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出境医 / 临床实验 / A Safety Study of the Pan-immunotherapy in Patients With Unresectable/Metastatic Solid Tumors or Lymphomas

A Safety Study of the Pan-immunotherapy in Patients With Unresectable/Metastatic Solid Tumors or Lymphomas

Study Description
Brief Summary:
Identification of T cell inhibitory signals, including PD-1/PD-L1, has prompted the development of a new class of cancer immunotherapy that could restore an adequate immunosurveillance against the neoplasm and enhance T-cell-mediated anticancer immune responses. However, elimination of cancer by T cells is only one step in the Cancer-Immunity Cycle, which enable providing several therapeutic targets and tailoring of combinations of immune therapies. Manganese has been confirmed to activate antigen-presenting cells and function as mucosal immunoadjuvants in pre-clinical studies. This study is a first-in-man, Phase I, 3 + 3 dose escalation study of a combined regimen of Manganese and anti-PD-1 antibody with or without chemotherapies in subjects with unresectable/ metastatic solid tumors or lymphomas. This study is designed to assess the safety, tolerability, pharmacokinetic profile (PK profile), mode of delivery and Recommended Phase 2 Dose (RP2D) of this regimen.

Condition or disease Intervention/treatment Phase
Solid Tumor Lymphoma Drug: Manganese Chloride Drug: Anti-PD-1 antibody Combination Product: Systemic therapy Phase 1

Study Design
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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 20 participants
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase I, Two-arm, Open-label, Single-center, Dose-escalation Study to Evaluate the Safety, Tolerability and Recommended Dose and Delivery Mode of the Pan-immunotherapy in Subjects With Unresectable/ Metastatic Solid Tumors or Lymphomas
Actual Study Start Date : November 1, 2018
Estimated Primary Completion Date : December 31, 2019
Estimated Study Completion Date : May 31, 2020
Arms and Interventions
Arm Intervention/treatment
Active Comparator: Dose-Escalation, intranasally
With a standard 3+3 dose escalation design, the enrollment will proceed until the maximum tolerated dose (MTD) has been defined or the highest dose level has been reached.
Drug: Manganese Chloride
Administered intranasally in Arm 1 (0.05, 0.1 or 0.2 mg/kg/d) and by inhalation in Arm 2 (0.1, 0.2 or 0.4mg/kg/d) once daily in a 3-week cycle

Drug: Anti-PD-1 antibody
Administered intravenously, at 2-4mg/kg on day 3 in a 3-week cycle
Other Names:
  • Anti-PD-1 monoclonal antibody
  • PD-1 inhibitor

Combination Product: Systemic therapy
Whether and which should be given depends on the treatment regimen before enrollment.

Active Comparator: Dose-Escalation, inhalation
With a standard 3+3 dose escalation design, the enrollment will proceed until the MTD has been defined or the highest dose level has been reached.
Drug: Manganese Chloride
Administered intranasally in Arm 1 (0.05, 0.1 or 0.2 mg/kg/d) and by inhalation in Arm 2 (0.1, 0.2 or 0.4mg/kg/d) once daily in a 3-week cycle

Drug: Anti-PD-1 antibody
Administered intravenously, at 2-4mg/kg on day 3 in a 3-week cycle
Other Names:
  • Anti-PD-1 monoclonal antibody
  • PD-1 inhibitor

Combination Product: Systemic therapy
Whether and which should be given depends on the treatment regimen before enrollment.

Outcome Measures
Primary Outcome Measures :
  1. Number of Subjects with treatment-related adverse events (AEs) [ Time Frame: Approximately 6 months ]
    Incidence, nature, and severity of adverse events graded according to the NCI CTCAE v5.0. AEs were considered to be treatment-related if they had started or worsened within the interval from first study drug administration until the follow-up visit.

  2. Number of subjects with specific Manganese-related adverse events [ Time Frame: Approximately 6 months ]
    Manganese-related AEs were considered to be that start or worsen after administration Manganese administration,improve after withdrawal, and even occur again after re-administration.


Secondary Outcome Measures :
  1. Preliminary efficacy evaluation [ Time Frame: Approximately 6 months ]
    Objective response rate (ORR) and disease control rate (DCR) will be evaluated by investigators per the RECIST V1.1.

  2. The q3w pharmacokinetic profile of Manganese [ Time Frame: Approximately 3 months ]
    PK parameters such as Maximum concentration (Cmax) are assessed.

  3. Number of participants with laboratory test abnormalities [ Time Frame: Approximately 3 months ]
    The laboratory tests of serum cytokines and chemokines will be performed on day 1 and 3 of each cycle, and the abnormality will be determined by the investigator.


Eligibility Criteria
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Ages Eligible for Study:   18 Years to 80 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Subjects must have histologically proven unresectable/ metastatic solid tumors or lymphomas.
  2. ≥ 18 years old.
  3. Life expectancy of at least 6 months.
  4. Eastern Cooperative Oncology Group performance status 0-2.
  5. Subjects must have at least one measurable lesion ≥ 1 cm as defined by response criteria.
  6. Subjects must have received at least two frontline therapies, except for patients initially diagnosed with local advanced or metastatic pancreatic cancer or cholangiocarcinoma.
  7. Subjects must be off prior therapy for at least 4 weeks prior to Day 1. Subjects with autologous hematopoietic stem-cell transplantation are eligible which must be more than 3 months. Subjects with Anti-PD-1 antibody are eligible which must be resistance.
  8. Adequate organ function.
  9. Participants of childbearing potential must be willing to use an adequate method of contraception for the course of the study through 120 days after the last dose of study drug.

Exclusion Criteria:

  1. Subjects with any autoimmune disease or history of syndrome that requires corticosteroids or immunosuppressive medications.
  2. Serious uncontrolled medical disorders or active infections, pulmonary infection especially.
  3. T cell lymphomas or leukemia.
  4. Prior organ allograft.
  5. Women who are pregnant or breastfeeding.
  6. Women with a positive pregnancy test on enrollment or prior to investigational product administration.
  7. Subjects who are compulsorily detained for treatment of either a psychiatric or physical (eg, infectious disease) illness.
Contacts and Locations

Contacts
Layout table for location contacts
Contact: Weidong Han, M.D. +861066937463 hanwdrsw@sina.com

Locations
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China, Beijing
Biotherapeutic Department of Chinese PLA General Hospital Recruiting
Beijing, Beijing, China, 100853
Contact: Weidong Han, M.D    +86-10-66937463    hanwdrsw@sina.com   
Contact: Qingming Yang, M.D    +86-10-55499341    yangqm301@163.com   
Principal Investigator: Weidong Han, M.D         
Principal Investigator: Qian Mei, M.D         
Principal Investigator: Qingming Yang, M.D         
Principal Investigator: Meixia Chen, M.S         
Principal Investigator: Yan Zhang, M.S         
Principal Investigator: Kaichao Feng, M.S         
Sub-Investigator: Yang Liu, M.D.         
Sub-Investigator: Jiejie Liu, B.S         
Sub-Investigator: Xiang Li, B.S         
Sub-Investigator: Liang Dong, B.S         
Sponsors and Collaborators
Chinese PLA General Hospital
Tracking Information
First Submitted Date  ICMJE June 14, 2019
First Posted Date  ICMJE June 19, 2019
Last Update Posted Date August 28, 2019
Actual Study Start Date  ICMJE November 1, 2018
Estimated Primary Completion Date December 31, 2019   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: June 18, 2019)
  • Number of Subjects with treatment-related adverse events (AEs) [ Time Frame: Approximately 6 months ]
    Incidence, nature, and severity of adverse events graded according to the NCI CTCAE v5.0. AEs were considered to be treatment-related if they had started or worsened within the interval from first study drug administration until the follow-up visit.
  • Number of subjects with specific Manganese-related adverse events [ Time Frame: Approximately 6 months ]
    Manganese-related AEs were considered to be that start or worsen after administration Manganese administration,improve after withdrawal, and even occur again after re-administration.
Original Primary Outcome Measures  ICMJE Same as current
Change History
Current Secondary Outcome Measures  ICMJE
 (submitted: June 18, 2019)
  • Preliminary efficacy evaluation [ Time Frame: Approximately 6 months ]
    Objective response rate (ORR) and disease control rate (DCR) will be evaluated by investigators per the RECIST V1.1.
  • The q3w pharmacokinetic profile of Manganese [ Time Frame: Approximately 3 months ]
    PK parameters such as Maximum concentration (Cmax) are assessed.
  • Number of participants with laboratory test abnormalities [ Time Frame: Approximately 3 months ]
    The laboratory tests of serum cytokines and chemokines will be performed on day 1 and 3 of each cycle, and the abnormality will be determined by the investigator.
Original Secondary Outcome Measures  ICMJE Same as current
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE A Safety Study of the Pan-immunotherapy in Patients With Unresectable/Metastatic Solid Tumors or Lymphomas
Official Title  ICMJE A Phase I, Two-arm, Open-label, Single-center, Dose-escalation Study to Evaluate the Safety, Tolerability and Recommended Dose and Delivery Mode of the Pan-immunotherapy in Subjects With Unresectable/ Metastatic Solid Tumors or Lymphomas
Brief Summary Identification of T cell inhibitory signals, including PD-1/PD-L1, has prompted the development of a new class of cancer immunotherapy that could restore an adequate immunosurveillance against the neoplasm and enhance T-cell-mediated anticancer immune responses. However, elimination of cancer by T cells is only one step in the Cancer-Immunity Cycle, which enable providing several therapeutic targets and tailoring of combinations of immune therapies. Manganese has been confirmed to activate antigen-presenting cells and function as mucosal immunoadjuvants in pre-clinical studies. This study is a first-in-man, Phase I, 3 + 3 dose escalation study of a combined regimen of Manganese and anti-PD-1 antibody with or without chemotherapies in subjects with unresectable/ metastatic solid tumors or lymphomas. This study is designed to assess the safety, tolerability, pharmacokinetic profile (PK profile), mode of delivery and Recommended Phase 2 Dose (RP2D) of this regimen.
Detailed Description Not Provided
Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 1
Study Design  ICMJE Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Condition  ICMJE
  • Solid Tumor
  • Lymphoma
Intervention  ICMJE
  • Drug: Manganese Chloride
    Administered intranasally in Arm 1 (0.05, 0.1 or 0.2 mg/kg/d) and by inhalation in Arm 2 (0.1, 0.2 or 0.4mg/kg/d) once daily in a 3-week cycle
  • Drug: Anti-PD-1 antibody
    Administered intravenously, at 2-4mg/kg on day 3 in a 3-week cycle
    Other Names:
    • Anti-PD-1 monoclonal antibody
    • PD-1 inhibitor
  • Combination Product: Systemic therapy
    Whether and which should be given depends on the treatment regimen before enrollment.
Study Arms  ICMJE
  • Active Comparator: Dose-Escalation, intranasally
    With a standard 3+3 dose escalation design, the enrollment will proceed until the maximum tolerated dose (MTD) has been defined or the highest dose level has been reached.
    Interventions:
    • Drug: Manganese Chloride
    • Drug: Anti-PD-1 antibody
    • Combination Product: Systemic therapy
  • Active Comparator: Dose-Escalation, inhalation
    With a standard 3+3 dose escalation design, the enrollment will proceed until the MTD has been defined or the highest dose level has been reached.
    Interventions:
    • Drug: Manganese Chloride
    • Drug: Anti-PD-1 antibody
    • Combination Product: Systemic therapy
Publications * Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Recruiting
Estimated Enrollment  ICMJE
 (submitted: June 18, 2019)
20
Original Estimated Enrollment  ICMJE Same as current
Estimated Study Completion Date  ICMJE May 31, 2020
Estimated Primary Completion Date December 31, 2019   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

  1. Subjects must have histologically proven unresectable/ metastatic solid tumors or lymphomas.
  2. ≥ 18 years old.
  3. Life expectancy of at least 6 months.
  4. Eastern Cooperative Oncology Group performance status 0-2.
  5. Subjects must have at least one measurable lesion ≥ 1 cm as defined by response criteria.
  6. Subjects must have received at least two frontline therapies, except for patients initially diagnosed with local advanced or metastatic pancreatic cancer or cholangiocarcinoma.
  7. Subjects must be off prior therapy for at least 4 weeks prior to Day 1. Subjects with autologous hematopoietic stem-cell transplantation are eligible which must be more than 3 months. Subjects with Anti-PD-1 antibody are eligible which must be resistance.
  8. Adequate organ function.
  9. Participants of childbearing potential must be willing to use an adequate method of contraception for the course of the study through 120 days after the last dose of study drug.

Exclusion Criteria:

  1. Subjects with any autoimmune disease or history of syndrome that requires corticosteroids or immunosuppressive medications.
  2. Serious uncontrolled medical disorders or active infections, pulmonary infection especially.
  3. T cell lymphomas or leukemia.
  4. Prior organ allograft.
  5. Women who are pregnant or breastfeeding.
  6. Women with a positive pregnancy test on enrollment or prior to investigational product administration.
  7. Subjects who are compulsorily detained for treatment of either a psychiatric or physical (eg, infectious disease) illness.
Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 18 Years to 80 Years   (Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE No
Contacts  ICMJE
Contact: Weidong Han, M.D. +861066937463 hanwdrsw@sina.com
Listed Location Countries  ICMJE China
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT03991559
Other Study ID Numbers  ICMJE CHN-PLAGH-BT-039
Has Data Monitoring Committee Yes
U.S. FDA-regulated Product
Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
IPD Sharing Statement  ICMJE Not Provided
Responsible Party Han weidong, Chinese PLA General Hospital
Study Sponsor  ICMJE Chinese PLA General Hospital
Collaborators  ICMJE Not Provided
Investigators  ICMJE Not Provided
PRS Account Chinese PLA General Hospital
Verification Date August 2019

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP

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