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Dose Escalation Study With 99mTC - or 186 Re-labelled Humanised Monoclonal Antibody (hMAb) BIWA 4 in Patients With Head and Neck Cancer

Phase 1
Completed
Conditions
Head and Neck Neoplasms
Interventions
Drug: 99mTc - labelled hMAb BIWA 4
Drug: 186 Re - labelled hMAb BIWA 4
Drug: unlabelled hMAb BIWA 4 - high dose
Drug: unlabelled hMAb BIWA 4 - low dose
Drug: unlabelled hMAb BIWA 4 - medium dose
Registration Number
NCT02204033
Lead Sponsor
Boehringer Ingelheim
Brief Summary

The general aim of the present study was to assess the safety and tolerability of intravenously administered Technetium 99m (99mTc) and Rhenium-186 radionuclide (186 Re) -labelled hMAb BIWA 4, to confirm preferential accumulation in the tumour of 99mTc - labelled hMAb BIWA 4, to determine the maximum tolerated radiation dose of 186 Re-labelled hMAb BIWA 4 and to propose a safety dose for phase II development.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
33
Inclusion Criteria
  • Patients with histological confirmation of squamous cell carcinoma in the head and neck
  • Patients destined for surgery by means of neck dissection (Part A) or :
  • Patients with either local and/or regional recurrent disease for which curative treatment options were not available or distant metastases. The tumor deposits had to be measurable either clinically or by one or more radiological technique (s) (CT, MRI, bone scintigraphy). Because RIT was expected to be more effective in smaller size tumor deposits, patients with lesions measuring > 3 cm in greatest dimension were preferred (Part B)
  • Patients over 18 years of age
  • Patients younger than 80 years of age
  • Patients who had given 'written informed consent'
  • Patients with a life expectancy of at least 3 months
  • Patients with a good performance status: Karnofsky > 60
Exclusion Criteria
  • Life-threatening infection, allergic diathesis, organ failure (bilirubin > 30µmol/l and/or creatinine > 150 µmol/l) or evidence of a recent myocardial infarction on ECG or unstable angina pectoris

  • Pre-menopausal women (last menstruation <= 1 year prior to study start)

    • Not surgically sterile (hysterectomy, tubal ligation) and
    • Not practicing acceptable means of birth control, (nor not planned to be continued throughout the study). Acceptable methods of birth control include oral, implantable or injectable contraceptives
  • Women with a positive serum pregnancy test at baseline

  • Chemotherapy or radiotherapy within 4 weeks before inclusion in the study

  • White blood cell count < 3000/mm³, granulocyte count < 1500/mm³ or platelet count < 100000/mm³

  • Hematological disorders, congestive heart failure, bronchial asthma, alimentary or contact allergy, severe atopy or allergy

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
99mTc - labelled hMAb BIWA 4 - high dose99mTc - labelled hMAb BIWA 4-
99mTc - labelled hMAb BIWA 4 - high doseunlabelled hMAb BIWA 4 - high dose-
186 Re - labelled hMAb BIWA 4 - escalating dose186 Re - labelled hMAb BIWA 4-
99mTc - labelled hMAb BIWA 4 - medium dose99mTc - labelled hMAb BIWA 4-
99mTc - labelled hMAb BIWA 4 - low dose99mTc - labelled hMAb BIWA 4-
99mTc - labelled hMAb BIWA 4 - low doseunlabelled hMAb BIWA 4 - low dose-
99mTc - labelled hMAb BIWA 4 - medium doseunlabelled hMAb BIWA 4 - medium dose-
Primary Outcome Measures
NameTimeMethod
Presence of human-anti-human-antibody (HAHA)after 144 hours post infusion
Immunoscintigraphic imaging evaluation (Parts A + B)up to 21 hours after infusion
CL (Total body clearance)up to 336 hours after infusion
Number of patients with abnormal changes in laboratory parametersup to 6 weeks after infusion
Biodistribution of 99mTC-labelled hMAb BIWA 4 in tumour and normal tissue samples - Biopsy (Part A)at 48 h after infusion

uptake expressed as percentage of the injected dose per kg tissue (%ID/kg)

Cmax (Maximum measured concentration of the analyte in plasma)up to 336 hours after infusion
Vz (Apparent volume of distribution during the terminal phase)up to 336 hours after infusion
Cumulative urinary excretion of radioactivity over timeup to 96 hours after infusion
AUC0-∞ (Area under the concentration-time curve of the analyte in plasma over the time interval from 0 extrapolated to infinity)up to 336 hours after infusion
Number of patients with adverse eventsup to 10 weeks
Number of patients with clinically significant changes in vital signsup to 6 weeks after infusion
t½ (Terminal half-life of the analyte in plasma)up to 336 hours after infusion
Vss (Apparent volume of distribution under steady-state conditions)up to 336 hours after infusion
Actual organ uptake of 99mTC-labelled hMAb BIWA 4at 21 h after infusion

expressed as % I.D. (injected dose)

Occurence of dose limiting toxicities (DLT)up to 144 hours post infusion
tmax (Time from dosing to the maximum concentration of the analyte in plasma)up to 336 hours after infusion
MRT (Mean residence time)up to 336 hours after infusion
Uptake of 99mTC-labelled hMAb BIWA 4 in tumour and normal tissue samples (Part A)up to 6 weeks after infusion

Assessment of biodistribution by radioimmunoscintigraphy expressed as low, medium or high

Secondary Outcome Measures
NameTimeMethod
Tumour response according to response criteria of the World Health Organisation (WHO)up to 144 hours after infusion

assessed by Computer Tomography (CT) and/or by Magnet resonance imaging (MRI) and/or bone scintigraphy and/or by physical examination

Maximum tolerated radiation dose of 186Re-labelled hMAb BIWA 4up to 144 hours after infusion
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