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A Phase I, Open-label, Dose Escalation Study to Assess the Safety and Tolerability of FP253 in Combination With Fludarabine Phosphate


Phase 1
18 Years
N/A
Open (Enrolling)
Male
Prostate Cancer

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Trial Information

A Phase I, Open-label, Dose Escalation Study to Assess the Safety and Tolerability of FP253 in Combination With Fludarabine Phosphate


OBJECTIVES: The primary objective of this study is to determine the safety and tolerability
of FP253 for prostate cancer. FP253 contains an ovine atadenovirus that expresses the E.
coli enzyme purine nucleoside phosphorylase (PNP) under the control of a prostate-directed
promoter.

SUBJECT POPULATION: Up to eighteen male subjects (6 groups of 3 subjects) who have a
histological diagnosis of adenocarcinoma of the prostate, still have their prostate in situ,
have evidence of progressive disease despite continuous androgen deprivation therapy and who
meet all eligibility criteria, will be enrolled into this study.

STUDY DESIGN: This study is designed as an open-label, dose escalation trial in which each
patient in a cohort will receive a single defined dose. Subjects will be enrolled
consecutively into 6 escalating dose groups each of 3 subjects. Each subject will receive
the treatment as outlined in the protocol and will be followed up for a further 2 years at
regular intervals for life, as defined by current standard of care.

TREATMENT: Subjects will be administered a single injection of FP253 followed by five doses
of Fludarabine phosphate as outlined in the Intervention section.

SAFETY PARAMETERS: Adverse events will be recorded and physical examinations, 12-lead ECG,
vital sign monitoring, urinalysis and collection of blood samples for pathology laboratory
tests will be performed at regular intervals during the study to monitor safety. The
shedding of viral vector will be monitored as per regulatory requirement until negative.

ADDITIONAL PARAMETERS: In order to assess any haematological or immunological effects of
this novel agent or any effects on tumour response and survival, the following will be
assessed:

- Biochemical and Haematological Markers: including Prostate-Specific Antigen,

- Immunopathological Markers: including haematological markers and indicators of
cytotoxicity,

- ECOG assessment,

- Assessment of disease progression and survival.

DATA ANALYSIS: Descriptive statistical methods will be used to summarize key data including
demographics, vital sign measurements, ECG parameters, clinical laboratory parameters,
immune response, tumour response, adverse events and concomitant medication. The general
strategy of the safety analysis will be to examine the data summaries for any trends in
safety parameters across the dose levels. No formal hypothesis will be tested.

A formal data analysis will be performed after all subjects have completed the study period
(28 days) and an interim analysis will be performed after the first 3 dose cohorts have been
completed. For the first year, three monthly follow up reports will be produced followed by
6 monthly reports for the second year and a final follow up report when all subjects have
completed 2 years of follow up. Descriptive statistical methods will be used to summarise
key data including demographics, vital sign measurements, ECG parameters, clinical
laboratory parameters, immune response, tumour response, adverse events and concomitant
medication. The general strategy of the safety analysis will be to examine the data
summaries for any trends in safety parameters across the dose levels. No formal hypothesis
will be tested.

Inclusion Criteria


Inclusion Criteria (Prostate Cancer Categorization):

Subjects will have adenocarcinoma of the prostate which is progressive despite androgen
deprivation therapy.

Subjects MUST fulfil each of the following criteria for inclusion in this study:

1. Biopsy of the tumour must have been performed and histological status of
adenocarcinoma of the prostate documented. The diagnostic prostatic biopsy will have
taken place at least 4 weeks prior to the planned day 1.

2. Subjects will have their prostate in situ.

3. Biochemical evidence of prostate cancer recurrence; defined as a rise over 3
successive PSA measurements spanning a minimum of 3 months (no lower limit of PSA
exclusion).

4. Subjects will have been treated with androgen deprivation therapy and will remain on
hormone therapy for the duration of the study (LHRH agonists with or without
antiandrogens, or bilateral orchidectomy).

5. The Investigator should be able to localise the tumour either by digital rectal
examination (DRE) (i.e. tumour palpable); or the tumour should be visible on
transrectal ultrasound (TRUS). Localization of tumour will be documented and should
be adequate to allow the Investigators to inject it. Repeated TRUS will be at the
discretion of the Investigator General.

Inclusion Criteria (General):

Subjects MUST fulfil each of the following criteria for inclusion into this study:

1. Be male and be 18 years of age or greater.

2. Have voluntarily given written informed consent to participate in this study.

3. Have an ECOG performance status of 0, 1 or 2.

4. Have agreed to remain confined to the clinical testing facility for the first 3 days
(2 nights) of the study.

5. Have adequate baseline organ function.

6. Have an ECG which is normal, or, if there is any abnormality, it must be considered
to be clinically insignificant in the context of the trial.

Exclusion Criteria (Prostate Cancer Categorization):

Subjects with any of the following criteria will NOT be eligible for participation in this
study:

1. Subjects who have had prior radical prostatectomy.

2. Subjects who are expected to die of prostate cancer within 3 months.

Exclusion Criteria (General):

Subjects with any of the following criteria will NOT be eligible for participation in this
study:

1. Hypersensitivity to ciprofloxacin, fludarabine, pegfilgrastim or similar compounds.

2. Contraindications to fludarabine: subjects with decompensated haemolytic anaemia.

3. Contraindications to pegfilgrastim: known hypersensitivity to E. coli derived
products.

4. Other associated or concomitant medical conditions that would interfere with the
conduct of the study in the opinion of the treating physician.

5. Have used an investigational drug within 30 days or 5 half-lives (whichever is
longer) preceding the first dose of study medication.

6. Are immunocompromised or have used immunomodulatory agents/therapy within the 6
months preceding the initial treatment.

7. Subjects who, at the sole discretion of the Investigator, are judged to be unsuitable
for participation in the study.

Type of Study:

Interventional

Study Design:

Endpoint Classification: Safety Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Adverse events will be recorded. Physical examinations, 12-lead ECG, vital sign monitoring, urinalysis and collection of blood samples for pathology testing will be performed. Viral DNA and infectious virus will be monitored in serum and urine samples.

Outcome Time Frame:

Selected assessments at Day: -14 (screening); Days: 1 to 6, 11, 15, 28; Months: 3, 6, 9, 12, 24

Safety Issue:

Yes

Principal Investigator

David N Dalley, MB BS FRACP

Investigator Role:

Principal Investigator

Investigator Affiliation:

St. Vincent’s Hospital.

Authority:

Australia: Department of Health and Ageing Therapeutic Goods Administration

Study ID:

253/001

NCT ID:

NCT00625430

Start Date:

March 2008

Completion Date:

December 2012

Related Keywords:

  • Prostate Cancer
  • Prostate Cancer
  • Gene Therapy
  • Fludarabine
  • Adenovirus
  • phase I
  • Prostatic Neoplasms

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