CBL0137 in Treating Patients With Advanced Extremity Melanoma or Sarcoma

  • STATUS
    Recruiting
  • End date
    Aug 8, 2024
  • participants needed
    36
  • sponsor
    Roswell Park Cancer Institute
Updated on 9 April 2022

Summary

This phase I trial studies best dose and side effects of CBL0137 in treating patients with extremity melanoma or sarcoma that has spread to other places in the body. Drugs, such as CBL0137, may work by binding to tumor cell deoxyribonucleic acid (DNA) to stop the cell from growing further.

Description

PRIMARY OBJECTIVES:

I. To estimate the maximum tolerated dose (MTD) and examine the dose-limiting toxicities of intra-arterial facilitates chromatin transcription (FACT) complex-targeting curaxin CBL0137 (CBL0137) in patients with advanced extremity melanoma or sarcoma.

SECONDARY OBJECTIVES:

I. To assess the tumor response in advanced melanoma and sarcoma patients treated with intra-arterial administration of CBL0137.

II. To define both response in-field (area of the limb distal to the infusion point) and out-of-field (any area proximal to the infusion point) in patients treated with CBL0137 based intra-arterial infusion.

III. Assess the pharmacokinetics of CBL0137 in the study population pre-and post CBL0137 intraarterial infusion.

IV. Assess tumor protein expression profiles before and after treatment with CBL0137.

TERTIARY OBJECTIVES:

I. To assess if the proposed treatment has any effect on quality of life as measured by the Functional Assessment of Cancer Therapy ? Melanoma (assessment tool also applicable to sarcoma).

OUTLINE: This is a dose-escalation study of FACT complex-targeting curaxin CBL0137.

Patients receive FACT complex-targeting curaxin CBL0137 intra-arterially (IA) over 15 minutes.

After completion of study treatment, patients are followed up at 2, 6 and 12 weeks, every 3 months for 12 months, then at 24 months.

Details
Condition Advanced Cutaneous Melanoma of the Extremity, Advanced Sarcoma of the Extremity, Clinical Stage III Cutaneous Melanoma AJCC v8, Clinical Stage IV Cutaneous Melanoma AJCC v8, Pathologic Stage IIIB Cutaneous Melanoma AJCC v8, Pathologic Stage IIIC Cutaneous Melanoma AJCC v8, Pathologic Stage IV Cutaneous Melanoma AJCC v8, Recurrent Cutaneous Melanoma of the Extremity, Recurrent Sarcoma of the Extremity, Stage III Soft Tissue Sarcoma of the Trunk and Extremities AJCC v8, Stage IIIA Soft Tissue Sarcoma of the Trunk and Extremities AJCC v8, Stage IIIB Soft Tissue Sarcoma of the Trunk and Extremities AJCC v8, Stage IV Soft Tissue Sarcoma of the Trunk and Extremities AJCC v8
Treatment FACT Complex-targeting Curaxin CBL0137
Clinical Study IdentifierNCT03727789
SponsorRoswell Park Cancer Institute
Last Modified on9 April 2022

Eligibility

Yes No Not Sure

Inclusion Criteria

Patient must have a life expectancy of > 6 months
Have an Eastern Cooperative Oncology Group (ECOG) Performance Status of 0-2
Patients either
Must not have undergone any limb-directed treatment OR
Have undergone a previous Melphalan based regional therapy for which they did not have a complete response and, present with persistent, progressive, or recurrent disease
NOTE: Patients with indeterminate staging must be reviewed by the Principal
Investigator prior to registration
Patient must have had a washout period for at least 30 days or 5 half-lives from any prior chemotherapy, radioactive, or hormonal cancer therapy, or 4 weeks from any checkpoint inhibitors or other biologic (including TVEC), whichever is longer
Patient must have histologically proven primary or recurrent extremity melanoma (stage IIIB, IIIC, or IV), or advanced extremity sarcoma not amenable to surgical resection
(American Joint Committee on Cancer [AJCC] melanoma staging must be documented in patient's medical record, as determined by computed tomography [CT] of the chest, abdomen and pelvis, within six weeks prior to administration of study drug
Due to the heterogeneous nature of sarcoma, AJCC sarcoma staging is NOT required
Patient's disease must be measurable by caliper or radiological method as defined in the modified Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria
Stable or regressed disease must be present for at least the 2 months prior to IA CBL0137 and patient is no longer receiving systemic therapy (with the exception of immunotherapy) during this time period for melanoma
Patients with Stage IIIC disease must either have had regional lymph nodes previously
Patient must have adequate bone marrow, liver and renal function as assessed by the
Stable or regressed disease must be present for at least the 2 months prior to IA CBL0137 and patient is no longer receiving systemic therapy during this time period for sarcoma
removed or have stable or regressed disease on imaging from prior systemic
Hemoglobin >= 9 g/dL
therapy (defined as modified RECIST 1.1 SD, CR, or PR)
following
White blood count (WBC) of >= 3000 m^3
Stable or regressed disease must be present for at least the 2 months prior to IA CBL0137 and patient is not receiving systemic therapy (with the exception of immunotherapy) during this time period for melanoma
Absolute neutrophil count (ANC) >= 1,500/mm^3
Stable or regressed disease must be present for at least the 2 months prior to IA CBL0137 and patient is no longer receiving systemic therapy during this time period for sarcoma
Platelet count >= 100,000/mm^3
Patients with Stage IV disease must have had all distant disease resected at least 30
Total bilirubin =< 1.5 x upper limit of normal (ULN)
days prior to regional treatment, or exhibit stable or regressed disease .on
Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) =< 2.5 x the ULN
imaging from prior systemic therapy (defined as modified RECIST 1.1 SD, CR, or
Creatinine clearance (CrCl) > 45 mL/minute
PR)
Patient must have a palpable femoral/radial pulse in the affected extremity
Participants of child-bearing potential must agree to use adequate contraceptive methods (e.g., hormonal or barrier method of birth control; abstinence) prior to study entry. Should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately
Patients must have recovered from adverse events from previously administered agents (<=grade 2) prior to first study drug administration
Ability to read and understand English and the ability to complete paper and/or electronic survey assessments
Melanoma or sarcoma patients who have stable or completely responded brain metastases
from previous gamma knife surgery and/or systemic therapies are eligible
Participant must understand the investigational nature of this study and sign an Independent Ethics Committee/Institutional Review Board approved written informed consent form prior to receiving any study related procedure

Exclusion Criteria

Cardiac disease: Congestive heart failure > Class II New York Heart Association (NYHA). Patients must not have unstable angina (angina symptoms at rest) or new onset angina (began within the last 3 months) or myocardial infarction within the past 6 months
Males with mean QTcF values of >450 msec and females with QTcF values of >470 msec, patients who are known to have congenital prolonged QT syndromes, or patients who are on medications known to cause prolonged QT intervals on ECG
Use of drugs known to prolong QT
Patients with known hypersensitivity to any of the components of CBL0137
Uncontrolled hypertension defined as systolic blood pressure > 150 mmHg or diastolic pressure > 90 mmHg, despite optimal medical management
Evidence or history of bleeding diathesis or coagulopathy
Patients with known heparin induced thrombocytopenia
Untreated or growing brain metastasis: Patients with neurological symptoms must undergo a CT scan/magnetic resonance imaging (MRI) of the brain to exclude untreated or growing brain metastasis
Active clinically serious infection > Common Terminology Criteria for Adverse Events (CTCAE) Grade 2
Patients with symptoms or signs of vascular insufficiency. Specifically, patients with any history of blood clots (excluding prior catheter-related thrombus that has been adequately treated) or lifestyle altering ischemic peripheral vascular disease will be excluded
Serious non-healing wound, ulcer, or bone fracture
Known human immunodeficiency virus (HIV) infection or active hepatitis B or C
Thrombotic ((excluding prior catheter-related thrombus that has been adequately treated) or embolic events such as a cerebrovascular accident including transient ischemic attacks within the past 6 months
Major surgery or significant traumatic injury within 30 days of planned intra-arterial infusion
Current treatment or, treatment within the previous 24 months, for another non-melanoma or sarcoma malignancy
Patients who have already received 2 prior infusions of CBL0137
Pregnant or nursing female participants
Psychiatric conditions or diminished capacity that could compromise the giving of informed consent, or interfere with study compliance
Unwilling or unable to follow protocol requirements
Any condition which in the Investigator?s opinion deems the participant an unsuitable candidate to receive study drug
Received an investigational agent within 30 days prior to enrollment
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