A Phase 1, Dose Escalation Study of the Safety and Pharmacokinetics of ALB 109564(a) Administered Intravenously Every 3 Weeks to Subjects With Advanced Solid Tumors
This is the first clinical study of ALB 109564(a), a tubulin inhibitor, interfering with
tubulin polymerization, primarily targeting microtubules that compose the mitotic spindle,
resulting in metaphase arrest. The motivation for the development of ALB 109564(a) is to
create a molecule that will provide greater anti-tumor activity than other licensed vinca
alkaloids, without increasing the level of toxicity often associated with such therapies.
The objectives of the proposed study are: (1) to determine the safety and tolerability,
including the maximum tolerated dose (MTD) and dose limiting toxicity (DLT), of ALB
109564(a) administered intravenously every 3 weeks to subjects with advanced,
treatment-refractory solid tumors; (2) to evaluate the pharmacokinetics of ALB 109564(a);
and (3) to document any observed anti-tumor activity.
The starting dose of 1.2 mg/m2 once every 3 weeks is expected to ensure a safe
first-in-human dose and allow increases of 50% with the first several subject cohorts. The
first cohort will enroll 3 subjects, and the subsequent 3-subject cohorts will proceed
according to a modified Fibonacci scheme. The standard dose increase, in the absence of dose
limiting toxicity, will be 50%. However, once 1 subject experiences a DLT, or 2 or more
subjects within a cohort experience ≥ Grade 2 drug-related adverse events, all subsequent
dose escalations will occur at approximately 25% increments. In the case that the dose
escalation increment is decreased to 25% following 2 or more subjects with ≥ Grade 2
drug-related events, the increment can subsequently be reset at 50% if, in the 2 successive
cohorts, no DLTs are observed, and no more than 1 subject per cohort experiences a ≥ Grade 2
drug-related AE. DLT and MTD determinations will be made according to the first treatment
cycle (single dose plus 3-week follow-up). The MTD will be declared as the highest level at
which none of the original 3 subjects or no more than 1 of the expanded 6-subject cohort
experiences a DLT. At the MTD level, subjects will be enrolled into two parallel groups:
Group A, those with solid tumor of unrestricted tumor type, and Group B, those with primary
tumor type of soft tissue sarcoma. Up to a total of 24 subjects will be enrolled at the MTD.
Subjects who tolerate treatment will be eligible to continue receiving treatment to a
maximum of 12 cycles on the same 3-week schedule per the Investigator's medical judgment.
Subjects whose disease has not progressed after 12 cycles of treatment with ALB 109564(a)
may continue receiving treatment on the same 3-week cycle, with the same protocol
assessments, contingent upon the Investigator's judgment and the Sponsor's approval.
The actual enrollment of subjects will be determined by the safety experience and the number
of dose-escalation cohorts required to achieve the MTD. The projected enrollment is
approximately 60 subjects for a total study duration of approximately 2 years.
Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
Maximum tolerated dose and dose limiting toxicity.
Every treatment cycle
Daniel Cho, MD
Beth Israel Deaconess Medical Center
United States: Food and Drug Administration
|Beth Israel Deaconess Medical Center||Boston, Massachusetts 02215|
|Montefiore-Einstein Cancer Center||Bronx, New York 10461|