Dose-escalation Study of Oral CX-4945

Study Description

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Brief Summary:

This Phase 1 study of oral CX-4945 is designed to test the safety, tolerability and highest safe dose level of this CK2 inhibitor in patients with advanced solid tumor cancers, Castleman's Disease or Multiple Myeloma.

Condition or disease	Intervention/treatment	Phase
Advanced Solid Tumors; Breast Cancer; Inflammatory Breast Cancer; Castleman's Disease; Multiple Myeloma	Drug: CX-4945 oral formulation	Phase 1

Detailed Description:

Elevated CK2 activity has been associated with malignant transformation and aggressive tumor growth and overexpression of CK2 has been documented in multiple types of cancer. CK2 has emerged as a potential anticancer target and inhibition of CK2 represents a potential therapeutic strategy to target a specific molecular defect perpetuating many cancers. CX-4945 has demonstrated potent inhibition of CK2 enzymatic activity. This study will evaluate the safety, pharmacokinetics (PK), and pharmacodynamic (PD) effects of CX-4945 administered to patients with malignancies or lymphoproliferative disorders known to overexpress CK2 including advanced solid tumors, Multiple Myeloma and Castleman's Disease.

Study Design

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Study Type :	Interventional (Clinical Trial)
Estimated Enrollment :	55 participants
Allocation:	Non-Randomized
Intervention Model:	Single Group Assignment
Masking:	None (Open Label)
Primary Purpose:	Treatment
Official Title:	A Phase 1, Multi-Center, Open-Label, Dose-Escalation, Safety, Pharmacokinetic, and Pharmacodynamic Study of CX-4945 Administered Orally to Patients With Advanced Solid Tumors, Castleman's Disease or Multiple Myeloma
Study Start Date :	February 2009
Estimated Primary Completion Date :	December 2011
Estimated Study Completion Date :	December 2011

Arms and Interventions

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Intervention Details:

• Drug: CX-4945 oral formulation
  CX-4945 Capsules, Oral, Dose escalation study, Dose schedule: twice daily or four times daily for 21 consecutive days every 28 days.

Outcome Measures

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Primary Outcome Measures :

1. Safety (Dose limiting toxicities, maximum tolerated dose) [ Time Frame: One year (Assessed at Cycle 1) ]
2. Drug-related adverse events [ Time Frame: One Year (Asessed from first administration of study drug through 30 days after the last dose) ]

Secondary Outcome Measures :

1. Pharmacokinetic and pharmacodynamic assessments [ Time Frame: One Year (Assessed during Cycle 1) ]
2. Observe evidence of antitumor activity [ Time Frame: One Year (Assessed after every two cycles) ]
3. Establish the recommended Phase 2 dose [ Time Frame: One Year (Study completion) ]

Eligibility Criteria

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Ages Eligible for Study:	18 Years and older (Adult, Older Adult)
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

• Histologically or cytologically confirmed malignancy or lymphoproliferative disorder known to over express CK2 which has failed standard therapies (surgery, radiotherapy, endocrine therapy, chemotherapy) or for which effective therapy is not available, including the following types: (examples)

  • Lung cancer
  • Renal cell cancer
  • Breast cancer
  • Inflammatory breast cancer
  • Head and neck cancer - squamous cell
  • Prostate cancer
  • Colorectal cancer
  • Castleman's disease (multi-centric disease)
  • Multiple myeloma (Eligible patients must have quantifiable M-protein levels present in serum and/or urine)
• At least 18 years of age.
• One or more tumors measurable on radiograph or CT scan, or evaluable disease defined as non-measurable lesions per RECIST or detection of protein M in serum and/or urine of patients with Multiple Myeloma (serum ≥ 10 gm/L and urine ≥ 200 mg/24 hr).
• Laboratory data as specified below:
• Hematology: ANC >1500 cells/mm3, platelet count >100,000 cells/mm3 and Hemoglobin > 9 gm/L
• Hepatic: bilirubin <1.5 X ULN; alanine aminotransferase (ALT) or aspartate aminotransferase (AST) < 2.5 X ULN. Patients with known liver metastases or liver neoplasms: alanine aminotransferase (ALT) or aspartate aminotransferase (AST) < 5.0 X ULN
• Renal: serum creatinine within normal limits (WNL), defined as within 10% of the institution's stated reference range, or a calculated creatinine clearance >60 mL/min/1.73 m2 for patients with abnormal, increased, creatinine levels. Patients with Multiple Myeloma (only): serum creatinine ≤ 2.5 the institutional upper limit of the normal range and a calculated creatinine clearance > 40 mL/min/1.73 m2.
• Coagulation: INR < 1.5 times normal, aPTT < 1.5 times normal. Patients receiving therapeutic doses of anticoagulant therapy may be considered eligible for the trial if INR and aPTT are within the acceptable therapeutic limits for the institution.
• A negative pregnancy test (if female of childbearing potential).
• Estimated life expectancy of at least 3 months
• Karnofsky Performance Status ≥ 70%
• For men and women of child-producing potential, use of effective contraceptive methods during the study
• Ability to understand the requirements of the study, provide written informed consent.

Exclusion Criteria:

• Pregnant or nursing women.
• Seizure disorders requiring anticonvulsant therapy.
• Known brain metastases (unless previously treated and well controlled for a period of > or = 3 months).
• Major surgery, other than diagnostic surgery, within 4 weeks prior to the first dose of test drug.
• Treatment with radiation therapy or surgery within one month prior to study entry
• Treatment with chemotherapy or investigational drugs within 21 days prior to the screening visit. Acute toxicities from prior therapy must have resolved to Grade ≤ 1 above baseline.
• Patients with a history of a second malignancy within 3 years of the baseline visit excluding cutaneous carcinomas and in-situ carcinoma.
• Concurrent severe or uncontrolled medical disease.
• Active symptomatic fungal, bacterial and/or viral infection including active HIV or viral hepatitis.
• Difficulty with swallowing or an active malabsorption syndrome
• Chronic diarrhea
• Gastrointestinal diseases including gastritis, ulcerative colitis, Crohn's disease, or hemorrhagic coloproctitis
• History of gastric or small bowel surgery involving any extent of gastric or small bowel resection.
• Clinically significant bleeding event within the last 3 months, unrelated to trauma, or underlying condition that would be expected to result in a bleeding diathesis
• Patients who have exhibited allergic reactions to a similar structural compound or to a formulation component.
• Concomitant use of warfarin and HMG-CoA reductase inhibitors (statins)

Contacts and Locations

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Locations

United States, Arizona
Mayo Clinic Arizona	Recruiting
Scottsdale, Arizona, United States, 85259
Contact: Clinical Trials Office Mayo Clinic Cancer Center 507-538-7623
Principal Investigator: Donald Northfelt, MD
United States, Colorado
Front Range Cancer Specialists	Recruiting
Fort Collins, Colorado, United States, 80528
Contact: P. Zeller 970-212-7609
Principal Investigator: Robert F Marschke, MD
Front Range Cancer Specialists	Recruiting
Loveland, Colorado, United States, 80528
Contact: Pat Zeller 970-212-7609
Principal Investigator: R. McFarland, MD
United States, Texas
U T M D Anderson Cancer Center	Recruiting
Houston, Texas, United States, 77030
Contact: R. Alvarez, MD ralvarez@mdanderson.org
Principal Investigator: R. Alvarez, MD

Sponsors and Collaborators

Cylene Pharmaceuticals

Investigators

Study Director:	Study Director	Cylene Pharmaceuticals

More Information

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Responsible Party:	Study Director, Cylene Pharmaceuticals Inc
ClinicalTrials.gov Identifier:	NCT00891280 History of Changes
Other Study ID Numbers:	C4-08-001
First Posted:	May 1, 2009
Last Update Posted:	June 15, 2011
Last Verified:	June 2011

Keywords provided by Cylene Pharmaceuticals:

Inflammatory breast cancer; Castleman's Disease; Multiple Myeloma	Breast cancer; Solid tumors; CK2 inhibitor

Additional relevant MeSH terms:

Breast Neoplasms; Multiple Myeloma; Neoplasms, Plasma Cell; Inflammatory Breast Neoplasms; Giant Lymph Node Hyperplasia; Neoplasms by Site; Neoplasms; Breast Diseases; Skin Diseases; Neoplasms by Histologic Type; Hemostatic Disorders	Vascular Diseases; Cardiovascular Diseases; Paraproteinemias; Blood Protein Disorders; Hematologic Diseases; Hemorrhagic Disorders; Lymphoproliferative Disorders; Immunoproliferative Disorders; Immune System Diseases; Lymphatic Diseases