Clinical Trials /

Study of Insulin-like Growth Factor (IGF)-Methotrexate Conjugate in the Treatment of Advanced Tumors Expressing IGF-1R

NCT02045368

Description:

This phase I dose escalation study will evaluate IGF-Methotrexate conjugate (765IGF-MTX) in patients with advanced, previously treated tumors. 765IGF-MTX is administered as an IV infusion over 1 hour on days 1, 8 and 15 of a 28 day cycle. Treatment continues until disease progression, unacceptable toxicity, or patient refusal. Assessment of response will be confirmed with imaging studies performed at the end of cycle 2 +/- 7 days, and every 2 weeks thereafter.

Related Conditions:
  • Cancer
Recruiting Status:

Completed

Phase:

Phase 1

Trial Eligibility

Document

Title

  • Brief Title: Study of Insulin-like Growth Factor (IGF)-Methotrexate Conjugate in the Treatment of Advanced Tumors Expressing IGF-1R
  • Official Title: STM-02: Phase I Study of IGF-Methotrexate Conjugate in the Treatment of Advanced Tumors Expressing Insulin-like Growth Factor Receptor 1 (IGF-1R)

Clinical Trial IDs

  • ORG STUDY ID: STM-02
  • SECONDARY ID: 2013-0655
  • NCT ID: NCT02045368

Conditions

  • Breast Cancer
  • Brain Cancer
  • Gastrointestinal Cancers
  • Genitourinary Cancers
  • Gynecologic Cancers
  • Head and Neck Cancers
  • Melanoma
  • Thoracic Cancers

Interventions

DrugSynonymsArms
IGF-Methotrexate conjugate765IGF-MTXSubject Treatment with IGF-Methotrexate conjugate

Purpose

This phase I dose escalation study will evaluate IGF-Methotrexate conjugate (765IGF-MTX) in patients with advanced, previously treated tumors. 765IGF-MTX is administered as an IV infusion over 1 hour on days 1, 8 and 15 of a 28 day cycle. Treatment continues until disease progression, unacceptable toxicity, or patient refusal. Assessment of response will be confirmed with imaging studies performed at the end of cycle 2 +/- 7 days, and every 2 weeks thereafter.

Trial Arms

NameTypeDescriptionInterventions
Subject Treatment with IGF-Methotrexate conjugateExperimentalIV infusion at the assigned dose administered on days 1, 8, and 15 of a 28 day (4 week) cycle.
  • IGF-Methotrexate conjugate

Eligibility Criteria

        Inclusion Criteria:

          1. Diagnosis of advanced malignancy, refractory to or intolerant to standard therapy and
             is no longer likely to respond to such therapy.

          2. Tumor (tissue, bone marrow, or blood) must express IGF-1R, defined as 10% or higher of
             cells expressing IGF-1R by immuno-histochemistry (IHC), or 0.1% or higher for IGF-1R
             expression by flow cytometry (blood or bone marrow aspirate).

          3. Paraffin-embedded tissue sections will be stained with antibodies against insulin-like
             growth factor receptor 1 (IGFR-1) according to the manufacturer's recommended
             protocols. IHC staining and flow cytometry will be performed at the Pathology
             Department of the University of Illinois Cancer Center.

          4. Measurable or evaluable disease per RECIST 1.1 criteria for solid tumors and lymphoma
             as defined in the protocol. For other hematologic malignancies, see below (measurable
             disease per RECIST 1.1 criteria not necessary).

          5. Multiple Myeloma: Confirmed diagnosis of multiple myeloma as defined in the protocol
             with relapsed or refractory disease, and measurable disease defined as one of below:

               -  Serum monoclonal protein > 500mg/dL by serum protein electrophoresis (SPEP)

               -  Urine monoclonal protein > 200mg/24 hours by urine protein electrophoresis (UPEP)

               -  Measurable free light chain by free light chain assay > 10mg/dL with abnormal
                  kappa to lambda light chain ratio

               -  Measurable bone disease by > 1 bone lesion which is > 20 mm on conventional
                  techniques or > 10 mm with spiral CT (for lytic lesions)

               -  Monoclonal bone marrow plasmacytosis > 30%

          6. Lymphoma: Previously treated, histologically confirmed lymphoma with measurable
             disease via RECIST 1.1, with the exception of lymphoplasmacytic lymphoma, which can be
             diagnosed based on morphologic evidence in the bone marrow plus the appropriate
             paraprotein.

          7. Waldenstrom's Macroglobulinemia: Confirmed diagnosis with relapsed or refractory
             disease, and measurable disease defined as at least one lesion with a single diameter
             of greater than 2cm by CT or bone marrow involvement with greater than 10% malignant
             cells and immunoglobulin (IgM, IgG, IgA) greater than 1000mg/dL.

          8. Hematologic malignancies including myelodysplastic syndrome(MDS), leukemia: Confirmed
             histologic diagnosis with relapsed or refractory disease; measurable disease per
             RECIST 1.1 criteria is not required.

          9. Age ≥ 18 years

         10. Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1 or 2.

         11. Prior systemic chemotherapy, immunotherapy, or biological therapy, radiation therapy
             and/or surgery are allowed; however prior use of methotrexate allowed if > 6 months
             prior to study entry. Intrathecal methotrexate is allowed prior to and during
             treatment per investigator discretion. Time since prior therapy and the first dose of
             study drug:

               -  At least 2 weeks since prior radiation, non cytotoxic small molecule drugs (e.g.,
                  tyrosine kinase inhibitors such as erlotinib and hormonal agents such as
                  letrozole), prior major surgery (surgery defined as a surgery involving a risk to
                  the life of the patient; specifically: an operation upon an organ within the
                  cranium, chest, abdomen, or pelvic cavity), prior systemic FDA approved therapy

                    -  At least 3 weeks since prior antineoplastic therapy

                    -  At least 4 weeks since exposure to monoclonal antibodies (chimeric or fully
                       human)

                    -  At least 6 weeks since prior nitrosureas or mitomycin-C

         12. Patient must have recovered from the acute toxic effects (≤ grade 1 CTCAE v.4.0) of
             previous anti-cancer treatment prior to study enrollment; the only exception is that
             grade 2 neuropathy is permitted

         13. Adequate organ function within 14 days of study registration defined as the following
             laboratory values:

               -  Absolute neutrophil count (ANC) ≥ 1.5 X 10^9/L

               -  Hemoglobin ≥ 9g/dL* (Patient may not have had a transfusion within 7 days of
                  blood draw.)

               -  Platelets ≥ 100 X 10^9/L* (Patient may not have had a transfusion within 7 days
                  of blood draw.)

               -  Total bilirubin ≤ 1.5 X upper limit of normal (ULN)

               -  Alkaline phosphatase, aspartate aminotransferase (AST) and alanine
                  aminotransferase (ALT) ≤ 3 X ULN < 5 X ULN is acceptable if liver has tumor
                  involvement)

               -  Serum creatinine ≤ 1.5 X ULN

               -  Creatinine clearance ≥ 60 ml/min^2 or glomerular filtration rate (GFR) ≥ 60
                  ml/min^2 or 24 hour urine creatinine clearance ≥ 50 ml/min

               -  Laboratory values for lymphoma patients:

                    -  Absolute neutrophil count (ANC) ≥ 1.0 X 10^9/L

                    -  Hemoglobin ≥ 8g/dL

                    -  Platelets ≥ 50 X 10^9/L

                    -  Total bilirubin ≤ 1.5 X ULN

                    -  Alkaline phosphatase, AST and ALT ≤ 3 X ULN (< 5 X ULN is acceptable if
                       liver has tumor involvement)

                    -  Serum creatinine ≤ 1.5 X ULN

                    -  Creatinine clearance ≥ 60 ml/min^2 or GFR ≥ 60 ml/min^2 or 24 hour urine
                       creatinine clearance ≥ 50 ml/min

         14. Negative urine or serum pregnancy test in females. Male and female patients with
             reproductive potential must use an approved contraceptive method if appropriate (for
             example, abstinence, oral contraceptives, implantable hormonal contraceptives, or
             double barrier methods) during and for 3 months after the last dose of 765IGF-MTX.

         15. Voluntary written informed consent before performance of any study-related procedure
             not part of normal medical care, with the understanding that consent may be withdrawn
             by the patient at any time without prejudice to future medical care.

        Exclusion Criteria:

          1. Untreated central nervous system (CNS) metastases

          2. Radiation therapy to more than 25% of the bone marrow. Whole pelvic radiation is
             considered to be over 25%.

          3. ≥ Grade 3 peripheral neuropathy within 14 days before enrollment.

          4. Systemic infection requiring IV antibiotic therapy within 7 days preceding the first
             dose of study drug, or other severe infection.

          5. Myocardial infarction within 6 months prior to enrollment or has New York Heart
             Association (NYHA) Class III or IV heart failure, uncontrolled angina, severe
             uncontrolled ventricular arrhythmias, or electrocardiographic evidence of acute
             ischemia or active conduction system abnormalities. Prior to study entry, any ECG
             abnormality at Screening has to be documented by the investigator as not medically
             relevant.

          6. Pregnant or breastfeeding - methotrexate is Pregnancy Category X - has been reported
             to cause fetal death and/or congenital abnormalities. Confirmation that the subject is
             not pregnant must be established by a negative serum beta-human chorionic gonadotropin
             (beta-hCG) pregnancy test result obtained during screening. Pregnancy testing is not
             required for post-menopausal or surgically sterilized women.

          7. Uncontrolled diabetes mellitus defined as a Hemoglobin A1C≥ 7% in patients with a
             prior history of diabetes, 28 days prior to study enrollment.

          8. Serious concomitant systemic disorders (e.g., active infection, uncontrolled diabetes)
             or psychiatric disorders that, in the opinion of the investigator, would compromise
             the safety of the patient or compromise the patient's ability to complete the study.

          9. Other severe acute or chronic medical or psychiatric conditions, or laboratory
             abnormality that may increase the risk associated with study participation or
             investigational product administration or may interfere with the interpretation of
             study results and, in the judgment of the investigator, would make the patient
             inappropriate for enrollment in this study.

         10. Recent (within 6 months) arterial thromboembolic events, including transient ischemic
             attack (TIA), cerebrovascular accident (CVA), unstable angina, or myocardial
             infarction (MI).

         11. History of abdominal fistula, gastrointestinal perforation, or intra abdominal abscess
             within 28 days prior to beginning study treatment.

         12. Abnormalities on 12-lead electrocardiogram (ECG) considered by the investigator to be
             clinical significant.

         13. History of cerebrovascular accident, pulmonary embolism or untreated deep venous
             thrombosis (DVT) within the past 6 months. Note: Subjects with recent DVT who have
             been treated with therapeutic anticoagulants for at least 6 weeks are eligible.

         14. Presence of any non-healing wound, fracture, or ulcer within 28 days prior to the
             first dose of study drug.

         15. Known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs
             chemically related to IGF or methotrexate
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Maximum Tolerated Dose (MTD)
Time Frame:Up to 30 days after final dose.
Safety Issue:
Description:The primary objective is to determine the maximum tolerated dose (MTD) of 765IGF-MTX by evaluation of toxicity for the treatment of advanced, previously treated malignancies that express IGF-1R.

Secondary Outcome Measures

Measure:Adverse Effects
Time Frame:Up to 30 days after last dose study drug.
Safety Issue:
Description:Characterize adverse effects (AE) of 765IGF-MTX in patients with advanced, previously treated malignancies as defined by CTCAE v 4.0.
Measure:Disease Response based on RECIST Criteria
Time Frame:Up to 8 weeks after last dose study drug.
Safety Issue:
Description:Evaluate clinical response of 765IGF-MTX in patients with advanced, previously treated malignancies. Disease response will be assessed every 8 weeks while on study treatment using the Response Evaluation Criteria In Solid Tumors version 1.1 (RECIST 1.1).

Details

Phase:Phase 1
Primary Purpose:Interventional
Overall Status:Completed
Lead Sponsor:IGF Oncology, LLC

Trial Keywords

  • refractory
  • intolerant
  • solid tumors

Last Updated

August 22, 2019