A Phase 1 Study of CC-486 as a Single Agent and in Combination With Carboplatin or ABI-007 in Subjects With Relapsed or Refractory Solid Tumors

This study has been completed.
Information provided by (Responsible Party):
Celgene Corporation
ClinicalTrials.gov Identifier:
First received: November 21, 2011
Last updated: December 8, 2015
Last verified: December 2015
The purpose of the study is to evaluate the safety and to define the Maximal Tolerated Dose (MTD) or the Maximal Administered Dose (MAD) of oral azacitidine as a single agent and in combination with carboplatin (CBDCA) or paclitaxel protein bound particles (ABI-007,ABX) in subjects with relapsed or refractory solid tumors.

Condition Intervention Phase
Urinary Bladder Neoplasms
Carcinoma, Transitional Cell
Ovarian Neoplasms
Fallopian Tube Neoplasms
Peritoneal Neoplasms
Carcinoma, Non-Small-Cell Lung
Carcinoma, Pancreatic Ductal
Tumor Virus Infections
Drug: CC-486 plus Carboplatin
Drug: CC-486 plus ABI-007
Drug: CC-486
Phase 1

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Safety Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Phase 1 Study of CC-486 as a Single Agent and in Combination With Carboplatin or ABI-007 in Subjects With Relapsed or Refractory Solid Tumors

Resource links provided by NLM:

Further study details as provided by Celgene Corporation:

Primary Outcome Measures:
  • Number of participants with adverse events [ Time Frame: Up to 3 years ] [ Designated as safety issue: Yes ]
    An adverse event (AE) is any noxious, unintended, or untoward medical occurrence that may appear or worsen in a subject during the course of a study. It may be a new intercurrent illness, a worsening concomitant illness, an injury, or any concomitant impairment of the subject's health, including laboratory test values, regardless of etiology. Any worsening (i.e., any clinically significant adverse change in the frequency or intensity.

Secondary Outcome Measures:
  • Cmax [ Time Frame: Up to 30 days ] [ Designated as safety issue: No ]
    Maximum observed concentration in plasma (Cmax)

  • AUC [ Time Frame: Up to 30 days ] [ Designated as safety issue: No ]
    Area under the concentration-time curve (AUC)

  • Tmax [ Time Frame: Up to 30 days ] [ Designated as safety issue: No ]
    Time to maximum concentration (tmax);

  • T1/2 [ Time Frame: Up to 30 days ] [ Designated as safety issue: No ]
    Terminal half-life (t1/2)

  • CL/F [ Time Frame: Up to 30 days ] [ Designated as safety issue: No ]
    Apparent total body clearance (CL/F)

  • Vz/F [ Time Frame: Up to 30 days ] [ Designated as safety issue: No ]
    Apparent volume of distribution (Vz/F).

  • DNA Methylation [ Time Frame: Up to 30 days ] [ Designated as safety issue: No ]
    Change from baseline (Cycle 1 Day 1 pre-dose) in DNA methylation (global and gene-specific assays) in whole blood and tumor tissue (as available in Part 1)

  • DNMT1 protein levels [ Time Frame: Up to 30 days ] [ Designated as safety issue: No ]
    Reduction from baseline (Cycle 1 Day 1 predose) in DNMT1 protein levels in tumor tissue (as available in Part 1)

  • Tumor Response Rate [ Time Frame: Up to 3 years ] [ Designated as safety issue: No ]

    Response and progression were evaluated using the RECIST 1.1 criteria. Treatment response includes both complete response and partial response.

    • Complete response-disappearance of all lesions
    • Partial response-30% decrease in the sum of diameters of target lesions from baseline

  • Progression Free Survival [ Time Frame: Up to 3 years ] [ Designated as safety issue: No ]
    Progression-free survival is defined as the time from first dose of study drug to the start of disease progression or patient death, whichever occurs first.

  • Duration of Response [ Time Frame: Up to 3 years ] [ Designated as safety issue: No ]
    Duration of response is defined as progression-free survival in responders, i.e. as the time between the start of a complete response (CR) or partial response (PR) and the start of progressive disease (PD) or patient death from any cause, whichever occurred first

Enrollment: 169
Study Start Date: November 2011
Study Completion Date: November 2015
Primary Completion Date: November 2015 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Arm A: CC-486 plus Carboplatin Drug: CC-486 plus Carboplatin
CC-486 will be administered at doses between 100-300 mg daily for either 14 or 21 days depending on tolerability. Carboplatin will be given once every 21 Days at a dosage of AUC x4.
Experimental: Arm B: CC-486 plus ABI-007 Drug: CC-486 plus ABI-007

CC-486 will be administered at doses between 100-300 mg daily for either 14 or 21 days depending on tolerability

ABI-007 will be administered on two of every three weeks at a dosage of 100 mg/m2

Experimental: Arm C: CC-486 Drug: CC-486
CC-486 will be administered at doses between 100-300 mg daily for either 14 or 21 days depending on tolerability


Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  1. Men and women, 18 years or older at the time of signing the Informed Consent Document (ICD).
  2. Understand and voluntarily sign an ICD prior to any study-related assessments or procedures are conducted.
  3. Able to adhere to the study visit schedule and other protocol requirements.
  4. With histological or cytological confirmation of advanced unresectable solid tumors, including those who have progressed on (or not been able to tolerate) standard anticancer therapy, or for whom no other effective therapy exists, or for who declines standard therapy.
  5. Consent to screening tumor biopsy (for accessible tumors when appropriate [optional in Part 1, mandatory in Part 2]).
  6. Eastern Cooperative Oncology Group (ECOG) Performance Status of ≤ 2.
  7. The following laboratory values:

    • Absolute neutrophil count (ANC) ≥ 1.5 X 10^9/L
    • Hemoglobin (Hgb) ≥90 g/L
    • Platelets (plt) ≥ 100 x 10^9/L
    • Potassium within normal range, or correctable with supplements;
    • AST and ALT ≤2.5 x Upper Limit Normal (ULN) or ≤5.0 x ULN if liver tumor is present;
    • Serum total bilirubin ≤ 1.5 x ULN
    • Serum creatinine ≤ 1.5 x ULN, or 24-hr clearance ≥ 60ml/min; and
    • Negative serum pregnancy test within 7 days before starting study treatment in females of childbearing potential (FCBP)
  8. Females of child-bearing potential {defined as a sexually mature women who

    • has not undergone a hysterectomy (the surgical removal of the uterus) or bilateral oophorectomy (the surgical removal of both ovaries) or,
    • has not been naturally postmenopausal for at least 24 consecutive months (i.e., has had menses at any time during the preceding 24 consecutive months} must

      • agree to the use of a physician- approved contraceptive method (oral, injectable, or implantable hormonal contraceptive ; tubal ligation; intra-uterine device; barrier contraceptive with spermicide; or vasectomized partner) while on oral azacitidine and for 3 months following the last dose of study medication; and
      • have a negative serum pregnancy test during screening
  9. Male subjects with female partner of childbearing potential must agree to the use of a physician-approved contraceptive method throughout the course of the study to avoid fathering a child during the course of the study and for 6 months following the last dose of oral azacitidine.

The criteria below are in addition to or supersede the Part 1 inclusion criteria above:

  1. With histological or cytological confirmation of relapsed or refractory advanced unresectable solid tumors as listed below for each Arm, including those who have progressed on or were unable to tolerate standard anti-cancer therapy.

    • Arm A: CC-486 plus CBDCA:
    • Relapsed or refractory urothelial carcinoma of the bladder, renal pelvis, ureter, or urethra (mixed histologies are permitted provided a component of urothelial carcinoma is present)
    • Epithelial ovarian, fallopian tube, or primary peritoneal carcinoma
    • Arm B: CC-486 plus ABI-007:
    • NSCLC
    • Pancreatic carcinoma
    • Arm C: CC-486 single agent:
    • Virally-associated tumors - tumor types known to be driven by Epstein-Barr Virus (EBV), Human Papilloma Virus (HPV), and Merkel cell carcinoma of the skin (MC Polomavirus)
    • Nasopharyngeal carcinoma (a minimum of 5 subjects)
    • Cervical carcinoma
    • Anal carcinoma
    • Merkel cell carcinoma (MCC)
    • Note: Hepatitis B virus (HBV) and Hepatitis C virus (HCV)-associated tumors (hepatocellular cancers) are not eligible.
    • Note: Head and neck squamous cell cancers (HNSCC) must have HPV-positive status documented to be eligible
  2. Subjects with documented liver metastases must have serum albumin ≥ 3 g/dL;
  3. Sites of disease (primary or metastatic) that are, in the opinion of the investigator, accessible for biopsy without undue risk to the subject
  4. Consent to tumor biopsy at screening (prior to the first dose of CC-486) and at Cycle 1 Day 15.
  5. Measurable disease according to RECIST v1.1.

Exclusion Criteria:

  1. Any significant medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from participating in the study.
  2. Any condition, including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she were to participate in the study.
  3. Any condition that confounds the ability to interpret data from the study.
  4. Symptomatic central nervous system metastases. Subjects with brain metastases that have been previously treated and are stable for 6 weeks are allowed.
  5. Known acute or chronic pancreatitis.
  6. Any peripheral neuropathy ≥ NCI CTCAE grade 2.
  7. Persistent diarrhea or malabsorption ≥ NCI CTCAE grade 2, despite medical management.
  8. Impaired ability to swallow oral medication.
  9. Unstable angina, significant cardiac arrythmia, or New York Heart Association (NYHA) class 3 or 4 congestive heart failure.
  10. Prior systemic cancer-directed treatments or investigational modalities ≤ 5 half lives or 4 weeks, whichever is shorter, prior to starting study drug or who have not recovered from side effects of such therapy. (except alopecia).
  11. Major surgery ≤ 2 weeks prior to starting a study drug or who have not recovered from side effects of such therapy.
  12. Pregnant or breast feeding.
  13. Known Human Immunodeficiency Virus (HIV) infection.
  14. Known chronic hepatitis B or C virus (HBV/HCV) infection, unless this is a comorbidity in subjects with HCV.
  15. Liver metastases with serum albumin < 3 g/dL.
  16. Other prior cancers within previous 5 years except adequately treated in situ carcinoma cervix, or basal, or squamous carcinoma of the skin.
  17. Subjects with > 4 prior systemic chemotherapy regimens will require approval by the Celgene Medical Monitor prior to enrollment. A regimen is defined as >/= 2 cycles of systemic anti-cancer therapy containing 1 or more agents in the following classes: topoisomerase 1 or 2 inhibitors, platinum salts, alkylating agents, tubulin inhibitors, anti-metabolites or vinca alkaloids.
  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: NCT01478685

United States, Arizona
Scottsdale Healthcare Research Institute
Scottsdale, Arizona, United States, 85258
United States, California
University of California, San Francisco
San Francisco, California, United States, 94115
United States, Indiana
Indiana University Cancer Center
Indianapolis, Indiana, United States, 46202
United States, Michigan
Karmanos Cancer Institute
Detroit, Michigan, United States, 48201-2014
United States, South Carolina
Greenville Hospital
Greenville, South Carolina, United States, 29605
United States, Tennessee
Sarah Cannon Research Institute
Nashville, Tennessee, United States, 37205
United States, Texas
South Texas Accelerated Research Therapeutics
San Antonio, Texas, United States, 78229
Centre Georges Francois Leclerc
Dijon, France, 21079
Institut Curie
Paris, France, 75005
The Netherlands Cancer Instiute Antoni Van Leeuwenhoekziekenhuis
Amsterdam, Netherlands, 1066 CX
Erasmus Medical Center
Rotterdam, Netherlands, 3015 CN
Hospital General Universitario Gregorio Marañon
Madrid, Spain, 28007
Hospital Universitario 12 de Octubre
Madrid, Spain, 28041
Sponsors and Collaborators
Celgene Corporation
Study Director: Gordan Bray, M.D., Ph.D Celgene Corporation
  More Information

No publications provided

Responsible Party: Celgene Corporation
ClinicalTrials.gov Identifier: NCT01478685     History of Changes
Other Study ID Numbers: AZA-ST-001 
Study First Received: November 21, 2011
Last Updated: December 8, 2015
Health Authority: United States: Food and Drug Administration

Keywords provided by Celgene Corporation:
Relapsed or Refractory Solid Tumors

Additional relevant MeSH terms:
Carcinoma, Non-Small-Cell Lung
Carcinoma, Pancreatic Ductal
Carcinoma, Transitional Cell
Fallopian Tube Neoplasms
Ovarian Neoplasms
Peritoneal Neoplasms
Tumor Virus Infections
Urinary Bladder Neoplasms
Virus Diseases
Abdominal Neoplasms
Adnexal Diseases
Bronchial Neoplasms
Carcinoma, Bronchogenic
Carcinoma, Ductal
Digestive System Diseases
Digestive System Neoplasms
Endocrine Gland Neoplasms
Endocrine System Diseases
Fallopian Tube Diseases
Genital Diseases, Female
Genital Neoplasms, Female
Gonadal Disorders
Lung Diseases
Lung Neoplasms
Neoplasms by Histologic Type
Neoplasms by Site
Neoplasms, Ductal, Lobular, and Medullary

ClinicalTrials.gov processed this record on February 11, 2016