Study of Drug to Reduce Thrombocytopenia in Patients Receiving Chemo for Ovarian, Fallopian Tube or Peritoneal Cancer

Ph IIb Study Evaluating the Safety & Efficacy of TXA127 in the Reduction of Incidence and Severity of Thrombocytopenia in Patients Receiving Combination Gemcitabine and Platinum Therapy for Ovarian, Fallopian Tube, or Peritoneal Carcinoma

This research study will investigate the safety and effectiveness of two different dose levels of a new, unapproved drug to be given along with the chemotherapy regimens gemcitabine and carboplatin or gemcitabine and cisplatin prescribed to women for the treatment of ovarian cancer. This experimental drug is called TXA127 and is being tested for effectiveness to see if it will help reduce some of the side effects of the chemotherapy, primarily low blood platelet levels that lead to excess bleeding. This study also intends to test the safety of TXA127 when given as an injection under the skin on a daily basis concurrently with up to 6 cycles of the prescribed chemotherapy.

Study Overview

• Status: Completed
• Conditions: Anemia; Thrombocytopenia; Neutropenia; Lymphopenia
• Intervention / Treatment: Drug: Placebo; Drug: TXA127; Drug: TXA127

Detailed Description

This is a Phase IIb, multicenter, randomized, double-blind, placebo-controlled study comparing safety and efficacy of two dose levels of TXA127 when administered during 6 cycles of combination gemcitabine and platinum-based chemotherapy. This study intends to investigate the effectiveness of TXA127 for the mitigation of severity and/or incidence of thrombocytopenia, as well as safety when administered as a self-injected, subcutaneous solution.

Females 18 years of age or older with a confirmed diagnosis of ovarian carcinoma who are scheduled to undergo combination chemotherapy with gemcitabine and carboplatin or gemcitabine and cisplatin will be considered for this study. Subjects may be chemotherapy naïve, newly diagnosed, or post a single course of chemotherapy followed by a progression- and treatment-free interval of at least 3 months, or post 2 or more previous courses of chemotherapy after a progression- and treatment-free interval of at least 6 months.

Subjects will be randomized in a 1:1:1 ratio to one of the following three blinded treatment groups: placebo, 100 ug/kg/day TXA127 and 300 ug/kg/day TXA127.

Treatment will be concurrent with up to six consecutive 21-day cycles of one of the following gemcitabine and platin regimens:

Regimen A

• Intravenous cisplatin therapy at a dose of 30-50 mg/m2 given on Day 1 of the cycle
• Intravenous gemcitabine at a dose of 800 mg/m2 given on Day 1 after cisplatin and on Day 8 of the cycle.

Regimen B

• Intravenous gemcitabine at a dose of 1000 mg/m2 given on Days 1 and 8 of the cycle
• Intravenous carboplatin AUC 4 given after gemcitabine on Day 1 of the cycle

TXA127 will be self-administered as a subcutaneous injection by the subject once daily on Days 2-6 and 9-15 during each cycle of chemotherapy. Blood specimens will be drawn for hematologic analysis on Days 1, 8 and 15 of each treatment cycle.

• Study Type: Interventional
• Enrollment (Actual): 34
• Phase: Phase 2

Contacts and Locations

Study Locations

• United States
  • Alabama
    • Mobile, Alabama, United States, 36604
      • University of Southern Alabama Mitchell Cancer Institute
  • California
    • Los Angeles, California, United States, 90033
      • USC - LAC Medical Center
    • Orange, California, United States, 92868
      • University of California - Irvine, Chao Family Comprehensive Cancer Center
  • Illinois
    • Chicago, Illinois, United States, 60612
      • Rush University Medical Center
  • Kansas
    • Wichita, Kansas, United States, 67208
      • Associates in Women's Health
  • New York
    • Brightwaters, New York, United States, 11718
      • Schwartz Gynecologic Oncology, PLLC

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: Female

Description

Inclusion Criteria:

• Females at least 18 years of age with ovarian carcinoma who are one of the following:

  • Newly diagnosed with ovarian cancer and chemotherapy naïve, or
  • Post a single previous course of chemotherapy, with a 3-month disease-progression and treatment-free interval, with the exception of antibody therapy, prior to the study screening visit, or
  • Post two or more previous courses of chemotherapy with a 6-month disease-progression and treatment-free interval, with the exception of antibody therapy, prior to the study screening visit.
• Must be scheduled for a course of combination chemotherapy consisting of gemcitabine and cisplatin or gemcitabine and carboplatin to be administered in 21-day cycles
• Eastern Cooperative Oncology Group (ECOG) Performance Status of 0, 1, or 2
• Adequate bone marrow, renal, and hepatic functions as measured by standard chemistry and hematology blood tests
• Adequate blood coagulation parameters as measured by standard blood tests for coagulation

Exclusion Criteria:

• Any clinical or laboratory abnormality greater than Grade 2 toxicity (NCI criteria), with the exception of laboratory parameters specified in the inclusion criteria
• Significant unstable cardiovascular disease
• Uncontrolled high blood pressure
• Current use of an angiotensin converting enzyme (ACE) inhibitor or angiotensin II antagonists
• Evidence of metastatic disease to the bone
• Metastatic disease to the CNS requiring treatment or radiation therapy
• Uncontrolled infection(s)
• Radiation therapy or chemotherapy (except as specified in the inclusion criteria) within the previous 5 years
• Concurrent use of hematopoietic or erythropoietic agents

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Quadruple

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Placebo Comparator: Placebo; Combination gemcitabine and platinum-based chemotherapy with concurrent placebo	Drug: Placebo; Once daily subcutaneous injection of placebo
Experimental: TXA127 100 ug/kg; Combination gemcitabine and platinum-based chemotherapy with concurrent 100 ug/kg/day TXA127	Drug: TXA127; Once daily subcutaneous injection of 100 ug/kg; Other Names: Angiotensin 1-7; Drug: TXA127; Once daily subcutaneous injection of 300 ug/kg; Other Names: Angiotensin 1-7
Experimental: TXA127 300 ug/kg; Combination gemcitabine and platinum-based chemotherapy with concurrent 300 ug/kg/day TXA127	Drug: TXA127; Once daily subcutaneous injection of 100 ug/kg; Other Names: Angiotensin 1-7; Drug: TXA127; Once daily subcutaneous injection of 300 ug/kg; Other Names: Angiotensin 1-7

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Chemotherapy Cycles During Which the Platelet Count Measures Below 50,000/mm3	Mean percentage of cycles with platelet counts below 50,000/mm3	During a maximum of six 3-week chemotherapy cycles

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Subjects With Platelet Counts Below 50,000/mm3	Number of subjects who experienced a platelet count below 50,000/mm3	During a maximum of six 3-week chemotherapy cycles
Treatment Cycles With Platelets Counts Below 25,000/mm3	Mean percentage of treatment cycles where platelets counts were below 25,000/mm3	During a maximum of six 3-week chemotherapy cycles
Chemotherapy Dose Intensity and Dose Density	Mean percentage of cycles where projected (target) chemotherapy dose was maintained	During a maximum of six 3-week chemotherapy cycles
Lymphopenia as Determined by Lymphocyte Count	Number of subjects with a treatment emergent adverse event of lymphopenia	During a maximum of six 3-week chemotherapy cycles
Neutropenia	Number of subjects with a treatment emergent adverse event of neutropenia	During a maximum of six 3-week chemotherapy cycles
Anemia	Number of subjects with a treatment emergent adverse event of anemia	During a maximum of six 3-week chemotherapy cycles
Mucositis	Number of subjects with a treatment emergent adverse event of mucositis	During a maximum of six 3-week chemotherapy cycles
Alopecia	Number of subjects with a treatment emergent adverse event of alopecia	During a maximum of six 3-week chemotherapy cycles
Rescue Treatment for Hematopoiesis and Mucositis	Number of subjects with a treatment emergent adverse event of hematopoiesis and mucositis who received rescue treatment as determined by the administration of: Transfusions; Filgrastim or Pegfilgrastim; Erythropoietin; Palifermin	During a maximum of six 3-week chemotherapy cycles

Collaborators and Investigators

• Sponsor: Tarix Pharmaceuticals

Publications and helpful links

General Publications

• Rodgers KE, Oliver J, diZerega GS. Phase I/II dose escalation study of angiotensin 1-7 [A(1-7)] administered before and after chemotherapy in patients with newly diagnosed breast cancer. Cancer Chemother Pharmacol. 2006 May;57(5):559-68. doi: 10.1007/s00280-005-0078-4. Epub 2005 Aug 12.
• Ellefson DD, diZerega GS, Espinoza T, Roda N, Maldonado S, Rodgers KE. Synergistic effects of co-administration of angiotensin 1-7 and Neupogen on hematopoietic recovery in mice. Cancer Chemother Pharmacol. 2004 Jan;53(1):15-24. doi: 10.1007/s00280-003-0710-0. Epub 2003 Oct 16.

Study record dates

Study Major Dates

• Study Start: October 1, 2008
• Primary Completion (Actual): December 1, 2011
• Study Completion (Actual): December 1, 2011

Study Registration Dates

• First Submitted: October 9, 2008
• First Submitted That Met QC Criteria: October 9, 2008
• First Posted (Estimate): October 13, 2008

Study Record Updates

• Last Update Posted (Actual): November 13, 2017
• Last Update Submitted That Met QC Criteria: October 10, 2017
• Last Verified: October 1, 2017

More Information

Terms related to this study

• Keywords: Chemotherapy; Ovarian Cancer; Thrombocytopenia; Cytopenia
• Additional Relevant MeSH Terms: Immunologic Deficiency Syndromes; Immune System Diseases; Hematologic Diseases; Blood Platelet Disorders; Agranulocytosis; Leukopenia; Leukocyte Disorders; Neutropenia; Thrombocytopenia; Lymphopenia; Antihypertensive Agents; Vasodilator Agents; Angiotensin I (1-7)
• Other Study ID Numbers: TXA127-2007-002