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Safety and Activity of G-202 in Patients With Clear Cell Renal Cell Carcinoma That Expresses PSMA

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ClinicalTrials.gov Identifier: NCT02607553
Recruitment Status : Completed
First Posted : November 18, 2015
Last Update Posted : February 24, 2017
Information provided by (Responsible Party):
GenSpera, Inc.

Brief Summary:
An open-label, single-arm, single-center Phase II study to evaluate the safety and activity of G-202 in patients with clear cell renal cell carcinoma that expresses PSMA

Condition or disease Intervention/treatment Phase
Clear Cell Renal Cell Carcinoma Drug: G-202 Phase 2

Detailed Description:
Epithelial tumors, including clear cell renal cell carcinoma (RCC), have the ability to grow to only a finite size in the absence of vascularization. RCC is characterized as a highly-vascularized tumor and inhibiting angiogenesis has the potential to impair tumor growth, including growth of RCC. Therapeutic targeting of integral biological pathways in RCC, including those involving VEGF and mTOR, has produced robust clinical effects and revolutionized the treatment of metastatic RCC. These approaches offers significant clinical benefit and sequential use of these agents has become the empirical standard of care. However, complete or durable responses are uncommon and resistance develops after a median interval of 6-15 months. This raises the pressing clinical need for additional therapeutic approaches for patients with metastatic clear cell RCC. The purpose of this study is to investigate the approach of targeted delivery of cytotoxic chemotherapy with G-202 in patients with advanced, refractory RCC. This study is based on prodrug tumor targeting, in which an inactive form of a toxic agent is administered systemically and gets activated in specific locations in the body, resulting in higher concentrations of the cytotoxic form at the tumor location. G-202 is a prodrug that is activated by PSMA in the blood vessels of tumors, but not normal tissue; once activated, G-202 leads to disruption of intracellular calcium levels and subsequent induction of apoptosis. Thus, G-202 is expected to bring about cell death in RCC and destroy the blood supply of RCC tumors. This single-arm, open-label Phase II clinical trial will evaluate the safety and activity of G-202 in patients with RCC that expresses PSMA.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 2 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: G-202-006: An Open-Label, Single-Arm, Phase II Study to Evaluate the Safety and Activity of G-202 in Patients With Clear Cell Renal Cell Carcinoma That Expresses PSMA
Study Start Date : June 2016
Actual Primary Completion Date : December 2016
Actual Study Completion Date : February 2017

Arm Intervention/treatment
Experimental: Experimental: G-202
G-202 administered by intravenous infusion on 3 consecutive days of a 28-day cycle
Drug: G-202
G-202 administered by intravenous infusion on Days 1, 2 and 3 of each 28-day cycle until disease progression
Other Name: Mipsagargin

Primary Outcome Measures :
  1. Clinical activity [ Time Frame: 8 weeks from first administration of G-202 ]
    Use RECIST criteria to assess the clinical activity of G-202 administered by intravenous infusion daily for 3 consecutive days of a 28-day cycle

Information from the National Library of Medicine

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

Inclusion Criteria:

  • Male or female patients age ≥ 18 years
  • Pathologic documentation of clear cell renal cell carcinoma
  • Disease that is resistant or refractory to standard of care
  • ECOG Performance Status < 2
  • Most recent tissue biopsy demonstrates PSMA expression by immunohistochemical staining
  • Adequate bone marrow function measured within 7 days prior to first infusion of G-202 (absolute peripheral granulocyte count > 1500 cells/m3; platelet count > 100,000 cells/m3)
  • Adequate hepatic function measured within 7 days prior to first infusion of G-202 (Albumin ≥ 2.8 g/dL; AST and ALT ≤ 5 x ULN; Total bilirubin <2 mg/dL)
  • Adequate renal function measured within 7 days prior to first infusion of G-202 (Proteinuria level ≤ 2 by urine dipstick; Serum creatinine ≤1.5 x ULN)
  • Normal coagulation profile measured within 14 days prior to first infusion of G-202 (INR ≤ 2.3; aPTT ≤ 1.5 X ULN)
  • No history of substantial non-iatrogenic bleeding diatheses. Use of anti-coagulants is limited to local use only (for control of central line patency)
  • Patients must sign an informed consent indicating that they are aware of the investigational nature of the study and are willing to participate in the study
  • Females of child-bearing potential and males with female partners of child-bearing potential must be willing to use acceptable methods of contraception to avoid pregnancy (for example, oral, injectable, or implantable hormonal contraceptive; tubal ligation; intra-uterine device; barrier contraceptive with spermicide; or vasectomized partner) beginning before the first infusion of G-202 and for 3 months after the last infusion of G-202

Exclusion Criteria:

  • Uncontrolled cardiac, hepatic, renal, or neurologic/psychiatric disorder
  • HIV positivity or history of chronic hepatitis B or C infection
  • Congestive heart failure New York Heart Association (NYHA) class 3 or 4, or history of congestive heart failure New York Heart Association (NYHA) class 3 or 4, unless a 2D echocardiogram or multi-gated acquisition scan (MUGA) performed within 3 months of enrollment demonstrates a left ventricular ejection fraction >45%
  • History of another malignancy within the previous 5 years other than curatively treated non-melanoma skin cancer or or intraepithelial carcinoma of the cervix
  • Surgical resection or major surgery within 4 weeks or stereotactic biopsy within 1 week of first G-202 treatment
  • Treatment, chemotherapy, radiation therapy, immunotherapy, or investigational drug for the patient's renal cell cancer within 28 days prior to first infusion of G-202
  • Currently requiring systemic administration of antibiotics or chronic administration of anti-viral agents
  • Use of anti-coagulants is limited to local use for control of central line patency
  • History or evidence of cardiac risk, including corrected QT interval on screening ECG > 470 msec, clinically significant uncontrolled arrhythmias or arrhythmia requiring treatment with the exceptions of atrial fibrillation and paroxysmal supraventricular tachycardia, history of acute coronary syndromes within 6 months prior to the first dose of study therapy (including myocardial infarction and unstable angina, coronary artery bypass graft, angioplasty, or stenting), any history of congestive heart failure with most recent ejection fraction < 45%
  • Uncontrolled cardiac or coronary artery disease
  • Uncontrolled hypertension (mean systolic BP ≥ 160 mm Hg and/or mean diastolic BP ≥ 100 mm Hg on 3 determinations 5 minutes apart while on 2 anti-hypertensive agents) or hypertension requiring treatment with more than 2 anti-hypertensive agents.
  • Severe or uncontrolled medical disease, including uncontrolled diabetes, congestive heart failure, chronic renal disease or chronic pulmonary disease
  • Severe gastrointestinal bleeding within 12 weeks of treatment with G-202
  • Requirement for chronic use of medications known to be strong inhibitors or inducers of cytochrome (CYP3A4) iso-enzymes (Appendix 3) Note: If patients can stop receiving these medications, CYP3A4 inhibitors should be discontinued at least 7 days prior to starting treatment with G-202
  • Known hypersensitivity to any study drug component including thapsigargin derivatives, polysorbate 20, or propylene glycol
  • Any other condition, including concurrent medical condition, social circumstance or drug dependency, which in the opinion of the investigator could compromise patient safety and/or compliance with study requirements

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 ClinicalTrials.gov identifier (NCT number): NCT02607553

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United States, Texas
University of Texas Health Science Center, Houston
Houston, Texas, United States, 77030
Sponsors and Collaborators
GenSpera, Inc.
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Principal Investigator: Robert Amato, D.O. University of Texas Health Sciences Center at Houston
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Responsible Party: GenSpera, Inc.
ClinicalTrials.gov Identifier: NCT02607553    
Other Study ID Numbers: G-202-006
First Posted: November 18, 2015    Key Record Dates
Last Update Posted: February 24, 2017
Last Verified: February 2017
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No
Additional relevant MeSH terms:
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Carcinoma, Renal Cell
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Kidney Neoplasms
Urologic Neoplasms
Urogenital Neoplasms
Neoplasms by Site
Kidney Diseases
Urologic Diseases