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The purpose of this study is to evaluate the safety, tolerability, preliminary efficacy, and PK/PD of SCB-313 (recombinant human TRAIL-Trimer fusion protein) administered once via intrapleural injection (SAD) and once daily over 2 to 3 days (MAD)for the treatment of cancer patients with symptomatic malignant pleural effusions requiring drainage.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| SCB-313 | Experimental | Cohorts in SAD phase: 5 mg, 10mg, 20mg, 40mg, 80 mg. Cohort in MAD phase: biological effective dose determined from SAD phase. 1 intrapleural injection of SCB-313 on Day 1 for the SAD cohorts, and 3 intrapleural injections of SCB-313 on Days 1, 2 and 3 for the MAD cohort. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| SCB-313 | Drug | 5 mg or 20 mg lyophilized powder in a single-use glass vial |
|
| Measure | Description | Time Frame |
|---|---|---|
| Occurrence of DLT | Occurrence of dose limiting toxicity (DLT) | Up to 21 days after start of treatment |
| Measure | Description | Time Frame |
|---|---|---|
| SAEs or TEAEs | Occurrence of serious adverse events (SAEs) and/or treatment-emergent adverse events (TEAEs) regardless of causality or relationship to SCB-313, graded using National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) v4.03 | Up to 21 days after start of treatment |
| Immunogenicity |
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Inclusion Criteria:
Histologically or cytologically confirmed cancer of any primary tumor type.
Malignant pleural effusion causing respiratory symptoms requiring drainage that is histologically or cytologically confirmed; or pleural effusion with radiologically proven pleural malignancy as diagnosed in normal clinical practice on thoracic computed tomography in the absence of histocytological or cytological proof.
Eastern Cooperative Oncology Group (ECOG) performance status: 0 to 2. Patients with an ECOG performance status of 3 may be included if the Investigator determines that removal of pleural fluid would improve their performance status to 2 or better.
Life expectancy of at least 8 weeks.
Age ≥18 years.
Adequate hematologic function, defined as:
Adequate renal function, defined as creatinine clearance >40 mL/minute.
Adequate liver function, defined as:
Female patients of childbearing potential (excluding women who have undergone surgical sterilization or are menopausal, defined as no menstrual periods for 1 year or more without any other medical reasons) are eligible if they have negative serum pregnancy test result 7 days before the first dose of SCB-313 and are willing to use an effective method of birth control/contraception to prevent pregnancy until 6 months after discontinuation of SCB-313.
Both men and women of reproductive potential must agree to use effective contraception during the study and for 6 months after discontinuation of SCB-313.
Note: Contraceptive methods that are considered highly effective areas follows: total abstinence, intrauterine device, double barrier method (such as condom plus diaphragm with spermicide), contraceptive implant, hormonal contraceptives (contraceptive pills, implants, transdermal patches, hormonal vaginal devices, or injections with prolonged release), or vasectomized partner with confirmed azoospermia.
Willing to attend follow-up visits on Days 10, and 21 after the first study drug administration.
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Liverpool Hospital | Liverpool | New South Wales | 2170 | Australia | ||
| Orange Health Service |
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| ID | Term |
|---|---|
| D016066 | Pleural Effusion, Malignant |
| ID | Term |
|---|---|
| D010997 | Pleural Neoplasms |
| D012142 | Respiratory Tract Neoplasms |
| D013899 | Thoracic Neoplasms |
| D009371 | Neoplasms by Site |
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Occurrence of binding and neutralizing anti-SCB-313 antibodies |
| Up to 21 days after start of treatment |
| Pleural effusion response rate at Day 21 | Based on chest radiographs at Day 21, compared to Baseline. | At Day 21 after start of treatment |
| Pleural effusion drainage-free rate at Day 21 | Defined as the probability of being effusion-drainage free at Day 21 | At Day 21 after start of treatment |
| The changes in effusion volume and flow rate after SCB-313 treatment , and at next drainage over the baseline daily effusion flow rate. |
| Up to 6 months after start of treatment |
| Blood oxygen levels | To compare blood oxygen levels during the study | Up to 21 days after start of treatment |
| Overall survival | The time from the first dose of SCB-313 until death from any cause. | Up to 6 months after start of treatment |
| Pharmacokinetics (Cmax) | Maximum SCB-313 concentration | Up to 4 days after start of treatment |
| Pharmacokinetics(Cmax/D) | Dose-normalized Cmax of SCB-313 | Up to 4 days after start of treatment |
| Pharmacokinetics(Tmax) | Time to Cmax of SCB-313 | Up to 4 days after start of treatment |
| Pharmacokinetics ([AUC]0-24) | Area under SCB-313 concentration time curve from zero to 24 hours after dosing | Up to 4 days after start of treatment |
| Pharmacokinetics (AUC0-24/D) | Dose-normalized AUC0-24 | Up to 4 days after start of treatment |
| Pharmacokinetics ((AUC0-last)) | Area under the SCB-313 concentration-time curve from time zero to the last quantifiable concentration time point | Up to 4 days after start of treatment |
| Pharmacokinetics (Ctrough) | Trough concentration (Ctrough) at each predose time point and at 24 hours after the last dose | Up to 4 days after start of treatment |
| Amount of drug in pleural effusion | Amount of SCB-313 in pleural effusion at 24 hours after each dose | Up to 4 days after start of treatment |
| Pharmacokinetics (AUC 0-inf) | Area under the curve from time zero extrapolated to infinity | Up to 4 days after start of treatment |
| Pharmacokinetics (AUC0-inf/D) | Dose-normalized AUC0-inf | Up to 4 days after start of treatment |
| Pharmacokinetics (t1/2) | Terminal half-life | Up to 4 days after start of treatment |
| Pharmacokinetics (CL/F serum only) | Apparent systemic clearance after intrapleural dosing | Up to 4 days after start of treatment |
| Pharmacokinetics (Vz/F serum only) | Apparent volume of distribution after intrapleural dosing | Up to 4 days after start of treatment |
| Pharmacokinetics (λz) | Terminal rate constant | Up to 4 days after start of treatment |
| Tumor response | Tumor response in patients with measurable disease using RECIST v1.1 as applicable. | Up to 6 months after start of treatment |
| Carcinoembryonic antigen (CEA) | Changes in serum tumor markers | Up to 21 days after start of treatment |
| CA-125 | Changes in serum tumor markers | Up to 21 days after start of treatment |
| CA-19-9 | Changes in serum tumor markers | Up to 21 days after start of treatment |
| Changes in 24-hour urine volume | Measured urine volume at baseline and postdose | Up to 4 days after start of treatment |
| Changes in GFR | The changes in glomerular filtration rate | Up to 4 days after start of treatment |
| Changes in tumor cell count in pleural effusion samples | The changes in tumor cell count | Up to 4 days after start of treatment |
| Caspase-cleaved CK18 | Changes in serum PD biomarker | Up to 10 days after start of treatment |
| KRAS mutation | Predictive biomarker analysis (assessed using archival tumor specimens ) | Baseline |
| MMR defects | Predictive biomarker analysis (assessed using archival tumor specimens ) | Baseline |
| Bcl2 overexpression | Predictive biomarker analysis (assessed using archival tumor specimens ) | Baseline |
| TRAIL resistance | Predictive biomarker analysis (assessed using pleural effusion samples) | Baseline |
| Orange |
| New South Wales |
| 2800 |
| Australia |
| The Royal Melbourne Hospital | Parkville | Victoria | 3050 | Australia |
| SCGH (Sir Charles Gairdner Hospital) | Nedlands | Western Australia | 6009 | Australia |
| D009369 |
| Neoplasms |
| D010996 | Pleural Effusion |
| D010995 | Pleural Diseases |
| D012140 | Respiratory Tract Diseases |