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Phase I/II Dose-escalation Study of Lutetium-177-labeled cG250 in Patients With Advanced Renal Cancer

This study has been completed.
Sponsor:
Collaborator:
Radboud University
Information provided by (Responsible Party):
Ludwig Institute for Cancer Research
ClinicalTrials.gov Identifier:
NCT00142415
First received: August 31, 2005
Last updated: February 1, 2017
Last verified: February 2017
  Purpose
This was a Phase I/II, single-center, dose-escalation study. 177-Lutetium-1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid-cG250 (177-Lu-DOTA-cG250) was administered at a starting dose of 30 mCi/m^2 of 177-Lu (fixed dose of 10 mg cG250) and escalated in increments of 10 mCi/m^2 of 177-Lu in sequentially enrolled cohorts according to a standard 3 + 3 design until determination of the maximum tolerated dose (MTD). The primary objectives were to determine the safety, targeting, and dosimetry of 177-Lu-DOTA-cG250 in subjects with advanced renal cell carcinoma. The secondary objective was measurement of tumor response according to the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.0.

Condition Intervention Phase
Metastatic Renal Cell Carcinoma
Drug: 111-In-DOTA-cG250
Drug: 177-Lu-DOTA-cG250
Phase 1
Phase 2

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: No masking
Primary Purpose: Treatment
Official Title: Phase I/II Study of Increasing Doses of Lutetium-177 Labeled Chimeric Monoclonal Antibody cG250 (177^Lu-DOTA-cG250) in Patients With Advanced Renal Cancer

Resource links provided by NLM:


Further study details as provided by Ludwig Institute for Cancer Research:

Primary Outcome Measures:
  • Number of Subjects With Treatment-emergent Adverse Events [ Time Frame: Up to 1 year ]
    Toxicity was graded in accordance with the NCI CTCAE version 3.0. Treatment-emergent adverse events (TEAEs) were reported based on clinical laboratory tests, physical examinations, and vital signs from pre-treatment through 4 weeks after the last dose of study treatment.

  • Number of Subjects With Dose-limiting Toxicity (DLT) During Cycle 1 [ Time Frame: 12 weeks ]
    Subjects were monitored for AEs for ≥ 8 weeks after the last infusion of 177-Lu-DOTA-cG250 before dose escalation could be implemented. Toxicity was graded in accordance with the NCI CTCAE version 3.0. DLT was defined as the following treatment-related events: ≥ Grade 3 non-hematologic toxicity; ≥ Grade 4 hematologic toxicity (platelets < 25 × 10^9/L or leukocytes < 1.0 × 10^9/L) that persisted for > 4 weeks except anemia; thrombocytopenia < 10 × 10^9/L; clinically relevant myelotoxicity that required hospitalization and/or blood product transfusion (e.g., uncontrolled bleeding, infections that had to be treated clinically).

  • Radiation Absorbed Doses by Organ for 177-Lu-cG250 [ Time Frame: 12 weeks ]
    After each 177-Lu-cG250 administration, 3 whole-body scintigrams were acquired (directly after injection and 2-4 days and 5-7 days post-injection) and blood samples were drawn at 5, 30, 60, and 120 min, 2-4 days, and 5-7 days post-infusion. Estimated radiation absorbed doses were calculated according to the Medical Internal Radiation Dose scheme, which permits estimation of the factors required to calculate dose to one organ attributable to a source in another organ.


Secondary Outcome Measures:
  • Number of Subjects With Best Overall Tumor Response [ Time Frame: Up to 9 months ]
    Tumor responses were evaluated using computed tomography and categorized according to RECIST v1.0 at baseline and at the end of every cycle (every 12 weeks) or after recovery from toxicity. Per RECIST v1.0 for target lesions and assessed by MRI: Complete Response (CR): Disappearance of all target lesions [no evidence of disease]; Partial Response (PR): ≥ 30% decrease in the sum of the longest diameter of target lesions; Progressive Disease (PD): ≥ 20% increase in the sum of the longest diameter of target lesions; Stable Disease (SD): small changes that do not meet above criteria.


Enrollment: 26
Study Start Date: February 2005
Study Completion Date: January 2011
Primary Completion Date: January 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Cohort 1, 30 mCi/m^2 177-Lu-DOTA-cG250
Subjects received an initial single dose of 10 mg of cG250 coupled to DOTA and labeled with 30 mCi/m^2 of 177-Lu.
Drug: 111-In-DOTA-cG250
On Day 1, each subject received a single intravenous (IV) infusion of 10 mg of cG250 coupled to DOTA and labeled with 5 mCi of 111-In.
Other Names:
  • cG250
  • DOTA-cG250
  • cG250-In111
Drug: 177-Lu-DOTA-cG250
On Day 8, 9, or 10, each subject received a single IV infusion of 10 mg of cG250 coupled to DOTA and labeled with a dose of 177-Lu at a starting dose of 30 mCi/m^2 in the initial cohort.
Other Names:
  • cG250
  • DOTA-cG250
  • cG200-Lu177
Experimental: Cohort 2, 40 mCi/m^2 177-Lu-DOTA-cG250
Subjects received an initial single dose of 10 mg of cG250 coupled to DOTA and labeled with 40 mCi/m^2 of 177-Lu.
Drug: 111-In-DOTA-cG250
On Day 1, each subject received a single intravenous (IV) infusion of 10 mg of cG250 coupled to DOTA and labeled with 5 mCi of 111-In.
Other Names:
  • cG250
  • DOTA-cG250
  • cG250-In111
Drug: 177-Lu-DOTA-cG250
On Day 8, 9, or 10, each subject received a single IV infusion of 10 mg of cG250 coupled to DOTA and labeled with a dose of 177-Lu at a starting dose of 30 mCi/m^2 in the initial cohort.
Other Names:
  • cG250
  • DOTA-cG250
  • cG200-Lu177
Experimental: Cohort 3, 50 mCi/m^2 177-Lu-DOTA-cG250
Subjects received an initial single dose of 10 mg of cG250 coupled to DOTA and labeled with 50 mCi/m^2 of 177-Lu.
Drug: 111-In-DOTA-cG250
On Day 1, each subject received a single intravenous (IV) infusion of 10 mg of cG250 coupled to DOTA and labeled with 5 mCi of 111-In.
Other Names:
  • cG250
  • DOTA-cG250
  • cG250-In111
Drug: 177-Lu-DOTA-cG250
On Day 8, 9, or 10, each subject received a single IV infusion of 10 mg of cG250 coupled to DOTA and labeled with a dose of 177-Lu at a starting dose of 30 mCi/m^2 in the initial cohort.
Other Names:
  • cG250
  • DOTA-cG250
  • cG200-Lu177
Experimental: Cohort 4, 60 mCi/m^2 177-Lu-DOTA-cG250
Subjects received an initial single dose of 10 mg of cG250 coupled to DOTA and labeled with 60 mCi/m^2 of 177-Lu.
Drug: 111-In-DOTA-cG250
On Day 1, each subject received a single intravenous (IV) infusion of 10 mg of cG250 coupled to DOTA and labeled with 5 mCi of 111-In.
Other Names:
  • cG250
  • DOTA-cG250
  • cG250-In111
Drug: 177-Lu-DOTA-cG250
On Day 8, 9, or 10, each subject received a single IV infusion of 10 mg of cG250 coupled to DOTA and labeled with a dose of 177-Lu at a starting dose of 30 mCi/m^2 in the initial cohort.
Other Names:
  • cG250
  • DOTA-cG250
  • cG200-Lu177
Experimental: Cohort 5, 70 mCi/m^2 177-Lu-DOTA-cG250
Subjects received an initial single dose of 10 mg of cG250 coupled to DOTA and labeled with 70 mCi/m^2 of 177-Lu.
Drug: 111-In-DOTA-cG250
On Day 1, each subject received a single intravenous (IV) infusion of 10 mg of cG250 coupled to DOTA and labeled with 5 mCi of 111-In.
Other Names:
  • cG250
  • DOTA-cG250
  • cG250-In111
Drug: 177-Lu-DOTA-cG250
On Day 8, 9, or 10, each subject received a single IV infusion of 10 mg of cG250 coupled to DOTA and labeled with a dose of 177-Lu at a starting dose of 30 mCi/m^2 in the initial cohort.
Other Names:
  • cG250
  • DOTA-cG250
  • cG200-Lu177
Experimental: Cohort 6, 65 mCi/m^2 177-Lu-DOTA-cG250
Subjects received an initial single dose of 10 mg of cG250 coupled to DOTA and labeled with 65 mCi/m^2 of 177-Lu.
Drug: 111-In-DOTA-cG250
On Day 1, each subject received a single intravenous (IV) infusion of 10 mg of cG250 coupled to DOTA and labeled with 5 mCi of 111-In.
Other Names:
  • cG250
  • DOTA-cG250
  • cG250-In111
Drug: 177-Lu-DOTA-cG250
On Day 8, 9, or 10, each subject received a single IV infusion of 10 mg of cG250 coupled to DOTA and labeled with a dose of 177-Lu at a starting dose of 30 mCi/m^2 in the initial cohort.
Other Names:
  • cG250
  • DOTA-cG250
  • cG200-Lu177

Detailed Description:

Prior to administration of 177-Lu-DOTA-cG250, subjects received 5 mCi/10 mg of the 111-Indium-DOTA-cG250 (111-In-DOTA-cG250) antibody (an imaging dose). Whole body and blood measurements of radioactivity were obtained on at least 3 occasions for 1 week to determine targeting and dosimetry. If at least one known and evaluable metastatic lesion was visualized with 111-In-DOTA-cG250, a single dose of therapeutic 177-Lu-DOTA-cG250 was administered the following week. In the absence of disease progression and after recovery from toxicity, subjects may have been retreated no sooner than 12 weeks after the previous treatment with a dose of no more than 75% of the previous dose, for a total of not more than 3 treatments. Only subjects with normal pharmacokinetics on the diagnostic 111-In-DOTA-cG250 study (indicative of human anti-chimeric antibody [HACA] negativity) were eligible for re-treatment.

Subjects in the initial cohort were enrolled sequentially to receive 30 mCi/m^2 of 177-Lu-DOTA-cG250 (fixed dose of 10 mg cG250). In the absence of a dose-limiting toxicity, the dose was escalated in each subsequent cohort in 10 mCi/m^2 increments of 177-Lu. At least 3 subjects per dose level were followed for up to 12 weeks with imaging, biochemical, and hematologic tests. Safety was monitored continuously throughout the study.

  Eligibility

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

Inclusion Criteria:

  1. Subjects with proven advanced and progressive renal cell carcinoma (RCC) of the clear cell type.
  2. At least one evaluable lesion < 5 cm.
  3. Karnofsky performance status ≥ 70%.
  4. Laboratory values obtained < 14 days prior to registration:

    • White blood cells (WBC) ≥ 3.5 × 10^9/L
    • Platelet count ≥ 100 × 10^9/L
    • Hemoglobin ≥ 6 mmol/L
    • Total bilirubin ≤ 2 × upper limit of normal (ULN)
    • Aspartate aminotransferase and alanine aminotransferase ≤ 3 × ULN (< 5 × ULN if liver metastases present)
    • Serum creatinine ≤ 2 × ULN
  5. Negative pregnancy test for women of childbearing potential (urine or serum).
  6. Age over 18 years.
  7. Ability to provide written informed consent.

Exclusion Criteria:

  1. Known metastases to the brain.
  2. Untreated hypercalcemia.
  3. Metastatic disease limited to the bone.
  4. Pre-exposure to murine/chimeric antibody therapy.
  5. Chemotherapy, external beam radiation or immunotherapy within 4 weeks prior to study. Limited field external beam radiotherapy to prevent pathological fractures was allowed, when unirradiated, evaluable lesions were present elsewhere.
  6. Cardiac disease with New York Heart Association classification of III or IV.
  7. Subjects who were pregnant, nursing or of reproductive potential and were not practicing an effective method of contraception.
  8. Any unrelated illness, e.g., active infection, inflammation, medical condition or laboratory abnormality, that in the judgement of the investigator would have significantly affected the subject's clinical status.
  9. Life expectancy < 6 months.
  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: NCT00142415

Locations
Netherlands
University Medical Center Nijmegen
Nijmegen, Netherlands, 6500HB
Sponsors and Collaborators
Ludwig Institute for Cancer Research
Radboud University
Investigators
Principal Investigator: W.J.G. Oyen, MD Department of Nuclear Medicine, University Medical Center Nijmegen
Principal Investigator: P.F.A. Mulders, MD Department of Urology, University Medical Center Nijmegen
  More Information

Additional Information:
Publications:
Responsible Party: Ludwig Institute for Cancer Research
ClinicalTrials.gov Identifier: NCT00142415     History of Changes
Other Study ID Numbers: LUD2003-006
Study First Received: August 31, 2005
Results First Received: November 30, 2016
Last Updated: February 1, 2017
Individual Participant Data  
Plan to Share IPD: Yes
Plan Description: Data have been published

Keywords provided by Ludwig Institute for Cancer Research:
Advanced Renal Cell Carcinoma
Clear Cell Renal Cell Carcinoma (CCRCC)
Lutetium-177
177-Lu
cG250
DOTA-cG250
Monoclonal Antibody

Additional relevant MeSH terms:
Carcinoma
Carcinoma, Renal Cell
Kidney Neoplasms
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Neoplasms
Adenocarcinoma
Urologic Neoplasms
Urogenital Neoplasms
Neoplasms by Site
Kidney Diseases
Urologic Diseases
Antibodies, Monoclonal
Immunologic Factors
Physiological Effects of Drugs

ClinicalTrials.gov processed this record on March 29, 2017