Clinical trial NCT03077698: An Endometrial Cancer Study for Women With Recurrent or Persistent Endometrial Cancer
Official title: A Phase 2, Single Arm, Two Period Study of Sodium Cridanimod in Conjunction With Progestin Therapy in Patients With Endometrial Carcinoma
Study type: INTERVENTIONAL
Overall status: TERMINATED
Phase: PHASE2
Conditions: Endometrial Cancer
Keywords: Endometrial cancer
Recurrent or persistent endometrial carcinoma
Progesterone Receptor Negative
Sodium Cridanimod
Lead sponsor: Xenetic Biosciences, Inc.
Sponsor class: INDUSTRY
First posted: 2017-03-13
Enrollment: 25
Sex: FEMALE
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Intervention model description: Phase 2, Single Arm, Two Period Study
Primary purpose: TREATMENT

Brief summary: This is an open-label, multi-center, single-arm, two-period Phase 2 study. The study will investigate the efficacy of Sodium Cridanimod in conjunction with progestin therapy in a population of subjects with recurrent or persistent endometrial cancer, who have failed progestin monotherapy or who have been identified as Progesterone Receptor (PrR) negative. All patients must have endometrial cancer PrR status determined from an archival sample at Screening. The PrR status (positive or negative) will be determined by central laboratory by ImmunoHistoChemistry (IHC) testing.

There are two treatment periods and a follow-up period within the study.

Detailed description: Treatment Period 1 (Progestin Monotherapy): During Treatment Period 1, all subjects determined to be PrR positive will receive progestin monotherapy, megestrol acetate, for up to 24 weeks. Subjects will have an MRI or CT scan after 12 and 24 weeks of progestin monotherapy, with response to treatment being assessed according to RECIST 1.1 criteria. All subjects that achieve disease control confirmed by tumor assessment after Treatment Period 1, will be ineligible to enter Treatment Period 2. These subjects will be terminated from the trial and treated according to local standards of practice, which may include continued progestin therapy.

Subjects determined to be PrR negative at Screening will not enroll into Treatment Period 1. These subjects will enroll directly into Treatment Period 2.

Treatment Period 2 (Combination Treatment): All subjects determined to be PrR negative at Screening and those who received at least 4 weeks of progestin monotherapy and who experienced disease progression at the conclusion of Treatment Period 1 will enter Treatment Period 2 of the study. During Treatment Period 2, subjects will receive Sodium Cridanimod in combination with continued progestin treatment, megestrol acetate. Subjects will receive treatment until disease progression as defined according to RECIST 1.1 criteria, with response assessments performed at 12-week intervals.

Follow-up Period: Once subjects progress during Treatment Period 2, they will return for a Safety Follow-up Visit 4 weeks following the last treatment, and then continue to be followed for an additional 12-month period for overall survival.

Eligibility criteria: Inclusion Criteria:

1. Female patients 18 years of age or older;
2. Histologically confirmed serous carcinoma or endometrioid type of endometrial carcinoma (histological documentation of recurrence is not required);
3. Recurrent or persistent progressive disease which is refractory to curative therapy or established treatments and cannot be treated with surgery or radiotherapy;
4. Measurable disease, as defined by RECIST 1.1 criteria;
5. At least one "target lesion" to be used to assess response, as defined by RECIST 1.1 criteria. Tumors within a previously irradiated field will be designated as "non-target" lesions unless previous progression is documented;
6. Availability of archived tumor tissue sample that can be used for assessment of PrR status by the central laboratory;
7. GOG (Gynecologic Oncology Group) performance status 0-2 (refer to Appendix A);
8. Calculated Glomerular filtration rate ≥ 50 mL/min;
9. Total bilirubin ≤ 2.5 times upper limit of normal (ULN);
10. AST ≤ 2.5 times ULN (≤ 5 times ULN for patients with liver metastases);
11. Alkaline phosphatase ≤ 2.5 times ULN (≤ 5 times ULN for patients with liver metastases);
12. Albumin ≥ 3.0 mg/dL;
13. Ability to take oral medication;
14. Patients able to understand the nature of the study and who are willing to give written informed consent;
15. And for Treatment Period 2 only: 1) Patients participating in Treatment Period 1 must have had disease progression after receiving at least 4 weeks of progestin therapy or 2) Patients must be determined as PrR negative status at Screening.

Exclusion Criteria:

1. Mixed histology of the tumor or evidence of tumor histology other than serous carcinoma or endometrioid type of endometrial carcinoma;
2. Concurrent systemic corticosteroid therapy;
3. Concurrent oral contraceptive use / Women of childbearing potential not using highly effective means of contraception;
4. Pregnancy confirmed by pregnancy test / Lactating women;
5. Prior therapy with hormonal progestin agents;
6. Patients who are candidates for treatment with standard chemotherapy agents (there is no limit to the number of lines of chemotherapy);
7. History of blood clot;
8. History of known bleeding disorder (i.e. disseminated intravascular coagulation or clotting factor deficiency);
9. Major surgery within 4 weeks prior to the start of the study;
10. Patients with clinically significant illnesses which, according to the Investigator, could compromise participation in the study;
11. History of other clinically active malignancies within 5 years, except for carcinoma in situ of the cervix, basal cell carcinoma, or squamous carcinoma of the skin.
12. Known hypersensitivity or idiosyncratic reaction to any of the study drugs (Sodium Cridanimod, megestrol acetate, lidocaine) and excipients;
13. Patients with known brain metastases;
14. Patients currently receiving any other investigational agents;
15. Patients currently receiving any other anticancer therapies;
16. Participation in any other clinical study within the last 4 weeks prior to the start of the study

Primary outcomes:
measure: Overall Disease Control (ODC) as Determined by Radiographic Imaging Measurements
timeFrame: During TP2 Every 12 weeks, until disease progression up to 24 months
Secondary outcomes:
measure: Objective Response Rate (ORR)
timeFrame: 24 months
measure: Progression-free Survival (PFS)
timeFrame: 24 months
measure: Duration of Stable Disease
timeFrame: 24 months
measure: Overall Survival (OS)
timeFrame: 12 months
Other outcomes:
Locations:
city: Burbank
country: United States
facility: Providence St. Joseph Medical Center - Gynecology
state: California
city: Irvine
country: United States
facility: University of California - Irvine Healthcare
state: California
city: Los Angeles
country: United States
facility: UCLA
state: California
city: Santa Rosa
country: United States
facility: St. Josephs Heritage Healthcare
state: California
city: Aurora
country: United States
facility: University of Colorado School of Medicine, Division of Gynecologic Oncology
state: Colorado
city: Jacksonville
country: United States
facility: Baptist MD Anderson Cancer Center
state: Florida
city: Orlando
country: United States
facility: Florida Hospital Cancer Institute
state: Florida
city: Sarasota
country: United States
facility: Sarasota Memorial Health Care System
state: Florida
city: Atlanta
country: United States
facility: Northside Hospital [University Gynecologic Oncology]
state: Georgia
city: Savannah
country: United States
facility: MUMC - Curtis and Elizabeth Anderson Cancer Institute
state: Georgia
city: Boise
country: United States
facility: Saint Alphonsus Regional Medical Center
state: Idaho
city: Chicago
country: United States
facility: RUSH University Medical Center
state: Illinois
city: Lexington
country: United States
facility: University of Kentucky, Markey Cancer Center
state: Kentucky
city: Covington
country: United States
facility: Women's Cancer Care [Mary Bird Cancer Center at Tammany Parish Hospital]
state: Louisiana
city: Jackson
country: United States
facility: St. Dominic-Jackson Memorial Hospital
state: Mississippi
city: Brooklyn
country: United States
facility: SUNY Downstate Medical Center
state: New York
city: New York
country: United States
facility: Columbia University Medical Center
state: New York
city: Winston-Salem
country: United States
facility: Wake Forest Baptist Health
state: North Carolina
city: Cincinnati
country: United States
facility: University of Cincinnati Cancer Institute-UC Health Barrett Center
state: Ohio
city: Tulsa
country: United States
facility: Oklahoma Cancer Specialists and Research Institute, LLC
state: Oklahoma
city: Pittsburgh
country: United States
facility: Magee Women's Hospital (UPMC)
state: Pennsylvania
city: Rapid City
country: United States
facility: Rapid City Regional Cancer Care
state: South Dakota
city: Dallas
country: United States
facility: UT Southwestern
state: Texas
city: Galveston
country: United States
facility: UT Galveston; University of Texas Medical Branch (UTMB)
state: Texas
city: Seattle
country: United States
facility: Seattle Cancer Care Alliance / University of Washington
state: Washington
Study officials:
affiliation: Xenetic Biosciences, Inc.
name: Curtis Lockshin, PhD
role: STUDY_DIRECTOR
References: