarcoma, Ewing
Eligibility Criteria
- Willing and able to provide written IRB/IEC-approved Informed Consent. For patients < 18 years of age, their parents or legal guardians must sign a written informed consent. Assent, when appropriate, will be obtained according to institutional guidelines.
- Have histologically or cytologically confirmed diagnosis of Ewing sarcoma (including ESFT) with relapsed or refractory disease. Patients with metastatic disease who had standard chemotherapy at the time of diagnosis Pathology reports and slides or blocks should be available for review or additional testing. If not available, site must discuss with Sponsor.
- Measurable disease according to RECIST version 1.1. Measurable disease can be verified from a previously documented computed tomography (CT) scan or MRI as long as no anti-cancer treatments have been administered in the interim.
- Must have a central venous catheter in place prior to initiating infusion of study drug.
Prior cancer therapy:
Patients may have received no more than 5 prior systemic regimens. At the time of treatment initiation, at least 2 weeks or 5 half-lives, whichever is longer, must have elapsed since prior cytotoxic chemotherapy. At least 7 days must have elapsed since completion of any prior non-cytotoxic cancer therapy.
- Prior radiotherapy is allowed If ≥ 4 weeks has elapsed for radiation therapy (RT); ≥ 6 months must have elapsed if prior total body irradiation, craniospinal RT or if > 50% radiation of the pelvis; > 6 weeks must have elapsed if other substantial bone marrow radiation. Patients who have received brain irradiation must have completed whole brain radiotherapy and/or gamma knife at least 4 weeks prior to enrollment.
- Stem Cell Transplant or Rescue without TBI: No evidence of active graft vs. host disease and ≥ 3 months must have elapsed since transplant.
- Patients with controlled asymptomatic CNS involvement are allowed (see Concomitant Medications). Patients not requiring steroids or requiring steroids at stable dose (≤ 4 mg/day dexamethasone or equivalent) for at least 2 weeks are eligible.
- Resolution of all acute toxic effects (excluding alopecia) of any prior anti-cancer therapy to NCI CTCAE (Version 4.03) Grade < 1. Details can be provided by Sponsor.
- Eastern Cooperative Oncology Group (ECOG) performance status (PS) ≤ 2 in patients ≥17 years old; or Karnofsky/Lansky >50 in patients <16 years old.
- Life expectancy of at least 3 months.
Sites / Locations
- UCLA Jonsson Comprehensive Cancer Center
- Children's Hospital of Colorado
- Children's National Hospital
- Memorial Sloan Kettering Cancer Center
- Duke Cancer Institute
- Cleveland Clinic Foundation
- Oregon Health & Science University
- Texas Children's Cancer & Hematology Centers, Baylor College
- UT MD Anderson Cancer Center
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
TK216 treatment
Arm Description
Dose escalation and expansion cohorts to determine dose-limiting toxicities, maximally tolerated dose, preliminary efficacy, and recommended phase 2 dose.
Outcomes
Primary Outcome Measures
Dose-limiting toxicities (DLTs)
Listing of dose-limiting toxicities by daily dose in mg/m^2
Maximum tolerated dose (MTD)
Maximum daily dose in mg/m^2
Biologically effective and recommended Phase 2 dose (RP2D)
Daily dose in mg/m^2
Number of participants with treatment-related adverse events as assessed by CTCAE.
Daily dose of 175 mg/m2/day of TK216 administered intravenously via continuous infusion over 28-days
Secondary Outcome Measures
Adverse Events
Antitumor activity as measured by Overall Response Rate (ORR)
Antitumor activity as measured by Duration of Response (DOR)
Duration of Disease Control
Assay methods to detect EWS-FLI1 (or EWS-ERG and EWS-ets)
Pharmacokinetics: Maximum Plasma Concentration [Cmax]
Pharmacokinetics: Area Under the Curve [AUC]
Pharmacokinetics: Halflife [T1/2]
Pharmacodynamics: serum miRNA profile
Pharmacodynamics: tumor tissue RNA assays
Pharmacodynamics: tumor tissue protein assays
Full Information
NCT ID
NCT02657005
First Posted
January 12, 2016
Last Updated
June 21, 2022
Sponsor
Oncternal Therapeutics, Inc
1. Study Identification
Unique Protocol Identification Number
NCT02657005
Brief Title
TK216 in Patients With Relapsed or Refractory Ewing Sarcoma
Official Title
A Phase 1 / 2, Dose Escalation Study of Intravenous TK216 in Patients With Relapsed or Refractory Ewing Sarcoma
Study Type
Interventional
2. Study Status
Record Verification Date
June 2022
Overall Recruitment Status
Terminated
Study Start Date
August 2016 (Actual)
Primary Completion Date
May 2022 (Actual)
Study Completion Date
June 2022 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Oncternal Therapeutics, Inc
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
Ewing sarcoma is characterized by genomic rearrangements resulting in over-expression of ets family transcription factors driving tumor progression. TK216 is designed to inhibit this effect by inhibiting downstream effects of the EWS-FLI1 transcription factor. This study is a first in human study of TK216 in subjects with Ewing sarcoma. The study is designed to establish initial safety and efficacy data in monotherapy and in combination with vincristine to assess the potential of TK216 for further development.
Detailed Description
The study has been expanded to explore single agent TK216 for longer treatment duration. Approximately 26 patients will be enrolled in this Cohort.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Sarcoma, Ewing
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
85 (Actual)
8. Arms, Groups, and Interventions
Arm Title
TK216 treatment
Arm Type
Experimental
Arm Description
Dose escalation and expansion cohorts to determine dose-limiting toxicities, maximally tolerated dose, preliminary efficacy, and recommended phase 2 dose.
Intervention Type
Drug
Intervention Name(s)
TK216
Intervention Description
Inhibitor of protein-protein interactions of EWS-FLI1 fusion protein
Primary Outcome Measure Information:
Title
Dose-limiting toxicities (DLTs)
Description
Listing of dose-limiting toxicities by daily dose in mg/m^2
Time Frame
18 months
Title
Maximum tolerated dose (MTD)
Description
Maximum daily dose in mg/m^2
Time Frame
18 months
Title
Biologically effective and recommended Phase 2 dose (RP2D)
Description
Daily dose in mg/m^2
Time Frame
18 months
Title
Number of participants with treatment-related adverse events as assessed by CTCAE.
Description
Daily dose of 175 mg/m2/day of TK216 administered intravenously via continuous infusion over 28-days
Time Frame
12 months
Secondary Outcome Measure Information:
Title
Adverse Events
Time Frame
18 months
Title
Antitumor activity as measured by Overall Response Rate (ORR)
Time Frame
18 months
Title
Antitumor activity as measured by Duration of Response (DOR)
Time Frame
18 months
Title
Duration of Disease Control
Time Frame
18 months
Title
Assay methods to detect EWS-FLI1 (or EWS-ERG and EWS-ets)
Time Frame
18 months
Title
Pharmacokinetics: Maximum Plasma Concentration [Cmax]
Time Frame
18 months
Title
Pharmacokinetics: Area Under the Curve [AUC]
Time Frame
18 months
Title
Pharmacokinetics: Halflife [T1/2]
Time Frame
18 months
Title
Pharmacodynamics: serum miRNA profile
Time Frame
18 months
Title
Pharmacodynamics: tumor tissue RNA assays
Time Frame
18 months
Title
Pharmacodynamics: tumor tissue protein assays
Time Frame
18 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
8 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Willing and able to provide written IRB/IEC-approved Informed Consent. For patients < 18 years of age, their parents or legal guardians must sign a written informed consent. Assent, when appropriate, will be obtained according to institutional guidelines.
Have histologically or cytologically confirmed diagnosis of Ewing sarcoma (including ESFT) with relapsed or refractory disease. Patients with metastatic disease who had standard chemotherapy at the time of diagnosis Pathology reports and slides or blocks should be available for review or additional testing. If not available, site must discuss with Sponsor.
Measurable disease according to RECIST version 1.1. Measurable disease can be verified from a previously documented computed tomography (CT) scan or MRI as long as no anti-cancer treatments have been administered in the interim.
Must have a central venous catheter in place prior to initiating infusion of study drug.
Prior cancer therapy:
Patients may have received no more than 5 prior systemic regimens. At the time of treatment initiation, at least 2 weeks or 5 half-lives, whichever is longer, must have elapsed since prior cytotoxic chemotherapy. At least 7 days must have elapsed since completion of any prior non-cytotoxic cancer therapy.
Prior radiotherapy is allowed If ≥ 4 weeks has elapsed for radiation therapy (RT); ≥ 6 months must have elapsed if prior total body irradiation, craniospinal RT or if > 50% radiation of the pelvis; > 6 weeks must have elapsed if other substantial bone marrow radiation. Patients who have received brain irradiation must have completed whole brain radiotherapy and/or gamma knife at least 4 weeks prior to enrollment.
Stem Cell Transplant or Rescue without TBI: No evidence of active graft vs. host disease and ≥ 3 months must have elapsed since transplant.
Patients with controlled asymptomatic CNS involvement are allowed (see Concomitant Medications). Patients not requiring steroids or requiring steroids at stable dose (≤ 4 mg/day dexamethasone or equivalent) for at least 2 weeks are eligible.
Resolution of all acute toxic effects (excluding alopecia) of any prior anti-cancer therapy to NCI CTCAE (Version 4.03) Grade < 1. Details can be provided by Sponsor.
Eastern Cooperative Oncology Group (ECOG) performance status (PS) ≤ 2 in patients ≥17 years old; or Karnofsky/Lansky >50 in patients <16 years old.
Life expectancy of at least 3 months.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
James Breitmeyer, MD
Organizational Affiliation
Oncternal Therapeutics
Official's Role
Study Director
Facility Information:
Facility Name
UCLA Jonsson Comprehensive Cancer Center
City
Los Angeles
State/Province
California
ZIP/Postal Code
90095
Country
United States
Facility Name
Children's Hospital of Colorado
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Facility Name
Children's National Hospital
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20010
Country
United States
Facility Name
Memorial Sloan Kettering Cancer Center
City
New York
State/Province
New York
ZIP/Postal Code
10174
Country
United States
Facility Name
Duke Cancer Institute
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27710
Country
United States
Facility Name
Cleveland Clinic Foundation
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States
Facility Name
Oregon Health & Science University
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239
Country
United States
Facility Name
Texas Children's Cancer & Hematology Centers, Baylor College
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
UT MD Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
No
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TK216 in Patients With Relapsed or Refractory Ewing Sarcoma
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