Cohort Study of Increasing Doses of Yttrium-90 Conjugated to Chimeric Monoclonal Antibody cG250 (^90Y-DOTA-cG250) in Patients With Advanced Renal Cancer
试验速览
- 阶段
- 1 期
- 状态
- 已完成
- 入组人数
- 18
- 试验地点
- 1
- 主要终点
- Number of Patients With Treatment-emergent Adverse Events
研究概览
简要总结
This was a Phase 1, open-label, dose-escalation study of yttrium-90 conjugated chimeric G250 (^90Y-DOTA-cG250) in patients with advanced, measurable clear cell renal cell carcinoma (RCC). Study objectives were to determine the safety, targeting, and dosimetry of ^90Y-DOTA-cG250, using indium-111 conjugated chimeric G250 (^111In-DOTA-cG250) as a surrogate, as well as to evaluate the immunogenicity of cG250.
详细描述
Patients were enrolled sequentially into cohorts of 3 to 6 patients until determination of the maximum tolerated dose (MTD) of ^90Y-DOTA-cG250, defined as the dose level below the dose at which ≥ 2 patients experienced dose-limiting toxicity (DLT). In an attempt to mitigate liver uptake and toxicity, patients initially received a nontherapeutic injection with ^111In-DOTA-cG250 at an imaging dose of 5 mCi of ^111In + 10 mg of cG250 on Day 1. Whole body and blood measurements of radioactivity were obtained on at least 3 occasions for 1 week to determine targeting and dosimetry. Provided that protocol-specified criteria were met, including targeting to lesions > 2 cm detected on computed tomography (CT) scan, a single dose of therapeutic ^90Y-DOTA-cG250 was administered on Day 8, 9, or 10. The starting dose of ^90Y-DOTA-cG250 was 0.2 mCi/kg of ^90Y + 10 mg of cG250 administered as an intravenous (IV) infusion, with escalation of the ^90Y dose in subsequent cohorts in 0.05 to 0.1 mCi/kg increments.
Patients were treated in an outpatient setting and were observed for at least 2 hours following each infusion, at which point vital signs and blood samples were obtained. Patients were followed for 6 to 8 weeks post-treatment (or after recovery from toxicity) with imaging, biochemical, serological, and hematologic tests to determine the safety of ^90Y-DOTA-cG250 and to inform dose-escalation decisions. Extent of disease evaluations, preferably by positron emission tomography (PET)/CT or standard CT, were performed at baseline and 6 to 8 weeks post-treatment (or after recovery from toxicity). Long-term follow-up was performed, when possible, every 12 weeks thereafter for up to 2 years.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Sequential
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •All patients must have had histologically proven clear cell renal carcinoma.
- •Age ≥ 18 years. Children were not enrolled because clear cell renal cancer is rarely seen in children.
- •All patients must have had a clinical presentation consistent with metastatic renal carcinoma.
- •Patients must have had bidimensionally measurable disease by conventional imaging methods including radiography, ultrasound, CT, or other anatomic imaging modalities. Lesions seen on skeletal scintigraphy alone were not considered measurable.
- •Female patients of childbearing age were required to have a negative pregnancy test carried out the day of and prior to receiving therapy, and were asked to use effective contraception during the study.
- •All patients must have been ambulatory with a Karnofsky Performance Status of at least
- •The following laboratory results within the last 2 weeks prior to study Day 1:
- •serum creatinine ≤ 2.0 mg/dL
- •serum bilirubin (total) ≤ 2.0 mg/dL
- •aspartate aminotransferase (AST) ≤ 2.5 × the upper limit of normal (ULN)
- •alanine aminotransferase (ALT) ≤ 2.5 × ULN
- •white blood cell (WBC) count ≥ 3500/mm^3
- •platelet count ≥ 100,000/mm^3
- •prothrombin time ≤ 1.3 × control
- •Able and willing to give valid written informed consent.
排除标准
- •Significant prior radiotherapy (> 30 Gy) to the entire pelvis and/or lumbosacral spine.
- •Clinically significant cardiac disease (New York Heart Association Class [III/IV]).
- •Serious infection requiring treatment with antibiotics, or other serious illness.
- •Chemotherapy, radiation therapy, or immunotherapy within 4 weeks prior to study agent administration.
- •Survival expectancy of less than 12 weeks.
- •Patients with central nervous system (CNS) involvement were excluded under the following criteria:
- •Brain metastasis, except for stable disease over 3 months.
- •Untreated brain metastasis.
- •Evidence of progression of neurologic CNS involvement within 3 months prior to entering the protocol.
- •Hypercalcemia > 12.5 mg/100 mL or symptomatic.
- •Mental impairment that may have compromised the ability to give informed consent and comply with the requirements of the study.
- •Lack of availability of the patient for clinical and laboratory follow-up assessment.
- •Patients known to have hepatobiliary disease and/or human immunodeficiency virus/acquired immune deficiency syndrome.
- •Participation in any other clinical trial involving another investigational agent within 4 weeks prior to enrollment.
- •Pregnancy or breastfeeding.
- •Refusal or inability to use effective means of contraception in men or women of childbearing potential.
研究组 & 干预措施
Cohort 1 (0.2 mCi/kg)
Patients initially received a nontherapeutic injection of ^111In-DOTA-cG250 (5 mCi ^111In + 10 mg cG250) on Day 1. Pending satisfaction of protocol-specified lesion targeting criteria, a single dose of therapeutic ^90Y-DOTA-cG250 (0.2 mCi/kg ^90Y + 10 mg cG250) was administered on Day 8, 9, or 10 as a continuous IV infusion over approximately 5 to 15 minutes.
干预措施: Yttrium-90 conjugated chimeric G250 (^90Y-DOTA-cG250) (Drug)
Cohort 2 (0.3 mCi/kg)
Patients initially received a nontherapeutic injection of ^111In-DOTA-cG250 (5 mCi ^111In + 10 mg cG250) on Day 1. Pending satisfaction of protocol-specified lesion targeting criteria, a single dose of therapeutic ^90Y-DOTA-cG250 (0.3 mCi/kg ^90Y + 10 mg cG250) was administered on Day 8, 9, or 10 as a continuous IV infusion over approximately 5 to 15 minutes.
干预措施: Yttrium-90 conjugated chimeric G250 (^90Y-DOTA-cG250) (Drug)
Cohort 3 (0.4 mCi/kg)
Patients initially received a nontherapeutic injection of ^111In-DOTA-cG250 (5 mCi ^111In + 10 mg cG250) on Day 1. Pending satisfaction of protocol-specified lesion targeting criteria, a single dose of therapeutic ^90Y-DOTA-cG250 (0.4 mCi/kg ^90Y + 10 mg cG250) was administered on Day 8, 9, or 10 as a continuous IV infusion over approximately 5 to 15 minutes.
干预措施: Yttrium-90 conjugated chimeric G250 (^90Y-DOTA-cG250) (Drug)
Cohort 4 (0.45 mCi/kg)
Patients initially received a nontherapeutic injection of ^111In-DOTA-cG250 (5 mCi ^111In + 10 mg cG250) on Day 1. Pending satisfaction of protocol-specified lesion targeting criteria, a single dose of therapeutic ^90Y-DOTA-cG250 (0.45 mCi/kg ^90Y + 10 mg cG250) was administered on Day 8, 9, or 10 as a continuous IV infusion over approximately 5 to 15 minutes.
干预措施: Yttrium-90 conjugated chimeric G250 (^90Y-DOTA-cG250) (Drug)
Cohort 5 (0.55 mCi/kg)
Patients initially received a nontherapeutic injection of ^111In-DOTA-cG250 (5 mCi ^111In + 10 mg cG250) on Day 1. Pending satisfaction of protocol-specified lesion targeting criteria, a single dose of therapeutic ^90Y-DOTA-cG250 (0.55 mCi/kg ^90Y + 10 mg cG250) was administered on Day 8, 9, or 10 as a continuous IV infusion over approximately 5 to 15 minutes.
干预措施: Yttrium-90 conjugated chimeric G250 (^90Y-DOTA-cG250) (Drug)
结局指标
主要结局
Number of Patients With Treatment-emergent Adverse Events
时间窗: Continuously for up to 5 months
Toxicity was graded in accordance with the National Cancer Institute (NCI) Common Toxicity Criteria (CTC), version 3.0. Treatment-emergent adverse events (TEAEs) were reported based on clinical laboratory tests, physical examinations, and vital signs from pre-treatment through the study period. Dose-limiting toxicity (DLT) was defined as follows for the purposes of dose escalation: Grade 4 hematopoietic toxicity in excess of 5 days or Grade 3 or greater nonhematopoietic toxicity.
次要结局
- Number of Patients Who Met Protocol-Specified Criteria to Receive ^90-Y-DOTA-cG250 Following ^111In-DOTA-cG250 Administration(Up to 5 months)
- Number of Patients With Samples Collected for Evaluation of Human Antichimeric Antibody(Up to 6 months)
