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Trial record 1 of 2 for:    BMX-001
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A Trial of Concurrent Radiation Therapy, Cisplatin, and BMX-001 in Locally Advanced Head and Neck Cancer (BMX-HN)

This study is currently recruiting participants.
Verified July 2017 by BioMimetix JV, LLC
Sponsor:
ClinicalTrials.gov Identifier:
NCT02990468
First Posted: December 13, 2016
Last Update Posted: August 8, 2017
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. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
Collaborator:
Duke University
Information provided by (Responsible Party):
BioMimetix JV, LLC
  Purpose
This is a Phase 1a-b study of newly diagnosed patients with biopsy-proven head and neck cancer (squamous cell carcinoma) who are undergoing standard radiation therapy and treatment with cisplatin. BMX-001 added to radiation therapy and cisplatin is expected to reduce radiation-induced mucositis and xerostomia and also has the potential to benefit the survival of head and neck cancer patients. In Phase 1a, safety and tolerability of BMX-001 will be assessed using a Continual Reassessment Method (CRM) and a maximum tolerated dose (MTD) will be determined. BMX-001 will be given subcutaneously first with a loading dose zero to four days prior to the start of chemoradiation and followed by twice a week doses at one-half of the loading dose for the duration of radiation therapy plus two weeks. In Phase 1b both safety and efficacy of BMX-001 will be evaluated. Impact on mucositis and xerostomia will also be assessed. A maximum of 48 patients will be enrolled to the MTD dose determined in Phase 1a to confirm the MTD. The investigators hypothesize that BMX-001 when added to standard radiation therapy and cisplatin will be safe at pharmacologically relevant doses in patients with newly diagnosed head and neck cancer. The investigators also hypothesize that in Phase 1b of this study the addition of BMX-001 will reduce the severity of radiation-induced mucositis and xerostomia in patients receiving head and neck radiation therapy.

Condition Intervention Phase
Head and Neck Cancer Drug: BMX-001 Radiation: Radiation Therapy Drug: Cisplatin Phase 1

Study Type: Interventional
Study Design: Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase 1a-b Trial of Concurrent Radiation Therapy, Cisplatin, and BMX-001 in Locally Advanced Head and Neck Cancer

Resource links provided by NLM:


Further study details as provided by BioMimetix JV, LLC:

Primary Outcome Measures:
  • Maximum Tolerated Dose (MTD) of BMX-001 in combination with standard radiation therapy and cisplatin, defined as the dose level that has an estimated dose limited toxicity (DLT) rate nearest to 0.25. [ Time Frame: 1 year ]

Secondary Outcome Measures:
  • Reduction of radiation-induced mucositis [ Time Frame: 1 year ]
    Mucositis will be scored using the CTCAE version 4.03 and evaluation will also be done using the Functional Assessment of Cancer Therapy for Head and Neck (FACT-HN) to be administered on screening and post therapy.

  • Reduction of radiation-induced mucositis [ Time Frame: 1 year ]
    Mucositis will be scored using the CTCAE version 4.03 and evaluation will also be done using the Oral Mucositis Weekly Questionaire-Head+Neck (OMWQ-HN) to be administered on screening and post therapy.

  • Reduction of radiation-induced xerostomia [ Time Frame: 1 year ]
    Xerostomia will be assessed using the Functional Assessment of Cancer Therapy - Head and Neck (FACT-HN).

  • Reduction of radiation-induced xerostomia [ Time Frame: 1 year ]
    Xerostomia will be assessed using the Xerostomia-Related Quality of Life Scale (XeQoLS).

  • Reduction of radiation-induced xerostomia [ Time Frame: 1 year ]
    Xerostomia will also be assessed by measurement of both unstimulated and stimulated saliva production at baseline, at the end of radiation therapy, and at 6 and 12 months post radiation therapy.

  • Progression-free survival [ Time Frame: 1 year ]
  • Peak plasma concentrations (Cmax) for BMX-001 [ Time Frame: 1 year ]
  • Area under the plasma concentration versus time curve (AUC) for BMX-001 [ Time Frame: 1 year ]

Estimated Enrollment: 66
Actual Study Start Date: April 19, 2017
Estimated Study Completion Date: April 2019
Estimated Primary Completion Date: April 2019 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Radiation Therapy, Cisplatin and BMX-001
In Phase 1a, safety and tolerability of BMX-001 will be assessed using a Continual Reassessment Method and a maximum tolerated dose (MTD) will be determined using a single arm design. In Phase 1b, the severity of radiation-induced mucositis and xerostomia will be assessed using a single arm design.
Drug: BMX-001
Subcutaneous injection.
Radiation: Radiation Therapy
Patients will receive standard dose intensity modulated radiation therapy (IMRT).
Drug: Cisplatin
Cisplatin will be administered per institution's standard of care practice.

  Eligibility

Information from the National Library of Medicine

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

Inclusion Criteria:

  1. Pathologically confirmed diagnosis of squamous cell carcinoma of the oropharynx, larynx, hypopharynx, or oral cavity with clinical or pathologic high-risk features for whom cisplatin and radiation would be considered appropriate care.
  2. Treatment plan to receive a continuous course of IMRT delivered as single daily fractions of 2.0 to 2.1 Gy with a cumulative radiation dose between 60 Gy and 70 Gy depending on whether patients are considered post-operative high risk or unresectable/organ preservation high risk. Planned radiation treatment fields must include at least two oral sites buccal mucosa, retromolar trigone, floor of mouth, oral tongue, soft palate, hard palate) with a portion of each site receiving a minimum total of 50 Gy.
  3. Patients who are to undergo definitive chemoradiation must have clinically or radiographically evident measurable disease at the primary site and/or at nodal stations. Tonsillectomy or local excision of the primary without removal of nodal disease is permitted.
  4. Limited neck dissections retrieving ≤ 4 nodes are permitted and considered as non-therapeutic nodal excisions. Fine needle aspirations of the neck that are positive for squamous cell carcinoma are sufficient for diagnosis pending pathology review at participating institutions.
  5. For patients undergoing curative intent resection the following criteria are required:

    • Pathologically (histologically or cytologically) proven diagnosis of head and neck squamous cell carcinoma
    • Patients must have undergone gross total surgical resection within 42 days prior to registration and beginning of therapy under the clinical trial. Note: Patients may have biopsy under general anesthesia in an operating room followed by definitive ablative cancer surgery representing gross total resection.
  6. Clinical or pathologic stage Stage III-IVb per the American Joint Committee on Cancer (AJCC), 7th edition.
  7. General history and physical examination by a radiation oncologist and medical oncologist within 4 weeks prior to enrollment.
  8. Examination by an ear/nose/throat (ENT) or head and neck surgeon, including laryngopharyngoscopy (mirror and/or fiberoptic and/or direct procedure) within 8 weeks prior to enrollment.
  9. Zubrod Performance Status 0-2 within 4 weeks prior to enrollment
  10. Complete blood count (CBC)/differential obtained within 7 days prior to starting the study drug with adequate bone marrow function, defined as follows:

    • Hemoglobin ≥ 9.0 g/dl;
    • Platelets ≥ 100,000 cells/mm3;
    • Absolute neutrophil count (ANC) > 1,500 cell/mm3.
  11. Adequate hepatic function as defined as follows:

    • Total bilirubin < 2x institutional upper limit of normal (ULN) within 7 days prior to starting the study drug;
    • Aspartate aminotransferase (AST) and AST <3x institutional ULN within 7 days prior to starting the study drug.
  12. Adequate renal function defined as follows:

    • Serum creatinine < 1.5 mg/dl within 7 days prior to starting the study drug or creatinine clearance rate (CCr) ≥ 50 mL/min within 7 days prior to starting the study drug determined by 24-hour collection or estimated by Cockcroft-Gault formula:

    CCr male = [(140 - age) x (wt in kg)]/[(Serum Cr mg/dl) x (72)] CCr female = 0.85 x (CrCl male)

  13. Negative pregnancy test for women of child-bearing potential within 48 hours prior to first dose of BMX-001.
  14. Women of childbearing potential and male participants must agree to use a medically effective means of birth control throughout their participation in the treatment phase of the study and until 12 months following the last study treatment.

Exclusion Criteria:

  1. Stage I or II; T1N1 and T2N1 stage III presentations per AJCC 7th edition
  2. Distant metastasis
  3. Hypertension requiring 3 or more anti-hypertensive medications to control
  4. Grade ≥2 hypotension at screening
  5. Requirement for concurrent treatment with nitrates or other drugs that may, in the judgment of the treating investigator, create a risk for a precipitous decrease in blood pressure
  6. History of syncope within the last 6 months
  7. Patients receiving, or unable to stop use at least 1 week prior to receiving the first dose of BMX-001, medications listed in Section 12.2 of the protocol are not eligible.
  8. Pregnancy or women of childbearing potential and men who are sexually active and not willing/able to use medically acceptable forms of contraception; this exclusion is necessary because the treatment involved in this study may be significantly teratogenic
  9. Women who are breast feeding are not eligible
  10. Prior allergic reaction to cisplatin
  11. Known hypersensitivity to compounds of similar chemical composition to BMX-001
  12. Grade 3-4 electrolyte abnormalities (CTCAE v 4.03) except sodium, which must be ≥126 mmol/L.
  13. Prior unrelated malignancy requiring current active treatment with the exception of cervical carcinoma in situ, basal cell carcinoma of the skin, resected T1-2N0M0 differentiated thyroid cancers, invasive cancers with a 3-year disease-free interval, Ta bladder cancers, or low and favorable intermediate risk prostate cancer.
  14. Prior history of HNSCC receiving radiation or chemo-radiation.
  15. Prior systemic chemotherapy for the study cancer (including neoadjuvant chemotherapy); note that prior chemotherapy for a different cancer is allowable.
  16. Prior radiotherapy that would result in overlap of radiation treatment fields with planned treatment for study cancer.
  17. Severe, active co-morbidity, defined as follows:

    • Cardiovascular disease or cerebrovascular disease, for example cerebrovascular accidents or myocardial infarction ≤ 6 months prior to study enrollment, unstable angina, New York Heart Association (NYHA) Grade II or greater congestive heart failure (CHF), or serious cardiac arrhythmia uncontrolled by medication or with the potential to interfere with protocol treatment;
    • Significant vascular disease (e.g., aortic aneurysm requiring surgical repair or recent arterial thrombosis) within 6 months prior to enrollment;
    • History or evidence upon physical/neurological examination of central nervous system disease (e.g., seizures) unrelated to cancer unless adequately controlled by medication;
    • Acute bacterial or fungal infection requiring intravenous antibiotics within 7 days of enrollment;
    • Chronic Obstructive Pulmonary Disease exacerbation or other respiratory illness requiring hospitalization or precluding study therapy within 30 days of registration;
    • Patients known to be HIV positive or have active viral hepatitis.
  Contacts and Locations
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): NCT02990468


Contacts
Contact: Sara Penchev 610-308-6640 sara.penchev@bmxpharma.com
Contact: James D Crapo, MD 303-808-7314 james.crapo@bmxpharma.com

Locations
United States, North Carolina
Duke University Medical Center Recruiting
Durham, North Carolina, United States, 27710
Contact: Joan Cahill, RN    919-668-5211    joan.cahill@duke.edu   
Sponsors and Collaborators
BioMimetix JV, LLC
Duke University
  More Information

Responsible Party: BioMimetix JV, LLC
ClinicalTrials.gov Identifier: NCT02990468     History of Changes
Other Study ID Numbers: BMX-HN-001
First Submitted: November 28, 2016
First Posted: December 13, 2016
Last Update Posted: August 8, 2017
Last Verified: July 2017
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No

Keywords provided by BioMimetix JV, LLC:
Mucositis
Xerostomia

Additional relevant MeSH terms:
Head and Neck Neoplasms
Neoplasms by Site
Neoplasms
Cisplatin
Antineoplastic Agents