Dose-Escalation Study of TH-302 in Combination With Doxorubicin to Treat Patients With Advanced Soft Tissue Sarcoma

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
Threshold Pharmaceuticals
ClinicalTrials.gov Identifier:
NCT00742963
First received: August 26, 2008
Last updated: November 14, 2013
Last verified: November 2013
  Purpose

The purpose of this study is to determine whether TH-302 in combination with Doxorubicin is safe and effective in the treatment of Advanced Soft Tissue Sarcoma.


Condition Intervention Phase
Soft Tissue Sarcoma
Drug: TH-302
Phase 1
Phase 2

Study Type: Interventional
Study Design: Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Phase 1/2, Multicenter, Dose-Escalation Study to Determine the Safety, Efficacy and Pharmacokinetics of TH-302 in Combination With Doxorubicin in Patients With Advanced Soft Tissue Sarcoma

Resource links provided by NLM:


Further study details as provided by Threshold Pharmaceuticals:

Primary Outcome Measures:
  • To determine the MTD and DLT(s) of TH- 302 when used in combination with doxorubicin and prophylactic growth factor support in subjects with advanced soft tissue sarcoma [ Time Frame: Two years ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • To make an assessment of the efficacy of TH-302 in combination with doxorubicin as determined by progression-free rate at 3 months, progression free survival, response rate, duration of response, and overall survival in subjects with relapse [ Time Frame: Two years ] [ Designated as safety issue: Yes ]

Enrollment: 102
Study Start Date: August 2008
Study Completion Date: September 2013
Primary Completion Date: September 2013 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: 1
75 mg/m2 of Doxorubicin administered by bolus injection starting on Day 1 of a 21-day cycle.
Drug: TH-302

TH-302 will be administered by IV infusion over 30-60 minutes on Days 1 and 8 of a 21-day cycle.

Dose escalation dose levels:

Dose level -1 (if needed): 180 mg/m2 Starting dose: 240 mg/m2


Detailed Description:

A broad range of tumors have been shown to contain significant numbers of hypoxic cells and hypoxia has been shown to be associated with a poor prognosis and an increase in resistance to chemotherapy and radiotherapy (Brizel 1997, Vaupel 2007, Shannon 2003).

It is likely that an agent that could effectively target hypoxic regions in tumors would improve efficacy when combined with standard chemotherapy or radiotherapy. TH-302 is activated at lower oxygen concentrations than other bioreductive prodrugs (Duan 2008) and tirapazamine, a hypoxic cytotoxin that has been extensively studied in both preclinical and clinical studies. This should result in an improved therapeutic ratio (tumor vs normal tissue toxicity) as compared with other bioreductive agents. Because TH-302 is expected to be minimally toxic to aerobic cancer cells, optimal efficacy would be expected when TH-302 is combined with treatments that are most effective under aerobic conditions such as radiotherapy and cytotoxic chemotherapy. Preclinical data have shown at least additive efficacy when TH-302 is combined with chemotherapy. In order to minimize the risk of additive toxicity, TH-302 is not being evaluated in combination with alkylating agents. The study will enroll subjects with advanced soft tissue sarcoma. These tumors have evidence supporting the presence of hypoxia based on pO2 histography, F-MISO and gene expression profiling (Vaupel 2007, Francis 2007, Rajendran 2003).

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria

All Subjects:

  • At least 18 years of age
  • Ability to understand the purposes and risks of the study and has signed a written informed consent form approved by the investigator's IRB/Ethics Committee
  • Pathologically confirmed diagnosis of soft tissue sarcoma of the following subtypes:
  • Synovial sarcoma
  • High grade fibrosarcoma
  • Unclassified, undifferentiated sarcoma
  • Liposarcoma
  • Leiomyosarcoma (excluding GIST)
  • Angiosarcoma (excluding Kaposi's sarcoma)
  • Pleomorphic sarcoma/malignant fibrous histiocytoma
  • Locally advanced unresectable or metastatic disease with no standard curative therapy available and for whom treatment with single agent doxorubicin is considered appropriate; subjects in the dose escalation cohorts must have progressed since their most recent systemic therapy
  • Recovered from reversible toxicities of prior therapy
  • Evaluable disease by RECIST criteria (at least one target or non-target lesion for dose escalation cohorts; at least 1 target lesion for dose expansion cohort)
  • ECOG performance status of 0 or 1
  • Life expectancy of at least 3 months
  • Acceptable liver function:
  • Bilirubin ≤ 1.5 times upper limit of normal (ULN)
  • AST (SGOT) and ALT (SGPT) ≤ 2.5 times ULN
  • Acceptable renal function:
  • Serum creatinine within normal limits
  • Acceptable hematologic status (without hematologic support):
  • ANC ≥ 1500 cells/μL
  • Platelet count ≥ 100,000/μL
  • Hemoglobin ≥ 9.0 g/dL
  • Acceptable cardiac function:
  • Normal 12-lead ECG (clinically insignificant abnormalities permitted)
  • LVEF normal by MUGA or echocardiogram
  • Urinalysis: No clinically significant abnormalities
  • All women of childbearing potential must have a negative serum pregnancy test and all subjects must agree to use effective means of contraception (surgical sterilization or the use or barrier contraception with either a condom or diaphragm in conjunction with spermicidal gel or an IUD) with their partner from entry into the study through 6 months after the last dose

Exclusion Criteria

Prior therapy:

  • Dose escalation cohort: Prior treatment with more than 2 myelosuppressive cytotoxic chemotherapy regimens
  • Expanded cohort: Prior systemic therapy for advanced disease (neoadjuvant and adjuvant permitted)
  • Low grade tumors according to standard grading systems (eg AJCC Grade 1 and 2)
  • Prior therapy with ifosfamide or cyclophosphamide
  • Prior therapy with an anthracycline or anthracenedione
  • Prior mediastinal/cardiac radiotherapy
  • Current use of drugs with known cardiotoxicity or known interactions with doxorubicin (see product label)
  • Anticancer treatment with radiation therapy, chemotherapy, targeted therapies (erlotinib, lapatinib, etc.), immunotherapy, hormones or other antitumor therapies within 4 weeks prior to study entry (6 weeks for nitrosoureas or mitomycin C)
  • Significant cardiac dysfunction:
  • Any history of congestive heart failure
  • Any history of transmural myocardial infarction
  • Uncontrolled arrhythmias within the past 6 months
  • Angina pectoris requiring antianginal medication within the past 6 months
  • Clinically significant valvular heart disease
  • Poorly controlled hypertension within the last 6 months
  • Seizure disorders requiring anticonvulsant therapy
  • Known brain metastases (unless previously treated and well controlled for a period of ≥ 3 months) Previously treated malignancies, except for adequately treated non-melanoma skin cancer, in situ cancer, or other cancer from which the subject has been disease-free for at least 5 years
  • Severe chronic obstructive or other pulmonary disease with hypoxemia (requires supplementary oxygen, symptoms due to hypoxemia or oxygen saturation <90% by pulse oximetry after a 2 minute walk) or in the opinion of the investigator any physiological state likely to cause normal tissue hypoxia
  • Major surgery, other than diagnostic surgery, within 4 weeks prior to Day 1, without complete recovery
  • Active, uncontrolled bacterial, viral, or fungal infections, requiring systemic therapy
  • Prior therapy with an hypoxic cytotoxin
  • Subjects who participated in an investigational drug or device study within 28 days prior to study entry
  • Known infection with HIV, hepatitis B, or hepatitis C
  • Subjects who have exhibited allergic reactions to a structural compound, biological agent, or formulation (containing solutol and/or propylene glycol) similar to TH-302
  • Females who are pregnant or breast-feeding
  • Concomitant disease or condition that could interfere with the conduct of the study, or that would, in the opinion of the investigator, pose an unacceptable risk to the subject in this study
  • Unwillingness or inability to comply with the study protocol for any reason
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00742963

Locations
United States, Arizona
Arizona Cancer Center
Tucson, Arizona, United States, 85719
United States, California
Sarcoma Oncology Center
Santa Monica, California, United States, 90403
Stanford University
Stanford, California, United States, 94305
United States, Florida
H. Lee Moffitt Cancer Center and Research Institute
Tampa, Florida, United States, 33612
United States, Indiana
Indiana University Cancer Center
Indianapolis, Indiana, United States, 46204
United States, Massachusetts
Dana Farber Cancer Institute
Boston, Massachusetts, United States, 02115
United States, Minnesota
Mayo Clinic Rochester
Rochester, Minnesota, United States, 55905
United States, Missouri
Washingon University Siteman Cancer Center
St. Louis, Missouri, United States, 63110
United States, Texas
Mary Crowley Cancer Research Centers
Dallas, Texas, United States, 75201
Sponsors and Collaborators
Threshold Pharmaceuticals
Investigators
Principal Investigator: Kristen Ganjoo, MD Stanford University
  More Information

Additional Information:
No publications provided

Responsible Party: Threshold Pharmaceuticals
ClinicalTrials.gov Identifier: NCT00742963     History of Changes
Other Study ID Numbers: TH-CR-403
Study First Received: August 26, 2008
Last Updated: November 14, 2013
Health Authority: United States: Food and Drug Administration

Keywords provided by Threshold Pharmaceuticals:
TH-302
Advanced Soft Tissue Sarcoma
Doxorubicin
Phase 1/2

Additional relevant MeSH terms:
Sarcoma
Neoplasms, Connective and Soft Tissue
Neoplasms by Histologic Type
Neoplasms
Doxorubicin
Liposomal doxorubicin
Antibiotics, Antineoplastic
Antineoplastic Agents
Therapeutic Uses
Pharmacologic Actions
Topoisomerase II Inhibitors
Topoisomerase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action

ClinicalTrials.gov processed this record on August 01, 2014