A Study of CCI-001 in Patients With Recurrent and/or Metastatic Solid Tumours

A Phase 1 Open-Labelled, Single-Arm, Dose-Escalation, Clinical and Pharmacology Study of CCI-001 in Patients With Recurrent and/or Metastatic Solid Tumours

CCI-001 is a novel colchicine derivative that is being developed by PharmaMatrix Holdings Ltd. (PharmaMatrix). The drug binds to tubulin, a component of the microtubule polymers which are required for a wide range of cellular processes, perhaps most importantly, cell division and mitosis. CCI-001 has been shown to bind more strongly to β-III tubulin, a tubulin subtype which is overexpressed in many cancers.

This trial is being undertaken as a first-in-human, Phase I trial in patients with recurrent and/or metastatic solid tumours. Primary Objectives are to examine the compound's safety profile, and to determine the recommended dose. Secondary Objectives are to determine the compound's pharmacokinetic parameters and to evaluate the clinical response rate and survival. Expansion cohorts in in tumour types known to be sensitive to other approved agents with similar mechanism of action will be treated at the recommended dose: transitional cell bladder cancer, pancreaticobiliary adenocarcinomas, gynecologic cancers (ovarian, cervical, endometrial), and lung adenocarcinoma.

Study Overview

• Status: Recruiting
• Conditions: Cancer: Recurrent and/or Metastatic Solid Tumours
• Intervention / Treatment: Drug: CCI-001

• Study Type: Interventional
• Enrollment (Estimated): 70
• Phase: Phase 1

Contacts and Locations

• Study Contact: Name: Charles Allard; Phone Number: 780-430-2811; Email: crallard@shaw.ca

Study Locations

• Canada
  • Alberta
    • Edmonton, Alberta, Canada, T6G 1Z2
      • Recruiting
      • Cross Cancer Institute
      • Contact: Jennifer Spratlin, MD; Phone Number: 780 432-8514; Email: jennifer.spratlin@albertahealthservices.ca

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

1. Subject has provided informed consent/assent prior to initiation of any study-specific activities/procedures.

2. Dose escalation phase: Patients must have histologically or cytologically confirmed recurrent or metastatic solid tumours. Patients must have disease progression on the last treatment exposed to, have exhausted available approved lines of therapy or better-characterized therapies that, at the discretion of the investigator, is felt to be more appropriate therapy, or have malignancies for which there are no approved therapies.

   Dose expansion phase: patients with the following tumour types will be permitted to enroll: transitional cell bladder cancer, pancreaticobiliary adenocarcinomas, gynecologic cancers (ovarian, cervical, endometrial), and lung adenocarcinoma.

3. Four weeks must have elapsed since prior chemotherapy, hormonal therapy, targeted therapy, or radiation therapy. There is no restriction in the amount of bone marrow previously radiated.
4. Recovery to baseline or grade 1 for all drug-related toxicities due to prior chemotherapy, radiation, hormonal therapy, or molecular targeted therapy, except for alopecia.
5. Age ≥18 years.
6. Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) ≤1.
7. Life expectancy of greater than 12 weeks.

8. Patients must have normal organ and marrow function as defined below:

   • absolute neutrophil count ≥ 1.5 x 10^9/L
   • hemoglobin ≥ 90 g/L
   • platelets ≥ 100 x 10^9/L
   • total bilirubin ≤ 1.5 X upper limit of normal (ULN)
   • AST(SGOT) and ALT(SGPT) ≤ 2.5 X ULN (≤ 5 X ULN in the presence of liver metastases)
   • Creatinine (Cr) ≤ 1.5 X ULN
9. Cardiac ejection fraction by echocardiogram must be >50% at baseline. Any structural changes found must be reviewed by the treating investigator and deemed acceptable and safe prior to study enrolment. Any noted cardiac fibrosis will exclude a patient.
10. Baseline ECG with QTc ≤ 470msec for females and ≤ 450msec for males.
11. Agree to use adequate contraception for the duration of study participation and for 12 months after receiving the final dose of study drug.
12. Ability and willingness to adhere to study required procedures.
13. Patient must have measurable disease according to Response Evaluation Criteria in Solid Tumours (RECIST) 1.1 criteria.

Exclusion Criteria:

1. Patients may not be receiving any other investigational agents, chemotherapy, immunotherapy, radiotherapy, or molecular targeted agents within 28 days prior to enrollment to study unless discussed with the Principal Investigator.
2. Patients may not have symptomatic central nervous system (CNS) metastases. Patients with treated CNS metastases are eligible, provided their disease is radiographically stable over a period of ≥ 8 weeks, asymptomatic, and they are not currently receiving corticosteroids and/or anticonvulsants for the treatment of the symptoms from their brain metastases. Screening of asymptomatic patients without a history of CNS metastases is not required.
3. History of allergic reactions attributed to compounds of similar chemical or biologic composition to CCI-001 such as derivatives of colchicine.
4. The presence of grade 2 or higher peripheral neuropathy due to prior medical condition (such as multiple sclerosis), medications, or other etiologies.
5. Any psychological, familial, sociological, or geographical conditions that do not permit medical follow-up and compliance with the study protocol.
6. Uncontrolled intercurrent illness, including but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
7. Pregnant or nursing women.
8. Human Immunodeficiency Virus (HIV)-positive patients.
9. Hepatitis B- and/or C-positive patients. A negative test is required at screening.
10. History of other invasive cancer within 2 years of study entry. The exceptions are in situ cervical cancer, basal cell carcinoma or squamous cell carcinoma of the skin, and localized prostate cancer after curative therapy such as surgery, or radiation (Gleason score ≤ 7). For these exceptions, all treatment must have been completed 6 months prior to enrollment.
11. Patients taking warfarin. Low-dose or therapeutic dose of heparin or low-molecular weight heparin are allowed.
12. Cardiac fibrosis on echocardiogram. Adherence to all inclusion and exclusion criteria is mandatory; no waivers will be granted.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Sequential Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: Dose Escalation and Expansion; Dose escalation phase: CCI-001 will be administered at the starting dose to a cohort of patients with recurrent and/or metastatic solid tumours. The dose will be escalated sequentially in subsequent cohorts to determine the maximum tolerated dose, or recommended dose for the dose expansion cohort. Dose expansion phase: patients with the following tumour types will be permitted to enroll: transitional cell bladder cancer, pancreaticobiliary adenocarcinomas, gynecologic cancers (ovarian, cervical, endometrial), and lung adenocarcinoma. These patients will be treated at the dose determined during the dose escalation phase.

Drug: CCI-001; Dose Escalation Phase: CCI-001 will be administered by intravenous infusion starting at 1.2mg per square metre of body surface area in the first cohort. The dose will be escalated sequentially in subsequent cohorts. The degree of dose escalation between subsequent cohorts will depend on tolerability, as judged by NCI-CTCAE grading. Once the maximum tolerated dose is determined this phase will be complete. Dose Expansion Phase: cohorts of patients with the following tumour types will be enrolled: transitional cell bladder cancer, pancreaticobiliary adenocarcinomas, gynecologic cancers (ovarian, cervical, endometrial), and lung adenocarcinoma. These patients will be treated at the dose determined in the dose escalation phase.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
To assess the safety and tolerability of intravenously infused CCI-001 in patients with recurrent and/or metastatic solid tumours by determining the dose-limiting toxicity (DLT) of the compound.	DLT in this study will be determined against a pre-defined set of criteria based on the NCI-CTCAE v. 5.0 grading system.	Cycle 1 (28 days)
To determine, during the dose escalation phase, the recommended dose of intravenously infused CCI-001 for the dose expansion phase of the trial.	The recommended dose will be the dose level below that for the cohort in which maximum tolerated dose (MTD) was reached/exceeded. MTD will have been reached when 2 or more patients in a cohort experience DLT.	Cycle 1 (28 days)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
To evaluate the clinical response rate in patients treated with CCI-001 with recurrent and/or metastatic solid tumours, with particular attention to those in expansion cohorts	All patients with measurable disease will be assessed by standard criteria. Response Evaluation Criteria in Solid Tumours (RECIST) 1.1 criteria will be utilized to determine response based on CT and/or MRI scans.	Patients will have a baseline scan prior to dosing, and re-evaluated with imaging every 8 weeks. To continue from baseline scan to first documented date of disease progression, or date of death from any cause, to a maximum of 36 months.
To evaluate survival in patients treated with CCI-001 with recurrent and/or metastatic solid tumours, with particular attention to those in expansion cohorts	Descriptive statistics will be utilized to evaluate patient survival.	Start of treatment period (Cycle 1, Day1) to 30 days past the last treatment. Each Cycle is 28 days.
To determine the time to maximum plasma level (Tmax) of CCI-001 administered intravenously.	Tmax is the time at which the maximum plasma CCI-001 concentration is achieved.	Measured on Cycle 1 Days 1 and 15, Cycle 2 Day 1 (Each cycle is 28 days)
To determine the maximum plasma concentration (Cmax) of CCI-001 administered intravenously.	Cmax is the maximum plasma CCI-001 concentration that is achieved post administration.	Measured on Cycle 1 Days 1 and 15, Cycle 2 Day 1 (Each cycle is 28 days)
To determine the area under the curve (AUC) of CCI-001 administered intravenously.	AUC is the measure of total CCI-001 exposure after administration.	Measured on Cycle 1 Days 1 and 15, Cycle 2 Day 1 (Each cycle is 28 days)
To determine the terminal half life (t1/2) of CCI-001 administered intravenously.	t1/2 is the measure of the time it takes CCI-001 plasma concentration to decrease by 50%, after administration.	Measured on Cycle 1 Days 1 and 15, Cycle 2 Day 1 (Each cycle is 28 days)

Collaborators and Investigators

• Sponsor: PharmaMatrix Holdings Ltd
• Collaborators: University of Alberta
• Investigators: Principal Investigator: Jennifer Spratlin, MD, Alberta Health Services, University of Alberta

Study record dates

Study Major Dates

• Study Start (Actual): July 26, 2021
• Primary Completion (Estimated): May 1, 2025
• Study Completion (Estimated): May 1, 2025

Study Registration Dates

• First Submitted: March 23, 2021
• First Submitted That Met QC Criteria: March 29, 2021
• First Posted (Actual): April 1, 2021

Study Record Updates

• Last Update Posted (Actual): April 3, 2024
• Last Update Submitted That Met QC Criteria: April 2, 2024
• Last Verified: April 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Disease Attributes; Recurrence
• Other Study ID Numbers: PMH-001

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No