Safety and Efficacy Study Using Rexin-G for Sarcoma

Study Overview
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Brief Summary
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Rexin-G is a tumor-targeted (pathotropic or disease-seeking) nanoparticle that when injected intravenously, seeks out and accumulates in cancerous lesions, thus enhancing local drug concentration within tumors. The goal of the adaptive trial design is to confirm the over-all safety of Rexin-G and to determine the optimal dosing regimen for Rexin-G that would document the significant clinical benefits required to support a Phase II registration protocol.

Detailed Description
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The Phase I/II clinical trial incorporates a Phase II component that will evaluate the efficacy of Rexin-G using an adaptive trial design. Each treatment cycle will be six weeks: four weeks of treatment and two weeks of rest. Unlike a standard Phase I protocol, eligible patients may have repeat cycles after the safety data and objective tumor response/s are recorded. Continued Rexin-G treatment will enable the targeted nanomedicine to catch up with tumor growth, halt disease progression, and reduce tumor burden. The treatment strategy is to achieve tumor control as quickly as safely possible. The goal of the adaptive trial design is to confirm the over-all safety of Rexin-G and to determine the optimal dosing regimen for Rexin-G that would document the significant clinical benefits required to support a Phase II registration protocol.

Official Title
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Evaluation of Safety and Efficacy of Rexin-G as Intervention for Recurrent or Metastatic Sarcoma

Conditions
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Sarcoma

Intervention / Treatment
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* Genetic: Rexin-G
* Genetic: Rexin-G
* Genetic: Rexin-G
* Genetic: Rexin-G
* Genetic: Rexin-G


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Histologically or cytologically confirmed recurrent or metastatic sarcoma that is measurable. Adequate hepatic function: Total bilirubin < 2.0 mg/dL (upper limit included); AST/ALT < 2x institutional norm; alkaline phosphatase < 2.5x upper limit of institutional norm unless the patient has extensive bone metastases. Patients with elevated alkaline phosphatase due to extensive liver disease will be excluded from study; albumin > 3.0 mg/dL. There must be no substantial ascites. PT and PTT must be within normal limits. Performance status must be < 1 (ECOG 0-1) with a life expectancy of at least 3 months. Hemoglobin > 9 gms% Absolute granulocyte count > 1000/uL, and platelet count > 100,000/uL. Serum creatinine of less than 1.5 mg%. There must be no plans for the patient to receive further cancer therapy from the date of enrollment until the completion of the 6-week follow-up visit. Accessibility of peripheral or central IV line Age > 10 years Patients will be off chemotherapy for a minimum of 4 weeks prior to initiation of therapy and should have recovered to Grade 1 or less toxicity. The ability to understand and the willingness to sign a written informed consent document. Exclusion Criteria: Prior malignancy, except for non-melanoma skin cancer, stage 1 breast cancer, CIS of cervix from which the patient has been disease-free for 5 years. Woman who are pregnant or nursing Fertile patients unless they agree to use barrier contraception (condoms and spermicide jelly) during the vector infusion period and for six weeks after infusion. Male patients must agree to use barrier contraception. Patients who are transfusion dependent (more than one transfusion per month) Patients with medical, psychiatric, or social conditions that would compromise successful adherence to this protocol. Patient who do not meet the inclusion criteria.

Ages Eligible for Study
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Minimum Age: 10 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: 1<br>Dose Level 1 of escalating doses of Rexin-G i.v. | Genetic: Rexin-G<br>* Dosing Schedule: 1 x 10e11 cfu two times a week for 4 weeks followed by a 2-week rest period. Treatment cycle may be repeated if patient has Grade 1 or less toxicity<br>|
| Experimental: 3<br>Dose Level 3 of escalating doses of Rexin-G i.v. | Genetic: Rexin-G<br>* Dosing Schedule: 2 x 10e11 cfu i.v. three times a week for 4 weeks followed by a 2-week rest period. Treatment cycle may be repeated if patient has Grade 1 or less toxicity.<br>|
| Experimental: 4<br>Dose Level 4 of escalating doses of Rexin-G i.v. | Genetic: Rexin-G<br>* Dosing Schedule: 3 x 10e11 cfu i.w. three times a week for 4 weeks followed by a 2-week rest period. Treatment cycle may be repeated if patient has Grade 1 or less toxicity.<br>|
| Experimental: 5<br>Dose Level 5 of escalating doses of Rexin-G i.v. | Genetic: Rexin-G<br>* Dosing Schedule: 4 x 10e 11 cfu i.v. three times a week for 4 weeks followed by a 2-week rest period. Treatment cycle may be repeated if patient has Grade 1 or less toxicity.<br>|
| Experimental: 2<br>Dose Level 2 of escalating doses of Rexin-G i.v. | Genetic: Rexin-G<br>* Dosing Schedule: 1 x 10e11 cfu i.v. three times a week for 4 weeks followed by a 2-week rest period. Treatment cycle may be repeated if patient has Grade 1 or less toxicity.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Clinical toxicity (DLT and MTD) as defined by patient performance status, toxicity assessment score, hematologic, and metabolic profiles |  | 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| To identify an objective tumor response to Rexin-G |  | 12 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Sarcoma, Rexin-G, Gene Therapy