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The Wnt proteins belong to a family of proteins that have been demonstrated to play a role in the formation and dissemination of tumours. The present project focuses on the critical role of the Wnt-5a protein in the pathobiological processes that lead to metastatic cancer disease.
WntResearch has identified a formylated 6 amino acid peptide fragment, named Foxy-5, which mimick the effects of Wnt-5a to impair migration of epithelial cancer cells and thereby acting anti-metastatic.
The aim of the first clinical phase I study was to establish the recommended dose for a clinical phase II study and enable further development of Foxy-5 as a first in class anti-metastatic cancer drug. The study did not see any DLTs and therefore failed to reach maximum tolerated dose (MTD); no recommended phase II dose (RP2D) could therefore be established based on toxicity. The aim of this study is to continue to establish the safety profile of Foxy-5 in higher doses, and determine the RP2D for later stage development based on any observed DLT's/MTD and further analysis of the pharmacodynamic profile of Foxy-5 to determine the biological response dose (BRD).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Foxy-5 | Experimental | Slow infusion of lyophilised and reconstituted Foxy-5 three times weekly for three weeks. There will be a maximum of 8 dose cohorts. Cohorts 1-4 will be conducted in the United Kingdom and Denmark whereas cohorts 5-8 will only be conducted in Denmark. As doses in cohort 1 and 2 have been investigated in the previous phase I study, cohorts 1+2 and 3 can be run in parallel with dose escalation approved by the DSMB at all times. DK+UK: Cohort 1: 0.8 mg/kg DK+UK: Cohort 2: 1.3 mg/kg DK+UK: Cohort 3: 1.8 mg/kg DK+UK: Cohort 4: 2.3 mg/kg DK only: Cohort 5: 3.0 mg/kg DK only: Cohort 6: 4.0 mg/kg DK only: Cohort 7: 5.3 mg/kg DK only: Cohort 8: 7.0 mg/kg |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Foxy-5 | Drug |
|
| Measure | Description | Time Frame |
|---|---|---|
| Presence of Dose Limiting Toxicities (DLTs). | The number of adverse events along with the results of vital sign measurements, physical examinations, and clinical laboratory tests will be used to determine the safety and tolerability profile of Foxy-5 | 6 month |
| Measure | Description | Time Frame |
|---|---|---|
| Genome wide mRNA gene expression in tumour biopsies and blood (buffy coat) | Determination of the biological response dose (BRD) based on the alterations in the exploratory biomarkers during treatment with Foxy-5 | Tumour biopsies obtained prior to day 1 and on day 12 and 19 |
| Wnt-5a protein expression and hematoxylin-eosin (HE) staining of tumour biopsies |
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Inclusion Criteria:
Males and females of at least 18 years of age
Histologically/cytologically documented diagnosis of metastatic breast, colon or prostate cancer, refractory to standard therapy or for which no curative therapy exists
Must have an evaluable tumour appropriate for biopsy as determined by the Investigator.
Loss of or reduced Wnt-5a protein expression in primary or metastatic tumour cells, characterised by IHC analysis
Eastern Cooperative Oncology Group (ECOG) performance status of <= 1
Life expectancy of at least 3 months
Unresectable disease, i.e. the metastases cannot be surgically removed with a curative intent
Adequate haematological functions as defined by:
Absolute neutrophil count >= 1.5 10E9/L
Platelets >= 100 10E9/L
Hemoglobin >= 5.6 mmol/L
Adequate hepatic function as defined by:
Total bilirubin <= 1.5 x the upper limit of normal (ULN)
Aspartate aminotransferase (AST) <= 2.5 x ULN*
Alanine aminotransferase (ALT) <= 2.5 x ULN*
Adequate renal function as defined by Serum creatinine <= 1,5 x ULN
Patients in active anti-coagulating treatment must be evaluated according to local standards on the discretion of the Investigator..
Provision of written informed consent
Willingness and ability to comply with scheduled visits, treatment plans, laboratory tests and other study procedures
Sexually active males and females of child-producing potential, must use adequate contraception (intrauterine devices, hormonal contraceptives (contraceptive pills, implants, transdermal patches, hormonal vaginal devices or injections with prolonged release) or diaphragm always with spermicidal jelly and a male condom) for the study duration and at least six months afterwards
Exclusion Criteria:
Active uncontrolled bleeding or bleeding diathesis (e.g., active peptic ulcer disease)
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| Name | Affiliation | Role |
|---|---|---|
| Tine Mølvadgaard, M.Sc.Pharm | Smerud Medical Research Denmark | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Clinical Research Department, Oncology, Rigshospitalet | Copenhagen | 2100 | Denmark | |||
| Onkologisk Afdeling R, Herlev Hospital |
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| ID | Term |
|---|---|
| D001943 | Breast Neoplasms |
| D003110 | Colonic Neoplasms |
| D011471 | Prostatic Neoplasms |
| ID | Term |
|---|---|
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D001941 | Breast Diseases |
| D012871 | Skin Diseases |
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| ID | Term |
|---|---|
| C542624 | Foxy-5 peptide |
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Determination of the biological response dose (BRD) based on the alterations in the exploratory biomarkers during treatment with Foxy-5 |
| Tumour biopsies obtained prior to day 1 and on day 12 and 19 |
| Numbers of circulating tumour cells (CTCs) in blood | Determination of the biological response dose (BRD) based on the alterations in the exploratory biomarkers during treatment with Foxy-5 | Blood sample obtained prior to day 1 and on day 12 and 19 |
| Maximum tolerated dose (MTD) | Determined as the dose preceding the dose at which two or more patients have experienced DLTs. Assessment of adverse events and laboratory abnormalities | 6 month |
| Area under the plasma concentration curve (AUC) of Foxy-5 | The concentration of Foxy-5 in human biological samples will be measured with liquid chromatography with tandem mass spectrometry detection (LC-MS/MS) | immediately prior to treatment, at 0, 5, 15, 30, minutes 1, 3, 6, 8, 24, 48, 72 and 96 hours after infusion. |
| Bioavailability (F) of Foxy-5 | The concentration of Foxy-5 in human biological samples will be measured with liquid chromatography with tandem mass spectrometry detection (LC-MS/MS) | immediately prior to treatment, at 0, 5, 15, 30, minutes 1, 3, 6, 8, 24, 48, 72 and 96 hours after infusion. |
| Half life (T½) of Foxy-5 | The concentration of Foxy-5 in human biological samples will be measured with liquid chromatography with tandem mass spectrometry detection (LC-MS/MS) | immediately prior to treatment, at 0, 5, 15, 30, minutes 1, 3, 6, 8, 24, 48, 72 and 96 hours after infusion. |
| Absorption rate Constant (tmax) of Foxy-5 | The concentration of Foxy-5 in human biological samples will be measured with liquid chromatography with tandem mass spectrometry detection (LC-MS/MS) | immediately prior to treatment, at 0, 5, 15, 30, minutes 1, 3, 6, 8, 24, 48, 72 and 96 hours after infusion. |
| Volume of distribution (V) of Foxy-5 | The concentration of Foxy-5 in human biological samples will be measured with liquid chromatography with tandem mass spectrometry detection (LC-MS/MS) | immediately prior to treatment, at 0, 5, 15, 30, minutes 1, 3, 6, 8, 24, 48, 72 and 96 hours after infusion. |
| Clearance (C) of Foxy-5 | The concentration of Foxy-5 in human biological samples will be measured with liquid chromatography with tandem mass spectrometry detection (LC-MS/MS) | immediately prior to treatment, at 0, 5, 15, 30, minutes 1, 3, 6, 8, 24, 48, 72 and 96 hours after infusion. |
| Extraction Ratio (E) of Foxy-5 | The concentration of Foxy-5 in human biological samples will be measured with liquid chromatography with tandem mass spectrometry detection (LC-MS/MS) | immediately prior to treatment, at 0, 5, 15, 30, minutes 1, 3, 6, 8, 24, 48, 72 and 96 hours after infusion. |
| Hepatic and Renal Clearance of Foxy-5 | The concentration of Foxy-5 in human biological samples will be measured with liquid chromatography with tandem mass spectrometry detection (LC-MS/MS) | immediately prior to treatment, at 0, 5, 15, 30, minutes 1, 3, 6, 8, 24, 48, 72 and 96 hours after infusion. |
| Herlev |
| 2730 |
| Denmark |
| Odense University Hospital | Odense | Denmark |
| NCCC, Freeman Hospital | Newcastle | Newcastle Upon Tyne | NE7 7DN | United Kingdom |
| D017437 |
| Skin and Connective Tissue Diseases |
| D015179 | Colorectal Neoplasms |
| D007414 | Intestinal Neoplasms |
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
| D004066 | Digestive System Diseases |
| D005767 | Gastrointestinal Diseases |
| D003108 | Colonic Diseases |
| D007410 | Intestinal Diseases |
| D005834 | Genital Neoplasms, Male |
| D014565 | Urogenital Neoplasms |
| D005832 | Genital Diseases, Male |
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
| D011469 | Prostatic Diseases |
| D052801 | Male Urogenital Diseases |