The goal of this clinical research study is to evaluate the safety of PEG-BCT- 100 given as an infusion to treat patients who bear advanced solid tumors that are dependent on arginine (melanoma, renal cell carcinoma, prostate cancer and hepatocellular carcinoma), and who have progressed after receiving approved or established therapies. This is a Phase 1 study; PEG-BCT-100 is an enzyme that degrades arginine and is an investigational drug.
This is a phase 1, multiple sites, open label and non-randomized study to evaluate the safety of PEG-BCT-100. Patient enrollment and sample size will follow a classical 3 + 3 dose-escalation design. The study will enroll a maximum of 36 patients. Cohorts of 3 patients will receive an initial single dose of PEG-BCT-100 beginning at 0.5 mg/kg. Single dose safety parameters including hematology and chemistry laboratory profiles will be monitored for 3 weeks. Patients not demonstrating a dose-limiting toxicity (DLT) following the single dose may then receive two additional doses of PEG-BCT-100 at the same dose level on Day 22 and Day 29. After these 2 additional doses, patients will undergo a full tumor and safety assessment after Day 29. Patients whose cancer is stable or responding may then receive weekly doses of PEG-BCT- 100 until disease progression. Dose escalations are planned for the next cohorts of 3 patients, which will be enrolled after Day 22 of the previous cohort, assuming that no single dose DLTs were reported. Each cohort of 3 patients may begin weekly administration if there is no DLTs by Day 22, and if the previous and lower dose cohort has successfully passed Week 4 of the study (doses on Days 1, and 22 + one week). As of the beginning of 2018, an additional 22 patients will include only malignant melanoma patients. All newly enrolled patients will be enrolled at the dose level of Cohort Four (2.7 mg/kg) of PEG-BCT-100.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
California Cancer Associates for Research and Excellence, cCARE
San Diego, California, United States
John Wayne Cancer Institute
Santa Monica, California, United States
Number of patients undergoing adverse events (AEs) or serious adverse events (SAEs)
Time frame: at least 13 weeks
Optimal Biological Dose
The optimal biological dose (OBD) of PEG-BCT-100 will be calculated based on the pharmacodynamics (PD) endpoint of plasma arginine depletion relative to plasma pharmacokinetics (PK) of PEG-BCT-100
Time frame: 13 weeks
Maximum Tolerated Dose and Dosing Schedule
Time frame: 4 weeks of treatment
Overall response
Evaluate objective tumor responses by RECIST (Response Evaluation Criteria In Solid Tumors)
Time frame: 13 weeks
Pharmacokinetics (PK)-PEG-BCT-100 concentration
Determine the dose-related peak to trough concentrations of plasma PEG-BCT-100 over time
Time frame: 13 weeks
Pharmacodynamics (PD)
To determine the magnitude of plasma arginine depletion (AD) relative to the dose of PEG-BCT-100
Time frame: 13 weeks
PK-PEG-BCT-100 plasma clearance
the plasma clearance of PEG-BCT-100
Time frame: 13 weeks
PD-duration of AD
the time and duration of effective AD assessed by plasma arginine \<8 µM relative to the plasma peak and time to clearance over the range of PEG-BCT-100 doses
Time frame: 13 weeks
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PD-relationship between AD and PEG-BCT-100 dose
the temporal and quantitative relationships of depleted plasma arginine to dose and plasma concentrations of PEG-BCT-100
Time frame: 13 weeks
PD-relationship between PEG-BCT-100 dose and tumor markers
the temporal and quantitative relationships of depleted plasma arginine to dose and plasma concentrations of PEG-BCT-100; and, The relationship of PEG-BCT-100 dose and its resultant effective AD to changes in AFP/PSA and/or tumor symptoms and measurements.
Time frame: 13 weeks