E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Relpsed or refractory multiple myeloma |
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E.1.1.1 | Medical condition in easily understood language |
Relpsed or refractory multiple myeloma |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 14.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10028228 |
E.1.2 | Term | Multiple myeloma |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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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 |
During the dose escalation phase, the purpose of the study is to determine the maximum tolerated dose (MTD) of CHR-3996 and tosedostat administered in combination in subjects with relapsed or refractory multiple myeloma.
In the dose expansion phase the purpose of the study is to determine the safety profile of CHR-3996 and tosedostat administered in combination and to estimate the response rate.
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E.2.2 | Secondary objectives of the trial |
To estimate maximum response within six cycles of therapy To estimate maximum response to therapy overall To estimate time to maximum response from therapy To estimate progression free survival To estimate overall survival To determine the number of patients with CHR-3996 or tosedostat dose reductions To assess compliance to therapy until toxicity, intolerance or progression To assess the pharmacokinetic and pharmacodynamic profile of CHR-3996 when administered in combination with tosedostat.
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
•Able to give informed consent and willing to follow study protocol •Aged over 18 •Subjects with multiple myeloma, who have failed conventional treatment regimens, and currently require further treatment due to relapse or non-response •ECOG Performance Status ≤2 •Required laboratory values within 14 days of registration: o Absolute neutrophil count ≥1.0 x 10^9/L. Growth factor support is permitted o Platelet count ≥25 x 10^9/L. Platelet support is permitted o Haemoglobin ≥8.0 g/dL. Blood support is permitted o Bilirubin ≤2 times upper limit of normal (ULN) o AST and ALT ≤2.5 times ULN; except in subjects with known hepatic involvement, where AST and ALT ≤5.0 times ULN o Serum creatinine ≤2.0 times ULN o Corrected calcium ≤2.8 mmol/L. •Anticipated survival of at least 4 months •Evaluable disease utilising the following assessments as appropriate: o Measurement of serum monoclonal protein. o Measurement of serum free light chains. o Measurement of urine M protein (Bence Jones protein) (differential creatinine). o Detection of plasma cells in bone marrow biopsy or aspirate sample. •Female subjects of child-bearing potential must have a negative pregnancy test at baseline and agree to use dual methods of contraception for the duration of the study. Male subjects must agree to use a barrier method of contraception for the duration of the study if sexually active with a female of child-bearing potential.
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E.4 | Principal exclusion criteria |
•Pregnant (positive pregnancy test) or breastfeeding women. •Patients with high urinary light chain levels (≥1g/24 hours). (Where urinary light chain levels are unavailable, serum free light chain levels ≥1000mg/L) •Previous anti-tumour therapies, including prior experimental agents or approved anti-tumour small molecules and biologics within 28 days before the start of treatment.Steroid therapy to stop rapid relapse during this period is permitted, but must be stopped 7 days prior to study drug administration. Bisphosphonates for bone disease and radiotherapy for palliative intent are also permitted. •Concurrent or previous malignancies (<12 months post end of treatment) at other sites with the exception of appropriately treated localised epithelial skin or cervical cancer. Patients with histories (≥12 months) of other tumours may be entered. •A Poorly uncontrolled or serious medical or psychiatric illness that, in the Investigator’s opinion, is likely to interfere with participation and/or compliance in this clinical study. •Patients with significant cardiovascular disease (e.g. history of congestive heart failure requiring therapy, presence of severe valvular heart disease, presence of an atrial or ventricular arrhythmia requiring treatment, uncontrolled hypertension, a history of QTc abnormalities or with QTcF intervals >450 msec) •Active symptomatic fungal, bacterial, and/or viral infection including active HIV or viral (A, B, or C) hepatitis. •Gastrointestinal disorders that may interfere with absorption of the study drug •Abnormal plasma potassium, calcium or magnesium levels (CTCAE v4 grade 3 or greater) despite therapy
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E.5 End points |
E.5.1 | Primary end point(s) |
In the dose escalation phase, dose limiting toxicities within the first cycle of treatment (28 days) is the primary outcome.
In the dose expansion phase, the primary outcome is safety and toxicity and the proportion of patients achieving at least stable disease after 4 cycles of CHR-3996 and tosedosat. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
During the dose escalation phase, at the end of each cohort.
During the dose expansion, after 10 patients. |
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E.5.2 | Secondary end point(s) |
Proportion of patients with each maximum response category within 6 cycles of therapy Proportion of patients with each maximum response category overall Time to maximum response to therapy Progression-free survival Overall survival Number of dose reductions Treatment compliance to therapy until withdrawal from treatment Pharmacokinetic and pharmacodynamic profile of CHR-3996 and tosedostat. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
During the dose escalation phase, at the end of each cohort.
During the dose expansion, approximately 6 months after closing to recruitment and when patients have been followed up for at least 12 months
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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 | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | Yes |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
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) | Yes |
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 | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | No |
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 | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
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
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 8 |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.7 | Trial has a data monitoring committee | Yes |
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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The end of trial is defined as the date of the last patient’s last treatment visit plus 30 days. Long term follow-up for purposes of the Main REC and Research Governance to one month after the last patients last trial follow up visit constitutes the non-interventional phase of 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 | 2 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
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 | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |