Phase 1 Study of Anti-HB-EGF Monoclonal Antibody KHK2866 as Monotherapy in Subjects With Advanced Solid Tumors and in Combination With Chemotherapy in Ovarian Cancer
Brief SummaryThis is a two-part, Phase 1, open-label, multicenter, dose escalation study of KHK2866 as monotherapy in patients with advanced solid tumors, and in combination with chemotherapy in subjects platinum-sensitive and platinum-resistant ovarian cancer.
Detailed DescriptionDuring Phase 1a, groups of eligible patients with advanced solid tumors will receive KHK2866 as monotherapy in escalating doses. The Phase 1b portion will enroll patients with ovarian cancer who will receive KHK2866 in combination with one of three chemotherapy regimens (Arms): gemcitabine+carboplatin (platinum-sensitive, weekly paclitaxel (platinum-resistant), or pegylated liposomal doxorubicin (platinum-resistant). Escalating doses of the combination of KHK2866 and the chemotherapy regimen will given to two groups of subjects per Arm. The goal of the study is to learn about the side effects of KHK2866 alone or given in combination with chemotherapy. All subjects will receive study therapy for up to 6 cycles (up to 12 cycles for subjects assigned to PLD [Arm 3 of Phase 1b]), or until disease progression, the development of severe side effects, noncompliance or withdrawal of consent by the subject, or other removal criteria whichever comes first.
PhasePhase 1 - a new treatment that has not been tested, and researchers are looking for the best way to administer the treatment and how much can be given safely. Phase I trials are usually offered only to patients with advanced disease who would not be helped by other known treatments. Some patients are helped by these treatments, although in this early stage physicians don’t really know if the treatment will be effective.
Inclusion and Exclusion Criteria
- Histologically or cytologically documented, measurable or non-measurable, advanced primary or recurrent solid tumor (Phase 1a only) which is unresponsive to standard therapy or for which there is no standard therapy available.
- Histologically or cytologically documented ovarian, primary peritoneal, or fallopian tube cancer.
- The subject has objective radiographic disease progression and either unmeasurable or measurable disease during or following the last treatment regimen, or serum cancer antigen-125 (CA-125) greater than 2X the upper limit of normal ([ULN] >70 U/mL
- Life expectancy >3 months.
- Performance status < 3 at study entry.
- Age > 18 years.
- Normal left ventricular ejection fraction.
- Recovered from the effects of recent surgery, radiotherapy, chemotherapy, hormonal therapy, or other therapies for cancer
- Preserved hepatic, renal, and hematopoetic organ function.
- Male and female subjects must use medically accepted contraception.
- Ovarian malignancy of low malignant potential.
- Received anti-cancer chemotherapy, hormonal therapy, radiotherapy, immunotherapy, or investigational agents within 4 weeks prior to the first dose of KHK2866 (6 weeks for nitrosourea or mitomycin chemotherapy).
- received Mabs or had major surgery within 4 weeks of the first dose of KHK2866.
- Requires administration of a prohibited medication or treatment including: prophylactic use of erythroid and/or granulocyte colony stimulating factors; concurrent anti-cancer treatment; biologic response modifiers for any condition
- Brain metastases, leptomeningeal or primary brain neoplasm, even if treated.
- Previously untreated or uncontrolled epidural metastasis
- Cerebrovascular accident, Transient ischemic attack; symptomatic head trauma, or seizures or any kind within 6 months
- Dementia, or other disorders of mentation or difficulty speaking or difficulty with comprehension.
- Suspected impending bowel obstruction
- The subject is pregnant,or is lactating.
- Significant uncontrolled intercurrent illness
- Known HIV infection or AIDS-related illness.
- Known active hepatitis B or C or other active liver disease.
- Psychiatric illness, disability or social situation that would compromise the subject's safety, ability to provide consent, or limit his/her compliance with study requirements.
- Experienced a unmanageable hypersensitivity reactions to Mabs or other therapeutic proteins.
- History of second primary cancer, with the exception of: a) curatively resected non-melanomatous skin cancer; b) curatively treated cervical carcinoma in-situ; or c) other primary solid tumor treated with curative intent and no known active disease present and no treatment administered during the last 2 years.
- Additional exclusion criteria for subjects proposed for enrollment into the Phase 1b portion:
- History of hypersensitivity or infusion reaction to any of the proposed chemotherapy arm's agents that could not be controlled with pre-medication and/or infusion rate adjustment;
- Prior treatment with KHK2866;
- History of Grade ≥ 3 non-hematologic or Grade 4 hematologic toxicity attributable to any of the proposed chemotherapy arm's agents
- For subjects proposed to receive treatment with KHK2866 plus PLD: prior total cumulative exposure to doxorubicin must be ≤ 240 mg/m2.
- Subjects with a known history of interstitial lung disease or pulmonary fibrosis. Subjects must have pulse oximetry >88% on room air at rest, and a DLco of >49% if there is no evidence of lung metastasis.
- Cedar Sinai-Samuel Oschin Comprehensive Cancer Institute, Los Angeles, California, 90048
- Arizona Cancer Center, Tucson, Arizona, 85724
- Cancer Therapy and Research Center, San Antonio, Texas, 78229
- Oncology Consultants, Houston, Texas, 77030