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| Name | Class |
|---|---|
| Progenics Pharmaceuticals, Inc. | INDUSTRY |
| Rhode Island Hospital | OTHER |
| University of Texas | OTHER |
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The purpose of this study is to evaluate the effectiveness of Prostate Specific Membrane Antigen (PSMA ADC), as well as its safety and side effects for patients with advanced brain tumors. This study will also study how your body metabolizes (breaks down) PSMA ADC.
PSMA expression has been demonstrated in the tumor neovasculature of Glioblastoma Multiforme (GBM) by immunohistochemical staining. Strong reactivity to the antibody component of PSMA ADC was observed in the endothelial cells of new tumor blood vessels in GBM. Since the endothelial cells are located on the luminal surface of blood vessels, PSMA ADC does not need to cross the blood brain barrier to reach its target. Following binding and internalization of PSMA ADC, the cytotoxic component of PSMA ADC will be released and destroy the neovasculature that supports tumor growth. Therefore, PSMA ADC may be an active treatment for GBM.
Bevacizumab, an inhibitor of angiogenesis, has been shown to be effective in improving progression-free survival as a single agent. Thus PSMA ADC, which targets tumor angiogenesis by a mechanism different from that of bevacizumab, may be a novel therapeutic modality for GBM.
A phase 2 study of PSMA ADC is proposed for patients with GBM that have progressed after standard treatment that includes radiation, temozolomide and bevacizumab. A phase 1 study of PSMA ADC in prostate cancer is ongoing and a phase 2 dose level of 2.5 mg/kg IV every 3 weeks has been defined. Treatment after bevacizumab failure for patients with GBM is a major unmet medical need. If activity were demonstrated in this trial, a definitive randomized study would be proposed.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| PSMA ADC | Experimental | 2.5 mg/kg, IV, over 60 minutes every 3 weeks |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| PSMA ADC | Drug | 2.5 mg/kg, IV, over 60 minutes every 3 weeks |
|
| Measure | Description | Time Frame |
|---|---|---|
| Response Rate (Progression) for Patients With Glioblastoma That Have Progressed After Prior Treatment That Has Included Radiation, Temozolomide and Bevacizumab. | The response assessment in neuro-oncology (RANO) will be used to define radiographic response. (PD): A >25% increase in tumor area (product of two diameters) OR appearance of a new lesion/site, OR clear clinical worsening or failure to return for evaluation due to death or deteriorating condition (unless clearly unrelated to this cancer). | 3 months until progression, potentially up to 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Patients Who Experienced Toxicities (Adverse Events) Who Received PSMA ADC for Recurrent Glioblastoma. | Please note that toxicities outlined may not all be related to the treatment regimen. | at least every 3 weeks for a maximum of 30 post coming off drug, approximately 6 months |
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Inclusion Criteria:
Males and females Histologically confirmed GBM (Patients with gliosarcoma are also eligible)
Assessable or measurable disease by MRI
Progression after prior treatment that includes radiation, temozolomide and bevacizumab.
-> 4 weeks since prior chemotherapy, bevacizumab and other systemic treatment and > 3 weeks from prior radiation.
age >18 years
Weight < 150 kg.
Karnofsky performance score > 60
Life expectancy >12 weeks
Brain MRI within 21 days prior to registration
Laboratory results requirements
Stable corticosteroid dose at least 14 days prior to registration
Women of childbearing potential must have a negative pregnancy test.
Men and women of childbearing potential must be willing to consent to using effective contraception while on treatment and for at least 3 months thereafter.
Patients must not be on enzyme-inducing anti-epileptic drugs (EIAED). Patients may be on non-enzyme inducing anti-epileptic drugs (NEIAED) or may not be taking any anti-epileptic drugs. A list of AED that cause modest or no induction of hepatic metabolic enzymes will be discussed
Exclusion Criteria:
Non-GBM primary invasive malignant neoplasm within the five years prior to screening except for:
Clinically significant cardiac disease (New York Heart Association Class III/ IV or severe debilitating pulmonary disease
Subjects with QTc>500 msec (either Bazzett's or Fridericia's method)
Radiation therapy, cytotoxic chemotherapy, bevacizumab or other treatment for GBM within previous three weeks
Evidence of an active infection requiring ongoing intravenous antibiotic therapy
Any toxicity ≥ grade 2 (non-laboratory) (NCI CTCAE, Version 4.03) prior to first dose of study drug
Prior treatment with PSMA ADC or other therapies targeting PSMA, or other anti-body drug conjugate (ADC) products that contain monomethyl auristatin E (MMAE) (e.g., brentuximab vedotin, glembatumumab vedotin, ASG-5ME)
Known hypersensitivity reactions to PSMA ADC or any of its components.
Any medical condition that in the opinion of the Investigator may interfere with a subject's participation in or compliance with the study
Patients with a prior history of pancreatitis
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| Name | Affiliation | Role |
|---|---|---|
| Heinrich Elinzano, MD | Brown University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Rhode Island Hospital | Providence | Rhode Island | 02903 | United States | ||
| UT Southwestern |
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| ID | Title | Description |
|---|---|---|
| FG000 | PSMA ADC | 2.5 mg/kg, IV, over 60 minutes every 3 weeks PSMA ADC: 2.5 mg/kg, IV, over 60 minutes every 3 weeks |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | PSMA ADC | 2.5 mg/kg, IV, over 60 minutes every 3 weeks PSMA ADC: 2.5 mg/kg, IV, over 60 minutes every 3 weeks |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Response Rate (Progression) for Patients With Glioblastoma That Have Progressed After Prior Treatment That Has Included Radiation, Temozolomide and Bevacizumab. | The response assessment in neuro-oncology (RANO) will be used to define radiographic response. (PD): A >25% increase in tumor area (product of two diameters) OR appearance of a new lesion/site, OR clear clinical worsening or failure to return for evaluation due to death or deteriorating condition (unless clearly unrelated to this cancer). | Progression | Posted | Number | participants | 3 months until progression, potentially up to 1 year |
|
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | PSMA ADC | 2.5 mg/kg, IV, over 60 minutes every 3 weeks PSMA ADC: 2.5 mg/kg, IV, over 60 minutes every 3 weeks |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| eye disorder/ vision changes | Investigations | Systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| AKI | Investigations | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Heinrich Elinzano, MD | Brown University Oncology Research Group (BrUOG) | 4018633000 | kayla_rosati@brown.edu |
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| ID | Term |
|---|---|
| D005909 | Glioblastoma |
| D018316 | Gliosarcoma |
| ID | Term |
|---|---|
| D001254 | Astrocytoma |
| D005910 | Glioma |
| D018302 | Neoplasms, Neuroepithelial |
| D017599 | Neuroectodermal Tumors |
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| ID | Term |
|---|---|
| C569421 | PSMA ADC |
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| Dallas |
| Texas |
| 75235 |
| United States |
| Participants |
|
| Age, Continuous | Mean | Full Range | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| Units | Counts |
|---|---|
| Participants |
|
|
| Secondary | Number of Patients Who Experienced Toxicities (Adverse Events) Who Received PSMA ADC for Recurrent Glioblastoma. | Please note that toxicities outlined may not all be related to the treatment regimen. | Posted | Count of Participants | Participants | at least every 3 weeks for a maximum of 30 post coming off drug, approximately 6 months |
|
|
|
| 4 |
| 6 |
| 6 |
| 6 |
| H/A | Investigations | Systematic Assessment |
|
| Hypermagnesemia | Investigations | Systematic Assessment |
|
| Hypokalemia | Investigations | Systematic Assessment |
|
| Intratumoral hemorrhage | Investigations | Systematic Assessment |
|
| Nausea | Investigations | Systematic Assessment |
|
| Thrombocytopenia | Investigations | Systematic Assessment |
|
| seizure | Investigations | Systematic Assessment |
|
| UTI | Investigations | Systematic Assessment |
|
| WBC | Investigations | Systematic Assessment |
|
| confusion | Investigations | Systematic Assessment |
|
| muscle weakness/weakness general | Investigations | Systematic Assessment |
|
| dyspnea | Investigations | Systematic Assessment |
|
| Facial muscle weakness | Investigations | Systematic Assessment |
|
| CD4 Lymph count | Investigations | Systematic Assessment |
|
| Lymphopenia | Investigations | Systematic Assessment |
|
| Anorexia | Investigations | Systematic Assessment |
|
| syncope | Investigations | Systematic Assessment |
|
| pain | Investigations | Systematic Assessment |
|
| perforation-sigmoid | Investigations | Systematic Assessment |
|
| cholesterol | Investigations | Systematic Assessment |
|
| creatinine | Investigations | Systematic Assessment |
|
| hyperglycemia | Investigations | Systematic Assessment |
|
| hypoalbumin | Investigations | Systematic Assessment |
|
| troponin | Investigations | Systematic Assessment |
|
| Alopecia | Investigations | Systematic Assessment |
|
| ALT | Investigations | Systematic Assessment |
|
| AST | Investigations | Systematic Assessment |
|
| anemia | Investigations | Systematic Assessment |
|
| edema, lower leg | Investigations | Systematic Assessment |
|
| eye disorder/ vision changes | Investigations | Systematic Assessment |
|
| fatigue | Investigations | Systematic Assessment |
|
| H/A | Investigations | Systematic Assessment |
|
| Hypermagnesemia | Investigations | Systematic Assessment |
|
| Hypokalemia | Investigations | Systematic Assessment |
|
| Hyponatremia | Investigations | Systematic Assessment |
|
| Infection/shingles/thrush | Investigations | Systematic Assessment |
|
| Nausea | Investigations | Systematic Assessment |
|
| Neutrophil count | Investigations | Systematic Assessment |
|
| Thrombocytopenia | Investigations | Systematic Assessment |
|
| vomiting | Investigations | Systematic Assessment |
|
| rash- torso | Investigations | Systematic Assessment |
|
| parathesia/neuropathy | Investigations | Systematic Assessment |
|
| rash- papular | Investigations | Systematic Assessment |
|
| urinary incontinence | Investigations | Systematic Assessment |
|
| right ankle swelling | Investigations | Systematic Assessment |
|
| UTI | Investigations | Systematic Assessment |
|
| WBC | Investigations | Systematic Assessment |
|
| intracerebral hematoma | Investigations | Systematic Assessment |
|
| Lymphopenia | Investigations | Systematic Assessment |
|
| dysphasia | Investigations | Systematic Assessment |
|
| gait disturbance | Investigations | Systematic Assessment |
|
| cognitive disturbance/impairment | Investigations | Systematic Assessment |
|
| dysgeusia (taste) | Investigations | Systematic Assessment |
|
| pain- left calf/leg | Investigations | Systematic Assessment |
|
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| D009373 |
| Neoplasms, Germ Cell and Embryonal |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009380 | Neoplasms, Nerve Tissue |