Clinical trial NCT03282461: A Microdose Evaluation Study of ABY-029 in Head and Neck Oncology Surgery
Official title: A Phase 0 Open Label, Single-center Clinical Trial of ABY-029, an Anti-EGFR Fluorescence Imaging Agent Via Single Intravenous Injection to Subjects With Operable Head and Neck Cancer.
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: EARLY_PHASE1
Conditions: Head and Neck Cancer
Lead sponsor: Dartmouth-Hitchcock Medical Center
Sponsor class: OTHER
Collaborators: name: Dartmouth College
First posted: 2017-09-14
Enrollment: 12
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Intervention model description: open label
Primary purpose: TREATMENT

Brief summary: The primary study objective is to determine if microdoses of ABY-029 (up to 6X) lead to detectable signals (defined as signal-to-noise ratio, SNR ≥10, with wide-field iFI) in sampled tissues with an EGFR (epidermal growth factor receptor) pathology score ≥ 1 based on histological staining.

The secondary study objective is to assess ex vivo the specificity of tumor binding in resected specimens by measuring the corresponding molecular uptake and concentrations using histopathology.

Detailed description: The investigators plan to enroll a minimum of 6 and a maximum of 12 adult patients with a diagnosis of operable head and neck cancer in this open label, single center, clinical trial of ABY-029.

Administration of ABY-029 will occur as a single intravenous injection to subjects with operable head and neck cancer approximately 1-3 hours prior to surgery.

Documentation of the tumor with digital photography will be performed at several time points during surgery: pre-resection, at intermediate time points during surgery, and post-resection. White light assessment of the tumor and boundaries will be performed by the surgeon.

Intraoperative optical probe measurements will occur in areas of visible tumor as well as normal appearing tissue. At multiple time points during each surgery and at the discretion of the surgeon, optical probe measurements will be completed with the probe followed by biopsy sampling of the same sites when they are intended for resection. Commonly, these acquisitions will occur at first exposure of the tumor, at the approximate mid-point of tumor resection (when a significant amount of tumor tissue is present in the operative field), at a point nearing but prior to completion of tumor resection (when a small amount of tumor tissue is presumably present), and at the intended completion of tumor resection (when residual tumor may or may not exist). At a data collection time point, optical probe measurements will be performed and archived for analysis and locations may be biopsied when tissue is intended for resection.

Any normal tissue removed as part of surgical procedure will be sampled. Samples may be taken from tissue outside the "antic" tumor volume but resected as part of the procedure along the surgical corridor. All tissue collected will be submitted to pathology for routine processing.

After tissue is removed breadloafed sections will be placed on a fluorescence scanning imager for complete measurement of signal on the exposed surfaces. Pathological analysis for EGFR status will be completed at selected regions around the faces of each breadloaf section.

The protocol is not a safety study since no physiological effects are expected at microdose levels of ABY-029. Rather, doses have been selected to determine if a fluorescence signal can be detected by wide-field imaging technology with a signal-to-noise ratio of 10, which is considered necessary for subsequent assessment of diagnostic performance of ABY-029 as a tumor biomarker sufficient to guide surgical resection in the future. No diagnostic or therapeutic intent is proposed, and study drug administration is not intended to alter the extent of planned tumor resection during the surgical procedure.

Eligibility criteria: Inclusion Criteria:

1. Preoperative diagnosis of head and neck cancer.
2. Tumor judged to be operable based on preoperative imaging studies.
3. Valid informed consent by subject or subject's Legally Authorized Representative.
4. Age ≥ 18 years old.

Exclusion Criteria:

1. Pregnant women or women who are breast feeding.
2. Patients on any experimental anti-EGFR targeted therapies, either investigational or FDA approved.

Primary outcomes:
measure: Signal detection
timeFrame: Day of surgery, up to 1 week after surgery
Secondary outcomes:
measure: Correlation of spatial patterns of EGFR expression
timeFrame: within 1 week of surgery
Other outcomes:
Locations:
city: Lebanon
country: United States
facility: Dartmouth-Hitchcock Medical Center
state: New Hampshire
Study officials:
affiliation: Dartmouth-Hitchcock Medical Center
name: Joseph A Paydarfar, MD
role: PRINCIPAL_INVESTIGATOR
References: