A Pharmacokinetic and Safety Study of IV Gallium Nitrate (Ganite) in Cystic Fibrosis Patients

The purpose of this research study is to test the pharmacokinetics, safety, and tolerability of an intravenous infusion of a drug called Ganite (gallium nitrate) in patients with cystic fibrosis. We want to see this drug is safe and tolerable and to see if high levels of the drug are found in the sputum.

Funding Source - Food and Drug Administration (FDA) Office of Orphan Products Development (OOPD)

Study Overview

• Status: Completed
• Conditions: Cystic Fibrosis
• Intervention / Treatment: Drug: 100 mg/m2 dose; Drug: 200 mg/m2 dose

Detailed Description

This is a two center pharmacokinetic and safety dosing study of IV gallium nitrate (Ganite®) in cystic fibrosis (CF) patients. Eighteen subjects are planned. Each subject will be administered a single 5-day infusion of study medication (one of 2 doses). No placebo is used. Each subject will receive 5 days of continuous infusion of the experimental treatment. There will be two dosing cohorts (cohort 1: 100 mg/m2/day and cohort 2: 200 mg/m2/day). Cohort 2 will begin enrollment only after Data Safety Monitoring Committee (DSMC) safety review and approval of cohort 1 data. Study visits occur at baseline (day 1), day 3 (visit 2), day 6 (visit 3), day 8 (visit 4), day 14 (visit 5), day 28 (visit 6), and day 56 (visit 7).

Screening data will be reviewed to determine subject eligibility. Subjects who meet all inclusion criteria and none of the exclusion criteria will be entered into the study.

The following treatment regimens will be used:

• Experimental treatment continuous infusion of gallium nitrate at the following doses cohort 1: 100 mg/m2/day and cohort 2: 200 mg/m2/day All subjects who receive at least one dose of study medication will be considered evaluable for safety and efficacy analyses. Incidence of adverse events will be monitored during the trial.

Primary endpoints will be assessment of pharmacokinetic and safety/tolerability data.

Secondary efficacy assessments will be based on changes in lung function and sputum P. aeruginosa density in sputum.

Total duration of subject participation will be five weeks. Total duration of the study is expected to be 20 months.

• Study Type: Interventional
• Enrollment (Actual): 20
• Phase: Phase 1

Contacts and Locations

Study Locations

• United States
  • Iowa
    • Iowa City, Iowa, United States, 52242-1083
      • University of Iowa
  • Maryland
    • Baltimore, Maryland, United States, 21201
      • Johns Hopkins University
  • Washington
    • Seattle, Washington, United States, 98195
      • University of Washington

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 14 years to 51 years (Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

1. Adult male or female, between 18 and 55 years of age
2. Documented chronic colonization with Pseudomonas Aeruginosa (Pa)

3. Confirmed diagnosis of CF:

   1. Documented history of > 60 mmol/L chloride concentration in pilocarpine sweat chloride test And/Or
   2. Genotype with two identifiable mutations consistent with CF, accompanied by one or more phenotypic features consistent with diagnosis of CF
4. Forced expiratory volume in the first second (FEV1) ≥ 30% of predicted value
5. Able to expectorate sputum
6. Serum liver function tests ≤ 2.5 x upper limit of normal
7. Serum urea nitrogen (BUN) and creatinine ≤ 1.5 x upper limit of normal
8. Serum creatinine ≤ 2.0 mg/dl
9. Hemoglobin ≥ 9 g/dl, platelets ≥ 100,000/mm3, and white blood cells (WBC) ≥ 4,500/mm3 and ≤ 15,000/mm3
10. Ionized calcium ≥ the lower limit of normal
11. Able to understand and sign the informed consent document, communicate with the Investigator, and comply with the requirements of the protocol
12. If female and of childbearing potential, must have a negative pregnancy test on Day 1 prior to receiving study drug
13. If female and of childbearing potential, is willing to use adequate contraception, as determined by the investigator, for the duration of the study

Exclusion Criteria:

1. Acute pulmonary exacerbation requiring antibiotic intervention within 2 weeks prior to screening
2. Osteoporosis defined as the most recent dexa scan within the prior 5 years with a T-score ≤ -2.5
3. Pregnant or lactating female
4. Known sensitivity to gallium
5. Use of biphosphonates
6. Use of any investigational drug and/or participated in any clinical trial within 3 months prior to screening

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Non-Randomized
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: 100 mg/m2 dose; Five day continuous IV Gallium Nitrate (Ganite®) infusion at 100 mg/m2	Drug: 100 mg/m2 dose; 5 day infusion of gallium nitrate (IV Ganite®) at a dose of 100 mg/m2/day; Other Names: Ganite®; gallium nitrate
Experimental: 200 mg/m2 dose; Five day continuous IV Gallium Nitrate (Ganite®) infusion at 200 mg/m2	Drug: 200 mg/m2 dose; 5 day infusion of gallium nitrate (IV Ganite®) at 200 mg/m2/day; Other Names: Ganite®; gallium nitrate

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pharmacokinetic Assessment of a 5 Day Infusion of Gallium Nitrate (IV Ganite®)	To assess the summed area under the curves of a 5 day infusion of IV Ga from day 1 to day 28 at two doses: 100 mg/m2/day in adult subjects with CF; 200 mg/m2/day in adult subjects with CF. To assess the safety of a 5 day infusion of IV Ga at two doses: 100 mg/m2/day in adult subjects with CF; 200 mg/m2/day in adult subjects with CF. Safety and tolerability of 5 days of treatment with IV administered gallium nitrate (IV Ganite®) at a doses of 100 mg/m2/day and 200 mg/m2/day.	Day 1 at t=1, 2 and 6 hours, Day 3, Day 6 at t= 1, 2, 8, and 12, Day 14 and Day 28
Number of Serious Adverse Events	Safety as measured by serous adverse events	56 days from starting dose
Number of Events When Study Drug Infusion Was Stopped Early	Tolerability as measured by adverse events of a 5 day continuous infusion of IV Gallium as assessed by stopping study drug infusion	6 days from starting dose

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Spirometry From Baseline to Day 8	Change in spirometry as measured by FEV1 in liters from baseline to day 8	8 days
Change in Lung Function From Baseline to Day 15	Change in FEV1 in liters from baseline to day 15	15 days from starting dose
Change in Spirometry From Baseline to Day 28	Change in lung function as measured by FEV1 in liters from baseline to day 28	28 days from starting dose
Change in Spirometry From Baseline to Day 56	Change in lung function as measured by FEV1 in liters from baseline to day 56	56 days from starting dose
Change in Spirometry as Measured by FVC From Baseline to Day 8	Change from baseline in lung function assessed by FVC in liters after treatment with IV Ga at day 8	8 days from starting dose
Change in P. Aeruginosa Density From Baseline to Day 8	Change in sputum microbiology (specifically P. aeruginosa density based on quantitative cultures) from baseline to day 8	8 days from starting dose
Change in Sputum P. Aeruginosa Density From Baseline to Day 15	Change in sputum microbiology (specifically P. aeruginosa density based on quantitative cultures) from baseline to day 15	15 days from starting dose
Change in P. Aeruginosa Density From Baseline to Day 56	Change in sputum microbiology (specifically P. aeruginosa density based on quantitative cultures) from baseline to day 56	56 days from starting dose

Collaborators and Investigators

• Sponsor: University of Washington
• Collaborators: Cystic Fibrosis Foundation
• Investigators: Principal Investigator: Christopher H Goss, MD, MSc, University of Washington

Study record dates

Study Major Dates

• Study Start: April 1, 2010
• Primary Completion (Actual): April 1, 2012
• Study Completion (Actual): August 31, 2013

Study Registration Dates

• First Submitted: March 24, 2010
• First Submitted That Met QC Criteria: March 25, 2010
• First Posted (Estimate): March 26, 2010

Study Record Updates

• Last Update Posted (Actual): November 29, 2022
• Last Update Submitted That Met QC Criteria: October 31, 2022
• Last Verified: October 1, 2022

More Information

Terms related to this study

• Keywords: Cystic Fibrosis; Ganite; Gallium; IV Gallium; Gallium Infusion
• Additional Relevant MeSH Terms: Digestive System Diseases; Pathologic Processes; Respiratory Tract Diseases; Lung Diseases; Infant, Newborn, Diseases; Genetic Diseases, Inborn; Pancreatic Diseases; Fibrosis; Cystic Fibrosis; Physiological Effects of Drugs; Antineoplastic Agents; Calcium-Regulating Hormones and Agents; Gallium nitrate
• Other Study ID Numbers: 35876; US FDA 5R01FD003704 (Other Grant/Funding Number: FDA)