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To Assess the Safety of Continuous IV Administration of Plerixafor and Assess Impact on the Immune Microenvironment in Patients With Pancreatic, Ovarian and Colorectal Adenocarcinomas

2020年2月27日 更新者:Weill Medical College of Cornell University

To Assess the Safety of Continuous IV Administration of the CXCR4 Antagonist, Plerixafor at Potentially Active Plasma Concentrations and Assess Its Impact on the Immune Microenvironment in Patients With Advanced Pancreatic, High Grade Serous Ovarian and Colorectal Adenocarcinomas

A dose escalation trial to assess the safety of plerixafor in patients with advanced pancreatic, high grade serous ovarian and colorectal cancer. To identify the proof of mechanism, by demonstrating alterations in T-cell tumour distribution, ideally associated with loss of tumour cells, measured by immunostaining, and changes in FDG uptake.

研究概览

地位

终止

条件

干预/治疗

详细说明

This is a prospective, non-randomised, open label, Phase I, dose escalation trial of plerixafor in patients with histological documentation of advanced pancreatic, high grade serous ovarian or colorectal adenocarcinoma. We will investigate the feasibility of administering plerixafor in terms of safety, and will try to identify the proof of mechanism in patients. This trial will follow the standard 3+3, Phase I trial design, leading to a treatment expansion phase to confirm the RP2D.

研究类型

介入性

注册 (实际的)

2

阶段

  • 阶段1

联系人和位置

本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。

学习地点

    • New York
      • New York、New York、美国、10065
        • Weill Cornell Medical College
      • Cambridge、英国、CB2 0QQ
        • Cambridge University Hospitals NHS Foundation Trust

参与标准

研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

18年 及以上 (成人、年长者)

接受健康志愿者

有资格学习的性别

全部

描述

Inclusion Criteria:

  • Aged 16 years or over (In the US, aged 18 years or over only).
  • Dose escalation phase only: Patients with inoperable, histologically proven locally advanced or metastatic pancreatic, high grade serous ovarian or colorectal adenocarcinoma, refractory to conventional chemotherapy or a patient who has declined conventional chemotherapy OR;
  • Treatment expansion phase only: Patients with inoperable, histologically proven locally advanced or metastatic pancreatic, refractory to conventional chemotherapy or a patient who has declined conventional chemotherapy.
  • Tumour lesions considered to be accessible for core biopsy and immunostaining assessment.
  • ECOG performance status 0-1.
  • Life expectancy of at least 12 weeks.
  • All women of child-bearing potential and all sexually active male patients must agree to use effective contraception methods throughout the trial and for 3 months after the final dose of trial drug.

Exclusion Criteria:

  • Inadequate haematological function defined by:

    • Absolute neutrophil count (ANC) <1.5 x 109/L
    • Absolute lymphocyte count <1.0 x 109/L (counts shall be rounded to the nearest tenth. (e.g. 0.96 will be rounded to 1.0 x 109/L))
    • Haemoglobin <9.0 g/dL (90 g/L) (may be increased to this level with transfusion as long as there is no evidence of active bleeding)
    • Platelets <100 x 109/L
    • Clotting; INR >1.3
  • Inadequate renal function defined by calculated creatinine clearance by Cockcroft-Gault of <50 ml/min.
  • Inadequate hepatic function defined by:

    • Aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) >2.5 x upper limit of normal (ULN) or >5 x in the presence of liver metastases
    • Total bilirubin >1.5 x ULN
  • Current treatment (within 28 days of entry) with chemotherapy, steroids or other immunosuppressive drugs.
  • Significant acute or chronic medical or psychiatric condition, disease or laboratory abnormality which in the judgment of the Investigator would place the patient at undue risk or interfere with the trial.
  • Cardiac co-morbidity:

    • Past history of significant rhythm disturbance (e.g. SVT, AF or ventricular irregularities)
    • Requirement for pacemaker
    • Myocardial infarction in the previous 6 months
    • Known medical history of proven postural hypotension.
  • Active infection.
  • Patients with known allergy to plerixafor or its excipients.
  • Patients known to have hepatitis B, hepatitis C or HIV infection.
  • Participation in any other interventional clinical trial
  • Women, who are pregnant, plan to become pregnant or are lactating (during the trial or for up to 3 months after the last dose)

学习计划

本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。

研究是如何设计的?

设计细节

  • 主要用途:治疗
  • 分配:不适用
  • 介入模型:单组作业
  • 屏蔽:无(打开标签)

武器和干预

参与者组/臂
干预/治疗
实验性的:All Subjects
Plerixafor will be administered via IV as a continuous 7 day intravenous infusion starting at a dose of 20 ug/kg/hr and subsequent dose levels of 40, 80 and 120 ug/kg/hr
Plerixafor will be administered via IV as a continuous 7 day intravenous infusion starting at a dose of 20 ug/kg/hr and subsequent dose levels of 40, 80 and 120 ug/kg/hr

研究衡量的是什么?

主要结果指标

结果测量
措施说明
大体时间
Causality of adverse events (AEs) and serious adverse events (SAEs) and grading according to NCI CTCAE v.4.03.
大体时间:From baseline through Day 56
Assess safety of continuous IV administration of plerixafor in doses needed to achieve and maintain circulating levels similar to those active in a murine model of PDAC (2 μg/ml)
From baseline through Day 56

次要结果测量

结果测量
措施说明
大体时间
Assessment of metabolic changes in tumour using non-invasive imaging (18FDG-PET)
大体时间:From baseline through Day 56
To explore objective anticancer clinical impact of this strategy.
From baseline through Day 56

其他结果措施

结果测量
措施说明
大体时间
Change in T cell distribution within tumour regions within primary or metastatic lesions (e.g. CD3+ T cell accumulation in cancer cell "nests")
大体时间:From baseline through Day 56
To explore relationships between intratumoural T-cell distribution, CXCR4 and CXCL12 immunostaining and other potential biomarkers of immune activation in tissue and blood, such as circulating CD34+ cell counts and diurnal cortisol variation.
From baseline through Day 56
Changes in circulating tumour ctDNA levels within plasma, during and after treatment.
大体时间:From baseline through Day 56
From baseline through Day 56
Changes in proliferation and apoptosis markers (e.g. Ki67/Mib1), changes in tumour cell populations in samples.
大体时间:From baseline through Day 56
To assess modulation of the immune tumour microenvironment following CXCR4 inhibition by plerixafor administration.
From baseline through Day 56
Changes in immune cytokine serum levels.
大体时间:From baseline through Day 56
From baseline through Day 56
T cell receptor (TCR) sequencing in tumour tissue.
大体时间:From baseline through Day 56
From baseline through Day 56
DNA and RNA sequencing in tumour tissue.
大体时间:From baseline through Day 56
From baseline through Day 56
Evidence of systemic pharmacodynamic response to CXCR4i, such as increase in CD34+ cell numbers in blood.
大体时间:From baseline through Day 56
From baseline through Day 56
Correlation between changes in T cell distribution and diurnal cortisol variation.
大体时间:From baseline through Day 56
From baseline through Day 56

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

调查人员

  • 首席研究员:Elizabeta Popa, MD、Weill Medical College of Cornell University
  • 学习椅:Duncan Jodrell, MD、Cambridge University Hospitals NHS Foundation Trust

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (实际的)

2017年7月25日

初级完成 (实际的)

2019年12月30日

研究完成 (实际的)

2019年12月30日

研究注册日期

首次提交

2017年9月6日

首先提交符合 QC 标准的

2017年9月6日

首次发布 (实际的)

2017年9月8日

研究记录更新

最后更新发布 (实际的)

2020年3月2日

上次提交的符合 QC 标准的更新

2020年2月27日

最后验证

2020年2月1日

更多信息

与本研究相关的术语

药物和器械信息、研究文件

研究美国 FDA 监管的药品

是的

研究美国 FDA 监管的设备产品

在美国制造并从美国出口的产品

是的

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Plerixafor的临床试验

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