Clinical Trials /

Study of IRX4204 With Erlotinib in Previously Treated Advanced NSCLC

NCT02991651

Description:

Patient selection: a) Pathological confirmation of non-small cell lung cancer without activating EGFR mutations; b) Advanced stage disease (IV or IIIB with malignant effusion) with at least two prior chemotherapy regimens; c) No available curative therapy; d) Pregnant women are excluded; e) Informed consent. Pretreatment evaluation: a) Medical history and physical examination; b) Hepatic and renal function (bilirubin, aspartate aminotransaminase, creatinine); c) Preoperative staging evaluation including CT-chest or PET/CT scan; Treatment plan: Three dose levels of IRX4204 and erlotinib will be studied using intra-patient dose escalation for dose levels 1 and 2. These study agents will be administered orally until progression of disease, unacceptable toxicities, activation of a phase II study of the combination, or exhaustion of the IRX4204 drug supply. Evaluation on study: Adverse events will be graded on a scale of 0 to 5, using the Common Terminology Criteria for Adverse Events (CTCAE) v. 4.0. Efficacy will be assessed using the RECIST v1.1 criteria based on CT-chest or PET/CT scan after 8 weeks of study treatment.

Related Conditions:
  • Non-Small Cell Lung Carcinoma
Recruiting Status:

Recruiting

Phase:

Phase 1

Trial Eligibility

Document

Title

  • Brief Title: Study of IRX4204 With Erlotinib in Previously Treated Advanced NSCLC
  • Official Title: A Phase I Study of IRX4204 in Combination With Erlotinib in Patients With Previously Treated Advanced Non-Small Cell Lung Cancer

Clinical Trial IDs

  • ORG STUDY ID: IRX4204 NSCLC 1 01 2015
  • NCT ID: NCT02991651

Conditions

  • Lung Cancer, Nonsmall Cell

Interventions

DrugSynonymsArms
IRX4204Dose Level 1
erlotinibDose Level 1

Purpose

Patient selection: a) Pathological confirmation of non-small cell lung cancer without activating EGFR mutations; b) Advanced stage disease (IV or IIIB with malignant effusion) with at least two prior chemotherapy regimens; c) No available curative therapy; d) Pregnant women are excluded; e) Informed consent. Pretreatment evaluation: a) Medical history and physical examination; b) Hepatic and renal function (bilirubin, aspartate aminotransaminase, creatinine); c) Preoperative staging evaluation including CT-chest or PET/CT scan; Treatment plan: Three dose levels of IRX4204 and erlotinib will be studied using intra-patient dose escalation for dose levels 1 and 2. These study agents will be administered orally until progression of disease, unacceptable toxicities, activation of a phase II study of the combination, or exhaustion of the IRX4204 drug supply. Evaluation on study: Adverse events will be graded on a scale of 0 to 5, using the Common Terminology Criteria for Adverse Events (CTCAE) v. 4.0. Efficacy will be assessed using the RECIST v1.1 criteria based on CT-chest or PET/CT scan after 8 weeks of study treatment.

Detailed Description

      Numerous studies in pre-clinical models and in human clinical trials have clearly established
      the potential for the use of rexinoids in the treatment and prevention of cancer. IRX4204, a
      second generation rexinoid, is a highly potent and specific activator of RXRs. Because
      IRX4204 is significantly more potent and more selective for the RXRs relative to the RARs
      than a first generation approved RXR agonist drug, bexarotene, it potentially will be
      associated with fewer adverse events and greater activity in clinical use. Preclinical
      studies of the combination of IRX4204 plus erlotinib, and previous clinical studies of the
      combination of the bexarotene plus erlotinib indicated at least additive beneficial effects
      for treatment of NSCLC. This study seeks to investigate the safety and activity of IRX4204 in
      combination with erlotinib in patients with previously treated advanced NSCLC.
    

Trial Arms

NameTypeDescriptionInterventions
Dose Level 1ExperimentalIRX4204 5 mg/day PO + erlotinib 100 mg/day PO
  • IRX4204
  • erlotinib
Dose Level 2ExperimentalIRX4204 5 mg/day PO + erlotinib 150 mg/day PO
  • IRX4204
  • erlotinib
Dose Level 3ExperimentalIRX4204 10 mg/day PO + erlotinib 150 mg/day PO
  • IRX4204
  • erlotinib

Eligibility Criteria

        Inclusion Criteria:

          -  Patients must have histologically or cytologically confirmed stage IV non-small cell
             lung cancer, or recurrent non-small cell lung cancer which is not amenable to curative
             intent therapy.

          -  Documented disease progression on at least two prior lines of chemotherapy for
             advanced NSCLC. Progression within 6 months of adjuvant chemotherapy or definitive
             chemoradiation will count as one line of therapy.

          -  Age ≥18 years.

          -  ECOG performance status ≤2.

          -  Ability to take pills by mouth.

          -  Patients must have normal organ and marrow function as defined below:

          -  Leukocytes ≥3,000/mcL

          -  Absolute neutrophil count ≥1,500/mcL

          -  Platelets ≥100,000/mcL

          -  Hemoglobin ≥8.5 g/dL

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

          -  AST(SGOT)/ALT(SGPT) ≤2.5 × ULN or ≤5 x ULN if metastases to the liver

          -  Creatinine clearance ≥40 mL/min

          -  Patients with asymptomatic brain metastases are allowed, as long as they are stable
             and do not require treatment with anticonvulsants or escalating doses of steroids.
             Maximum daily dose of steroids should be prednisone 20 mg or equivalent. Radiation
             therapy for brain metastases must be completed at least 14 days prior to treatment on
             protocol.

          -  Women of child-bearing potential and men must agree to use highly effective
             contraception (if using hormonal birth control must add a second barrier method;
             abstinence) prior to study entry, for the duration of study participation as well as
             for at least 1 month after the last dose of IRX4204. Men treated or enrolled on this
             protocol must also agree to use highly effective contraception prior to the study, for
             the duration of study participation and 3 months after completion of IRX4204
             administration.

          -  Ability to understand and the willingness to sign a written informed consent document.

        Exclusion Criteria:

          -  Patients who have had chemotherapy or radiotherapy within 4 weeks prior to entering
             the study.

          -  Activating EGFR mutations detected in the tumor.

          -  Prior treatment with an EGFR tyrosine kinase inhibitor.

          -  Prior treatment with IRX4204 or another retinoid or rexinoid administered for the
             purpose of cancer treatment. Prior topical retinoid use is allowed.

          -  History of allergic reactions attributed to IRX4204 or erlotinib or to compounds of
             similar chemical or biologic composition.

          -  Uncontrolled intercurrent illness including, but not limited to, ongoing or active
             infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac
             arrhythmia, or psychiatric illness/social situations that would limit compliance with
             study requirements.

          -  Pregnant and nursing women.

          -  Patients with a history of another active malignancy within the past two years, with
             the exception of non-melanoma cutaneous malignancy, cervical carcinoma in situ, or
             ductal carcinoma in situ which has been successfully treated with curative intent
             therapy.

          -  Any gastrointestinal disorder expected to limit absorption of IRX4204 or erlotinib.

          -  Patients with a history of active thyroid disease. However, patients with a history of
             hypothyroidism maintained in euthyroid state by supplementation with thyroid hormone,
             or a thyroid hormone containing preparation may be enrolled.

          -  Patients taking coumarin-derived anticoagulants.
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Safety of co-administration of IRX4204 + erlotinib to determine recommended phase 2 dose based on number of participants experiencing treatment-related adverse events as assessed as grade 4 by CTCAE v4.0
Time Frame:30 days
Safety Issue:
Description:To determine the recommended phase II dose (RP2D) for the combination of IRX4204 and erlotinib.

Secondary Outcome Measures

Measure:toxicity profile of the combination of IRX4204 and erlotinib based on number of participants experiencing treatment-related grades 1-4 adverse events as assessed by CTCAE v4.0
Time Frame:one month
Safety Issue:
Description:
Measure:disease control rate (defined as rate of stable disease + partial response + complete response)
Time Frame:six months
Safety Issue:
Description:
Measure:progression free survival (PFS)
Time Frame:six months
Safety Issue:
Description:
Measure:overall survival (OS)
Time Frame:six months
Safety Issue:
Description:
Measure:response rate by RECIST 1.1
Time Frame:six months
Safety Issue:
Description:

Details

Phase:Phase 1
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:Io Therapeutics

Trial Keywords

  • RXR agonist IRX4204 erlotinib

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