A Phase 1, Open-Label, Two-Group, Dose- Escalation Study to Investigate the Safety, Tolerability, Pharmacokinetics, Biological and Clinical Activity of EMD 521873 Alone and in Combination With Fixed Low Doses of Cyclophosphamide in Patients With Metastatic or Locally Advanced Solid Tumors or B-Cell Non-Hodgkin Lymphoma
Inclusion Criteria:
1. Signed written informed consent
2. Male or female, aged ≥ 18 years, inpatient for treatment phase of cycle 1 and 2,
outpatient treatment possible for subsequent cycles
3. Histologically or cytologically proven metastatic or locally advanced solid tumors
(epithelial or mesenchymal cancers) or B-cell non-Hodgkin lymphoma for which no
standard therapy exists or after failure of standard therapy
4. Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1 at study entry
and an estimated life expectancy of at least 3 months
5. Adequate hematological function defined by WBC count ≥ 3 x 109/L with absolute
neutrophil count (ANC) ≥ 1.5 x 109/L and lymphocyte count ≥ 0.5 x 109/L; platelet
count ≥100 x 109/L; hemoglobin ≥9 g/dL ( If the laboratory values for hemoglobin are
outside the required entry level at Screening, a patient may receive a transfusion of
RBC. A stable hemoglobin level of ≥9 mg/dL for at least 7 days must be achieved prior
to receiving the first dose of study medication.)
6. Adequate hepatic function defined by a total bilirubin level ≤ 1.5 times the upper
limit of normal (ULN) and aspartate-aminotransferase (AST) and
alanine-aminotransferase (ALT) levels ≤ 2.5 x ULN or, for patients with documented
metastatic disease to the liver, AST and ALT levels ≤ 5 x ULN
7. No history of acute or chronic kidney disease and adequate renal function defined by
an estimated creatinine clearance above 50 mL/min determined by 24-hour urine
sampling or by the Cockcroft-Gault formula
8. Effective contraception for both male and female subjects if the risk of conception
exists
Exclusion Criteria:
1. Prior IL-2 therapy within the last 6 months
2. Requirement for concurrent anticancer treatment (chemotherapy, radiotherapy, immune
therapy, cytokine therapy except erythropoietin) or for concurrent systemic therapy
with steroids or other immunosuppressive agents. Short-term administration of
steroids (i.e. for allergic reactions) is allowed.
3. Radiotherapy, chemotherapy, surgery (excluding prior diagnostic biopsy) or any
investigational drug in the 30 days before the start of treatment in this study
4. Acquired immune defects such as human immunodeficiency virus (HIV)
5. Systemic autoimmune disease (e.g. lupus erythematodes, rheumatoid arthritis,
Addison's disease, autoimmune disease associated with lymphoma)
6. Organ transplant recipients
7. History of or active inflammatory bowel disease (e.g. Crohn's disease, ulcerative
colitis)
8. Chronic viral infections (e.g. hepatitis B virus [HBV], hepatitis C virus [HCV])
9. Uncontrolled hypertension (systolic >180 mmHg, diastolic >100 mmHg)
10. Known hypersensitivity reactions to any of the compounds of the study medication
11. Confirmed or clinically suspected brain metastases
12. Pregnancy (absence to be confirmed by beta-human chorionic gonadotropin [β-HCG] test)
or lactation period
13. Clinically significant (i.e. active) cardiovascular disease: Cerebral vascular
accident /stroke (< 6 months prior to enrolment), myocardial infarction (< 6 months
prior to enrolment), unstable angina, congestive heart failure or serious cardiac
arrhythmia requiring medication.
14. Pulmonary disease which, in the opinion of the investigator, might impair the
patient's respiratory tolerance to moderate pulmonary fluid overload (e.g.
interstitial lung disease, severe chronic obstructive pulmonary disease)
15. All conditions which are associated with significant necroses of non tumor-bearing
tissues like e.g. esophageal or gastroduodenal ulcers (< 6 months prior to
enrolment), organ infarctions (< 6 months prior to enrolment) or active ischemic
bowel disease
16. Presence of medically significant third space fluid (pericardial effusion or ascites/
pleural infusion requiring repetitive paracentesis)
17. Known alcohol or drug abuse
18. Participation in another clinical trial within the past 30 days before start of study
treatment
19. All other significant diseases which, in the opinion of the investigator, might
impair the patient's tolerance of study treatment.
20. Dementia, altered mental status, or any psychiatric condition that would prohibit the
understanding or rendering of informed consent