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| ID | Type | Description | Link |
|---|---|---|---|
| NCI-2017-00050 | Registry Identifier | CTRP (Clinical Trial Reporting Program) | |
| CCCWFU 03716 | Other Identifier | Comprehensive Cancer Center of Wake Forest University | |
| P30CA012197 | U.S. NIH Grant/Contract | View source |
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| Name | Class |
|---|---|
| National Cancer Institute (NCI) | NIH |
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This phase I trial studies the side effects and best dose of APN401 in treating patients with pancreatic cancer, colorectal cancer, or other solid tumors that have spread to other places in the body or have come back. APN401 may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth.
PRIMARY OBJECTIVES:
I. To determine the toxicities and establish the safety of multiple infusions of small interfering ribonucleic acid (siRNA)-transfected peripheral blood mononuclear cells APN401 (APN401).
SECONDARY OBJECTIVES:
I. To determine the immunologic effects of multiple infusions of APN401. II. To document clinical response and survival.
OUTLINE:
Patients receive siRNA-transfected peripheral blood mononuclear cells APN401 intravenously (IV) over 30 minutes on days 1, 29, and 57 in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed up for 5 years.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Treatment (APN401) | Experimental | Patients receive siRNA-transfected peripheral blood mononuclear cells APN401 IV over 30 minutes on days 1, 29, and 57 in the absence of disease progression or unacceptable toxicity. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Laboratory Biomarker Analysis | Other | Correlative studies |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Adverse Events Common Terminology Criteria for Adverse Events Version 4.0 | Will be categorized by organ system and severity, graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events. Related treatment emergent adverse events by maximum severity. Unexpected grade 4 and all grade 5 events are considered severe adverse events. CTCAE grades 3-5 allergic reactions related to study cell infusion CTCAE grades 3 and greater autoimmune reactions other than that vitiligo CTCAE grades 3 and greater organ toxicity (cardiac, dermatologic, gastrointestinal, hepatic, pulmonary, renal/genitourinary or neurologic) not pre-existing or due to the underlying malignancy and occurring within 30 days of study product infusion | Up to 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| Clinical Response as Assessed by RECIST | Will be summarized as frequency counts and percentages. RECIST criteria: Complete Response (CR): Disappearance of all target lesions; Partial Response (PR): At least a 30% decrease in the sum of the longest diameter (LD) of target lesions, taking as reference the baseline sum LD; Progressive Disease (PD): At least a 20% increase in the sum of the LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions; Stable Disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum LD since the treatment started |
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Inclusion Criteria:
Patients with histologically confirmed inoperable, recurrent or metastatic malignant solid tumors, deemed incurable, and who have either:
The study is intended to enroll patients with pancreatic and colorectal cancer; patients with other types of solid tumors will require approval by the principal investigator
Measurable disease as defined by Response Evaluation Criteria in Solid Tumors (RECIST)
Patients with treated, stable, and asymptomatic brain metastases are eligible
Patients on every 3 or every 4 week systemic therapy programs must be at least 4 weeks since treatment and recovered from any clinically significant toxicity experienced; patients on weekly or daily systemic therapy programs and patients receiving radiation must be at least 1 week since treatment and recovered from any clinically significant toxicity experienced; must be at least 4 weeks and have recovered from major surgery
Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1
White blood cells >= 3000/uL
Platelets >= 100,000/uL
Hematocrit >= 28%
Creatinine =< 1.6 mg/dL
Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) < 2.5 x upper limit of normal
Bilirubin =< 1.6 mg/dL (except patients with Gilbert's syndrome, who must have a total bilirubin less than 3.0 mg/dL)
Albumin >= 3.0 g/dL
International normalized ratio (INR) =< 1.5
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Pierre Triozzi | Wake Forest University Health Sciences | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Comprehensive Cancer Center of Wake Forest University | Winston-Salem | North Carolina | 27157 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35362047 | Derived | Wolf D, Baier G. IFNgamma Helps CBLB-Deficient CD8+ T Cells to Put Up Resistance to Tregs. Cancer Immunol Res. 2022 Apr 1;10(4):370. doi: 10.1158/2326-6066.CIR-22-0080. |
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| ID | Title | Description |
|---|---|---|
| FG000 | Treatment (APN401) | Patients receive siRNA-transfected peripheral blood mononuclear cells APN401 IV over 30 minutes on days 1, 29, and 57 in the absence of disease progression or unacceptable toxicity. Laboratory Biomarker Analysis: Correlative studies siRNA-transfected Peripheral Blood Mononuclear Cells APN401: Given IV |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | May 10, 2019 |
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| siRNA-transfected Peripheral Blood Mononuclear Cells (PBMC) APN401 |
| Biological |
Given IV |
|
|
| Up to approximately 4 years |
| Frequency of Immune Cells | Immune response as measured by frequency of immune cells | Days 15 and 28 |
| Immune Response as Measured by Interferon Production | Immune response as measured by interferon production | Days 15 and 28 |
| Neutrophil to Lymphocyte Ratio | Immune response as measured by neutrophil to lymphocyte ratio | Days 15 and 28 |
| Overall Survival (OS) | Exploratory survival plots will be estimated using the Kaplan Meier approach and median overall survival will be estimated if enough events occur. | From the initial infusion to confirmation of death, assessed up to approximately 4 years |
| Progression-free Survival (PFS) | Exploratory survival plots will be estimated using the Kaplan Meier approach and median PFS will be estimated if enough events occur. | From the initial infusion to confirmation of progression or death, assessed up to approximately 4 years |
| COMPLETED |
|
| NOT COMPLETED |
|
|
Out of the 11 participants, only 9 actually received treatment have data collected.
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| ID | Title | Description |
|---|---|---|
| BG000 | Treatment (APN401) | Patients receive siRNA-transfected peripheral blood mononuclear cells APN401 IV over 30 minutes on days 1, 29, and 57 in the absence of disease progression or unacceptable toxicity. Laboratory Biomarker Analysis: Correlative studies siRNA-transfected Peripheral Blood Mononuclear Cells APN401: Given IV |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean | Full Range | years |
| |||||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
| ||||||||||||||||||
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
| ||||||||||||||||||
| Race (NIH/OMB) | Count of Participants | Participants |
| ||||||||||||||||||
| Region of Enrollment | Number | participants |
| ||||||||||||||||||
| CD3+ | Mean | Standard Deviation | percentage of cells |
| |||||||||||||||||
| CD4+ | Mean | Standard Deviation | percentage of cells |
| |||||||||||||||||
| CD8+ | Mean | Standard Deviation | percentage of cells |
| |||||||||||||||||
| CD4+ICOS+ | Mean | Standard Deviation | percentage of cells |
| |||||||||||||||||
| CD8+ICOS+ | Mean | Standard Deviation | percentage of cells |
| |||||||||||||||||
| CD4+FOXP3+ | Mean | Standard Deviation | percentage of cells |
| |||||||||||||||||
| CD4+CD45RO+ | Mean | Standard Deviation | percentage of cells |
| |||||||||||||||||
| CD3-CD56+ | Mean | Standard Deviation | percentage of cells |
| |||||||||||||||||
| CD14+ | Mean | Standard Deviation | percentage of cells |
| |||||||||||||||||
| CD19+ | Mean | Standard Deviation | percentage of cells |
| |||||||||||||||||
| CD56+ | Mean | Standard Deviation | percentage of cells |
| |||||||||||||||||
| Neutrophil to Lymphocyte Ratio | Mean | Standard Deviation | ratio |
| |||||||||||||||||
| IFN | Mean | Standard Deviation | pg/ml |
| |||||||||||||||||
| IL-2 | Mean | Standard Deviation | pg/ml |
|
| 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 | Number of Adverse Events Common Terminology Criteria for Adverse Events Version 4.0 | Will be categorized by organ system and severity, graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events. Related treatment emergent adverse events by maximum severity. Unexpected grade 4 and all grade 5 events are considered severe adverse events. CTCAE grades 3-5 allergic reactions related to study cell infusion CTCAE grades 3 and greater autoimmune reactions other than that vitiligo CTCAE grades 3 and greater organ toxicity (cardiac, dermatologic, gastrointestinal, hepatic, pulmonary, renal/genitourinary or neurologic) not pre-existing or due to the underlying malignancy and occurring within 30 days of study product infusion | Posted | Count of Participants | Participants | Up to 1 year |
|
|
| |||||||||||||||||||||||||||||||
| Secondary | Clinical Response as Assessed by RECIST | Will be summarized as frequency counts and percentages. RECIST criteria: Complete Response (CR): Disappearance of all target lesions; Partial Response (PR): At least a 30% decrease in the sum of the longest diameter (LD) of target lesions, taking as reference the baseline sum LD; Progressive Disease (PD): At least a 20% increase in the sum of the LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions; Stable Disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum LD since the treatment started | Posted | Count of Participants | Participants | Up to approximately 4 years |
|
| ||||||||||||||||||||||||||||||||
| Secondary | Frequency of Immune Cells | Immune response as measured by frequency of immune cells | Posted | Mean | Standard Deviation | percentage of cells | Days 15 and 28 |
|
| |||||||||||||||||||||||||||||||
| Secondary | Immune Response as Measured by Interferon Production | Immune response as measured by interferon production | Posted | Mean | Standard Deviation | pg/ml | Days 15 and 28 |
|
| |||||||||||||||||||||||||||||||
| Secondary | Neutrophil to Lymphocyte Ratio | Immune response as measured by neutrophil to lymphocyte ratio | Posted | Mean | Standard Deviation | ratio | Days 15 and 28 |
|
| |||||||||||||||||||||||||||||||
| Secondary | Overall Survival (OS) | Exploratory survival plots will be estimated using the Kaplan Meier approach and median overall survival will be estimated if enough events occur. | Posted | Median | Full Range | days | From the initial infusion to confirmation of death, assessed up to approximately 4 years |
|
| |||||||||||||||||||||||||||||||
| Secondary | Progression-free Survival (PFS) | Exploratory survival plots will be estimated using the Kaplan Meier approach and median PFS will be estimated if enough events occur. | Posted | Median | Full Range | days | From the initial infusion to confirmation of progression or death, assessed up to approximately 4 years |
|
|
Adverse events were recorded during treatment and follow up 30 days past treatment and up to approximately 4 years for survival.
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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 | Treatment (APN401) | Patients receive siRNA-transfected peripheral blood mononuclear cells APN401 IV over 30 minutes on days 1, 29, and 57 in the absence of disease progression or unacceptable toxicity. Laboratory Biomarker Analysis: Correlative studies siRNA-transfected Peripheral Blood Mononuclear Cells APN401: Given IV | 7 | 9 | 2 | 9 | 9 | 9 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| ABDOMINAL PAIN | Gastrointestinal disorders | Systematic Assessment |
| ||
| ASCITES | Gastrointestinal disorders | Systematic Assessment |
| ||
| NAUSEA | Gastrointestinal disorders | Systematic Assessment |
| ||
| FATIGUE | General disorders | Systematic Assessment |
| ||
| HEPATIC HEMORRHAGE | Hepatobiliary disorders | Systematic Assessment |
| ||
| ANOREXIA | Metabolism and nutrition disorders | Systematic Assessment |
|
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| ANEMIA | Blood and lymphatic system disorders | Systematic Assessment |
| ||
| ABDOMINAL PAIN | Gastrointestinal disorders | Systematic Assessment |
| ||
| ASCITES | Gastrointestinal disorders | Systematic Assessment |
| ||
| CONSTIPATION | Gastrointestinal disorders | Systematic Assessment |
| ||
| DIARRHEA | Gastrointestinal disorders | Systematic Assessment |
| ||
| FLATULENCE | Gastrointestinal disorders | Systematic Assessment |
| ||
| NAUSEA | Gastrointestinal disorders | Systematic Assessment |
| ||
| RECTAL HEMORRHAGE | Gastrointestinal disorders | Systematic Assessment |
| ||
| VOMITING | Gastrointestinal disorders | Systematic Assessment |
| ||
| CHILLS | General disorders | Systematic Assessment |
| ||
| EDEMA LIMBS | General disorders | Systematic Assessment |
| ||
| FATIGUE | General disorders | Systematic Assessment |
| ||
| FEVER | General disorders | Systematic Assessment |
| ||
| FLU LIKE SYMPTOMS | General disorders | Systematic Assessment |
| ||
| RIGORS | General disorders | Systematic Assessment |
| ||
| BILE DUCT STENOSIS | Hepatobiliary disorders | Systematic Assessment |
| ||
| ALANINE AMINOTRANSFERASE INCREASED | Investigations | Systematic Assessment |
| ||
| ALKALINE PHOSPHATASE INCREASE | Investigations | Systematic Assessment |
| ||
| ASPARTATE AMINOTRANSFERASE INCREASED | Investigations | Systematic Assessment |
| ||
| BLOOD BILIRUBIN INCREASE | Investigations | Systematic Assessment |
| ||
| CREATININE INCREASE | Investigations | Systematic Assessment |
| ||
| WHITE BLOOD CELL DECREASED | Investigations | Systematic Assessment |
| ||
| HYPERURICEMIA | Metabolism and nutrition disorders | Systematic Assessment |
| ||
| HYPOALBUMINEMIA | Metabolism and nutrition disorders | Systematic Assessment |
| ||
| HYPOKALEMIA | Metabolism and nutrition disorders | Systematic Assessment |
| ||
| HYPONATREMIA | Metabolism and nutrition disorders | Systematic Assessment |
| ||
| ARTHRALGIA | Musculoskeletal and connective tissue disorders | Systematic Assessment |
| ||
| BACK SPASM | Musculoskeletal and connective tissue disorders | Systematic Assessment |
| ||
| MYALGIA | Musculoskeletal and connective tissue disorders | Systematic Assessment |
| ||
| NECK PAIN | Musculoskeletal and connective tissue disorders | Systematic Assessment |
| ||
| DIZZINESS | Nervous system disorders | Systematic Assessment |
| ||
| HEADACHE | Nervous system disorders | Systematic Assessment |
| ||
| PARESTHESIA | Nervous system disorders | Systematic Assessment |
| ||
| CYSTITIS NONINFECTIVE | Renal and urinary disorders | Systematic Assessment |
| ||
| DYSURIA | Renal and urinary disorders | Systematic Assessment |
| ||
| HEMATOMA | Vascular disorders | Systematic Assessment |
| ||
| HOT FLASHES | Vascular disorders | Systematic Assessment |
| ||
| HYPERTENSION | Vascular disorders | Systematic Assessment |
| ||
| HYPOTENSION | Vascular disorders | Systematic Assessment |
| ||
| ANOREXIA | Metabolism and nutrition disorders | Systematic Assessment |
|
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Principal Investigator | Wake Forest Baptist Comprehensive Cancer Center | 336-716-5772 | ptriozzi@wakehealth.edu |
| Dec 20, 2023 |
| Prot_SAP_001.pdf |
| ICF | No | No | Yes | Informed Consent Form | May 13, 2019 | Aug 5, 2022 | ICF_000.pdf |
| ID | Term |
|---|---|
| D001932 | Brain Neoplasms |
| D009362 | Neoplasm Metastasis |
| D015179 | Colorectal Neoplasms |
| D010190 | Pancreatic Neoplasms |
| ID | Term |
|---|---|
| D016543 | Central Nervous System Neoplasms |
| D009423 | Nervous System Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D009385 | Neoplastic Processes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D007414 | Intestinal Neoplasms |
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
| D004066 | Digestive System Diseases |
| D005767 | Gastrointestinal Diseases |
| D003108 | Colonic Diseases |
| D007410 | Intestinal Diseases |
| D012002 | Rectal Diseases |
| D004701 | Endocrine Gland Neoplasms |
| D010182 | Pancreatic Diseases |
| D004700 | Endocrine System Diseases |
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| Unknown or Not Reported |
|
| Native Hawaiian or Other Pacific Islander |
|
| Black or African American |
|
| White |
|
| More than one race |
|
| Unknown or Not Reported |
|
| Grade 3 |
|
| Nervous System Disorders |
|
| Gastrointestinal Disorders |
|
| Musculoskeletal and connective tissue disorders |
|
|
| Title | Denominators | Categories | ||||
|---|---|---|---|---|---|---|
| CD3+ (day 15) |
| |||||
| CD3+ (day 28) |
| |||||
| CD4+ (day 15) |
| |||||
| CD4+ (day 28) |
| |||||
| CD8+ (day 15) |
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| CD8+ (day 28) |
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| CD14+ (day 15) |
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| CD14+ (day 28) |
| |||||
| CD19+ (day 15) |
| |||||
| CD19+ (day 28) |
| |||||
| CD45RO+ (day 15) |
| |||||
| CD45RO+ (day 28) |
| |||||
| CD56+ (day 15) |
| |||||
| CD56+ (day 28) |
| |||||
| CD4+ICOS+ (day 15) |
| |||||
| CD4+ICOS+ (day 28) |
| |||||
| CD4+CD45RO+ (day 15) |
| |||||
| CD4+CD45RO+ (day 28) |
| |||||
| CD4+FOXP3+ (day 15) |
| |||||
| CD4+FOXP3+ (day 28) |
| |||||
| CD8+ICOS+ (day 15) |
| |||||
| CD8+ICOS+ (day 28) |
| |||||
| CD3-CD56+ (day 15) |
| |||||
| CD3-CD56+ (day 28) |
|
| Title | Denominators | Categories | ||||
|---|---|---|---|---|---|---|
| IFN (day 15) |
| |||||
| IFN (day 28) |
| |||||
| IL-2 (day 15) |
| |||||
| IL-2 (day 28) |
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| Title | Denominators | Categories | ||||
|---|---|---|---|---|---|---|
| Day 15 |
| |||||
| Day 28 |
|
|
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