Mapatumumab, Cisplatin and Radiotherapy for Advanced Cervical Cancer

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01088347
Recruitment Status : Completed
First Posted : March 17, 2010
Last Update Posted : April 22, 2015
Human Genome Sciences Inc.
Information provided by (Responsible Party):
A.K.L. Reyners, University Medical Center Groningen

Brief Summary:

Chemoradiotherapy has become the standard of care for women with locally advanced cervical cancer. The available data support a 30 to 50% reduction in the risk of death from cervical cancer for women with locally advanced disease undergoing radiotherapy (RT) and concomitant cisplatin-based chemotherapy compared to RT alone. Despite the fact that this is currently the best treatment of locally advanced cervical cancer, 5-year overall survival is still only 52%.

The fully human, agonist monoclonal antibody mapatumumab binds to the Tumor necrosis factor-Related Apoptosis-Inducing Ligand Receptor 1 (TRAIL-R1, DR4) and induces cytotoxicity in multiple tumor cell lines in vitro and in vivo. In multiple phase I and phase II studies, mapatumumab appeared to be safe both as single agent and in combination with chemotherapy, including cisplatin.

In cervical cancer cell lines, mapatumumab induced apoptosis in 51% of the cells. Mapatumumab in combination with irradiation increased apoptosis to 83%.

In this phase 1b/2 study, the investigators will evaluate the safety, tolerability and efficacy of mapatumumab in combination with cisplatin and radiotherapy in patients with locally advanced cervical cancer.

Condition or disease Intervention/treatment Phase
Advanced Cervical Cancer Drug: mapatumumab Drug: cisplatin Radiation: radiotherapy Phase 1 Phase 2

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 9 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase 1b/2 Study With the Agonistic TRAIL-R1 Antibody, Mapatumumab, in Combination With Cisplatin and Radiotherapy as a First Line Therapy in Patients With Advanced Cervical Cancer.
Study Start Date : March 2010
Actual Primary Completion Date : March 2014
Actual Study Completion Date : March 2014

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Cervical Cancer
Drug Information available for: Cisplatin

Arm Intervention/treatment
Experimental: Advanced cervical cancer patients Drug: mapatumumab
Mapatumumab (10 or 30 mg/kg) intravenously on days 1, 22, and 45. In phase 2 the MTD established in phase 1 will be used.

Drug: cisplatin
Cisplatin 40 mg/m2 intravenously on days 8, 15, 22, 29, 36, and 45

Radiation: radiotherapy
Radiotherapy: a total dose of 45 Gy will be given in fractions of 1.8 Gy, five fractions per week (days 8-12, 15-19, 22-26, 29-33, and 36-40), by external beam irradiation by photon beam of at least 6 MV. After completing the five weeks of external beam irradiation, evaluation will take place to determine whether the boost can be given by brachytherapy. If brachytherapy is not feasible, the boost will be given by external beam irradiation to a total dose of 70.2 Gy in fractions of 1.8 Gy.

Primary Outcome Measures :
  1. Phase 1b: safety and tolerability of mapatumumab in combination with cisplatin and radiotherapy Phase 2: efficacy of mapatumumab in combination with cisplatin and radiotherapy [ Time Frame: 5 months ]
    Phase 2: pathological complete response rate

Secondary Outcome Measures :
  1. Disease free survival, overall survival [ Time Frame: From enrollment until recurrence of disease, from enrollment until death ]
  2. Apoptotic pathway biomarkers, PK parameters [ Time Frame: During the study, until 5 months after enrollment ]

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

Inclusion Criteria:

  1. Patients with histologically or cytologically confirmed stage IB2, IIA2, IIB, III, and IVA cervical cancer, according to the FIGO classification
  2. Adequate bone marrow, renal and liver function:

    • Absolute neutrophil count ≥ 1.5 x 109 /L.
    • Platelet count ≥ 100 x 109 /L.
    • Serum creatinine level ≤ 1.5 x upper limit of normal (ULN).
    • Total bilirubin < 1.25 x ULN.
    • Aspartate transaminase (AST) and alanine transaminase (ALT) ≤ 2.5 x ULN.
  3. Performance status of 0 to 1 on the Eastern Cooperative Oncology Group (ECOG) Scale.
  4. Age 18 years or older.
  5. Life expectancy of ≥ 12 weeks.
  6. Have the ability to understand the requirements of the study, provide written informed consent (including consent for the use and disclosure of research-related health information), and comply with the study and follow-up procedures.

Exclusion Criteria:

  1. Any co-morbid condition that in the judgment of the investigator renders the subject at high risk of treatment complications or reduces the possibility of assessing clinical effect.
  2. Cytotoxic agent, hormonal therapy, or radiation therapy within 3 weeks (6 weeks for nitrosoureas or mitomycin-C) prior to day 1, cycle 1; investigational agent within 4 weeks prior to day 1, cycle 1.
  3. Need for concomitant anticancer therapy (surgery, radiation therapy, chemotherapy, immunotherapy, radiofrequency ablation) or other investigational agents during the study treatment period.
  4. Major surgery within 4 weeks before enrollment; minor surgery (except for insertion of vascular access device) within 2 weeks before enrollment; or not yet recovered from the effects of the surgery.
  5. Systemic steroids within 1 week before enrollment except steroids used as part of an antiemetic regimen or maintenance-dose steroids for non-cancerous disease.
  6. History of any infection requiring hospitalization or antibiotics within 2 weeks before enrollment.
  7. Known brain or spinal cord metastases unless adequately treated (surgery or radiotherapy) with no evidence of progression and neurologically stable off anticonvulsants and steroids.
  8. Known human immunodeficiency virus infection.
  9. Unstable angina, myocardial infarction, cerebrovascular accident, > Class II congestive heart failure according to the New York Heart Association Classification for Congestive Heart Failure within 6 months before enrollment.
  10. Pregnant female or nursing mother.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01088347

University Medical Center Groningen
Groningen, Netherlands, 9700 RB
Sponsors and Collaborators
University Medical Center Groningen
Human Genome Sciences Inc.
Principal Investigator: An KL Reyners, MD,PhD University Medical Center Groningen

Responsible Party: A.K.L. Reyners, Medical Oncologist, University Medical Center Groningen Identifier: NCT01088347     History of Changes
Other Study ID Numbers: 24-11-2009 (versions 2.0)
2009-015941-22 ( EudraCT Number )
First Posted: March 17, 2010    Key Record Dates
Last Update Posted: April 22, 2015
Last Verified: April 2015

Keywords provided by A.K.L. Reyners, University Medical Center Groningen:
advanced cervical cancer
Uterine cervical neoplasm

Additional relevant MeSH terms:
Uterine Cervical Neoplasms
Uterine Neoplasms
Genital Neoplasms, Female
Urogenital Neoplasms
Neoplasms by Site
Uterine Cervical Diseases
Uterine Diseases
Genital Diseases, Female
Antibodies, Monoclonal
Antineoplastic Agents
Immunologic Factors
Physiological Effects of Drugs