A Clinical Trial of ADI-PEG 20TM in Patients With Malignant Pleural Mesothelioma (ADAM)
A Randomized Stratified Multicentre Phase II Clinical Trial of Single Agent ADI-PEG 20TM (Pegylated Arginine Deiminase) in Patients With Malignant Pleural Mesothelioma
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Locations
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-
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Brighton, United Kingdom, BN2 5BE
- The Royal Sussex County Hospital
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Cambridge, United Kingdom, CB2 0QQ
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital
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Hull, United Kingdom, HU8 9HE
- Hull and East Yorkshire Hospitals NHS Trust,The Princess Royal Hospital
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London, United Kingdom, EC1 A 7BE
- Barts and The London NHS, St Bartholomew's Hospital
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London, United Kingdom, SE1 9RT
- Guy's and St Thomas' Foundation Trust, Guy's Hospital
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Manchester, United Kingdom, M23 9LT
- University Hospital of South Manchester NHS Foundation Trust, Wythenshawe Hospital
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Southampton, United Kingdom, SO16 6 YD
- Southampton University Hospitals NHS Trust, Southampton General Hospital
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Males and Females aged 18 years and older. (There is no upper age limit)
- Histopathological evidence of ASS-negative MPM. All biopsies will be reviewed for ASS expression using immunohistochemistry. Central lab confirmation is required before randomization
- Performance status ECOG ≤ 1. Life expectancy should be greater than 3 months
- Chemo-naive patients OR, Patients who have been previously treated with platinum-based combination chemotherapy with progressive disease at entry. In the event of a baseline diagnostic ASS-positive test, a repeat biopsy confirming loss of ASS expression will be required post platinum-based combination chemotherapy, with at least a 4 week interval from the last treatment episode.
- CT evaluable disease by modified RECIST criteria
Adequate bone marrow function, or supported through treatment:
- Haemoglobin 10g/dl or greater.
- White cell count 2 x 109/L or greater, neutrophil count 1.5 x 109/L or greater
- Platelets 75 x 109 /L or greater.
- Adequate hepatic function (AST and ALT < 3 x upper limit of normal; bilirubin < 1.5 x upper limit of normal)
- Creatinine clearance >30ml/min
- Able to give written informed consent to participate
Exclusion Criteria:
- Participation in another clinical trial using an investigational agent
- Patients with surgically resectable disease
- Recurrent pleural effusion (not pleurodesed)
- Receipt of extensive radiation (hemi-thorax) therapy within 6 weeks before enrollment. Radiation to chest port sites following thoracotomy is permitted
- A history of prior malignant tumour, unless the patient has been without evidence of disease for at least three years, or the tumour was a non-melanoma skin tumour or in-situ cervix carcinoma
- Symptomatic or known brain or leptomeningeal metastases
- Uncontrolled or severe cardiovascular disease including myocardial infarction within 6 months of enrollment
- New York Heart Association (NYHA) Class III or IV heart failure (Attachment 10, NYHA Classification of Cardiac Disease), uncontrolled angina, clinically significant pericardial disease, or cardiac amyloidosis
- Serious medical (e.g. uncontrolled diabetes, hepatic disease, infection, uncontrolled gout) or psychiatric illness likely to interfere with participation in this clinical study
- History of seizures
- Patients of child-bearing age must not become pregnant. Females of childbearing potential must have a negative pregnancy test within 7 days prior to being registered for protocol therapy. All patients enrolled on the study must agree to use acceptable birth control measures whilst on the study; using both barrier and hormonal methods. Patients that are surgically sterile are also eligible to participate in this study
- Females must not be breastfeeding
- Prior exposure to ADI-PEG 20
- Preplanned surgery or procedures that would interfere with the study protocol
- Allergy to pegylated products
- Exposure to another investigational drug within 4 weeks prior to start of study treatment
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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NO_INTERVENTION: A
Arm A is control arm with best supportive care.
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|
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EXPERIMENTAL: B
Arm B is the treatment arm with best supportive care plus ADI-PEG20.
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36.8mg/m2 based on BSA, weekly treatment for 6 months
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
progression-free survival
Time Frame: 18 months
|
18 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
overall survival
Time Frame: 18 months
|
18 months
|
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response rate
Time Frame: 18 months
|
18 months
|
|
time to progression
Time Frame: 18 months
|
18 months
|
|
safety (adverse events)
Time Frame: 18 months
|
18 months
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Peter Szlosarek, Barts and the London NHS
Publications and helpful links
General Publications
- Szlosarek PW, Luong P, Phillips MM, Baccarini M, Stephen E, Szyszko T, Sheaff MT, Avril N. Metabolic response to pegylated arginine deiminase in mesothelioma with promoter methylation of argininosuccinate synthetase. J Clin Oncol. 2013 Mar 1;31(7):e111-3. doi: 10.1200/JCO.2012.42.1784. Epub 2013 Jan 14. No abstract available.
- Szlosarek PW, Steele JP, Nolan L, Gilligan D, Taylor P, Spicer J, Lind M, Mitra S, Shamash J, Phillips MM, Luong P, Payne S, Hillman P, Ellis S, Szyszko T, Dancey G, Butcher L, Beck S, Avril NE, Thomson J, Johnston A, Tomsa M, Lawrence C, Schmid P, Crook T, Wu BW, Bomalaski JS, Lemoine N, Sheaff MT, Rudd RM, Fennell D, Hackshaw A. Arginine Deprivation With Pegylated Arginine Deiminase in Patients With Argininosuccinate Synthetase 1-Deficient Malignant Pleural Mesothelioma: A Randomized Clinical Trial. JAMA Oncol. 2017 Jan 1;3(1):58-66. doi: 10.1001/jamaoncol.2016.3049.
Helpful Links
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (ANTICIPATED)
Primary Completion
Study Completion (ANTICIPATED)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
First Posted
Study Record Updates
Last Update Posted (ESTIMATE)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 6837 (Other Identifier: CTEP)
- 2006-004592-35 (EUDRACT_NUMBER)
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