A Phase I/II Study of Ganetespib in Combination With Doxorubicin

Phase 1

Terminated

Brief Summary: This is a Phase I/safety dose expansion study of the combination of the drug ganetespib and doxorubicin in patients with advanced solid tumors. The purpose of the Phase I part of the study is to determine the recommended phase II dose of ganetespib when given in combination with doxorubicin. The recommended Phase II dose determined at the end of the dose escalation phase will be used to conduct a safety dose expansion phase in relapsed/refractory small cell lung cancer to determine if there is a signal of efficacy in this population.

Detailed Description: The dose escalation phase of the study will follow a standard 3+ 3 dose escalation scheme with two dose levels of ganetespib (1-- mg/m2 and 150 mg/m2) administered weekly on Days 1 and 8 of a 21-day cycle, in combination with a fixed dose of doxorubicin at 50 mg/m2 administered on Day 1 alone. After 4-6 cycles of combination therapy, continuation of single agent ganetespib will be permitted for subjects who are deriving clinical benefit.

Pharmacokinetic samples for plasma drug levels of ganetespib will be collected pre-dose and 4 hours after completion of treatment on Day 1 and Day 8 of cycle 1 only in subjects in the dose escalation phase.

The recommended Phase II dose determined at the end of the dose escalation phase will be used to conduct a safety dose expansion phase in relapsed/ refractory small cell lung cancer to determine if there is a signal of efficacy in this population.

Recruitment & Eligibility

Inclusion Criteria

Dose escalation phase: histologically confirmed malignancy that is metastatic or unresectable and for which standard curative or palliative measures do not exist or are no longer effective. OR safety dose expansion phase: histologically or cytologically confirmed relapsed or refractory small cell lung cancer
No more than 3 prior lines of chemotherapy; prior therapy with doxorubicin is permitted but no more than lifetime cumulative dose of 150 mg/m2; at least 3 weeks since prior chemotherapy or radiotherapy; at least 6 weeks if the last regimen included BCNU (1,3-bis(2-chloroethyl)-1-nitrosourea bis-chloronitrosourea) or mitomycin C
Age >/= 18 years
ECOG (Eastern Cooperative Oncology Group) performance status 0-1
Life expectancy of greater than 3 months
Adequate organ and marrow function
Women of child-bearing potential must agree to avoid becoming pregnant and men must agree not to father a child for the duration of study participation.
Ability to understand and willingness to sign a written informed consent document

Exclusion Criteria

Chemotherapy or radiotherapy within 3 weeks (6 weeks for nitrosureas or mitomycin C) prior to entering the study or those who have not recovered from adverse events due to agents administered more than 3 weeks earlier.
Receiving any other investigational agents
Untreated symptomatic brain metastases
History of allergic reactions attributed to compounds of similar chemical or biologic composition to ganetespib or other agents used in the study
Receiving any medications or substances that are strong inhibitors or inducers of CYP3A4 or CYP2C18
Left ventricular ejection fraction < 50%
Known serious cardiac illness or medical conditions
uncontrolled inter-current illness including, but not limited to, ongoing or active infection, unstable angina pectoris, or psychiatric illness/social situations that would limit compliance with study requirements.
Pregnant women
HIV-positive on combination antiretroviral therapy

Arm && Interventions

Group	Intervention	Description
Ganetespib and doxorubicin - Phase Ib Dose Level 1	Ganetespib	Ganetespib 100 mg/m2 IV on days 1 and 8 of a 21-day cycle Doxorubicin 50 mg/m2 IV on day 1 of a 21-day cycle
Ganetespib and doxorubicin - Phase Ib Dose Level 2	Ganetespib	Ganetespib 150 mg/m2 IV on days 1 and 8 of a 21-day cycle Doxorubicin 50 mg/m2 IV on day 1 of a 21-day cycle
Ganetespib and doxorubicin - Phase Ib Dose Level 1	Doxorubicin	Ganetespib 100 mg/m2 IV on days 1 and 8 of a 21-day cycle Doxorubicin 50 mg/m2 IV on day 1 of a 21-day cycle
Ganetespib and doxorubicin - Phase Ib Dose Level 2	Doxorubicin	Ganetespib 150 mg/m2 IV on days 1 and 8 of a 21-day cycle Doxorubicin 50 mg/m2 IV on day 1 of a 21-day cycle
Ganetespib and doxorubicin - Phase II Expansion	Doxorubicin	Ganetespib 150 mg/m2 IV on days 1 and 8 of a 21-day cycle Doxorubicin 50 mg/m2 IV on day 1 of a 21-day cycle
Ganetespib and doxorubicin - Phase II Expansion	Ganetespib	Ganetespib 150 mg/m2 IV on days 1 and 8 of a 21-day cycle Doxorubicin 50 mg/m2 IV on day 1 of a 21-day cycle

Primary Outcome Measures

Name	Time	Method
Maximum Tolerated Dose	1 year	The dose of ganetespib at which 1 or more out of 3-6 patients experiences a dose-limiting toxicity

Secondary Outcome Measures

Name	Time	Method
Objective Response Rate	2 years	Objective response rate included the count of confirmed complete responses (CR) and partial responses (PR) and was based on Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1.