Patient case: 49-year-old male with colorectal cancer; genetic feature: NRAS

Clinical trial: Phase I of SGM-101 in Patients With Cancer of the Colon, Rectum or Pancreas

Summary: This study evaluates the safety and performance of SGM-101, a Carcinoembryonic Antigen (CEA)-specific chimeric antibody conjugated with a NIR emitting fluorochrome, for the visualization of CEA-expressing cancers during surgery. SGM-101 is injected 2 to 4 days before surgery and visualized using an optimized camera system.

Detailed description: Surgery is the most important therapy for patients with cancer of the colon, rectum or pancreas. Complete resection, which is a crucial factor in the prognosis of a patient, is challenging as surgeons have to rely on visual appearance and palpation to discriminate between tumor and normal tissue.
  Carcinoembryonic antigen (CEA) is a tumor-specific marker that is highly expressed in a number of tumors of epithelial origin (such as colorectal carcinoma and pancreas carcinoma) while it is minimally expressed in normal adult tissues. The compound that will be studied in this research project is SGM-101, a CEA-specific chimeric antibody conjugated with a near-infrared (NIR) emitting moiety. The hypothesis is that, following preoperative iv administration of SGM-101 in patients with carcinoma of the colon, rectum or pancreas, SGM-101 will bind to CEA expressing cancer cells and these cells can then be visualized with a NIR fluorescence imaging system, thereby increasing the chance of radical resection.

Eligibility: Inclusion Criteria:
  -  Patients aged over 18 years old;
  -  Patient should be scheduled and eligible for surgery because of a clinical diagnosis of cancer of the colon, rectum or cancer of the pancreas;
  -  Both pancreatic and colorectal cancer patients: Circulating plasma CEA ≥ the upper limit of normal range (eg ≥ 3.0 ng / ml);
  -  Patient suffering from recurrences and metastasis of colorectal cancer: Rising circulating plasma CEA
  -  Patients should be capable and willing to give informed consent before study specific procedures.
  Exclusion Criteria:
  -  Anticancer therapy (e.g. chemotherapy, radiotherapy (except for routine pre-operative radiotherapy for colorectal cancer), targeted therapy, concomitant systemic immune therapy, or any experimental therapy) within 4 weeks before inclusion;
  -  History of a clinically significant allergy;
  -  Circulating plasma concentration CEA ≥ 300 ng / ml;
  -  Other malignancies either currently active or diagnosed in the last 5 years, except adequately treated in situ carcinoma of the cervix and basal or squamous cell skin carcinoma;
  -  Patients pregnant or breastfeeding (pregnancy should be ruled out by an assay of βhCG plasma within 4±1 weeks prior to administration of the conjugate), lack of effective contraception in male or female patients with reproductive potential;
  -  Laboratory abnormalities defined as:
  Colorectal cancer patients only:
  -  Aspartate AminoTransferase, Alanine AminoTransferase, Gamma Glutamyl Transferase) or Alkaline Phosphatase levels above 5 times the or;
  -  Total bilirubin above 2 times the Upper Limit Normal (ULN) or; Both pancreatic and colorectal cancer patients:
  -  Serum creatinine above 1.5 times the ULN or;
  -  Absolute neutrophils counts below 1.5 x 109/L or;
  -  Platelet count below 100 x 109/L or;
  -  Hemoglobin below 4 mmol/L (females) or below 5 mmol/l (males);
  -  Known positive test for human immunodeficiency virus (HIV), hepatitis B surface antigen (HBsAG) or hepatitis C virus (HCV) antibody or patients with untreated serious infections;
  -  Any condition that the investigator considers to be potentially jeopardizing the patients' wellbeing or the study objectives.

Relevance to patient case: not relevant