A phase I study of the safety, tolerability, and antitumor activity of escalating doses of combretastatin A4 phosphate given in combination with bevacizumab to subjects with advanced solid tumors

ISRCTN ISRCTN96787846
DOI https://doi.org/10.1186/ISRCTN96787846
ClinicalTrials.gov number NCT00395434
Secondary identifying numbers OXC4P1-105
Submission date
30/10/2006
Registration date
21/12/2006
Last edited
13/11/2013
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Cancer
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Not provided at time of registration

Contact information

Dr Paul Nathan
Scientific

Mount Vernon Hospital
Northwood
Middlesex
HA6 2RN
United Kingdom

Phone +44 (0)1923 84 4729
Email nathan.pd@gmail.com

Study information

Study designOpen-label multi-centre ascending-dose single-arm study
Primary study designInterventional
Secondary study designMulti-centre
Study setting(s)Hospital
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific title
Study objectives1. To determine the safety and tolerability of three dose levels of Combretastatin A4 Phosphate (CA4P) given IntraVenously (IV) in combination with bevacizumab every 14 days in subjects with advanced solid tumours. The Maximum Tolerated Dose (MTD) will be defined if it is at one of the three dose levels under study
2. To obtain preliminary information on the anti-tumour activity of CA4P when administered in combination with bevacizumab
3. To assess the pharmacodynamic anti-tumour activity of CA4P in combination with bevacizumab utilising Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) for those patients with suitable lesions
4. To obtain pharmacokinetic information on the combination of CA4P and bevacizumab
5. To assess the effect of CA4P alone and the combination of CA4P and bevacizumab on circulating Endothelial Progenitor Cells (EPCs)

Please note that the anticipated end recruitment date of this trial has been extended to September 2007. The previous anticipated end date of this trial was 30/06/2007.
Ethics approval(s)NHS Leeds (East) Research Ethics Committee, 27/06/2006, REC reference number: 06/Q1206/89
Health condition(s) or problem(s) studiedAdvanced solid tumours
InterventionCA4P will be given IV as a single agent therapy on day one and then once every 14 days in combination with bevacizumab beginning on day eight. Three subjects will be evaluated at each dose level (three dose levels). If a Dose-Limiting Toxicity (DLT) is seen in one subject, the cohort will be expanded to six subjects. If two or more subjects experience a DLT, the cohort at the preceding level will be expanded to six subjects. If the MTD is not found to be at one of the three dose levels under study, no further dose escalation will be performed. At the end of the treatment schedule, if a subject is showing clinical benefit, the subject may continue to receive additional cycles at the discretion of the Principal Investigator (PI) and agreement of the sponsor.
Intervention typeDrug
Pharmaceutical study type(s)
PhasePhase I
Drug / device / biological / vaccine name(s)Combretastatin A4 Phosphate (CA4P) and bevacizumab.
Primary outcome measureTo determine the safety and tolerability of three dose levels of CA4P given IV in combination with bevacizumab every 14 days in subjects with advanced solid tumors. The MTD will be defined if it is at one of the three dose levels under study.
Secondary outcome measures1. To obtain preliminary information on the antitumor activity of CA4P when administered in combination with bevacizumab
2. To assess the pharmacodynamic anti-tumor activity of CA4P in combination with bevacizumab utilising DCE-MRI for those patients with suitable lesions
3. To obtain pharmacokinetic information on the combination of CA4P and bevacizumab
4. To assess the effect of CA4P alone and the combination of CA4P and bevacizumab on circulating EPCs
Overall study start date15/09/2006
Completion date01/09/2007

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participants~12 (3-6 per dose group)
Key inclusion criteria1. Histopathologically or cytologically confirmed malignant solid tumours that have failed standard therapy or for which no life prolonging treatment exists
2. Measurable disease as defined by the Response Evaluation Criteria In Solid Tumours (RECIST) criteria
3. At least four weeks since any prior immunotherapy, chemotherapy or radiation therapy prior to first dose of study drug (six weeks for therapy known to be associated with delayed toxicity such as nitrosoureas or mitomycin-C)
4. Age more than or equal to 18 years old
5. Adequate bone marrow function:
a. Absolute granulocyte count (neutrophils and bands) more than 1500 cells/mm^3
b. Platelet count more than 100,000 cells/mm^3
c. Haemoglobin more than 9 g/dL
6. Adequate renal function (Glomerular Filtration calculated by Cockcroft/Gault formula or measure urine creatinine clearance more than 50 mL/minute)
7. Adequate hepatic function:
a. Bilirubin less than 1.5 mg/dL
b. Aspartate Transaminase (AST) and Alanine Transaminase (ALT) less than 2.5 times the institutional Upper Limit of Normal (ULN) (or less than five times ULN if liver metastases are present)
8. Eastern Cooperative Oncology Group (ECOG) performance status zero to two
9. Life expectancy of more than or equal to 12 weeks
10. Written, signed, dated, and witnessed (if applicable as per International Conference on Harmonisation [ICH] guidelines) Independent Ethics Committee (IEC) approved informed consent form before any study specific screening procedures are performed
11. Fertile subjects must abstain from sexual intercourse or use effective birth control
12. All Women Of Child-Bearing Potential (WOCBP) must have a negative serum pregnancy test within 72 hours of first dose
Key exclusion criteria1. Contraindications, allergies or sensitivity to the use of the study medications or any other products required for participation in this study (i.e. contrast agents)
2. Presence of Central Nervous System (CNS) metastases
3. Diagnosed Squamous Non-Small Cell Lung Cancer (NSCLC)
4. History of Gastrointestinal Perforations
5. Surgery within 28 days of screening visit or a surgical incision that is not fully healed. Any surgery planned during the study period
6. Proteinuria more than 1 g/24 hours by 24 hour urine collection (perform 24 hour urine collection if more than 1+ on dipstick)
7. Recent haemoptysis (occurrence within the past three months)
8. Prior therapy with CA4P or bevacizumab, or other agents which target Vascular Endothelial Growth Factor (VEGF) or Vascular Endothelial Growth Factor Receptor (VEGFR) signalling such as Sorafenib and Sutent
9. Prior radiation involving more than 30% of the bone marrow
10. Radical radiotherapy to the thorax or abdomen at any time or post-operative radical radiotherapy to the pelvis. Palliative radiotherapy treatments are acceptable. Subjects with rectal primaries who have received pre-operative pelvic radiotherapy or chemoradiation are eligible if the small bowel was mobile and not stuck to the tumour
11. Active autoimmune disorder(s)
12. Immuno-compromised, including subjects known to be Human Immunodeficiency Virus (HIV) positive
13. Active infection requiring antibiotic therapy or any other serious intercurrent illness
14. History of angina (stable or severe, even if controlled with medications), myocardial infarction, Congestive Heart Failure (CHF), non-controlled atrial arrhythmias or clinically significant arrhythmias including conduction abnormality, nodal junctional arrhythmias and dysrhythmias, sinus bradycardia or tachycardia, supraventricular arrhythmias, atrial fibrillation or flutter, syncope or vasovagal episodes
15. Electrocardiogram (ECG) with evidence of prior myocardial infarction (e.g., significant Q waves), QTc more than 450 msec or other clinically significant abnormalities
16. Taking any drug(s) known to prolong the QTc interval, which cannot be interrupted for at least four days during each treatment cycle
17. Known significant heart wall abnormality or heart muscle damage as evidenced on Multiple Gated Acquisition (MUGA) scan or echocardiogram (this is not a required screening investigation)
18. Uncontrolled hypertension (defined as blood pressure consistently greater than 150/100 irrespective of medication), or controlled hypertension requiring use of more than two classes of anti-hypertensives
19. Uncontrolled hypokalemia and/or hypomagnesemia
20. Symptomatic peripheral vascular disease or cerebrovascular disease
21. Psychiatric disorders or other conditions rendering subjects incapable of complying with the requirements of the protocol
22. Receiving concurrent hormonal therapy with exception of gonadotropin-Releasing Hormone (GnRH) agonists in subjects with hormone refractory prostate cancer, Hormone Replcaement Therapy (HRT), oral contraceptive, and megestrol acetate used for anorexia/cachexia
23. Receiving anticoagulation with warfarin, heparin or low molecular weight heparin other than low dose (1 mg) warfarin for maintenance of central line patency
24. Women who are currently pregnant, nursing, or planning a pregnancy; or women who have a positive pregnancy test
25. Receiving concurrent antineoplastic therapy (radiation therapy, cytotoxic or biologic therapy)
26. Participation in an investigational drug or device trial within 30 days of entering the study
Date of first enrolment15/09/2006
Date of final enrolment01/09/2007

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

Mount Vernon Hospital
Middlesex
HA6 2RN
United Kingdom

Sponsor information

OXiGENE, Inc. (USA)
Industry

230 Third Ave
Waltham
MA 02451
United States of America

Phone +1 781 547 5900
Email oxigeneclinical@oxigene.com
Website http://www.oxigene.com
ROR logo "ROR" https://ror.org/00cj7p033

Funders

Funder type

Industry

OXiGENE, Inc. (USA)

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 15/06/2012 Yes No