Clinical trial NCT02567799: BIO 300 Non-Small Cell Lung Cancer Study
Official title: A Phase I/II Clinical Study Evaluating the Safety and Effectiveness of BIO 300 Oral Suspension in Patients Receiving Chemoradiation Therapy for Non-Small Cell Lung Cancer (NSCLC)
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE1
PHASE2
Conditions: Carcinoma, Non-Small-Cell Lung
Keywords: Lung Neoplasms
Lead sponsor: Humanetics Corporation
Sponsor class: INDUSTRY
Collaborators: name: National Cancer Institute (NCI)
name: Henry Ford Health System
name: Medical College of Wisconsin
name: University of Maryland, Baltimore
name: Milwaukee VA Medical Center
First posted: 2015-10-05
Enrollment: 21
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: PREVENTION

Brief summary: The purpose of this study is to determine the safety and effectiveness of BIO 300 Oral Suspension when used in combination with standard dose radiation therapy and chemotherapy in patients with non-small cell lung cancer. Based on preclinical data the investigators hypothesize that BIO 300 Oral Suspension will reduce the incidence of radiation-induced pneumonitis and pulmonary fibrosis.

Detailed description: This is an open-label, single-arm, ascending dose Phase I/II study of BIO 300 Oral Suspension given in combination with paclitaxel/carboplatin and radiotherapy in subjects with stage II, III, or IV NSCLC who are candidates for combined chemoradiotherapy.

A minimum of 6 subjects will be accrued sequentially at each dose level of BIO 300. BIO 300 will be administered daily for the entire course of concurrent chemoradiotherapy, a minimum of 6 weeks; in combination with standard paclitaxel / carboplatin chemotherapy and radiotherapy.

The initial dose of BIO 300 will be administered on Day 1, Visit 2 in which safety data (adverse events, electrocardiograms (ECGs), results of safety laboratory determinations), pharmacokinetic (PK) and pharmacodynamic (PD) data will be collected. PK data will be collected from a minimum of six (6) study subjects from each cohort. PD data will be collected from all subjects in each study cohort. Day 1 of chemotherapy will be scheduled at the discretion of the investigator provided the subject has completed a minimum of 1 day of BIO 300 dosing. BIO 300 will be administered in combination with the chemotherapy components of the protocol (paclitaxel and carboplatin). During the first or second chemotherapy infusion, additional safety, PK and PD data will be collected. Day 1 of radiation therapy (RT) may be scheduled at the discretion of the investigator provided the subject has completed a minimum of 2 days of BIO 300 dosing. BIO 300 will continue to be administered daily; paclitaxel and carboplatin will be administered weekly and radiotherapy will be administered daily until a total dose of 60-70 Gy has been administered. During the period of combined BIO 300 and chemoradiotherapy (6-7 weeks), additional safety, PK and PD data will be collected weekly. An interim data analysis will be completed once the highest dose cohort concludes chemoradiation therapy, in an effort to determine the optimal biological dose. Following analysis, there will be an option to enroll up to an additional 12 subjects at the optimal biological dose. At the conclusion of the study, primary and secondary outcome measures will be evaluated. Data will be analyzed from all cohorts to determine the oncologic response, safety of BIO 300, and a recommended BIO 300 dose.

Eligibility criteria: Inclusion Criteria:

1. Histological or cytological confirmation of NSCLC
2. Stage II, III, or IV NSCLC for whom radiation therapy of 60 Gy and concurrent weekly paclitaxel/carboplatin is recommended
3. Up to three small (≤ 3 cm each) lung oligometastases will be allowed and/or one oligometastasis at any other site in the body
4. Eastern Cooperative Oncology Group Performance Scale (ECOG PS) of 0 or 1
5. Forced expiratory volume at one second (FEV1): best value obtained pre- or post-bronchodilator must be ≥ 1.0 liters/second or \> 50% predicted value
6. Adequate bone marrow reserve
7. Adequate hepatic reserve
8. Adequate renal function
9. Female subjects of childbearing potential must have a negative pregnancy test
10. Female subjects of childbearing potential and male subjects with female sexual partners of childbearing potential must agree to use an effective method of contraception
11. Ability to read and provide written informed consent

Exclusion Criteria:

1. Weight loss greater than 10% in prior 4 weeks
2. Prior malignancy in which they received any thoracic radiotherapy unless the treating physician considers it unlikely to impact the clinical outcome of the patient
3. Patients with concurrent invasive malignancy other than non-melanoma skin cancer or cervical intraepithelial neoplasia unless the treating physician considers it unlikely to impact the clinical outcome of the patient
4. An active infection or with a fever ≥ 38.5°C
5. Poorly controlled intercurrent illnesses
6. Patients with a prior thoracotomy within 1 week of study registration
7. Chronic Obstructive Pulmonary Disease (COPD) exacerbation or other respiratory illness requiring hospitalization or precluding study therapy within 30 days before registration
8. Patients with any of the following are not eligible:

   * Previous history of Corrected QT Interval (QTc ) prolongation resulting from medication that required discontinuation of that medication
   * Congenital long QT syndrome, or 1st degree relative with unexplained sudden death under 40 years of age;
   * Presence of left bundle branch block (LBBB);
   * QTc with Fridericia's correction that is unmeasurable, or ≥ 480 msec on screening ECG. The average QTc from the screening ECG (completed in triplicate) must be \< 480 msec in order for the patient to be eligible for the study;
   * Subjects taking any concomitant medication that may cause QTc prolongation, induce Torsades de Pointes are not eligible if QTc ≥ 460 msec.
9. Patients must not have had a clinically significant cardiac event within 6 months before entry; or the presence of any other uncontrolled cardiovascular conditions that, in the opinion of the Investigator, increases the risk of ventricular arrhythmia.
10. Patients with a history of arrhythmia or asymptomatic sustained ventricular tachycardia are not eligible. Patients with atrial fibrillation with well-controlled ventricular rate on medication, are eligible.
11. Psychiatric conditions, social situations or substance abuse that precludes the ability of the subject to cooperate with the requirements of the trial and protocol therapy
12. Grade 2 or higher peripheral neuropathy
13. Known history of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS), hepatitis B or C.
14. Pregnancy or women of childbearing potential and men who are sexually active and not willing/able to use medically acceptable forms of contraception
15. Women who are breastfeeding are not eligible for this study.

Primary outcomes:
measure: Number of Participants With BIO 300 Oral Suspension-related Dose Limiting Toxicity
timeFrame: Day 1 up to 6 weeks or maximum tolerated dose
Secondary outcomes:
measure: Number of Participants With Adverse Events Throughout the Study
timeFrame: Day 1 up to month 13 post radiation or 12 months post chemotherapy consolidation for surgical participants.
measure: Mean Maximum Serum Concentration (Cmax) of BIO 300 Administered in the Absence of Chemotherapy
timeFrame: Day 1, prior to 1st dose then 0.5, 1, 2, 3, 4, 8 and 24 hours post dose
measure: Mean Area Under the Serum Concentration Curve (AUC) of BIO 300 Administered in the Absence of Chemotherapy
timeFrame: Day 1, prior to 1st dose then 0.5, 1, 2, 3, 4, 8 and 24 hours post dose
measure: Mean Maximum Serum Concentration (Cmax) of BIO 300 When Administered in Combination With Paclitaxel and Carboplatin
timeFrame: Week 1 or 2, during the 1st or 2nd chemotherapy infusion, prior to 1st dose then 0.5, 1, 2, 3, 4, 8, and 24 hours post dose
measure: Mean Area Under the Serum Concentration Curve (AUC) of BIO 300 When Administered in Combination With Paclitaxel and Carboplatin
timeFrame: Week 1 or 2, during the 1st or 2nd chemotherapy infusion, prior to 1st dose then 0.5, 1, 2, 3, 4, 8, and 24 hours post dose
measure: Mean Maximum Serum Concentration (Cmax) of Paclitaxel When Administered in Combination With BIO 300
timeFrame: Week 1 or 2, during the 1st or 2nd chemotherapy infusion, prior to BIO 300 dose then 0.5, 1, 2, 3, 4, 8 and 24 hours post initial dose
measure: Mean Area Under the Serum Concentration Curve (AUC) of Paclitaxel When Administered in Combination With BIO 300
timeFrame: Week 1 or 2, during the 1st or 2nd chemotherapy infusion, prior to BIO 300 dose then 0.5, 1, 2, 3, 4, 8 and 24 hours post initial dose
measure: Mean Maximum Serum Concentration (Cmax) of Carboplatin When Administered in Combination With BIO 300
timeFrame: Week 1 or 2, during the 1st or 2nd chemotherapy infusion, prior to BIO 300 dose then 0.5, 1, 2, 3, 4, 8 and 24 hours post initial dose
measure: Mean Area Under the Serum Concentration Curve (AUC) of Carboplatin When Administered in Combination With BIO 300
timeFrame: Week1 or 2, during the 1st or 2nd chemotherapy infusion, prior to BIO 300 dose then 0.5, 1, 2, 3, 4, 8 and 24 hours post initial dose
measure: Percent Change From Baseline in Expression Levels of Serum TGF-beta Isoform 1 (TGFB1)
timeFrame: Screening, once weekly during weeks 1-6 of concurrent chemoradiotherapy prior to BIO 300, paclitaxel, and carboplatin dose, and once at the end of consolidation, 3 months and 6 months after the completion of RT
measure: Rate of Progressive Disease Evaluated by the Response Evaluation Criteria in Solid Tumors (RECIST) (1.1) Criteria
timeFrame: Screening, visits 20, 37, 38, 39, 40, 41 & 42 (through visit 41 for surgical participants)
measure: Change in Tumor Diameter as Measured by Diagnostic Computerized Tomography (CT) Scan
timeFrame: Screening, visits 20 and 3, 6, 11 & 13 months post radiation therapy
measure: DLCO as Measured by Pulmonary Function Test (PFT)
timeFrame: Screening and months 6 & 13 post radiation therapy completion
measure: Number of Participants With Pulmonary Fibrosis Assessed by Four-dimensional Computerized Tomography (4D-CT)
timeFrame: Screening, visits 20 & 37 and 9 & 13 months post radiation therapy for non-surgical participants; screening only for surgical participants
measure: Quality of Life (QOL) as Measured by Functional Assessment of Cancer Therapy-Lung Scale Trial Outcome Index (FACT-L TOI) Patient Reported Outcome Questionnaire.
timeFrame: Screening and months 3, 6, & 13 post radiation therapy completion
measure: Quality of Life (QOL) as Measured by University of California, San Diego-Shortness of Breath Questionnaire (UCSD-SOBQ) Patient Reported Outcome Questionnaire.
timeFrame: Screening and months 3, 6, & 13 post radiation therapy completion
measure: Extent of Esophagitis by Patient Reported Swallowing Diary
timeFrame: Screening, weeks 1, 2, 3, 4, 5, & 6 and months 3 & 6 post radiation therapy completion
measure: Mean Weekly BIO 300 Trough Levels, Serum Concentration of BIO 300
timeFrame: Concurrent chemoradiotherapy weeks 1, 2, 3, 4, 5 and 6
measure: Weekly Paclitaxel Trough Levels, Plasma Concentration of Paclitaxel and Carboplatin
timeFrame: Concurrent chemoradiotherapy weeks 1, 2, 3, 4, 5 and 6
measure: FVC as Measured by Pulmonary Function Test (PFT)
timeFrame: Screening and months 6 & 13 post radiation therapy completion
measure: FEV1 as Measured by Pulmonary Function Test (PFT)
timeFrame: Screening and months 6 & 13 post radiation therapy completion
Other outcomes:
Locations:
city: Baltimore
country: United States
facility: University of Maryland School of Medicine
state: Maryland
city: Detroit
country: United States
facility: Henry Ford Hospital
state: Michigan
city: Milwaukee
country: United States
facility: Medical College of Wisconsin
state: Wisconsin
city: Milwaukee
country: United States
facility: Zablocki VA Medical Center
state: Wisconsin
Study officials:
affiliation: Humanetics Corporation
name: Michael D. Kaytor, PhD
role: STUDY_DIRECTOR
References:
citation: Simone CB 2nd, Serebrenik AA, Gore EM, Mohindra P, Brown SL, Wang D, Chetty IJ, Vujaskovic Z, Menon S, Thompson J, Fine G, Kaytor MD, Movsas B. Multicenter Phase 1b/2a Clinical Trial of Radioprotectant BIO 300 Oral Suspension for Patients With Non-Small Cell Lung Cancer Receiving Concurrent Chemoradiotherapy. Int J Radiat Oncol Biol Phys. 2024 Feb 1;118(2):404-414. doi: 10.1016/j.ijrobp.2023.08.048. Epub 2023 Aug 29.
citation: Citrin DE, Prasanna PGS, Walker AJ, Freeman ML, Eke I, Barcellos-Hoff MH, Arankalayil MJ, Cohen EP, Wilkins RC, Ahmed MM, Anscher MS, Movsas B, Buchsbaum JC, Mendonca MS, Wynn TA, Coleman CN. Radiation-Induced Fibrosis: Mechanisms and Opportunities to Mitigate. Report of an NCI Workshop, September 19, 2016. Radiat Res. 2017 Jul;188(1):1-20. doi: 10.1667/RR14784.1. Epub 2017 May 10.