The first testing of TargomiRs in the human setting: dose-finding studies in patients with recurrent malignant pleural mesothelioma and non-small cell lung cancer
TargomiRs are targeted minicells containing a microRNA mimic. They consist of three components: 1. A miR-16-based microRNA mimic. The miR-16 family has been implicated as a tumour suppressor in a range of cancer types. The mimic is a double-stranded, 23 base pair, synthetic RNA molecule. 2. Drug delivery vehicle - EDVs. EDVs are nonliving bacterial minicells (nanoparticles). They function as leak resistant micro-reservoir carriers that allow efficient packaging of a range of different drugs, proteins or nucleic acids. 3. Targeting moiety. The EDVs are targeted to EGFR-expressing cancer cells with an anti-EGFR bispecific antibody. TargomiRs are IV injected. Phase 1 Planned dose levels Dose level 1: 5 billion once a week Dose level 2: 5 billion twice a week Dose level 3: 5 billion once a week with cardiac monitoring Dose level 4: 2.5 billion twice and week with cardiac monitoring Dose level 5: as above with an additional dexamethasone challenge All patients begin on a micro dose of 1 billion once a week and escalate to the full phase 1 dose for their dose level on week 3. Duration of treatment for each dose level is on a patient by patient basis. Officially the cycle is 8 weeks long however a patient can continue on treatment if they are deriving clinical benefit from the treatment. If at any time point before or after the 8 week mark, a patient progresses, experiences ongoing or unreasonable toxicities or withdraws from the study, they will cease treatment. Escalation of dose in cohorts of 3-6 patients per dose level. If at least 2 patients are observed to experience Dose Limiting Toxicity (DLT), the prior dose level is defined as the MTD. Adherence to the protocol tends not to be problematic in patient groups where the trial treatment is their only treatment option. They are often very keen to participate and motivated to be part of the research.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
27
TargomiRs are targeted minicells containing a microRNA mimic. They consist of three components: 1. A miR-16-based microRNA mimic. The miR-16 family has been implicated as a tumour suppressor in a range of cancer types. The mimic is a double-stranded, 23 base pair, synthetic RNA molecule. 2. Drug delivery vehicle - EDVs. EDVs are nonliving bacterial minicells (nanoparticles). They function as leak resistant micro-reservoir carriers that allow efficient packaging of a range of different drugs, proteins or nucleic acids. 3. Targeting moiety. The EDVs are targeted to EGFR-expressing cancer cells with an anti-EGFR bispecific antibody. TargomiRs are IV injected.
Concord Repatriation General Hospital
Sydney, New South Wales, Australia
Chris O'Brien Lifehouse
Sydney, New South Wales, Australia
Northern Cancer Institute
Sydney, New South Wales, Australia
There is a composite primary outcome to establish maximum tolerated dose and dose limiting toxicities The MTD will be determined by the assessment of dose limiting toxicities.
There is a composite primary outcome to establish maximum tolerated dose and dose limiting toxicities. The MTD will be determined by the assessment of dose limiting toxicities. Toxicities, in the first 2 weeks of treatment for any given patient, are assessed with physical assessments 5 times in the 24 hours starting with a pre-dose assessment, and with laboratory assessments which are assessed 3 times in the 24 hours starting with pre-dose assessment. All adverse events are graded according to the CTCAE v4.0.
Time frame: DLTs assessed from treatment 1 for 2 weeks. MTD is measured from first treatment to toxicity (up to 18 months).
to evaluate the effect of multiple dosing of TargomiRs
to evaluate the effect of multiple dosing of TargomiRs using physical and lab assessments as well as tumour response via PET/CT.
Time frame: the lab and physical assessments are conducted from first treatment, multiple times in a 24 hour period after treatment for up to 18 months
to detect early signs of efficacy
to detect early signs of efficacy using QoL questionnaires and tumour response via PET/CT.
Time frame: 8 weeks, when formal assessment with RECIST is applied and QoL questionnaires assessed.
QOL assessment
QOL assessment using EORTC QLQ-C30 (Version 3)
Time frame: Baseline & weekly or twice weekly (depending on patient's cohort) up to 8 weeks
ECOG PS change
to monitor changes in ECOG PS during treatment
Time frame: ECOG PS will be assessed from baseline til 8 weeks
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Pulmonary function change
to monitor pulmonary function parameters during treatment using FEV1 and Vital Capacity measurements.
Time frame: Pulmonary function is measured in screening and at 8 weeks