This Phase Ib/II study is an openlabel, multicenter study for patients with solid tumors and breast cancer amenable to anthracyclin therapy. The study is divided in two parts: Phase I: an open-label, dose escalation study of F16IL2 in combination with doxorubicin for patients with solid tumors. Phase II: a prospective, single-arm, multicentre study of a fixed dose of F16IL2 in combination with doxorubicin, equivalent to stage 1 of the Simon two-stage phase II design, for patients with breast cancer amenable to anthracyclin therapy.
Breast cancer is a major cause of cancer mortality, second only to lung cancer as a cause of cancer death in women. The five-year survival rate for localized breast cancer has increased from 80 percent in the 1950s to 98 percent today. However, the mortality rate in the most advanced forms remains unsatisfactory. Indeed, the extensive use of mammography within screening programs has led to cancers being detected earlier, when early treatments may be more effective. A greater understanding of the molecular biology and genetic expression of breast cancer has therefore led to new pre-surgical and post-surgical treatments, including hormone modulators and monoclonal antibodies. Many of these agents have led to decreased mortality and disease recurrence. F16 is a human recombinant antibody fragment in the scFv (single chain Fragment variable) format that is directed against tenascin C, an angiogenesis marker common to most solid tumors independent of the tumor type. ScFv(F16) selectively localizes in tumor tissues in animal models as demonstrated both histologically and during mechanistic studies involving mice transfected with orthotopic human tumours. IL2, the human cytokine interleukin-2, is a potent stimulator of the immune response. It has a central role in the regulation of T cell responses and effects on other immune cells such as natural killer cells, B cells, monocyte/macrophages and neutrophils (Smith, 1988). IL2 can induce tumor regression through its ability to stimulate a potent cell-mediated immune response in vivo (Rosenberg, 2000).
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
Intravenous (i.v.) infusions of F16IL2 (Dose escalation: from 5 up to 25 MioIU) on days 1, 8, 15, 29, 36 and 43 over 60 minutes via automated device (perfusor), followed by a 30-minute i.v. infusion of doxorubicin (Dose escalation: from 20 up to 25 mg/m2) on Days 1, 8, 15 29, 36 and 43. Patients with objective tumor responses or stable disease will receive repeated cycles of treatment starting on Day 56. Patients will receive additional cycles of combination therapy for a maximum of 6 months, or until disease progression, unacceptable toxicity or withdrawal of consent.
A.O. UNIVERSITARIA OSPEDALI RIUNITI - OSPEDALE UMBERTO I DI ANCONA - ANCONA (AN) (Italy)
Ancona, Italy
Irst - Istituto Scientifico Romagnolo Per Lo Studio E La Cura Dei Tumori - Meldola (Fc)
Meldola, Italy
European Institute of Oncology
Milan, Italy
A.O. UNIVERSITARIA POLICLINICO DI MODENA (Italy)
Modena, Italy
Maximum tolerated and recommended dose (MTD) (RD)
Phase I: To establish the maximum tolerated dose (MTD) and the RD of F16IL2 when administered in combination with doxorubicin.
Time frame: 28 days
Efficacy of F16IL2 in combination with doxorubicin
Phase II: To investigate the efficacy in terms of objective response rate of F16IL2 in combination with doxorubicin in breast cancer patients amenable to anthracyclin therapy.
Time frame: 8 weeks
Safety/Tolerability
Phase I/II: To investigate the safety, tolerability of F16IL2 and doxorubicin when given as a combination
Time frame: 8 weeks
Pharmacokinetics of F16IL2
Phase I: To investigate pharmacokinetics of F16IL2 and doxorubicin when given as a combination.
Time frame: 2 weeks
Human anti-fusion protein antibodies
Phase I: To investigate the induction of human anti-fusion protein antibodies (HAFA).
Time frame: 18 months
Antitumor activity
To investigate the antitumor activity of the combination of F16IL2 and doxorubicin in solid tumour patients.
Time frame: 12 months
Median progression-free survival
For phase II to assess median progression-free survival of F16IL2 in combination with doxorubicin
Time frame: 12 months
Median overall survival
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NONE
Enrollment
29
Azienda Ospedaliera Universitaria Senese
Siena, Italy
For phase II to assess median overall survival of F16IL2 in combination with doxorubicin
Time frame: 12 months