Safety and Tolerability Study of SNS01-T in Relapsed or Refractory B Cell Malignancies (Multiple Myeloma, B Cell Lymphoma, or Plasma Cell Leukemia (PCL)

Phase 1/2 Open-Label, Multiple-Dose, Dose-Escalation Study to Evaluate the Safety and Tolerability of SNS01-T Administered by Intravenous Infusion in Patients With Relapsed or Refractory B Cell Malignancies

The purpose of this study is to determine how well SNS01-T is tolerated by relapsed or refractory multiple myeloma, B cell lymphoma or plasma cell leukemia patients when given by intravenous infusion at various doses.

Study Overview

• Status: Unknown
• Conditions: Multiple Myeloma; Plasma Cell Leukemia; Multiple Myeloma in Relapse; Mantle Cell Lymphoma in Relapse; Diffuse Large B Cell Lymphoma in Relapse; Other B Cell Lymphoma in Relapse
• Intervention / Treatment: Biological: SNS01-T; Biological: SNS01-T; Biological: SNS01-T; Biological: SNS01-T

Detailed Description

The main purpose is to test the safety and tolerability of SNS01-T. The first group of patients with relapsed or refractory multiple myeloma, plasma cell leukemia or B cell lymphoma will be given a relatively low dose. If tolerated, a second group will receive a higher dose. If tolerated by the second group, a third and then a fourth group will receive higher doses. Treatment-related adverse events (side effects), changes in vital signs, physical examination, and laboratory values will be monitored. Patients will receive twice weekly infusions for 6 weeks and then will be followed monthly for 6 months. A secondary purpose is to explore whether SNS01-T is an effective treatment for multiple myeloma, B cell lymphoma and plasma cell leukemia.

• Study Type: Interventional
• Enrollment (Anticipated): 15
• Phase: Phase 2; Phase 1

Contacts and Locations

Study Locations

• South Africa
  • Cape Town, South Africa
    • Unversity of Cape Town - Groote Schuur Hospital
  • Pretoria, South Africa
    • Pretoria East Hospital
• United States
  • Arkansas
    • Little Rock, Arkansas, United States, 72205
      • The University of Arkansas for Medical Sciences
  • Minnesota
    • Rochester, Minnesota, United States, 55905
      • Mayo Clinic
  • New Jersey
    • Hackensack, New Jersey, United States, 07601
      • Hackensack University Medical Center
  • Washington
    • Seattle, Washington, United States, 98109
      • Fred Hutchinson Cancer Research Center/University of Washington Medical Center
  • West Virginia
    • Morgantown, West Virginia, United States, 26506
      • West Virginia University Mary Babb Randolf Cancer Center

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

1. B cell lymphoma patients must have had their diagnosis confirmed histologically. Plasma cell leukemia (PCL) patients must have peripheral clonal plasma cells >20% of peripheral WBC and >2 x 109/L. Multiple myeloma and PCL patients must have been diagnosed by having met all three of the following IMWG criteria:

   • Clonal bone marrow plasma cells >10%
   • Presence of serum and/or urinary M-protein or, if absent, kappa or lambda serum FLC must be > 10 mg/dl accompanied by an abnormal kappa to lambda ratio (<0.26 or >1.65)

   • Evidence of end-organ damage that can be attributed to the underlying plasma cell proliferative disorder, specifically, one or more of the following:

     • Hypercalcemia: serum calcium >11.5 mg/100 mL
     • Renal insufficiency: serum creatinine >2mg/dL
     • Anemia: normochromic, normocytic with a hemoglobin value >2 g/100 mL below the lower limit of normal or a hemoglobin value <10 g/100 mL
     • Bone lesions: lytic lesions, severe osteopenia, or pathologic fractures

2. B cell lymphoma patients must have measurable disease defined as at least one lesion that can be accurately measured for response in at least two perpendicular dimensions. Multiple myeloma patients must have measurable disease defined by the following:

   • Serum M-protein ≥0.5g/dL or urine M-protein ≥ 200 mg/24 hours by protein electrophoresis
   • If neither serum nor urine M-protein meet the criteria above, then kappa or lambda serum FLC must be ≥10 mg/dL accompanied by an abnormal kappa to lambda ratio (<0.26 or >1.65) (Serum FLC should only be used for patients without measurable serum or urine M-protein spike.)
   • If neither of the above criteria are met, the presence of plasmacytomata measurable radiographically (CT, PET or MRI) or by direct measurement.
3. Have relapsed or refractory disease after two or more prior treatment lines, each of which may have consisted of either single or multiple regimens. The investigators will ensure that patients have had the benefit of standard treatments before considering the SNS01-T clinical trial.
4. Be at least 2 weeks beyond the last therapy and have recovered from acute toxicities of prior therapies
5. Have Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2
6. Have life expectancy of at least 3 months
7. Be ≥18 years of age and willing to provide written informed consent
8. For women and men of childbearing potential, have used effective contraceptive methods for at least 4 weeks prior to dosing and agree to continue using such methods during the study, and for at least 4 weeks after completing the study
9. For women of childbearing potential, have a negative serum pregnancy test within 24 hours before the initiation of SNS01-T therapy
10. Have an absolute neutrophil count >1,000/mm3
11. Have a platelet count >75,000/mm3
12. Have total bilirubin <2.0 mg/dL
13. Have aspartate aminotransferase and alanine aminotransferase <3 times the upper limit of normal
14. Have serum creatinine ≤3 times the upper limit of normal
15. Have hemoglobin ≥8.0 g/dL

Exclusion Criteria:

1. Have presence of nonsecretory myeloma
2. Have an indolent lymphoma such as follicular lymphoma unless the disease is rapidly progressing
3. Requires renal dialysis
4. Have New York Heart Association Class III-IV heart failure classification
5. Have CNS or leptomeningeal disease
6. Have an active infection or serious comorbid medical condition
7. Be receiving other concurrent anticancer agents or therapies
8. Be receiving other concurrent investigational therapies or have received investigational therapies within 4 weeks of screening or 5 half-lives, if known, whichever is shorter
9. Be eligible to receive any other standard therapy available that is known to extend life expectancy
10. Be currently receiving steroids unless equivalent to 20 mg of prednisone or less
11. Be receiving or have received heparin therapeutically within two days before and after treatment with SNS01-T
12. Be pregnant or nursing

Study Plan

How is the study designed?

Design Details

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

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Cohort 1; 0.0125 mg/kg	Biological: SNS01-T; 0.05 mg/kg twice weekly x 6 weeks; Biological: SNS01-T; 0.2 mg/kg twice weekly x 6 weeks; Biological: SNS01-T; 0.375 mg/kg twice weekly x 6 weeks; Biological: SNS01-T; 0.0125 mg/kg twice weekly x 6 weeks
Experimental: Cohort 2; 0.05 mg/kg	Biological: SNS01-T; 0.05 mg/kg twice weekly x 6 weeks; Biological: SNS01-T; 0.2 mg/kg twice weekly x 6 weeks; Biological: SNS01-T; 0.375 mg/kg twice weekly x 6 weeks; Biological: SNS01-T; 0.0125 mg/kg twice weekly x 6 weeks
Experimental: Cohort 3; 0.2 mg/kg	Biological: SNS01-T; 0.05 mg/kg twice weekly x 6 weeks; Biological: SNS01-T; 0.2 mg/kg twice weekly x 6 weeks; Biological: SNS01-T; 0.375 mg/kg twice weekly x 6 weeks; Biological: SNS01-T; 0.0125 mg/kg twice weekly x 6 weeks
Experimental: Cohort 4; 0.375 mg/kg	Biological: SNS01-T; 0.05 mg/kg twice weekly x 6 weeks; Biological: SNS01-T; 0.2 mg/kg twice weekly x 6 weeks; Biological: SNS01-T; 0.375 mg/kg twice weekly x 6 weeks; Biological: SNS01-T; 0.0125 mg/kg twice weekly x 6 weeks

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Safety and tolerability	Safety and Tolerability assessed by frequency, severity, and duration of treatment-related adverse events, changes in vitals signs, physical exams and lab values	Week 6

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Profile of pharmacokinetics	Cmax, area under curve, Tmax. Performed on Weeks 1, 3, 6, 10, 14, 18	0.5 hours pre-dose and 0.5, 2, 6 and 24 hours post-dose
Explore tumor response	IMWG criteria, changes in M-protein, etc. for myeloma and plasma cell leukemia; Lymphoma response criteria, CT/PET scans for B cell lymphoma	Weeks 3 and 6, and monthly during a 24-week follow-up period

Collaborators and Investigators

• Sponsor: Senesco Technologies, Inc.
• Investigators: Principal Investigator: John A Lust, MD, PhD, Mayo Clinic

Study record dates

Study Major Dates

• Study Start: September 1, 2011
• Primary Completion (Anticipated): October 1, 2014
• Study Completion (Anticipated): December 1, 2014

Study Registration Dates

• First Submitted: September 14, 2011
• First Submitted That Met QC Criteria: September 16, 2011
• First Posted (Estimate): September 19, 2011

Study Record Updates

• Last Update Posted (Estimate): September 11, 2014
• Last Update Submitted That Met QC Criteria: September 9, 2014
• Last Verified: September 1, 2014

More Information

Terms related to this study

• Keywords: Multiple myeloma; B cell lymphoma; Mantle Cell Lymphoma; Diffuse Large B Cell Lymphoma; Hematologic disease; B cell malignancy; Blood protein disorder; Neoplasm, plasma cell; Plasma Cell Leukemia
• Additional Relevant MeSH Terms: Pathologic Processes; Cardiovascular Diseases; Vascular Diseases; Immune System Diseases; Neoplasms by Histologic Type; Lymphoproliferative Disorders; Lymphatic Diseases; Immunoproliferative Disorders; Lymphoma, Non-Hodgkin; Disease Attributes; Hematologic Diseases; Hemorrhagic Disorders; Hemostatic Disorders; Paraproteinemias; Blood Protein Disorders; Neoplasms; Lymphoma; Lymphoma, B-Cell; Lymphoma, Large B-Cell, Diffuse; Multiple Myeloma; Neoplasms, Plasma Cell; Leukemia; Recurrence; Lymphoma, Mantle-Cell; Leukemia, Plasma Cell
• Other Study ID Numbers: SNS01-T-001