An Open-label, Phase I/IIa, Dose Escalating Study of 2B3-101 in Patients With Solid Tumors and Brain Metastases or Recurrent Malignant Glioma.
This is a Phase I/IIa, multicenter, open-label, dose-escalation study. The study will be
conducted in 6 phases: "2B3-101 single agent dose-escalation phase", "a 2B3-101 with
trastuzumab dose-escalation phase", "a Breast cancer brain metastases study-expansion
phase","a Recurrent malignant glioma study-expansion phase", "a Melanoma brain metastases
study- expansion phase" and "SCLC brain metastases study-expansion phase"
2B3-101 single agent dose-escalation phase.
In the 2B3-101 single Agent dose-escalation phase, female and male patients with solid
tumors and brain metastases or recurrent malignant glioma will be enrolled. Patients will be
assigned to a dose level cohort. - The starting dose will be 5 mg/m2, which is equal to 1/10
of the human equivalent dose of the LD10 of 2B3-101 in rats. A "3+3" dose-escalation design
will be used. The study will investigate sequential cohorts consisting of 3-6 patients to be
enrolled and treated at the applicable dose level. Planned dose levels for subsequent
cohorts are 10, 20, 30, mg/m2 and steps of 10 mg/m2 thereafter. For more information on the
dose escalation design and the increments, please see the dose escalation criteria section.
There will be no intra-patient dose escalation. Each treatment cycle consists of 21 days.
Patients will receive a single IV dose of 2B3-101 on day 1 of each cycle. In order to
minimize the risk of infusion reactions 5% of the total dose of 2B3-101 (in mg) should be
infused slowly over the first 30 minutes. If tolerated, the infusion may then be completed
over the next hour for a total infusion time of 90 minutes. Blood samples will be taken on
day 1, 2, 3, 5, 8 and 11 of cycle 1 and day 1, 8 and 15 of cycle 2 to assess the PK profile
during the first 2 cycles. The dose limiting toxicity (DLT) observation period for each dose
level will be cycle 1 (day 1 to day 21). Patients who do not complete the DLT observation
period (cycle 1) for other reasons than a DLT will be replaced.
Once the MTD of 2B3-101 as single agent has been determined, the study will continue to the
breast cancer brain metastases and recurrent malignant glioma dose expansion phases.
2B3-101 in combination with trastuzumab dose-escalation phase
In the 2B3-101 in combination with trastuzumab dose escalation phase, only patients with
HER2+ breast cancer and brain metastases will be enrolled.
The patients will be assigned to a 2B3-101 dose level cohort. - The starting dose of 2B3-101
will be 40 mg/m2 every 3 weeks. This dose has been selected based upon safety information
from patients treated with 2B3-101 at this dose level, as well as upon previous treatment
with PEGylated liposomal doxorubicin in combinations trastuzumab (Chia et al 2006).
The dose-escalation will be conducted in steps of 10 mg/m2 up to the MTD level determined
for 2B3-101 as single agent. The trastuzumab dose will remain fixed to a loading dose of 8
mg/kg at day 1 and 6 mg/kg every 3 weeks at the subsequent cycles throughout the
determination of the MTD. Enrolment of HER2+ patients breast cancer patients in the "2B3-101
in combination with trastuzumab dose-escalation" phase of the study will be allowed in
parallel with the determination of the MTD of 2B3-101 as single agent. A "3+3"
dose-escalation design will be used. Thus, the study will investigate sequential cohorts of
3-6 patients, who will be enrolled and treated at the applicable dose levels.
No intra-patient dose-escalation will be allowed. Each treatment cycle consists of 21 days.
All patients will receive a single IV dose of 2B3-101 on day 1 of each cycle. In order to
minimize the risk of infusion reactions 5% of the total dose of 2B3-101 (in mg) should be
infused slowly over the first 30 minutes. As long as 2B3-101 is well tolerated, the
remaining 95% of the infusion could thereafter be administered over the next 60 min,
resulting in a total infusion time of 90 minutes. The infusion of trastuzumab will then
follow 30 minutes after the completion of the 2B3-101 infusion. Blood samples will be taken
on day 1, 2, 3, 5, 8 and 11 of cycle 1, and on day 1, 8 and 15 of cycle 2, to assess the PK
profile of 2B3-101 during the first 2 cycles. The dose limiting toxicity (DLT) observation
period will be cycle 1 (day 1 to day 21) at each individual dose level. Patients who do not
complete the DLT observation period (cycle 1) for other reasons than a DLT will be replaced.
Breast cancer brain metastases expansion phase.
In the breast cancer brain metastases expansion phase, each treatment cycle also consists of
21 days. Patients will receive a single IV dose of 2B3-101 on day 1 of each cycle. In order
to minimize the risk of infusion reactions 5% of the total dose of 2B3-101 (in mg) should be
infused slowly over the first 30 minutes. If tolerated, the infusion may then be completed
over the next hour for a total infusion time of 90 minutes. Blood samples will be taken on
day 1, 2, 3, 5, 8 and 11 of cycle 1 and day 1, 8 and 15 of cycle 2 to assess the PK profile
during the first 2 cycles.
Recurrent malignant glioma expansion phase.
In the recurrent malignant glioma expansion phase, each treatment cycle is equally 21 days
long. Patients will receive a single IV dose of 2B3-101 on day 1 of each cycle. In order to
minimize the risk of infusion reactions 5% of the total dose of 2B3-101 (in mg) should be
infused slowly over the first 30 minutes. If tolerated, the infusion may then be completed
over the next hour for a total infusion time of 90 minutes. Blood samples will be taken on
day 1, 2, 3, 5, 8 and 11 of cycle 1 and day 1, 8 and 15 of cycle 2 to assess the PK profile
during the first 2 cycles.
SCLC brain metastases study arm of the expansion phase
In the SCLC brain metastases study arm of the expansion phase, each treatment cycle is
equally 21 days long. Patients will receive a single IV dose of 2B3-101 at MTD determined
for 2B3-101 as single agent on day 1 of each cycle. In order to minimize the risk of
infusion reactions 5% of the total dose (in mg) should be infused slowly over the first 30
minutes. As long as 2B3-101 is well tolerated, the remaining 95% of the infusion could
thereafter be administered over the next 60 minutes, resulting in a total infusion time of
90 minutes.
Melanoma brain metastases study arm of the expansion phase
In the melanoma brain metastases study arm of the expansion phase, each treatment cycle is
equally 21 days long. Patients will receive a single IV dose of 2B3-101 at MTD determined
for 2B3-101 as single agent in the dose escalation phase on day 1 of each cycle. In order to
minimize the risk of infusion reactions 5% of the total dose (in mg) should be infused
slowly over the first 30 minutes. As long as 2B3-101 is well tolerated, the remaining 95% of
the infusion could thereafter be administered over the next 60 minutes, resulting in a total
infusion time of 90 minutes.
For all stages a patient will stay on treatment until disease progression, unacceptable
toxicity, or discontinuation for any other reason.
Interventional
Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
To characterize the safety and tolerability of intravenously administered 2B3-101 in patients with advanced solid tumors and metastatic brain cancer or recurrent malignant glioma.
16 months
Yes
Werner Gladdines, MSc
Study Director
to-BBB technologies B.V.
Netherlands: The Central Committee on Research Involving Human Subjects (CCMO)
2B3-101-CR-001
NCT01386580
July 2011
December 2013
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