E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 9.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10049280 |
E.1.2 | Term | Solid tumour |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To evaluate the safety and tolerability of figitumumab plus pegvisomant in patients with advanced solid tumors. |
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E.2.2 | Secondary objectives of the trial |
To evaluate circulating concentrations of IGF-I during therapy with figitumumab and pegvisomant; To evaluate the pharmacokinetics of figitumumab and pegvisomant in combination; To explore screening, cycle 1 day 8 and cycle 3 day 8 glucose tolerance; To monitor any anti-drug antibody (ADA) response to figitumumab; To document any anti-tumor activity of figitumumab plus pegvisomant. Additionally, blood samples will be collected for the measurement of IGF-1R related biomarkers, including IGF-1 (free and total), IGF-2, IGFBP1-6, insulin and C-peptide. The analysis of these biomarkers will be exploratory using descriptive statistics. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Subject eligibility should be reviewed and documented by an appropriately qualified member of the investigator’s study team before subjects are included in the study. Unless compelling reason(s) to be agreed upon and documented by the investigator and sponsor, subjects must meet all of the following inclusion criteria to be eligible for enrollment into the study: 1. Patients must be ≥18 years of age. Exception: Patients ≥10 years of age with a diagnosis of advanced sarcoma will be included in the Sarcoma Expansion Cohort. 2. Histologic verification of malignancy at original diagnosis. 3. Patients ≥18 years of age with advanced solid tumors for which the combination of figitumumab and pegvisomant are reasonable treatment options. 4. Patients ≥10 years of age with a diagnosis of Ewing’s sarcoma family of tumors or other advanced sarcoma for which there is no available curative therapy or therapy proven to prolong survival with an acceptable quality of life will be included in the Sarcoma Expansion Cohort. 5. ECOG 0 1 (or Lansky ≥70% for patients <18 years of age). 6. Adequate recovery from major surgery prior to study treatment. 7. Patients must have fully recovered from the acute toxic effects of prior therapy. 8. Adequate bone marrow function defined as: • Platelet count ≥75,000/µL (platelet transfusion allowed); • Hemoglobin ≥8.0 gm/dL (RBC transfusion allowed); • Peripheral absolute neutrophil count (ANC) ≥1000/µL without growth factor support during the 72 hours prior to enrollment. 9. Adequate renal function defined as creatinine ≤1.5 x ULN (upper limit of normal). 10. Adequate liver function defined as: • Total bilirubin ≤1.5 x ULN (except patients with liver metastasis or Gilbert’s syndrome); • Serum alanine aminotransferase (ALT) and serum aspartate aminotransferase (AST) ≤2.5 x ULN (≤5 x ULN if liver function abnormalities are attributed to underlying malignancy); 11. Sexually active female patients must be either postmenopausal or, if of childbearing age, must be surgically sterile or must agree to use effective contraception during the period of therapy and up to 5 months after the last dose of figitumumab. Acceptable contraception includes, but is not limited to: oral hormone therapy, partner vasectomy, or double barrier contraception (which is defined as a male condom plus spermicide in combination with either a female condom, or diaphragm, or cervical cap or intrauterine device). The following forms are not acceptable: withdrawal method, rhythm method, spermicide, barrier sponge with or without spermicide. Within these limits, the specific form of contraception employed is left to the discretion of the subject, principal Investigator, and/or primary care physician. Sexually active male patients must be sterile or must agree to use effective contraception during the period of therapy and up to 5 months after the last dose of figitumumab. 12. All patients must sign and date a written voluntary informed consent document indicating that the subject (or a legally acceptable representative) has been informed of all pertinent aspects of the study. Parental or legal guardian consent or patient assent/parent permission will be required for minors as per institutional practice; 13. Subjects who are willing and able to comply with scheduled visits, treatment plan, laboratory tests, and other study procedures.
This study can fulfill its objectives only if appropriate subjects are enrolled. The following eligibility criteria are designed to select subjects for whom protocol treatment is considered appropriate. All relevant medical and non medical conditions should be taken into consideration when deciding whether this protocol is suitable for a particular subject. |
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E.4 | Principal exclusion criteria |
Unless compelling reason(s) to be agreed upon and documented by the investigator and sponsor, subjects presenting with any of the following will not be included in the study: 1. Concurrent treatment with any anti tumor agents. 2. Participation in other studies within 28 days before the current study begins and/or during study. 3. Concurrent therapy with a somatostatin analogue. 4. CNS tumors or symptomatic brain metastases. 5. Pregnant or breastfeeding females. 6. Significant active cardiac disease including: • Left ventricular ejection fraction <50%; • Uncontrolled hypertension (systolic BP >160 mmHg and/or disastolic BP >100 mmHg); • Any ventricular arrhythmia; • Mitral valve regurgitation > trivial as determined by Doppler Echocardiogram. 7. Subjects receiving or are likely to require corticosteroids at doses higher than physiologic replacement (ie, Prednisone equivalent 5 mg/day) or other immunosuppressive therapy during study participation. 8. Active infection, including hepatitis B or C, or receiving antiretroviral therapy for HIV disease. 9. Glycosylated hemoglobin (HgbA1c) ≥7%. 10. History of diabetes mellitus. 11. Concurrent treatment with medications indicated for the treatment of diabetes mellitus. 12. History of allergic reaction to IgGs. 13. History of hypersensitivity to any pegvisomant component, including latex. The stopper on the vial of pegvisomant contains latex. 14. Other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or investigational product administration, or may interfere with the interpretation of study results and, in the judgment of the Investigator, would make the subject inappropriate for study entry. 15. Subjects who have been admitted to an institution by virtue of an order issued by either the judicial or administrative authorities. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Safety and tolerability of figitumumab and pegvisomant (Adverse events per CTCAE v3.0) |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | No |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | Yes |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
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E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | Yes |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | Yes |
E.8.1.7.1 | Other trial design description |
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E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Yes |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.3 |
The trial involves single site in the Member State concerned
| Information not present in EudraCT |
E.8.4 | The trial involves multiple sites in the Member State concerned | Information not present in EudraCT |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 2 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
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E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 2 |
E.8.9.2 | In all countries concerned by the trial months | 2 |
E.8.9.2 | In all countries concerned by the trial days | 5 |