A Phase 1 Study Of Ramucirumab, a Human Monoclonal Antibody Against the Vascular Endothelial Growth Factor-2 (VEGFR-2) Receptor in Children With Refractory Solid Tumors, Including CNS Tumors
Overview
- Phase
- Phase 1
- Intervention
- Ramucirumab
- Conditions
- Pediatric Solid Tumor
- Sponsor
- Eli Lilly and Company
- Enrollment
- 29
- Locations
- 21
- Primary Endpoint
- Number of Participants With Anti-Ramucirumab Antibodies
- Status
- Completed
- Last Updated
- 4 years ago
Overview
Brief Summary
The main purpose of this study is to evaluate the safety of the study drug known as ramucirumab in children with recurrent or refractory solid tumors including central nervous system (CNS) tumors.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Part A: participants with recurrent or refractory non-CNS solid tumors
- •Part B: participants with recurrent or refractory CNS tumors
- •Measurable or evaluable disease
- •No other therapeutic options
- •Performance Status: Karnofsky ≥50% for participants \>16 years and Lansky ≥50 for participants ≤16 years
Exclusion Criteria
- •Active or recent history of serious bleeding events
- •Active or recent history of gastrointestinal perforations, ulcers, fistulas or abscesses
- •Active or recent history of hypertensive crisis or hypertensive encephalopathy
- •Active non-healing wound or bone fracture
- •History of solid organ transplant
Arms & Interventions
Ramucirumab
(Part A-Non-CNS Solid Tumors) Escalating doses of 8 milligrams per kilogram (mg/kg) or 12 mg/kg Ramucirumab administered as an intravenous infusion every 2 weeks (Q2W) with 3 doses per 42 day cycle. (Part B-CNS Tumors) Participants received 12 mg/kg Ramucirumab as an intravenous injection Q2W with 3 doses per cycle.
Intervention: Ramucirumab
Outcomes
Primary Outcomes
Number of Participants With Anti-Ramucirumab Antibodies
Time Frame: Predose Cycle 1 Day 1 through Follow-Up (Up to 42 Months)
Number of participants with positive treatment emergent anti-ramucirumab antibodies was summarized by treatment group. A treatment-emergent anti-drug antibodies (TEADA) sample was defined as: a post treatment sample with at least a 4-fold increase in titer from pre treatment sample; or 1:20 post treatment titer for participants that had no detectable ADA titer at baseline.
Part A: Number of Participants With Dose Limiting Toxicities (DLTs): Maximum Tolerated Dose of Ramucirumab
Time Frame: Baseline to Study Completion (Up to 42 Months)
A DLT is defined as an Adverse Event (AE) that is likely related to the study medication or combination, and fulfills any one of the following criteria, graded according to the National Cancer Institute's (NCI) Common Terminology Criteria for Adverse Events (NCI-CTCAE) Version 5.0: 1. Any death not clearly due to the underlying disease or extraneous causes 2. Neutropenic fever 2. Any Grade ≥3 non-hematologic toxicity 3. Grade ≥4 neutropenia or thrombocytopenia \>7 days 4. Grade ≥3 thrombocytopenia with bleeding 5. Grade ≥3 nausea/vomiting or diarrhea\>72 hours with adequate antiemetic and other supportive care 6. Grade ≥3 fatigue ≥1 week 7. Grade ≥3 electrolyte abnormality that lasts\>72 hours, unless the Participant has clinical symptoms, in which case all Grade 3+electrolyte abnormality regardless of duration should count as a DLT. 8. Grade ≥3 prolongation of QT interval corrected using the Fridericia formula on 2 separate electrocardiogram readings approximately 5 min apart.
Population Pharmacokinetics (PK): Minimum Concentration (Cmin) of Ramucirumab
Time Frame: Predose, Cycle 1 Day 1 (end of infusion (EOI), 1 hour after EOI) and Cycle 1 Day 43 (1 hour after EOI)
Population Pharmacokinetics (PK): Minimum observed plasma concentration of Ramucirumab.
Secondary Outcomes
- Percentage of Participants With a Best Overall Response of Complete Response (CR), Partial Response (PR) or Stable Disease (SD): Disease Control Rate (DCR)(Baseline to Date of Objective Disease Progression (Up to 42 Months))
- Overall Survival(Baseline to Date of Death from Any Cause (Up to 42 Months))
- Overall Response Rate (ORR): Percentage of Participants Who Achieve Complete Response (CR) or Partial Response (PR)(Baseline to Date of Objective Disease Progression (Up to 42 Months))
- Duration of Response (DOR)(Date of Complete Response (CR) or Partial Response (PR) to Date of Objective Disease Progression or Death Due to Any Cause (Up to 42 Months))