- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00686842
PTC299 in Treating Patients With HIV-Related Kaposi Sarcoma
A Phase I/II Trial of PTC299 in Patients With HIV-Related Kaposi's Sarcoma
RATIONALE: PTC299 may stop the growth of Kaposi sarcoma by blocking blood flow to the tumor.
PURPOSE: This phase I/II trial is studying the side effects and best dose of PTC299 and to see how well it works in treating patients with HIV-related Kaposi sarcoma.
Study Overview
Status
Conditions
Detailed Description
OBJECTIVES:
Primary
- To define the safety and toxicity of anti-VEGF small molecule PTC299 in patients with HIV-related Kaposi sarcoma.
- To establish the maximum tolerated dose of this drug in these patients.
- To estimate the response rate in patients treated with this drug.
Secondary
- To describe the pharmacokinetics of this drug in these patients.
- To describe the effects of this drug on serum and plasma VEGF, VEGFR, and cytokine profiles in these patients.
- To describe the effects of this drug on HIV and KSHV viral loads in these patients.
- To describe the effects of this drug on T-lymphocyte subsets (i.e., CD4 and CD8) in these patients.
- To describe the effects of this drug on VEGF, VEGFR-2 and -3, phospho-Akt, p53, and HIF-1α expression and tumor cell proliferation, as measured by Ki-67 staining, in tumor biopsy samples obtained from these patients.
- To describe the effects of this drug on viral gene expression and cellular gene transcription, as measured by real-time quantitative PCR-based profiling, in tumor biopsy samples obtained from these patients.
OUTLINE: This is a multicenter, phase I dose-escalation study of anti-VEGF small molecule PTC299 followed by a phase II study.
Patients receive oral anti-VEGF small molecule PTC299 twice daily on days 1-28. Treatment repeats every 28 days for up to 12 courses in the absence of disease progression or unacceptable toxicity. Patients who do not demonstrate an objective response of their Kaposi sarcoma (KS) lesions after 6 courses of treatment are removed from the study.
Patients undergo blood sample collection and punch biopsies periodically during study for correlative laboratory studies. Biopsy samples are assessed for VEGF, VEGFR-2, VEGFR-3, phospho-Akt, KSHV LANA, orf59, p53, and HIF-1α expression by IHC; tumor cell proliferation by Ki-67 staining; and viral gene expression at the messenger RNA level and KSHV transcription by real-time quantitative PCR-based profiling. Blood samples are assessed for pharmacokinetics and levels of secreted cytokines or other potential serum markers characteristic for KS.
After completion of study treatment, patients are followed at 30 days.
Study Type
Enrollment (Actual)
Phase
- Phase 2
- Phase 1
Contacts and Locations
Study Locations
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California
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La Jolla, California, United States, 92093-0658
- Rebecca and John Moores UCSD Cancer Center
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Los Angeles, California, United States, 90095-1793
- UCLA Clinical AIDS Research and Education (CARE) Center
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Los Angeles, California, United States, 90033-1048
- USC/Norris Comprehensive Cancer Center and Hospital
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Hawaii
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Honolulu, Hawaii, United States, 96813
- Cancer Research Center of Hawaii
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Massachusetts
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Boston, Massachusetts, United States, 02215
- Beth Israel Deaconess Medical Center
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New York
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New York, New York, United States, 10065
- Memorial Sloan-Kettering Cancer Center
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Ohio
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Columbus, Ohio, United States, 43210-1240
- Arthur G. James Cancer Hospital and Richard J. Solove Research Institute at Ohio State University Comprehensive Cancer Center
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Washington
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Seattle, Washington, United States, 98111
- Floyd and Delores Jones Cancer Institute at Virginia Mason Medical Center
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
DISEASE CHARACTERISTICS:
Biopsy-proven Kaposi sarcoma (KS) involving the skin (with or without lymph node), oral cavity, gastrointestinal (GI) tract, and/or lung
- Patients with GI and/or pulmonary involvement must be asymptomatic or minimally symptomatic and not require systemic cytotoxic chemotherapy
Has at least five bidimensionally measurable cutaneous lesions that have not been previously irradiated AND can be used as indicator lesions
- Must have a sufficient number of non-indicator cutaneous lesions measuring ≥ 4 x 4 mm available to obtain a total of four 3-mm punch biopsies (two at baseline and two during the course of study treatment)
- Serologic documentation of HIV infection, as evidenced by positive ELISA, western blot, or other federally approved licensed HIV test OR a detectable blood level of HIV RNA
- Patients receiving antiretroviral therapy for HIV infection are eligible provided they have been on a stable regimen for ≥ 12 weeks prior to study entry AND there is no evidence of improvement in KS during those 12 weeks or there is evidence of progression of KS within the immediate 4 weeks prior to study entry
- No symptomatic visceral KS requiring cytotoxic therapy
PATIENT CHARACTERISTICS:
- Karnofsky performance status 60-100%
- Life expectancy ≥ 3 months
- Absolute neutrophil count ≥ 1,000/mm³
- Platelet count ≥ 75,000/mm³
- Hemoglobin ≥ 8 g/dL
- Creatinine ≤ 2.0 mg/dL
Total bilirubin normal (grade 0)
- No specific limit of total serum bilirubin for patient receiveing indinavir or atazanavir therapy AND direct serum bilirubin ≤ 30% of total bilirubin
- AST and ALT ≤ 2.5 times upper limit of normal (grade 1)
- INR and aPTT normal
- Proteinuria < 2+
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective barrier contraception during and for up to 3 months after completion of study treatment
- Capable of complying with the study, in the opinion of the investigator
- No acute, active opportunistic infection (other than oral thrush or genital herpes) within the past 14 days
- No other concurrent neoplasia requiring cytotoxic therapy
No history of any of the following:
- Myocardial infarction
- Severe/unstable angina
- Coronary/peripheral artery bypass graft
- Symptomatic congestive heart failure
- Cerebrovascular accident
- Transient ischemic attack
- Pulmonary embolism
- Deep vein thrombosis
- Other significant thromboembolic event
- No known coagulopathy or bleeding diathesis
- No history of CNS, pulmonary, GI, or urinary bleeding
- No known history of drug-induced liver injury
- Resting systolic blood pressure ≤ 160 mm Hg or diastolic blood pressure ≤ 100 mm Hg
- No history of or ongoing clinically significant illness, medical condition, surgical history, physical finding, ECG finding, or laboratory abnormality that, in the opinion of the investigator, could affect the safety of the patient, alter the absorption of the study drug, or impair the assessment of study results
PRIOR CONCURRENT THERAPY:
- More than 4 weeks since prior and no other concurrent anti-neoplastic therapy for KS, including chemotherapy, radiotherapy, local therapy, or biological therapy
More than 60 days since prior local therapy for any KS-indicator lesion unless the lesion has clearly progressed since treatment
- Any prior local therapy for indicator lesions (regardless of the elapsed time) should not be allowed unless there is evidence of clear-cut progression of that lesion
- More than 28 days since prior and no other concurrent investigational drugs or therapy (other than antiretroviral therapy or agents available on a treatment IND)
- More than 30 days since prior major surgery and recovered
- More than 14 days since prior treatment for an acute infection (other than oral thrush or genital herpes) or other serious medical illness
- No concurrent surgical procedures
- No concurrent systemic corticosteroid therapy, other than replacement doses
No concurrent anticoagulant therapy, including warfarin, heparin (including low molecular weight heparin), or antiplatelet drugs (e.g., clopidogrel bisulfate)
- Concurrent aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) allowed provided the dose does not exceed the maximum recommended dose
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: NA
- Interventional Model: SINGLE_GROUP
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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EXPERIMENTAL: VEGF Inhibitor PTC299
Single arm study - all subjects received PTC299
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20 mg capsules to be taken by mouth BID.
Three dose levels will be evaluated: 40 mg, 80mg, and 100mg BID.
Subjects will receive PTC299 in consecutive 28-day cycles for a maximum of 12 cycles.
To describe the effects of PTC299 on viral gene expression and cellular gene transcription in KS tumor biopsies using real-time QPCR-based profiling.
To describe the effects of PTC299 on viral gene expression and cellular gene transcription in KS tumor biopsies using real-time QPCR-based profiling.
To describe the effects of PTC299 on viral gene expression and cellular gene transcription in KS tumor biopsies using real-time QPCR-based profiling.
To describe the effects of PTC299 on KS tumor biopsies with respect to expression of VEGF, the VEGFR-2 and -3, phospho-Akt, p53, HIF-1α and proliferation, measured by Ki-67 staining.
To describe the effects of PTC299 on KS tumor biopsies with respect to expression of VEGF, the VEGFR-2 and -3, phospho-Akt, p53, HIF-1α and proliferation, measured by Ki-67 staining.
To describe the pharmacokinetics of PTC299 in patients with HIV-associated KS.
To describe the effects of PTC299 on circulating VEGF, VEGFR and cytokine levels in patients with HIV-associated KS.
To describe the effects of PTC299 on KS tumor biopsies with respect to expression of VEGF, the VEGFR-2 and -3, phospho-Akt, p53, HIF-1α and proliferation, measured by Ki-67 staining.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Safety and Toxicity of Anti-VEGF Small Molecule PTC299
Time Frame: All study visits
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Patients who experienced an adverse event of grade 3 or greater
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All study visits
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Maximum Tolerated Dose
Time Frame: After each group of 3 subjects completes cycle 1 of treatment
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After each group of 3 subjects completes cycle 1 of treatment
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Response to Treatment
Time Frame: After each 28-day cycle of treatment and at discontinuation of therapy
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After each 28-day cycle of treatment and at discontinuation of therapy
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Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Pharmacokinetics
Time Frame: Days 1, 15, 28, 57
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Days 1, 15, 28, 57
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Effects of Study Drug on Serum and Plasma VEGF, VEGFR, and Cytokine Profiles
Time Frame: On the first day of every 28-day cycle of treatment, Day 15, and treatment discontinuation
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On the first day of every 28-day cycle of treatment, Day 15, and treatment discontinuation
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Effects of Study Drug on HIV and KSHV Viral Loads
Time Frame: Screening, end of cycle 1, end of every third cycle thereafter, and treatment discontinuation
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Screening, end of cycle 1, end of every third cycle thereafter, and treatment discontinuation
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Effects of Study Drug on T-lymphocyte Subsets (i.e., CD4 and CD8)
Time Frame: Screening, day 29, every 3 cycles thereafter, and at treatment discontinuation
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Screening, day 29, every 3 cycles thereafter, and at treatment discontinuation
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Effects of Study Drug on VEGF, VEGFR-2 and -3, Phospho-Akt, p53, and HIF-1α Expression and Tumor Cell Proliferation, as Measured by Ki-67 Staining, in Tumor Biopsy Samples
Time Frame: Screening and day 28
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Screening and day 28
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Effects of Study Drug on Viral Gene Expression and Cellular Gene Transcription, as Measured by Real-time Quantitative PCR-based Profiling, in Tumor Biopsy Samples
Time Frame: Screening and day 28
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Screening and day 28
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Collaborators and Investigators
Sponsor
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- AMC-059
- U01CA121947 (U.S. NIH Grant/Contract)
- CDR0000596565 (OTHER: NCI)
- PTC299-ONC-005-KS (OTHER: PTC Therapeutics)
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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