search
Back to results

TKM 080301 for Primary or Secondary Liver Cancer

Primary Purpose

Colorectal Cancer With Hepatic Metastases, Pancreas Cancer With Hepatic Metastase, Gastric Cancer With Hepatic Metastase

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
TKM-080301
Sponsored by
National Cancer Institute (NCI)
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Colorectal Cancer With Hepatic Metastases focused on measuring SNALP, Regional Therapy, Stage IV Disease, Adenocarcinoma, Unresectable, Liver Metastases, Colorectal Cancer, Stomach Cancer, Gastric Cancer, Breast Cancer, Ovarian Cancer, Pancreatic Cancer, Liver Cancer

Eligibility Criteria

18 Years - 99 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

-INCLUSION CRITERIA:

  1. Histologically or cytologically confirmed colorectal, pancreas, gastric, breast, ovarian and esophageal cancers with hepatic metastases, or primary liver cancers (Hepatocellular carcinoma and Cholangiocarcinoma).
  2. Hepatic disease must be measurable per RECIST Criteria (version 1.1).
  3. Hepatic disease should be deemed unresectable as per standard of care criteria.

    Note: Evidence of limited unresectable extrahepatic disease on preoperative radiological studies is acceptable if the life-limiting component of progressive disease is in the liver.

  4. All patients must have failed to respond to standard regimens or therapies known to provide clinical benefit. For example:

    - Patients with metastatic colorectal cancer must have received 5-FU and

    leucovorin in combination with either oxaliplatin and/or irinotecan, since level

    1 evidence support increase survival with these regimens, compared to 5-FU and leucovorin alone.

    - Patients with hepatocellular carcinoma must have received sorafenib, since level 1 evidence support increase survival.

  5. Greater than or equal to 18 years of age
  6. Must be able to understand and sign the Informed Consent Document
  7. Clinical performance status of ECOG less than or equal to 2
  8. Life expectancy of greater/equal than two months
  9. Patients of both genders must be willing to practice birth control during and for four months after receiving chemotherapy
  10. Hematology:

    • Absolute neutrophil count greater than or equal to 1500/mm(3) without the support of filgrastim.
    • Platelet count greater than or equal to 100,000/mm(3).
    • Hemoglobin greater than or equal to 9.0 g/dl.
  11. Chemistry:

    • Serum ALT/AST less than or equal to 2.5 times the upper limit of normal.
    • Serum Albumin greater than or equal to 3.0 g/dL
    • Serum creatinine less than or equal to 1.5 times ULN unless the measured

    creatinine clearance is greater than 60 mL/min/1.73 m(2)

    - Total bilirubin less than or equal to 1.2 mg/dl

  12. International Normalized Ratio (INR) less than or equal to 1.5
  13. Seronegative for HIV antibody
  14. No chemotherapy or any other investigational drugs within 4 weeks of treatment
  15. LVEF greater than or equal to 50 percent
  16. QT/QTc interval less than 450 ms

EXCLUSION CRITERIA:

  1. Any known brain metastases (prior or current regardless of treatment status)
  2. Women of child-bearing potential who are pregnant or breastfeeding, because of the potentially dangerous effects of the chemotherapy on the fetus or infant.
  3. Active systemic infections, coagulation disorders or other major medical illnesses of the cardiovascular, respiratory or immune systems, recent myocardial infarction or heart failure (within 6 months of enrollment).
  4. NYHA greater than or equal to 2
  5. Childs B or C cirrhosis or with evidence of severe portal hypertension by history, endoscopy, or radiologic studies
  6. Weight less than 40 kg
  7. Significant ascites, greater than 1000cc in the absence of peritoneal disease
  8. Concomitant medical problems that would place the patient at an unacceptable risk for the procedure/drug
  9. Patient has known hypersensitivity or previous severe reactions to oligonucleotideor lipid-based products, including liposomal drug products (e.g. Doxil) and phospholipid-based products (parenteral nutrition, Intralipid)
  10. Discretion of the PI

Sites / Locations

  • National Institutes of Health Clinical Center, 9000 Rockville Pike

Outcomes

Primary Outcome Measures

To evaluate feasibility of administering TKM-080301 via HAI, and establish MTD and DLT.

Secondary Outcome Measures

Characterize PK & pharmacodynamics of TKM 080301
Eval biological effects of TKM-080301 on biopsies performed before & after 1 cycle of tx
To evaluate the potential conversion rate from unresectable to resectable disease.

Full Information

First Posted
September 16, 2011
Last Updated
August 2, 2018
Sponsor
National Cancer Institute (NCI)
search

1. Study Identification

Unique Protocol Identification Number
NCT01437007
Brief Title
TKM 080301 for Primary or Secondary Liver Cancer
Official Title
A Phase 1 Dose Escalation Study of Hepatic Intra-Arterial Administration of TKM 080301 (Lipid Nanoparticles Containing siRNA Against the PLK1 Gene Product) in Patients With Colorectal, Pancreas, Gastric, Breast, Ovarian and Esophageal Cancers With Hepatic
Study Type
Interventional

2. Study Status

Record Verification Date
October 9, 2012
Overall Recruitment Status
Completed
Study Start Date
August 26, 2011 (undefined)
Primary Completion Date
June 21, 2012 (Actual)
Study Completion Date
June 21, 2012 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
Background: Cancer in the liver can start in the liver (e.g., primary liver cancer or hepatocellular cancer) or spread to the liver from cancers in other parts of the body (e.g. colon, pancreas, gastric, breast, ovarian, esophageal cancers, cancer with metastases to the liver.) People who have tumors that can be removed by surgery live longer than those whose cancer cannot be removed. Chemotherapy can shrink some tumors in the liver, which also helps people to live longer, and sometimes chemotherapy can shrink tumors enough that they can be removed by surgery. However, most chemotherapy drugs do not work well on tumors in the liver. In this study we are testing a new drug, TKM-080301, given directly into the cancer blood supply in the liver circulation, to see if it will cause tumors to shrink. Objectives: - To test the safety and effectiveness of TKM-080301 for cancer in the liver that has not responded to standard treatments. Eligibility: - Individuals at least 18 years of age who have inoperable cancer that has started in or spread to the liver. Design: Participants will be screened with a medical history and physical exam. They will also have blood tests, and imaging studies. Participants will have a liver angiogram (type of X-ray study) to look at the blood flow in the liver and to place a catheter for delivery of the TKM080301. Participants will have a single dose of TKM-080301 given directly into the liver. After the drug has been given, the catheter will be removed. They will have frequent blood tests and keep a diary to record side effects. Participants may have two more doses, each dose given 2 weeks apart. {Before each dose, participants will have another angiogram and catheter placement.}They may also have liver biopsies to study the tumors. Two weeks after the third treatment (one full course), participants will have a physical exam, blood tests, and imaging studies. If the tumor is shrinking, they may have up to three more courses of the study drug. Participants will have follow up visits every 3 months for 2 years after the last course and then every 6 months as required.
Detailed Description
BACKGROUND: - Metastatic liver disease is a life-limiting factor for patients with a variety of cancers. For unresectable liver metastases, the 5-year survival is < 5%. For selected histologies the 5-year survival of resectable hepatic metastases ranges from 20-60%, suggesting that control of liver metastases could result in prolonged survival. Phase I through III trials have shown that Hepatic Arterial Infusion (HAI) is safe. However, agents used thus far in HAI have limited efficacy. TKM-080301 is a lipid nanoparticle (LNP) formulation containing siRNA against the PLK1 (polo-like kinase-1) gene product. More specifically, TKM-080301 is a type of LNP formulation, referred to as SNALP (Stable Nucleic Acid Lipid Particles). PLK1 has been validated as a molecular target and a prognostic factor in a variety of cancers. Inhibition of PLK1 activity in proliferating cancer cells rapidly induces mitotic arrest and apoptosis. This study will offer HAI with TKM-080301 to patients with unresectable and/or life threatening primary liver cancer or liver metastases. OBJECTIVES: Primary Objective: - To evaluate feasibility of administering TKM-080301 via HAI and to characterize the pharmacokinetics (PK) and pharmacodynamics of TKM-080301 administered by HAI. Secondary Objectives: To establish the maximum tolerated dose (MTD) and dose-limiting toxicities (DLT) of TKM-080301. To evaluate response rate using RECIST, PET and EASL criteria. To evaluate the conversion rate from unresectable to resectable disease. ELIGIBILITY: Patients with unresectable colorectal, pancreas, gastric, breast, ovarian and esophageal cancers with hepatic metastases; or primary liver cancer patients who have demonstrated progressive disease following standard of care treatment. 18 years old or greater with an ECOG 0-2 Laboratory and physical examination parameters within acceptable limits by standard of practice guidelines prior to surgery or chemotherapy. DESIGN: - This is a dose escalation phase-I study testing HAI of TKM-080301 for patients with unresectable colorectal, pancreas, gastric, breast, ovarian and esophageal cancers with hepatic metastases, or primary liver cancers. Up to 54 patients who meet eligibility criteria will receive HAI with TKM-080301. Initial dose will be 4 mg/m(2); treatment will be given every 2 weeks for up to 12 doses. Patients will be evaluated every 6 weeks. Patients whose tumors become resectable will be offered this option; patients who show progressive disease will be taken off treatment. All patients will be followed for survival.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Colorectal Cancer With Hepatic Metastases, Pancreas Cancer With Hepatic Metastase, Gastric Cancer With Hepatic Metastase, Breast Cancer With Hepatic Metastase, Ovarian Cancer With Hepatic Metastase
Keywords
SNALP, Regional Therapy, Stage IV Disease, Adenocarcinoma, Unresectable, Liver Metastases, Colorectal Cancer, Stomach Cancer, Gastric Cancer, Breast Cancer, Ovarian Cancer, Pancreatic Cancer, Liver Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
1 (Actual)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
TKM-080301
Primary Outcome Measure Information:
Title
To evaluate feasibility of administering TKM-080301 via HAI, and establish MTD and DLT.
Time Frame
2 years
Secondary Outcome Measure Information:
Title
Characterize PK &amp; pharmacodynamics of TKM 080301
Time Frame
2 years
Title
Eval biological effects of TKM-080301 on biopsies performed before &amp; after 1 cycle of tx
Time Frame
2 years
Title
To evaluate the potential conversion rate from unresectable to resectable disease.
Time Frame
2.5 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
99 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
-INCLUSION CRITERIA: Histologically or cytologically confirmed colorectal, pancreas, gastric, breast, ovarian and esophageal cancers with hepatic metastases, or primary liver cancers (Hepatocellular carcinoma and Cholangiocarcinoma). Hepatic disease must be measurable per RECIST Criteria (version 1.1). Hepatic disease should be deemed unresectable as per standard of care criteria. Note: Evidence of limited unresectable extrahepatic disease on preoperative radiological studies is acceptable if the life-limiting component of progressive disease is in the liver. All patients must have failed to respond to standard regimens or therapies known to provide clinical benefit. For example: - Patients with metastatic colorectal cancer must have received 5-FU and leucovorin in combination with either oxaliplatin and/or irinotecan, since level 1 evidence support increase survival with these regimens, compared to 5-FU and leucovorin alone. - Patients with hepatocellular carcinoma must have received sorafenib, since level 1 evidence support increase survival. Greater than or equal to 18 years of age Must be able to understand and sign the Informed Consent Document Clinical performance status of ECOG less than or equal to 2 Life expectancy of greater/equal than two months Patients of both genders must be willing to practice birth control during and for four months after receiving chemotherapy Hematology: Absolute neutrophil count greater than or equal to 1500/mm(3) without the support of filgrastim. Platelet count greater than or equal to 100,000/mm(3). Hemoglobin greater than or equal to 9.0 g/dl. Chemistry: Serum ALT/AST less than or equal to 2.5 times the upper limit of normal. Serum Albumin greater than or equal to 3.0 g/dL Serum creatinine less than or equal to 1.5 times ULN unless the measured creatinine clearance is greater than 60 mL/min/1.73 m(2) - Total bilirubin less than or equal to 1.2 mg/dl International Normalized Ratio (INR) less than or equal to 1.5 Seronegative for HIV antibody No chemotherapy or any other investigational drugs within 4 weeks of treatment LVEF greater than or equal to 50 percent QT/QTc interval less than 450 ms EXCLUSION CRITERIA: Any known brain metastases (prior or current regardless of treatment status) Women of child-bearing potential who are pregnant or breastfeeding, because of the potentially dangerous effects of the chemotherapy on the fetus or infant. Active systemic infections, coagulation disorders or other major medical illnesses of the cardiovascular, respiratory or immune systems, recent myocardial infarction or heart failure (within 6 months of enrollment). NYHA greater than or equal to 2 Childs B or C cirrhosis or with evidence of severe portal hypertension by history, endoscopy, or radiologic studies Weight less than 40 kg Significant ascites, greater than 1000cc in the absence of peritoneal disease Concomitant medical problems that would place the patient at an unacceptable risk for the procedure/drug Patient has known hypersensitivity or previous severe reactions to oligonucleotideor lipid-based products, including liposomal drug products (e.g. Doxil) and phospholipid-based products (parenteral nutrition, Intralipid) Discretion of the PI
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Udo Rudloff, M.D.
Organizational Affiliation
National Cancer Institute (NCI)
Official's Role
Principal Investigator
Facility Information:
Facility Name
National Institutes of Health Clinical Center, 9000 Rockville Pike
City
Bethesda
State/Province
Maryland
ZIP/Postal Code
20892
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
17291758
Citation
Steegmaier M, Hoffmann M, Baum A, Lenart P, Petronczki M, Krssak M, Gurtler U, Garin-Chesa P, Lieb S, Quant J, Grauert M, Adolf GR, Kraut N, Peters JM, Rettig WJ. BI 2536, a potent and selective inhibitor of polo-like kinase 1, inhibits tumor growth in vivo. Curr Biol. 2007 Feb 20;17(4):316-22. doi: 10.1016/j.cub.2006.12.037. Epub 2007 Feb 8.
Results Reference
background
PubMed Identifier
15173822
Citation
Barr FA, Sillje HH, Nigg EA. Polo-like kinases and the orchestration of cell division. Nat Rev Mol Cell Biol. 2004 Jun;5(6):429-40. doi: 10.1038/nrm1401. No abstract available.
Results Reference
background
PubMed Identifier
16557283
Citation
Strebhardt K, Ullrich A. Targeting polo-like kinase 1 for cancer therapy. Nat Rev Cancer. 2006 Apr;6(4):321-30. doi: 10.1038/nrc1841.
Results Reference
background

Learn more about this trial

TKM 080301 for Primary or Secondary Liver Cancer

We'll reach out to this number within 24 hrs